Dr Fallon (00:00)
When families come to see us in the sleep clinic for the first time, many tell us they've tried other approaches. What continues to surprise us is that parents report feeling traumatized and deeply sleep deprived. Not because they've been told to use a really harsh or difficult approach, but because they've been told to do nothing. They've been told that their child's extreme sleep difficulties are normal.
that any number of night wakes or tricky settles is acceptable and that their job as a parent is simply to endure. These parents are often burdened with an extreme amount of guilt for seeking support for their child's sleep difficulties. They've been told that to try to settle their child in any other way, no matter how gentle and respectful, that it's likely to cause irreparable damage to their child.
This is of course not true. There is no evidence to support these ideologies and actually the opposite is likely to be true. Sleep quality is known to be important for many aspects of child development. I'm your host, Dr. Fallon Cook and today on Brand New Little People, we are going to explore the impact of this type of ideology.
on parents and children describing the experiences and outcomes for a family Dr. Laura saw a couple of months ago in our clinics.
Dr Laura (01:33)
Yeah, this is such an important topic of conversation, Fallon, isn't it? You and I will most days have conversations around this because we're at the coal face seeing families who are really struggling and they're experiencing very challenging nights for weeks, months, sometimes years on end. And they're absolutely terrified of making any change at all.
And it's, they're very distressed. The family is distressed. And, you know, we spend a lot of time supporting these families to understand those ideologies and how to make changes, which are perfectly reasonable changes to make.
Dr Fallon (02:20)
Hmm. It's really interesting, isn't it? Cause some of these ideas that parents are, you know, have heard online and they're really concerned. Of course, every parent thinks, well, no, I want the best for my baby. I don't want to do anything that's going to cause harm. but I think with those ideologies around, you know, never make any changes to a baby or a toddler sleep and any amount of difficult sleep is, is completely normal. it really flies in the face of,
Well, things like the International Classification of Sleep Disorders, the ICSD, it's a system for classifying different sleep disorders. And even babies six months of age can be diagnosed with a sleep disorder that requires treatment. if we, you know, if people are out there saying any amount of nightwakes, any kind of disrupted sleeps, all normal, it's all totally fine. Don't do anything about it. What about the babies that have a diagnosable disorder that are then not being treated?
Dr Laura (03:16)
Mm. Yeah.
Dr Fallon (03:18)
and the problems that can cause for the baby and the family as well. And it's pretty terrible that that is getting overlooked for a lot of families. So I don't like this idea of yeah, just any amount of suffering is normal. And what I actually think of it as being a little bit like is, for the diagnosis of mental health conditions, we have the DSM. Most people probably have heard of that.
And it's a system for classifying different mental health conditions in humans. You know, it's a little bit like if someone was to say, well, I don't think depression is really a thing. Just go for a walk. You know, everyone gets a bit sad sometimes. know, you'll be right. Chin up. Carry on with it. You'll be right. You know, we would be horrified if people, there probably are some people out there who do say those terrible things. But, you know, we know that sometimes
Dr Laura (03:57)
Yes.
Dr Fallon (04:11)
things can become so challenging that it's no longer within the realm of typical and actually requires some assistance to improve. And we don't disregard mental disorders. We also shouldn't disregard sleep disorders either. And I think that, yeah, that's really important to keep in mind that identifying disordered sleep is a really important thing to do so that families can get the support that they need. Laurie, you recently saw a family in clinic
when you, we often have a debrief at the end of the day and we were talking about this family and I thought this is just such a great case to talk about in more detail because I think for parents, it can be really helpful to hear what other people have been through, that other people have felt just as lost, maybe just as frightened and worried as they have felt as well, but that things can resolve and there are ways through this. We do see a lot of parents who feel so entirely lost.
and alone and you're absolutely not lost or alone. It's going to be okay.
Laura, you recently were telling me about a family who you first saw a couple of months ago and you've more recently seen them for a follow -up appointment, where they had, had a really challenging time. They had started that they'd been told that because sleep was so challenging, just co -sleep, with their, their baby. but no one was sleeping well. and they were carrying a lot of fear and a lot of guilt. Tell me more about.
When this family walked into the clinic and sat down, what were the things you really noticed first up about this family?
Dr Laura (05:51)
Yeah, so both of the parents, the mum and the dad came in with their 11 month old and they were absolutely exhausted. They looked just like they'd had the wind knocked out of them. And they sat down on the sofa and they would just look so despondent and, also a little bit uncomfortable. They
they were expressing that they are not really sure whether we should be here. Maybe they shouldn't be there. Maybe they're not the right kind of client. And I said, okay, well, just tell me what's going on. Where are things at right now? And they went on to describe that their 11 month old baby,
was waking up to 14 times a night, even when they were bed sharing.
