Dr Fallon (00:37)
Dropping overnight milk feeds in your older baby or toddler can be really hard to do. It's not uncommon to get a lot of pushback as your little one makes this very big adjustment. Welcome back to Brand New Little People, the podcast where we talk about sleep and settling across those first few years. I'm your host, Dr. Fallon Cook, and I'm here with Dr. Laura Conway. How are you, Laura?
Dr Laura (01:02)
I'm good, thanks, Val and how are you?
Dr Fallon (01:04)
Yeah, I'm good. Do you have any bad memories of trying to drop those overnight milk feeds in your kids or did they manage that transition pretty
Dr Laura (01:13)
One of them managed quite well, one not so well. And I remember actually, back in the day where I used to work at the Royal Children's Hospital and I'd leave home really early in the morning to get to work early. I used to have to go in, try and time a feed at around five o 'clock in the morning so that I could get a feed in before heading off to work really early so that she didn't scream the house down a bit later if she woke up and I wasn't there.
Dr Fallon (01:38)
Yeah.
Dr Laura (01:42)
So yeah, really tricky. Yeah. What were yours like?
Dr Fallon (01:43)
Ooooo
Yeah, not too bad. One of mine in particular had night feeds for a little bit longer than typical, um, because he had a whole lot of pretty serious allergies and had a diet mostly consisting of an amino acid based formula to meet his nutrition. So he needed night feeds a little bit longer than average. I was trying to remember before how old he was and it's just a blur now, but he'd given up, I think about 18 months or so. Um, but yeah, it can be a really tricky thing to do.
And we had a really great question coming from a Sombal parent who I'm going to call Billy. And I thought this is just such a great topic to dive into. So let's do a bit of a deep dive into it. So Billy says, she has a 15 month old boy who until recently was mostly fed to sleep. Her husband has started to work towards self settling using the quick fade approach.
And this has resulted in night waking reducing to just one to two wakes each night, which is great. That's really good progress. She says, for the first wake up, dad goes in and resettles him. But for the second wake up, he refuses to resettle for dad. He screams, thrashes and throws himself around the cot quite violently if they try to avoid that feed.
Dr Laura (02:44)
Yeah.
Dr Fallon (03:02)
So Billy wonders if it's okay to just keep this feed because she feels like one feed per night is probably manageable for her family. But she also wants to know if it's normal for toddlers to have such big physical reactions to not being offered a night feed. They worry about his emotional wellbeing and whether they should try to stop offering the night feed when he is not eating all that much solid food in the daytime. So it's a big,
Dr Laura (03:27)
Mmm.
Dr Fallon (03:31)
Question, it's a big problem and I think there are so many factors that we would consider with this one. But what are your first thoughts, Laura?
Dr Laura (03:37)
Yeah, look, I just want to jump in straight off the bat to say there is never any pressure to drop overnight feeds before you as a family are ready to do it. So a very quick answer to Billy's question is whether you do I have to drop the feed? No, you don't have to drop the feed. It's perfectly okay to continue offering one feed for as long as you want to. And since you say that's manageable for your family, Billy, that's okay to continue doing
Dr Fallon (03:49)
Absolutely.
Yeah.
Dr Laura (04:08)
What we sometimes see is that when there is just that one feed offered, certainly in older babies and toddlers, that occasionally, if say Billy, your 15 month old is waking up at three o 'clock for that feed, they might start to wake up at two o 'clock and then they might start to wake up at one o 'clock. It starts to get earlier and earlier. And then what can begin to happen is that then they go back to having more than one feed overnight.
Dr Fallon (04:31)
Hmm.
Yeah, can be a slippery slope.
Dr Laura (04:37)
because it's a slippery slope, yeah. But if that isn't happening for you, Billy, and your 15 month old is managing just well on that one feed later on in the night and it's working for you, totally fine. The other things that jump out at me that I feel would be worth you exploring, Billy, is that you say that your toddler isn't eating much solid food during the daytime.
And I would just be wanting you to think about, that something that you've spoken to with your health nurse or your GP? there any concerns over your child's feeding, the ability to swallow and tolerate different textures? Is his weight gain okay? If you're concerned in any way that he's not thriving,
the amount of food he's taking in during the day is really low and he has any issues with the actual process, physical process of eating, then definitely follow up with your doctor to get that ruled out. Because in those instances where there is actually something physically impeding your child's ability to get all the nutrients that they need, we do need to be sure that we are giving them the additional nutrients, which can be overnight.
In the same way, Fallon, that you were just describing that for one of your children who had some special dietary issues going on, you needed to use a particular formula and use overnight feats for longer than might be considered typical. Yeah.