Dr Fallon (06:48)
Whoa.
my goodness. mean, that, that's gotta be a bit of a record breaker for the families we see in clinic 14 is a huge, huge number. I often wonder how these families even have the, the mental clarity to book an appointment because that is incredibly punishing. And I, yeah, I have no doubt that we're feeling, yeah, pretty despondent and exhausted the poor things. So what was the
Dr Laura (07:01)
Yes.
Yes.
Dr Fallon (07:18)
How were things going? What were they, what had they been led to believe and what were you trying to kind of open up conversations with them
Dr Laura (07:26)
So yeah, I was really interested in why they were a little bit hesitant even about being there. And so I said, okay, so 14 times a night, and are you needing to intervene? Are you having to do anything? Because I was thinking, well, maybe because they were so hesitant about being there, maybe it's actually not too much of a problem. And like we've spoken about, think in some of our social media, Reels, Fallon, it is normal for babies to wake overnight and go back to sleep.
independently without needing a lot of support, because that's actually what humans just do. We go through sleep cycles overnight. So I thought, maybe this is what's happening. But no, their baby was waking 14 times a night and needing intense support to go back to sleep. And on a good night, which were few and far between, they could count on one hand, their baby was only having, you know, only, their words, four or five wakes a night.
Dr Fallon (08:00)
Mmm.
Dr Laura (08:23)
So and that, as you know, is often a starting point for some of the families that we're helping when they have a baby that, you know, particularly an 11 month old, you'd be waking that number of times and needing a lot of support to go back to sleep. You know, that's a high number, that's high frequency of wakes So yeah, I once I got that idea, so I kind of got there, well, what does a good night look like? And what does a bad night look like? And what does a usual night
Dr Fallon (08:30)
Yes.
Dr Laura (08:53)
like. I then just started to try and unpick with mum and dad about what part of this feels like you shouldn't be seeking help about. know, when you're feeling a bit hesitant about being here and you're thinking perhaps this, you're wasting my time and this is normal. And the parents were like, well, we've been told that night waking is normal.
Dr Fallon (09:07)
Mmm.
Dr Laura (09:23)
And it doesn't matter how many times your baby wakes up overnight. If, if they do wake up overnight, then it's our job to support them back to sleep. However, that baby needs to be supported back to sleep. And therefore maybe it's us. Maybe we're the ones who, a weak or there's something wrong with us because what our baby's doing is normal. Cause that's what we're hearing.
Dr Fallon (09:24)
Mmm.
Mmm.
Dr Laura (09:51)
but we're feeling so shattered. So they came to me with that kind of disconnect or the dissonance between they're hearing it's normal, but their baby's waking this number of times and they're struggling. Is their struggle, is that the abnormal thing? Because they're being told that the wakes are actually normal.
Dr Fallon (09:59)
Yes.
Okay. So they would be feeling a lot of guilt because they're probably thinking, well, we're being told there's nothing wrong with our baby that 14 night wakes or any number of night wakes is acceptable. And that our job is to just endure. And I'm guessing just the approach was to wait for that to pass. so they're feeling guilty cause they're like, we can't cope with this, but maybe we're not coping with what's actually typical baby behavior, it absolutely is not not typical to be waking.
Dr Laura (10:39)
No. No.
Dr Fallon (10:41)
Even four or five times per night at 11 months of age is a lot. 14 is off the charts. It just feels terrible to me that any family would be thinking that they needed to cope with that. I don't think it's actually possible for any human to cope with 14 wake -ups per night. That is really horrendous. So what had stopped them from...
I mean, I'm imagining there's a sleep pressure component to this as our listeners would know that so many wake ups, there's a bit of work to do on the daily rhythm so that we can increase that nighttime sleep pressure. But parking the sleep pressure side of the equation, what do you feel was stopping them from just going, okay, well, let's work on settling our baby in the cot and having a little bit more independence at sleep time?
Dr Laura (11:32)
Well, it is interesting, Fallon, that when I asked them to take me through the history of what they've tried in the past, because I should say that this family are co -sleeping, but they didn't want to be co -sleeping. They had felt compelled to co -sleep because the baby's waking that many times a night.
And when they, so when I unpicked, well, what has happened in the past, given that you don't want to have your baby in the bed, have, tell me what's happened when you've tried to help your baby go to sleep in the cot. Both the parents became very tearful multiple times during this conversation. And they felt that to put the baby in the cot caused the baby to cry.
and that they were traumatizing their baby by letting their baby cry at all. And they felt so strongly that they were damaging their attachment to their baby if they did anything that caused their baby in their minds to cry and to become upset. And so
Dr Fallon (12:26)
Mmm.
Mmm.
Dr Laura (12:47)
Each time they attempted to settle their baby, even when they're settling the baby in their arms and then popping him down into his cot asleep, he would spring awake, be very upset, crying. They thought each of those times they're doing him damage. And they had read stuff that said that it was doing him damage. yeah.
Dr Fallon (13:05)
it's heartbreaking.
That is heartbreaking. I've had many families like that too, that really feel like their role as parent is to prevent their baby or toddler from having any negative experiences, any negative emotions, rather than it being their job to support their child through their big emotions. And sometimes those emotions are, you know, that they're feeling sad or they're not liking change. They see it as I have to remove any obstacle.
But when it comes to sleep, that sometimes means that parents are just too fearful to go, even though a cot is like a very comfortable, very safe place. You you might have your hands on them when they're in the cot and be, you know, talking to them and reassuring them the whole time. Some parents will say, yes, but if they're still crying when I'm giving all that support, it's damaging them. Whereas it's, yeah, it's just such a strange thought, isn't it? We're talking about
Dr Laura (13:57)
Mmm. Yes.
Dr Fallon (14:04)
a little earlier before we started recording that, you know, 15 odd years ago, 10 years ago, even it was such a different landscape with sleep that if parents were having trouble with that, you settling their baby and getting a good night's sleep, they might go to their doctor or even a psychologist who would just say, look, it's probably that they need to be settled in their cot because once they do that, we know that sleep improves out of sight.
And with very little kind of instructional direction, lot of these parents would go home and go, okay, well, I've been told it's perfectly fine, put my baby in the cot. Maybe we'll just give them a lot of patting and support and help them with making that transition. We'll just kind of keep working towards helping them get more comfortable in that space. And parents would approach that with no guilt, no shame, no fear of harming their babies. Because they're like, this is what's actually going to help my baby be well rested and we're all going to do better.
Dr Laura (14:49)
Hmm
Dr Fallon (14:58)
And then social media came along and things got real noisy on the internet. And now so many parents are just plagued with guilt about all sorts of things. But I think sleep in particular, if you're a new parent being told that, you know, choosing to settle your baby in the cot is going to harm them. mean, like how devastating that is just, it's really awful. and I
Dr Laura (15:19)
Yeah. Yeah. It is. Yeah.
Dr Fallon (15:25)
we feel really sensitive to that because we see the terrible impact that can have on families every day. So anyway, I've gone a little off track, but Laura, what I wanna know is when you were having the conversation with the family around, you you've worked out what the sleep pressure problem is, you've got a bit of a plan in place for that daily rhythm. And then you're talking to them about, you know, settling and they're wanting to stop co -sleeping, they're terrified, don't know how to do it. Were you kind
talking them through different approaches, demonstrating to them, you know, this is how you could do it. How did that conversation go? Because it can be a really tough conversation to have.
Dr Laura (16:00)
Yeah, yeah, it can. So I have a doll that I have in the clinic, which I can use to demonstrate to families what a settling approach might look like. Obviously, this family had their 11 month old with them, but I wasn't going to start trying to settle here when he was very happy cruising around the furniture, having a lovely time with all the toys. So
But so they did have their baby was with them. And then I had a doll which I was saying, so imagine this is let's say his name was John, let's say this is little Johnny. And I put the baby in down on the ground, let's pretend this is the cot. And then I was patting the baby and actually the parents said he hates patting. I said, well, what does he like?
Dr Fallon (16:38)
Hmm.
Dr Laura (16:56)
when his back is rubbed. So remember this is an 11 month old, he's cruising and crawling and so it's okay for him to be on his tummy. So I said, okay, so let's rub his back. And you might say to him, as you're rubbing his back, I love you darling, it's time for sleep. And just rubbing his back. And the parents were particularly the mum at this point, burst out crying.
that this and I said, tell me what's going through your mind as I'm as I'm doing this. And she said, it's it's just traumatizing. I just know he's going to be screaming. He's going to be hysterical. And yeah.
Dr Fallon (17:39)
so she's interpreting that as being traumatizing. Even though you've got hands on support. So he's got his mum right with him, hands on being told that he's loved and it's time for sleep. So really there's so much support in around that baby or almost toddler. And that poor mum is still thinking this could be harmful.
Dr Laura (17:43)
Traumatising.
could be harmful. Yeah. And we'd chosen a physical reassurance that the baby likes. So back rubbing. So we're respectful of he doesn't like patting. So we're doing back rubbing, which he likes. And yeah, it was really interesting to look, we're not clinical psychologists, are we, Fallon? So there would be more work that needs to be done with a clinical psychologist to do lots of unpacking about where those
Dr Fallon (18:08)
Mmm.