Dr Fallon (06:15)
Yeah, that's it. think that's a really, really important consideration to make the physiological side of things. Are they actually capable of taking in a good amount of calories during the daytime? I think one of the best ways of assessing that is through weight gain. So by and large, if toddlers are having steady weight gain, they might not be, you know, 99th percentile, but if they're pretty much sticking to their percentile, they're gaining weight, you know, they're looking pretty solid. Most toddlers have got some lovely chubby cheeks going on.
Chances are that they're more than capable of getting their calories through daytime feeds alone. But yes, if you're in doubt, absolutely just check in with a health professional and see what they say. Are they ready for dropping night feeds or not? And I think as well, you know, let's imagine that Billy and her partner do decide, okay, we want to, we definitely want to get rid of this night feed. How are we going to go about it? And what do they, what factors I suppose do they need to be?
Dr Laura (06:56)
Mmm.
Dr Fallon (07:14)
considering and this is where, you know, in a, if we were together in an appointment, we would do a really big deep dive into these sorts of factors. but I think it's great to bring it to a podcast because we know there are so many families out there who battle this type of thing as well, who might not see us for an appointment. but I think what's really important to consider in these situations is that toddlers can and will get very, very mad when.
They're expecting us to do something and we don't do it. And that is normal toddler behavior. They might go absolutely off their tree and some toddlers will go, gee, I bet if I, you know, fling myself over here or I, you know, bang my head on this, mum and dad will definitely change what they're doing. Maybe they'll offer a feed. It just takes one or two times of them.
doing something really extreme and us responding by going, yes, have a milk feed, have this, do this, you know, this other thing. They remember it. And that's really, it's a horrible cycle to be in because sometimes we do see toddlers that just get so completely overwhelmed, really kind of excessive behaviors because history has taught them that it works essentially. It's so, so hard for families in these situations.
So just on that note, if you are seeing really extreme behaviors in your toddler, chances are it's normal. They're toddlers, they're like little scientists. They're trying to figure out if I do this, what happens? But if you think this is really excessive and concerning, go and get a referral to a developmental and behavioral pediatrician or a psychologist who works with children and get their view on things. Is this normal or is this a little bit too much?
Dr Laura (08:34)
Mmm.
Mm -hmm.
Dr Fallon (08:59)
They'll be able to offer you really valuable advice on whether there is some sort of behavioral concern present that is making dropping that night feed such a challenge. But look, we're saying all of this, but by and large, most families will not need to go down that path. They get a toddler who's a bit cranky after a couple of nights without feeds, they move on, they take on that extra feed in the daytime instead. And it's all ancient history. They tend to forget about those night feeds.
Dr Laura (09:22)
Yeah.
Yeah.
Dr Fallon (09:28)
pretty quickly.
Dr Laura (09:30)
Yeah. And I think in previous episodes, Fallon, we've spoken about this magical two night experience that many families of toddlers and older babies have, which is often for some reason, it seems to take about two nights of no longer having feeds during the night for a older baby or toddler to realise that that's the new normal and that there won't be feeds overnight anymore.
Dr Fallon (09:55)
Mmm.
Dr Laura (09:59)
And so Billy, I'd be thinking about if you've ruled out any physiological issue and you've spoken to your health and us or GP about the behavior, if we've decided that yet this is just normal, typical behavior and your son is just really pushing back, then know that you may have a couple of days where you need to stay kind but firm.
And we'll talk about exactly how you might do that in a moment. But it will then be over and done with within a couple of days, you know, maybe three at a push. But when you hold firm and you support your older baby or toddler to no longer have those feeds overnight that they do not need anymore to meet their nutritional requirements, within a few days, the balance shifts, they'll be taking on more calories during the day. And they've learnt
Okay, there's no fees on offer overnight anymore. When I wake up in the night, I know that there isn't going to be a feed on offer. Therefore, I might as well just roll over and go back to sleep and then I'll have a feed or brekkie in the morning.
Dr Fallon (11:14)
Yeah, absolutely. Whereas if they think there's a bit of wiggle room here, and this could even be happening for Billy's son, maybe he thinks, well, sometimes at night I do have a feed and other times I don't. That might be confusing him and he's thinking, well, what is it that that means I do get the feed? yeah. So if you do go to drop the feed, just drop it, be really firm, just get rid of it. It's not going to happen again.
Dr Laura (11:32)
Yes.
Dr Fallon (11:40)
but I know what parents will be thinking. They'll be going, oh, but what do you do? What do you do when you've got a toddler who is furious at 3 a .m.? I mean, most parents don't have a lot of resolve and determination at 3 a .m. That's very, very normal. So let's talk about that. What I would say to parents is sometimes we have to introduce a middle ground when we're trying to drop a feed in a toddler who is very, very reluctant. So in Billy's case, they're doing the quick fade approach, which is great, and that's fantastic.