Yeah.
Dr Laura (18:33)
you know, where some of those deets seated, feelings are coming from, or those reactions are coming from. but what I was able to talk through with the, family was, okay, what part of this telling your baby you love them and rubbing his back in the way he likes, in his warm, comfortable sleep suit in his cot,
a traumatic experience. What part of this is bad? Which part of this is harming him? And the parents were then able to kind of take a look, because it's a doll, they're able to kind of discuss it in a bit more detail. Well, actually, yeah, I can see that it's the rubbing his back. likes that.
Dr Fallon (19:12)
Mmm.
Yeah.
Mmm.
Dr Laura (19:28)
I can see that we're with him, or we will be with him. They're imagining it in their mind's eye. Yeah, we're telling him that we love him. There's nothing in this space that is hurting him. The cock doesn't have nails. doesn't have, you know, there's nothing that is uncomfortable about this. This isn't traumatic. You're right there with him. And they actually then had a go with the doll.
Dr Fallon (19:44)
Yes.
Mmm.
Good, a bit of practice.
Dr Laura (19:57)
just to see what it might, yeah, bit of practice. And of course it's a doll and their little boy is cruising around, like I was saying, but they're kind of, they kind of got down to get a little bit of, got down to the level of this doll just to get a sense of, is this something bad that you're doing? And it's not, it's not something bad. And the, just the,
Dr Fallon (20:18)
Yes.
Dr Laura (20:23)
It was almost like the parents had been shocked to see this, but then getting down and having a go at it with the doll got them beyond that initial shock. they were, and could, they could start to go, well, maybe those beliefs that we're holding onto that doing any kind of cot settling is going to be traumatizing. Maybe those beliefs aren't true because actually I can see that all I'm doing is rubbing my son's back and saying, I love you.
Dr Fallon (20:33)
Yes.
Yes, yes.
Dr Laura (20:53)
and I'm not, doing anything like just walking out and shutting the door and saying, good luck to you. See you in the morning. but also not doing anything that he doesn't like physically. it seemed to, there was like a damn burst and then they were like, okay, yep. All right. Maybe this is something that is okay to do.
Dr Fallon (21:00)
Mm. Yep.
Mmm.
Yeah.
That whole process is amazing. And I'm so glad they had you to just show them in a very practical way that you can surround a baby with so much love and they're okay. It's okay. And I'm, guessing, I mean, I can't wait to hear how the review appointment was with this family, but you know, it's.
it would have that conversation just would have opened that door to thinking, well, you know, if he's surrounded by our love and we're right there with him, we're talking to him, we're telling him what, you know, we love him. That maybe that that's okay. Like he might get upset. He might be cranky thinking, I don't like falling asleep here. What do think you're doing? But that he it's with he can cope. He's not frightened. He's not worried. Because he's got the people he loves right with him. But
Dr Laura (22:00)
Yes.
Dr Fallon (22:09)
tell me when they came back for their review appointment, how had they gone? Because I think when we work with families, we often think, okay, they have agreed that they're going to give this approach a try. It sounds like you got them on board with this idea of let's just give this a bit of a try. How had they gone? Was it horrendous for them? Did they manage to make some progress?
Dr Laura (22:31)
Yeah, they made tremendous progress. They made tremendous progress. And when I saw them, generally do our follow -ups online. And when I saw their faces over telehealth, they just looked so different from how they had presented initially in the clinic. And they reported that their baby had gone from these 14 wakes overnight
Dr Fallon (22:34)
yep.
amazing.
Dr Laura (23:00)
to just waking once or twice overnight.
Dr Fallon (23:03)
my goodness, that must have just been absolutely life changing for them. I'm really keen to know how did they go? The first sort of couple of settles, were they able to stick with the settling in the cot or was it too much for them? Cause we always say to families, if it's too much, stop and we'll reassess and you know, kind of talk about other strategies. Did you need to reassess or how did they go?
Dr Laura (23:08)
Yeah, yes.
No, they went really well. actually had chosen one of our very gradual approaches, which don't always work actually with babies that that bit older, like 11 months old when they're standing up, they can be a little bit tricky. They don't suit all bigger babies. But with this baby, it did work and
Dr Fallon (23:39)
Hmm.
Dr Laura (23:54)
Parents decided that they would both be doing it together. And again, that's not always what parents do. Sometimes if there's one parent who finds crying harder to tolerate, they might stay out of the room for the first few settles and then come involved a bit later. But this family decided that they would support each other and that they would
Dr Fallon (24:01)
lovely.