Dr Laura (11:50)
No.
Dr Fallon (12:09)
and for a lot of families, would say when you drop that fee, just stick to whatever approach you've chosen and just do it until they fall asleep, which is definitely an option. That is the first thing I would be trying. And if that is being seriously derailed, that's when we go, okay, what's the middle ground here? What I would be looking at is what is it that normally helps your toddler to down regulate and calm down? So not the feed, but thinking about the daytime, let's just say they.
Dr Laura (12:33)
Hahaha.
Dr Fallon (12:38)
fell over and bumped their knee or they're really cross because you dared to cut that sandwich into squares instead of triangles, right? What comfort would they look for? What do you do to support their regulations? So a lot of parents will say it's a cuddle or they love it when I sing this particular song and we have a bit of a rock or we wander outside, we look at the wind in the trees or like it could be any number of things. Maybe they love a rhythmic pat.
Dr Laura (12:44)
Hahaha!
Dr Fallon (13:06)
So have a think what helps them to downregulate, could even just be the dummy. And then for that, when you're dropping that overnight feed for two or three nights, when they are still waking up thinking, where's my feed, you offer that support, you help them downregulate, even though it's not part of the quick fade approach to be maybe, you maybe you decide, okay, I'm gonna pick them up, I'm gonna rock them and sing to them and help them get completely calm before I put them back down. Of course, that's going outside of the approach that that family's chosen,
we put a time limit on it. It's for two or three nights while they're getting used to not having any calories overnight. And then on that second or third night, if they're even still waking at all, and they probably won't, because having a cuddle is not that exciting, really. Most of them will just go, I'll just go back to sleep. But if they're still looking for it, that's when you go, okay, we're getting back to the quick fade approach or whatever other approach you've been using. And we're just going to stick with that from now on. So what you're doing is you're introducing this sort of extra step.
where you're leaning in a little bit, you're helping them to down regulate. You're showing them that you're there for them through their big emotions, but you're also showing them that there is a limit here. And that's really important too, because provided your toddler is ready to drop night feeds, which was sort of already discussed, it's perfectly reasonable for them to go through the night without a feed. No matter how big those emotions are, dropping that night feed for a lot of families is actually crucial for family wellbeing because parents are exhausted.
Dr Laura (14:29)
Mm -hmm.
Dr Fallon (14:30)
Even the toddlers themselves are having quite interrupted night sleep. So to improve sleep health for the whole family, it is an important step to take. So I think, you know, keep that in mind. If you do decide you're going to commit to dropping the night feed, be really consistent. It's okay to do it. Add in that middle step if you need to, to help them regulate, show them that you're there for them. But then once they're used to not having that night feed, get straight back on track
focusing on building those self settling skills so they no longer need your help overnight, you know, after every sleep cycle, which some toddlers do.
Dr Laura (15:06)
Yeah, yeah, I think that's great advice, Fallon. So Billy, really good luck. I think you've got a lot of tips there to get you through. Roll out the physiological side of things and then help your little toddler by doing the cuddling, the pacing, whatever you need to do in the middle of the night when your husband's going in to do that resettle.
just for a couple of nights to get him out the other side and then go back to using the quick fade approach. I'd also really encourage you to double check the information sheet about the quick fade as well, just to make sure that you are progressing through the steps in the quick fade. Sometimes what can happen is when a child is really pushing back when, for example, you're dropping a feed overnight,
Dr Fallon (15:40)
Mmm.
Dr Laura (16:02)
It's really very hard to make progress through the steps. But once you've taken away that particular element of the overnight feed and your toddler is happy to go the night without a feed, then just make sure that you are starting to reduce the support on the patting and the humming and the shushing in the way that is described in the information sheet. So that the end point will be that you and your husband can pop your toddler down at the start of the night.
Dr Fallon (16:23)
Hmm.
Dr Laura (16:32)
have a say good night lovingly to them, give them a kiss and a cuddle and then be able to leave them to go to sleep without any additional support from
Dr Fallon (16:43)
Yeah, absolutely. And I'm increasingly finding that families are, instead of gradually phasing out padding and humming, they're switching to the supported accelerated approach because they can see that their toddler or their baby is really confident being in their cot. And for toddlers, it'll be the advanced accelerated approach. But they feel confident moving to that slightly faster approach where you're still present, you're still getting lots of reassurance, but it provides a bit more structure to quickly
Dr Laura (16:58)
Hmm.
Dr Fallon (17:11)
reduce that support and some babies and toddlers, they're just ready for it at that point. So it could be worth considering that too. Awesome. So yeah, thank you so much, Billy, for sending in that question, because I think that is one that a lot of parents will be really keen to hear the answer to. Even if you've got a younger baby and you're not quite dropping night feeds yet, I think it's always good to have a few things to sort of put in your pocket going forward. So, you know, when you reach that point, there's some options there that you can try.
Dr Laura (17:24)
Mmm.
Yeah.
Dr Fallon (17:40)
Laura, we got an email come through from Maddie. And Maddie actually sent us through her questions on Instagram and then sent them through via email. I was just going to say, if you're a Sombelle member, always send them via email. Maddie did the exact right thing. We often miss messages on Instagram. Sometimes they're in that like request folder or whatever it's called. So if you're a Sombelle member, just send them through to Sombelle @ infant sleep .com .au and then we'll definitely flag it in our inbox and get onto it for the next episode.
So yeah, Maddie says my three and a half month old is learning to settle in the bassinet on her own after being rocked to sleep. She has a 14 to 15 hour sleep need and typically sleeps through from 7 p .m. To 6 30 a .m. Settling throughout on her own about 80 % of the time. Wow Nice one Maddie. Lucky lucky lady
Dr Laura (18:29)
amazing.
Dr Fallon (18:35)
Maddie says, I find she usually gets tired around after 130 to one, oh sorry, one and a half hours to one and three quarter hours of time awake. However, it is taking me 40 minutes of her crying or screaming and me patting and shushing in the cot. And of course picking her up when she's upset to eventually get her to sleep. that's yeah, tricky settles. And Maddie says, often in this 40 minute period, she'll fall asleep for 10 minutes and then wake
Dr Laura (18:58)
Mmm.
Dr Fallon (19:03)
again and start again, particularly for the first nap of the day, and resettling for the lunchtime nap. So Maddie's got a few questions. The first one is, is it that she's overtired or is there not enough sleep pressure causing her to take ages to finally doze off?
Dr Laura (19:06)
Mmm.
Mm.
Mm. So Maddie, well done. sounds like you're doing a brilliant job. Your little baby is just coming out of that very little baby phase now. So three and a half months. We know can settle and resettle herself in the bassinet multiple times. So she is having lots of experience, lots of practice doing
Dr Fallon (19:28)
Mmm.
Dr Laura (19:49)
after previously needing to be rocked to sleep, which is often appropriate for little babies. So I would be thinking when I'm seeing that she's, you're describing that she seems tired after an hour and a half, then it's taking another 40 minutes for her actually to go to sleep, that you probably could start to help her be awake for a little bit longer and not be rushing to put her in the bassinet.
straight away when she's showing tired signs. She's out of that little baby phase where we don't have to be quite so vigilant about getting a baby down as soon as they show tired signs. We can wait until we see a number of tired signs. so think about distracting your baby for a little bit longer, maybe taking her into the garden or getting a new book or just walking her around the house, showing her photos on the wall.
just to distract her for a little bit longer before you put her down. Because that 40 minutes that it's taking of her screaming and crying and you patting and shushing, could just be time that she's up and awake and you're enjoying her rather than being in that frustrating cycle. And she'll start to get used to being awake for a little bit longer.
Dr Fallon (21:05)
Yes.
Dr Laura (21:10)
each time it might be in the morning, it's an hour and 45 minutes that she stays awake and then between the first and second nap, it might be starting to get more like two hours and then having the longer wake window before she goes down at bedtime.
Dr Fallon (21:27)
Yeah, absolutely. And I think this is an age where often the total sleep duration per day is dropping quite quickly. so it could just be that the total sleep she's needing is starting to decline. And that's where you're getting a bit more pushback with naps, excuse me, that you hadn't had, previously. I was going to say something, Laura I've completely forgotten.
Dr Laura (21:49)
Was it about the resettling? Maddie says that she's taking can take about 40 minutes to resettle her during the lunchtime nap and kind of tapping into what you were just saying there with her sleep. These could have declined a little bit. And that lunchtime that might not need to be as long as it was. If you're finding that she's waking up after a shorter lunch nap than she used to, but is actually happy. That's fine. Just get it, get her up and don't be trying to resettle her.
Dr Fallon (21:54)
Mmm.
Yeah, yep.
Yes, that's a really good point. Yeah, absolutely. Absolutely. It's a really, really good point. Yeah. And I think too, it's really common at this age that, you're having great nights, Maddie, if we keep trying for more day sleep than she needs and she actually does it, there's a chance she'll start to wake at night instead. you know, protect those nights. If she wants a bit more time awake, that's fine. And start to look for a collection of tired signs. So
Dr Laura (22:33)
Mmm.