Dr Laura (24:23)
in a very practical sense that they were in the room together. And they knew during the appointment, we'd worked out, well, how long might you do this back rubbing for before you need to have a little bit of a break and give your baby a bit of a cuddle and then carry on. So we'd put in quite a few circuit breakers and resets so that they would be able to persist.
And they described that actually by staying in the room with their baby, by keeping their hands on him, by giving him constant support, he actually responded really well. The sleep pressure was nice and high. And that first time they settled him, of course it was hard because he's had months and months and months of going into the cot, waking
Dr Fallon (25:06)
God.
Mmm.
Dr Laura (25:18)
And then being picked up and whisked into bed, as if, know, or, you're, thank you for letting us. Yeah, it's different. They were persisting. Yeah. And he was cranky for that first settle. But they persisted. He did go off to sleep in the cot. They couldn't believe it. Couldn't believe it. And then that gave them the confidence to do it each time he woke again overnight.
Dr Fallon (25:21)
Yeah, it's different. Big change.
Mmm, I bet, yeah.
Dr Laura (25:46)
They had the agreement with each other that they wouldn't bring him into their bed anymore. That was something they wanted to move away from. So they were able to, because they committed to that, they committed to each time he woke overnight to give him the cuddles and he feeds that he was still having overnight, changes nappy if he needed to, but other than that, they would be using this one settling approach. And they found that each time they used it, it got easier and easier.
Dr Fallon (26:15)
Amazing. That's so fantastic. And how were things then? So I'm imagining, well, you've said, you know, sleep improved. You got to a point of just waking once or twice overnight. Often that has so many flow on effects. Did they feel like that process was traumatizing or had resulted in other negative outcomes?
Dr Laura (26:25)
Mmm.
No, and I think this is really interesting because they were so convinced that they would be traumatizing him, that they were being vigilant to any signs that they had done him damage. So they were really watching him like a hawk to make sure that they would pick up on any change in his behavior that would indicate that they should stop.
because they'd chosen this more gradual approach, they knew it was gonna take quite a few weeks until things were where they wanted it to be, i .e. just waking once or twice a night. And so they were all ready actually to stop as soon as they started. And we'd built in, like I said, lots of circuit breakers, but because they were so, even though during the appointment they were in tears and they...
Dr Fallon (27:16)
Mm.
Mmm.
Dr Laura (27:35)
were on board with knowing that they needed to change something about the sleep. again, all the way through that initial appointment, were kept coming back to, are we going to traumatize him? Are we going to be doing something damage? Surely this is normal. Are you sure that there's something wrong with him waking 14 times a night? Because we've heard so much that it's okay. That they then were blown away when the day after the first settle.
Dr Fallon (27:55)
Mmm.
Dr Laura (28:03)
that as in they'd use that settling approach and he had stayed in his cot all night, albeit waking up multiple times out of night. You don't go from 14 down to none overnight. In the morning, their son woke up smiling and happy and making eye contact with them and giving them cuddles and slobbers on their faces and you know, it still was
Dr Fallon (28:28)
Yeah.
Dr Laura (28:30)
looking to them for support and comfort all during the day. And they could see, actually, he's fine. And he still loves us. Even though we, we settled him in his cot, he still loves us and we still love him. And they weren't seeing anything that would suggest that the attachment had somehow been broken. Yeah.
Dr Fallon (28:36)
Yes.
Yes,
Yes.
Yes. And I think that's a really good point. It takes a lot, a lot to harm attachment. And it certainly takes a heck of a lot more than surrounding a child with love as they fall asleep rather than beside you, but just 30 centimeters away in a cot. You know, like it's, takes a lot more than that to harm attachment. But I think a lot of parents believe that it can be very, very easily broken or damaged. And that's going to have these really long -term impacts, but there's just no evidence of
Dr Laura (29:10)
Yes. Yeah,
Dr Fallon (29:22)
And there have been studies looking at the attachment of children who have been through far more challenging approaches for cot settling. And they still find when they look a few years later, they're doing perfectly fine. Their attachment's okay. That just sounds incredible. I mean, I know we do have families with sleep problems all the time. We see things improve and it's so wonderful to see the improvements. But I think this family in particular,
you know, went through such a huge transformation, not just in sleep, but in their thinking and in their understanding of their child. And I can't imagine how much it would have built their confidence as parents to know that they can make a decision that's a good decision for their family. They can stick to it and they can support their child as they also, you know, adapt to it and get used to it. It's fantastic. I think, you know, before we move into answering some of the parent questions that came through this week, I just want parents to really,
Dr Laura (30:12)
Mm.
Dr Fallon (30:20)
I guess have front of mind that you are going to hear so many different things said and sometimes they will be said by people who appear to be qualified well enough. But always be just thinking, is that right? Does that sound logical? There's so much conflicting information out there and I wish we could just get rid of it, but at end of the day we can't. All we can do is keep putting good, sensible, practical information out there.
What I would say though, and Laura, you'll probably have things to add to this too, is that if you're hearing things like any number of night wakes is okay, or all night waking is normal, cot settling is going to cause harm, pretty good signs that you're not getting great information. And I mean, there's other ones too. mean, there's, you know, things like if you're settling them in the cot, you're ignoring them. And that's going to be hard.
That sort of that whole narrative, I think is just really not helpful for families at all. And as a parent, you can decide to switch off from that and just follow what what your family actually needs. And don't be afraid to get support and reach out to qualified people for that support. If you're reaching out to someone you think is qualified and they're saying, no, you've just got to learn to live with this big alarm bells, very big alarm bells.
Dr Laura (31:21)
No, it's
Yeah.
Dr Fallon (31:45)
sleep is really important to protect and they should know that as well. So if you're not feeling listened to you need to keep looking.
Dr Laura (31:52)
Yeah, that's right. And also I think it can be helpful to have some other scenarios in your mind, which you know 100 % you would not be swayed on by information online. For example, we all know it's important that babies and toddlers and well, in fact, children up to the age of seven or a certain height need to be secured in a car seat when they're in the car. And many babies and toddlers
absolutely hate it. Absolutely hate it. They do that back arching. They scream. They carry on. They really dislike being in the car seat. I don't think that there would be any listeners, Fallon, who would say, okay, we just won't put them in the car seat because we're traumatizing them by putting them in the car seat. Every single listener would be going, no, of course we would say,
Dr Fallon (32:39)
Yeah. Yes.
Dr Laura (32:48)
are they really don't like car rides, but they'll get used to it. It's not always going to be like this. They would not be saying, I'm not going to put my baby in a car seat because it's traumatizing. And yet these babies will scream blue murder as if they are trying to extract a kidney through their nostril.
Dr Fallon (32:54)
Yes.
Yeah, yes. It's such a good example, isn't it? Of like, there are times as a parent when your child, yeah, doesn't want to go in the car seat, they absolutely crack it. But we don't go, no, we can never take them anywhere again. We're never going to be able to go in the car again. Damn, you know, how are we going to manage that? You go, how am I going to support my child to get used to this? Maybe one parent rides in the back or
Maybe it's we try some different toys that might help, you know, keep them distracted. You troubleshoot it, you don't remove the obstacle because it's impractical to never put them in a car seat. And that's just parenting in a nutshell, isn't it? There are going to be challenges where you think, I would love to run away from this. I would love to not have to deal with it, but you've got to. And your job is, yeah, to lean into it and help your child work through that difficulty. And I think that's important.
Especially for listeners who have really little babies where bed sharing or having them sleep on you in a chair or on a couch can be very, very risky. Yeah, it feels hard putting them in the cot, but it's a bit like putting their seatbelt on in the car. It's got to be done. We want to minimize risk. We don't, we don't want to lose babies. We definitely do not.
Dr Laura (34:16)
Hmm.
No, absolutely. yes, here we
Dr Fallon (34:21)
so we've gone to some very deep places, haven't we Laura? So I definitely want to say if you are grappling with some of these things, if you have some big fears, some big concerns, you're anxious, you're feeling depressed, or you just feel like you're not coping, please talk to your GP, get a mental health care plan, go and see a psychologist. There's great supports available to help you work through some of these things. And if you need more immediate support, absolutely call Lifeline. We'll pop a link and a phone number in the show notes as well.
Yeah, well shall we talk through some of these parent questions that I come through? We've got some great ones Laura.
Dr Laura (34:55)
Yeah, we have. So our first question is from Katie and Katie describes how her little one responded so quickly to being settled in his cot. She says that they found he settled much faster when they wandered away from his cot at bedtime and Katie wonders why this is.
Dr Fallon (35:13)
Hmm. Yeah. It's a really good question, isn't it? Cause like in the example we've just talked through, some babies are like, if I can see mom and dad and their hands are on me, I'm good and I'm okay. Others will just be like, absolutely not. If I can see you, you are going to be settling me. it just comes down to temperament. I would say some babies, if they can see a parent, go, well, I'm going to get really cross until you come over here and do the settling for me.
Dr Laura (35:27)
Yeah. Yeah.