Dr Fallon (22:41)
With a newborn, we would rush in at the first tired sign and quickly try and get them to sleep. As they get older, we're looking for a collection of signs where they're starting to be a bit grizzly. Nothing's really making them happy. You can't distract them for long. That's when, yeah, I'd be going to do that settle. Excellent. Maddie also asks, sometimes I feel like me being in the room, padding her to sleep actually makes her more upset.
Dr Laura (22:55)
Mmm.
Dr Fallon (23:05)
but I really don't feel comfortable letting her cry for much longer than five minutes on her own. So if Maddie's not in the room, is there something else she should be trying? I love this question because I reckon it's a really good example of looking at what your baby needs. So a lot of babies would get so much comfort from having a parent nearby. They'd fall off asleep more easily, but not all of them.
Dr Laura (23:27)
Mmm.
Dr Fallon (23:27)
so it's totally fine to try wandering away. Cause sometimes as soon as they can't see, they're like, okay, well now I'm going to try and settle myself off asleep. But when I can see mom, there's a chance she might help me do it. So yeah, trial just wandering away and maybe you try wandering away for two minutes. You don't have to go for five minutes. just wander away for a couple of minutes and, and have a bit of an experiment and make a note evening, your sleep diary. Was that an easier settle when I left her to be,
Dr Laura (23:35)
Yes.
Yeah.
Dr Fallon (23:55)
And also dark room, definitely dark room, because she's self settling multiple times overnight when it's dark. If she's in a really dark room for her day sleep, she'll probably apply those same settling skills at that time. So you might get quicker settles.
Dr Laura (24:01)
Yes.
Yeah and Maddie if you don't want to leave the room, just sit a little bit out of her sight. So then you're listening to what she wants in that when she can see you she seems to cry for a bit longer but you're also listening to your own needs of not wanting to leave her on her own. So sit on a chair out of her line of sight and then both of you are happy.
Dr Fallon (24:33)
Yes. It's such a good example of how there is so much flexibility with all of this stuff. Like so many parents say to us, you know, I did this thing and it had to be really rigid and it felt really uncomfortable, you know, following this really rigid age -based thing or whatever the steps are from some other program. And like, just think why, why can't we look at the baby and the parent and come up with something sensible? It just seems really obvious to me, but anyway.
Dr Laura (24:51)
Mmm.
Yes.
Dr Fallon (25:02)
Hopefully that helps Maddie. The final question Maddie had was, sometimes she'll take the dummy to soothe and sometimes she won't. On the time she does take it, she then sometimes hits it out of her mouth and then gets upset. Is it worth trying this if she might take it or just removing it all together? I'm keen to hear your thoughts on this, Laura.
Dr Laura (25:20)
Hmm. Yeah. Look, I tend to go down the avenue of if your baby doesn't absolutely love it and really rely on it to go to sleep at this age, which sounds like that's the case for Maddie's baby, then, and, and it's becoming problematic on the time she does have it, that she's hitting it out of her mouth and getting upset, then just stop using it. that there's, there's no need to continue to, to use it. if your baby doesn't.
rely on it all of the time. What's your thoughts, Fallon I'm feeling you might say something different.
Dr Fallon (25:54)
Yeah. Yeah. No, I think in this case, I'd probably lean towards getting rid of it just because she's, it's going to take until she's around seven months before she can replace the dummy herself. And that's a long time. So if she's not absolutely, you know, loving her dummy and super attached to it, I'd probably push on without it. And then you just won't have that issue. but that's just our thinking, you know, Maddie, you can make a call on what you prefer to do. It's there's no clear right or wrong with that
Dr Laura (26:13)
Mm.
Okay, we have a question from Briellen. Have I pronounced that correctly, Fallon Is that how you would pronounce Briellen? so Brie... Yeah, let us know if it's actually Irish and I have just done something terrible to my Irish ancestry and it's actually... Actually, I won't even attempt to say what it might be in Gaelic.
Dr Fallon (26:31)
think so, Brie Allen, yeah. Brie Allen can write in and let us know if we're wrong.
Dr Laura (26:49)
So, Briellen has a seven -month -old boy who wakes every 45 to 60 minutes overnight. Oh my goodness, you poor thing. How we say your name is no doubt the least of your worries at the moment. Gosh. He's just recently started to take a dummy and this has been a helpful replacement for comfort feeds, which he was taking previously. Briellen, first of all, wonders if it's okay to introduce a dummy this late.
help himself soothe. right this is kind of linking back to the discussion we just had about Maddie's little one. She also asks if when doing the quick fade approach should she continue with this approach during the night even if it takes over an hour for him to resettle or should she stop and settle him a different way? She doesn't want to create any problems by being inconsistent but wasn't sure if she should just push
Dr Fallon (27:44)
Excellent, excellent question. This is a case where I am a fan of dummies because it can provide a really useful sort of transitional item to help a child stop from comfort feeding where they're not really taking big feeds, they're just having a bit of a suckle. And it's amazing that he has been willing to accept the dummy because most babies just wouldn't. He's also old enough to learn how to master replacing that dummy during the night if he wants it back again.
Dr Laura (27:49)
Hmm.
Yeah. Yeah.
Dr Fallon (28:11)
So if that's really helping you at the moment, Brielle, and that's an example where I'd say, well, just keep the dummy then it's kind of serving its purpose. So that's know, persisting for over an hour with any settling approach in the middle of the night is really, really hard. What I would say is it is normal for you to have one or two really tricky settles when you're trying to make big changes to how your baby falls asleep. You might have some that do take an hour. Usually that's not the case, but sometimes it will happen.
And if that happens, you know, once or twice, and then they start to settle really easily and they make that adjustment, I wouldn't be at all worried. There's a couple of things that are concerning me. The first is that, well, the first thing that jumped out at me, I suppose, is with waking every 45 to 60 minutes overnight, it implies that there isn't a long stretch of deep sleep at the start of the night. And that implies that sleep pressure is a problem at night time.
So Briallan hasn't mentioned anything about a sleep diary. If you haven't measured his sleep needs, please go and do it. Because if he's waking, you know, hourly all through the night, chances are he's overdoing the day's sleep. So work through that chapter on unique sleep needs so you can work out what his sleep needs are. You can use one of the daily rhythm charts to start to cater to that sleep need. Chances are you'll pretty quickly start to get some, you know, two or three hour stretches overnight just from doing
Dr Laura (29:12)
Mm.
Dr Fallon (29:33)
And then what you should find is that with increased sleep drive at night, when you go to start doing that quick fade approach, which is very, very hands on, if he's drive to sleep is very strong because you're working, you know, to his unique sleep needs, it's very unlikely that a settle will take an hour or more overnight. So like I said, in the short term, if you've just started it you have a tricky settle, that's fine. It will probably resolve. But if it's carrying on, I would say the sleep pressure really
Dr Laura (29:51)
Hmm.
Dr Fallon (30:01)
needs to be addressed. And that's what I'd be checking in on. Was there anything else that jumped out at you though, Laura?
Dr Laura (30:04)
Hmm. Hmm. No, simply the only additional things I'd say is that furry long time that this baby is awake for overnight does make me wonder what the amount of day sleep is tonight sleep in terms of his unique sleep needs. Because often when we do see those extended overnight wakes,
we are seeing a baby that's in bed overnight for longer than they need to to meet their own sleep needs. And, you know, just like as an adult, if we only have a seven hour sleep need and yet we put ourselves to bed at nine o 'clock at night and want to sleep through until seven, we will probably be up in the middle of the night for long stretches of time because we just we've got more time in bed than we actually need to be asleep.
Dr Fallon (30:54)
Yeah.
Dr Laura (31:01)
that will be happening for your little boy, Briellen. So just make sure that he's only in his cot overnight for roughly the amount of time that he can actually manage to be asleep. And that should start to reduce the length of time that he's awake for as well.
Dr Fallon (31:05)
Mmm.
Yeah, and in regards to that question of should she just keep going until he sleeps, I would say if you're sure that sleep pressure is high enough, like you've definitely catering to his unique sleep needs. Yeah, keep going because you're right there with him. You've got your hands on him. You're comforting him. You're giving him regular cuddles with that quick fade approach. and that's all wonderful. He's very, very well supported despite it taking him a long time to get back to sleep. You're there with him, supporting him.
Dr Laura (31:22)
yeah.
Dr Fallon (31:45)
You can carry on with it for as long as you need to. And as sleep pressure builds, chances are he will resettle much more quickly.
Dr Laura (31:53)
Yeah. Good. All right. We had another question from Lucinda. And Lucinda says, she says, my question for you both is why does my six and a half month old baby have false starts to sleep every night? I settle my baby to sleep in the cot using the quick fade approach. However, every night he will wake 40 minutes later. He sleeps in his cot most of the night, which is positioned next to me.