Dr Fallon (35:43)
Sometimes when we step out of their space and they can't see us and certainly really really briefly you're just kind of experimenting. Some of them just go, well they're not here so therefore I'm going to use myself soothing behavior so things like they'll bring their hands up to their mouth, have a bit of a suck on their fingers and then they're off to sleep. So yeah that's essentially why that is but it is different baby to baby and that's why it's really important and in Somba we have many modifications for different approaches.
depending on whether your baby responds better having you close by or if it's actually better to step away for a moment and see what they do. yeah, hope that helps Katie. It's very interesting question. I love it. Laura, we had Claire email in Claire's got a few questions. So we'll go through these one by one. Claire's daughter is two and a half years old and she sleeps from 8pm to 6am. She has a nap each day for around one and a half to two hours.
Claire says sometimes her daughter wants to nap closer to 11am and she's struggling to stay awake until midday which is the sort of usual nap time. So she lets her nap at that time and then puts her down a little earlier for bed which works for her and is that okay is what Claire wants to know is it okay to have that little bit of variability.
Dr Laura (36:55)
Yeah, think certainly once you have, you're seeing good sleep in your daughter and she's sleeping well overnight doesn't sound like they will come on to the future, the other questions doesn't sound like she's waking up loads overnight. So you can be really flexible. The only time we suggest kind of really being a bit stricter with a schedule is when we're just trying to consolidate.
the overnight sleep if a child was having loads of wakes overnight. So Claire, if your daughter was still waking up many times overnight, then we might say, just for a week, let's just try and be a little bit stricter around bedtime and wake up. But once your daughter's sleeping well overnight, we don't have to be so strict about it. And it's okay to put a child down for a nap a little bit earlier from some, you know, some days she goes down at 11, some days she goes down at midday. That's okay.
Dr Fallon (37:21)
Hmm.
Mmm.
Dr Laura (37:49)
If you start to see that the naps getting earlier and earlier and then bedtime's getting earlier and earlier and then she's starting to wake up overnight again or wake early for the day, then you might want to just work on stabilising that bedtime a bit again.
Dr Fallon (38:05)
Yeah and I would only add to that that if you bring bedtime earlier try not to let it be really excessively early like no matter how tired she is I wouldn't be putting her down at 6pm if she's used to an 8pm bedtime it might be 30 minutes earlier an hour maximum and yeah like you said Laura keeping an eye on other variables that might get a little bit wobbly that would indicate that there's too much variability excuse me
Dr Laura (38:16)
No.
Yeah. Yeah.
Dr Fallon (38:30)
Claire also says her daughter uses the toilet to delay bedtime, requesting a toilet visit about five times before bed, and yet she rarely actually does anything on the toilet. Claire, and she's only been toilet training for about a week and a half. Claire wonders how to set a boundary with a natural behavior like toileting. Hmm, good question.
Dr Laura (38:53)
It is a good question. And I think this is a brilliant example of where a bedtime routine chart would be really useful. So what I'd suggest Claire is having a look at the module that talks about bedtime routine charts, create one for your daughter where you have a visit to the toilet close to the start of the bedtime routine.
and then have a final visit to the toilet right at the end of the bedtime routine just before she gets into bed. And then you can be really confident that she's had two attempts or two opportunities rather during the bedtime routine to use the toilet. And then it's much easier for you as a parent to say, you've just been to the toilet, you don't need to go again. And then if you wanted to, you can use stickers to reward.
her getting into bed at the end of the bedtime routine. Do you have anything to add, Fallon?
Dr Fallon (39:49)
Hmm. No, I think that's a great idea. Two opportunities is plenty. If it kept being a really persistent problem, of course, just have a chat with your GP. If you're having persistent difficulties with toilet training and lots of requests for the toilet, it doesn't hurt just to get things checked out. But yeah, a good way to put a cap in any bedtime behavior is to just build it into the routine. In some values that routine chart template and.
Yeah, it works for so many different things, even, you know, extra stories or I need another drink or let me tell you about the meaning of life, Mum. Claire also wonders how she can get her daughter down for sleep earlier in the evenings. She tried to cut her nap to just 30 minutes on a particularly busy day, but her daughter still didn't fall asleep until 8pm. What would we suggest?
Dr Laura (40:20)
Yeah, yeah, another cuddle.
Hmm. As you've probably heard, I'll say quite a few times, Claire, in this podcast, it really, when we think about making a change to a daily rhythm, we really need to do it for a whole week before we see an impact. So you've tried to reduce the nap just for one day, and you didn't see
effect on that night's sleep. I wouldn't necessarily expect there to be an effect on that night's sleep. It would be across a whole week of doing that, that you would start to see an effect. So yeah.
Dr Fallon (41:12)
No, me either.
Hmm, yeah. And maybe not starting with 30 minutes, since the naps normally an hour and a half to two hours, it could even be some parents will just start by capping it at an hour and a half, and then seeing how bedtime's going and then maybe trimming it to an hour and seeing, you know, so you'll kind of get an idea of how much, how much you can trim it by and how early a bedtime might, might become.