He usually settles back to sleep very quickly, but with my help, which includes popping the dummy back in and a few pats. He is also continuing to wake every one and a half to two and a half hours per night. I am exhausted. Lucinda, I bet you are exhausted. And I think probably our responses to Brie Ellen's question would also apply to you at this point, Lucinda. That sounds very...
challenging to be waking up that frequently overnight. And we've got a couple of things going on, one being the dummy. So you're popping the dummy back in and it may be that your baby has that reliance on the dummy to go to sleep, is, you know, which is fine for them to have that reliance. You're very close to the point where they're going to be a boy or a girl. He's going to be able to
Dr Fallon (32:56)
Hmm.
Mmm.
Dr Laura (33:20)
start to replace that dummy himself during the day, so during the night rather. So any of those wakes that are due to him kind of coming up into light sleep and going, hang on, where's that dummy that I had, will start to fall away as he learns to find that dummy himself and pop it back in. Have a look at the information about dummy play during the day so that you can make a little game for him when
Brighten alert during the day to help him learn how to reach around his body to find the dummy and pop it back into his mouth and soon enough you'll find that he'll be able to do that overnight as
Dr Fallon (34:02)
Yeah. Yeah. And look, even though it's a really quick resettle, it is still a false start where typically we would see babies do a really big, deep stretch of sleep. So I think definitely checking the unique sleep needs, making sure there's not too much day sleep or that the naps aren't pushing too close to bedtime would be a really good idea. I'm so sorry if anybody can hear my dog snoring. Laura, don't know if you can hear it. Oh my gosh. Gracie is my, um, my 10 year old cavalier King Charles spaniel.
Dr Laura (34:12)
Mm -hmm. Mm.
Mm.
Dr Fallon (34:31)
and she's on the floor at the moment. She definitely needs a referral to a sleep and respiratory physician because she's snoring like a train. And for those who have watched on YouTube, would have seen me, I grabbed like an empty box of tissues and just kind of gently threw it in her direction to try, cause she's deaf. She's completely deaf. So try to nudge her so that she would wake up.
You know, it could just be a good example of if you hear your child making those noises, go and see your doctor.
Dr Laura (34:51)
It's crazy.
my goodness that's so funny I couldn't hear her but yes yeah little Gracie.
Dr Fallon (35:00)
gosh.
Yes, she's very old now. Anyway, all right, excellent. So one last question we have is from Louise who has a nine month old girl whose sleep has suddenly worsened. She says her daughter has a 14 hour sleep need and in the day has a 45 minute nap plus another one and a half hour
Louise recently tried to trim down the length of the second nap, but her daughter still woke three times that night. Louise says she still hasn't night weaned because when her husband tries to resettle her without a feed, she cries for 20 minutes in his arms, at which point Louise goes in to feed. She mostly self settles in her cot, but sometimes feeds to sleep. Louise wonders if the nine months sleep regression is a thing. Gosh, this really factors in nicely to the content of this episode, doesn't it?
Dr Laura (35:56)
Yeah, it does. Okay, Louise, let's see. So your nine month old daughter is having two naps a day, which is perfectly appropriate for a baby her age. And I love how when you found that her nighttime sleep suddenly worsened, you started to look at how the amount of sleep that she needs is distributed across the day and the night.
Dr Fallon (35:57)
Mmm.
Dr Laura (36:25)
I am not surprised that when you made a change to the second nap that there wasn't an immediate change that night. So that doesn't worry me at all that you, when you went to reduce the duration of the second nap that that night your daughter still woke up during the night. I would really advise you to make any changes overnight.
for sorry, changes during the day or in fact, any changes that you make to a daily rhythm, do it for at least a week so that you can give your child's body time to adjust and respond. We don't always see a day to night correspondence. It's lovely when we do, because we can go, look, but just there, that's, it's like almost instant gratification.
that you made a change and then it fixed that night. But it's not normal to or usual to always see that. And often we don't and we have to wait a whole week. So if you're confident that your daughter does just need that, has that 14 hour sleep need, either reducing the duration of the second nap, so it's also just a sleep cycle like the first one and keeping the nighttime the same and doing that for a whole week.
Dr Fallon (37:17)
Yeah.
Dr Laura (37:46)
or keeping one long nap and one short nap, but actually just moving bedtime a bit later, or wake up a bit earlier. Because she's not having a huge amount of daytime sleep. you don't have a child doesn't have to do who has such a sleep need like Louise's baby doesn't have to do 12 hours overnight and then the two hours during the day. You could move that to 11 hours overnight in order to maintain the longer day naps Louise.
Dr Fallon (38:11)
Mmm.
Dr Laura (38:14)
So whatever change you are going to make, do it for a whole week. And then you may find that the overnight wakes reduce. What extra things would you say, Fallon, in answer to Louise's question?
Dr Fallon (38:27)
Yeah. Well, just in terms, yeah, in terms of the night feed, I think this really factors back into Billy's question where Louise is describing she cries for 20 minutes in her partner's arms and then Louise goes in to feed. There's a very high chance that at nine months of age Louise's baby has realized, well, if I just kick
a big fuss for 20 minutes mum will come in and rescue me and I'll get this lovely feed. So once you're really sure you've got that daily rhythm happening and things are going pretty well start to reduce those night feeds and once you do drop a night feed stick to it really consistently. Often what I almost always tell families in clinic is choose one less feed than you normally would do. So if you've been feeding three times per night decide to feed just two times per night.
and choose rough times that you'll do it. So for a lot of families, I'll say if you're on two feeds aim for 11 to 12 or later and maybe three to 4 a .m. or later. And if she wakes up outside of that time dad just resettles or your partner just resettles them until they sleep. Even if it takes ages, they've got lots of support and comfort. Obviously this is taking into account all the things like are they gaining weight properly? Is it the okay time to be dropping night feeds? But just apply it really consistently because if
If someone starts to resettle her and then, you know, then a feed comes in after a certain amount of crying, you know, it's not what parents want to do. I know, but it often, it just tells that baby cry harder and you'll get a feed. And we don't like them being in that cycle because then they're constantly crying really hard wanting a feed. And that's when parents struggle to cope. because it's, there's just so much crying all the time and it feels like a big, horrible mess.
Dr Laura (40:16)
Yeah. And it also fell in, think, sometimes teach as a baby that they need to cry in order to have a feed, which isn't what we want to teach babies. If your baby is due a feed, then you give them that feed straight away. You're responsive. You give them the feed and then you settle them to sleep after they have had their feed using whatever approach you need to use or have chosen to use. But if they're not due a feed, they're not due a feed.
Dr Fallon (40:22)
Mmm.
Mmm.
Dr Laura (40:44)
And so then you settle them until they're asleep. We don't want the situation where Louise, your baby thinks, oh, okay, I have to cry for 20 minutes. This is now what I have to do to get a feed because that's not fair on anyone.
Dr Fallon (40:55)
Hmm.
Yeah, and not fun for anyone. And from that point too, then, you know, after three or four nights of two feeds, it's perfectly reasonable for a nine month old to just have one night feed. So you could drop to one night feed. I usually say it about one to 2 a .m. or later. So you sort of dropping one at a time. You're pushing it a little bit closer to morning. And that can work really well and just give you a really clear timeframe to kind of follow to help phase out the night feeds. Louise also asked, is the nine month sleep regression a thing? Nope.
Dr Laura (41:21)
Mmm.
No.
Dr Fallon (41:28)
not, no. Yeah, as, we've seen in the science where we track thousands of babies across those first few years, they don't all have a big bump in their sleep quality at the same time. All babies have ups and downs. And I would say the reason Louise's baby is currently having a bit of a tricky time is probably just that she's expecting feeds overnight. So she's waking up to check, is it feeding time? There's more of that sort of motivation component coming into things.
And once we address that motivation component, yeah, it's very likely that those nights will drastically improve. But if you do have trouble Louise, and same for any of our Sombelle families, we have coaching calls and they're there for those tricky moments that Sombelle for 90 % of families is everything they need to make great progress. And that's great. But there is the other 10 % where you hit a really tricky hurdle and you just think, gosh, I just want to talk to someone and get really clear advice that's specific to my child and Laura and I can.
help you with that. So for anybody who's a Sombelle member who's listening, do remember that those correction calls are there and you can book them through your dashboard if you need them. So that sort of wraps up this week's episode. I think it's been a really, really lovely episode and some really useful discussion there. So I hope families really enjoyed it. We just want to let you know that next week's episode will be out a little bit later than normal, probably Tuesday evening, maybe Wednesday morning.
Dr Laura (42:32)
Mm -hmm.
Dr Fallon (42:53)
I'm taking my kids away to visit their granddad, which is really nice because we don't see him very often. And I'm just a cheapskate. So I wanted the cheap flights, even though we were supposed to be recording a podcast. I was like, no, I'm on a budget. So it will be a day or so later than normal. But do keep an eye out for it. You make sure you hit the subscribe button. If you're enjoying our podcast, leave us a five star review. Thank you so much to those who have left beautiful reviews lately. We see you, we read them, we celebrate them.
Dr Laura (43:23)
Yeah.
Dr Fallon (43:23)
It means so, so much to us. And if you're not already following us on social media, go and look us up. infant .sleep .australia is our handle on most platforms. We're posting all sorts of cool, useful, interesting things on there. We would love to have you follow us along. So thanks everyone for tuning in and you'll hear from us again next week.
Dr Laura (43:44)
Thanks everyone, bye