Great questions and I love that we're getting some toddler questions through because they are my favorite to answer. It's so interesting. So yeah, good luck Claire. Laura Sammy had a question, just a short little one. She says, actually I don't know Sammy's gender. So they say they have a six month old who is having persistent difficulties with false starts. Sammy would like to know more about what causes these and how to resolve false starts.
Dr Laura (41:46)
Yes!
Good.
Hmm. So false. It is a big question. So false starts. They normally happen or they always happen at the start of the night, and often after one sleep cycle. So, yeah, so they wake up, you pop your baby down, they go to they seem to be asleep and then half an hour 45 minutes later, however long their sleep cycles are, they're bang wide awake again, and then you have to settle them again.
Dr Fallon (42:11)
Big question.
Mm, it's spring awake.
Although it can be even earlier if sleep pressure is really low, sometimes it's 10 or 20 minutes. They don't even get into a sleep cycle. So yeah, they're the painful ones.
Dr Laura (42:39)
True. That's true. Yes. Yeah. Yeah, they are. Yeah. So normally it's a really good sign that sleep pressure is not quite high enough when you're popping them down at the start of the night. So one of the things I'd be looking at, Sammy, is just what the daily rhythm is for your baby. And it may be, look, at six months old, perhaps if
they might be, if your baby is having three naps, for example, they might be ready to drop down to two naps. And then that means that there's just a little bit longer awake before the start of the night, which means the sleep pressure is a little bit higher. And you should find then that your baby stops having those false starts.
Dr Fallon (43:25)
Yeah, so works through the unique sleep needs chapter so you can really establish what their sleep needs are and start to think about that daily rhythm. Because yeah, beyond a shadow of a doubt when there's false starts there's a bit too much day sleep happening there and a little bit of work to do on that daily rhythm. But yeah, really glad we've got Sammy in Sombelle and really looking forward to hearing how that pans out so keep us posted.
Dr Laura (43:39)
Hmm.
Dr Fallon (43:48)
Now we've got a couple more questions, a couple more meatier ones. Laura, do want to read out Lena's question maybe?
Dr Laura (43:52)
Yes. So Lena has a six month old as well, like Sammy, and her baby has a history of reflux. He prefers contact mapping, bed sharing and feeding to sleep. Lena and her partner are currently making the transition to their baby sleeping in the cot rather than bed sharing. So Lena writes that her baby has a 14 hour sleep need, has three naps a day, totalling somewhere between three and a half and four hours.
during the day, leaving around 10 hours at night. So Lena writes that for the first settle of the night, he takes about 45 minutes of loud crying to fall asleep in the cot, usually after being fed and rocked to sleep in my arms first and then placed down after multiple attempts. Then he wakes up at least
five or six times a night and wants to be fed back to sleep. Lena, you must be shattered out. So Lena asks, maybe we take these one at a time, Fallon. Lena's first question is, is 45 minutes to fall asleep at the first settle too
Dr Fallon (44:50)
Ooh, ouch. Mmm, that's tough.
Yes, it's too long for anyone. Even if you were an 80 year old man, 45 minutes is too long to fall asleep. It's a really good sign that the body's just not quite ready for sleep yet. I would be thinking about even just noting down what time your baby usually falls asleep, Lena. So make a note of that over the course of a week, or if you've been keeping a diary, have a look back over it. That's your new bedtime.
that's when you're going to start settling him. So if you're starting to put him down for sleep at quarter past seven and he's always falling asleep around about 8 p 8 p will be the new bedtime. You're much more likely to have an easier time of things. But I'd say there's some confusion happening there. We always have to think about things from the baby's perspective. He's thinking, well, I fell asleep in your arms. Now you're putting me in the cot. I really want to be in your arms. So that can exacerbate the crying because he's thinking, well, maybe if I just cry a little harder or a little longer,
I'll be held or fed back to sleep again and maybe I'll stay in mom's arms this time, this time. So there could be bit of confusion there. And last thing I'll say is just that sometimes they think I'm not gonna fall asleep because I know you're gonna put me in the cot and I hate that feeling of waking up where I don't want to be. So they will really fight falling asleep. So that could be part of it too. So maybe shifting bedtime and then just having one approach. Don't do the feed or hold to sleep. Maybe it is just working.
on the cot settling to just make it really, really clear. This is just how we do it. Because I think there could be some confusion impacting things.
Dr Laura (46:38)
Yeah.
Yeah, and I think it's a useful piece of advice, Fallon, for listeners to know that cot settling is about your baby falling asleep in the cot, not falling asleep in your arms and then going into the cot. And I wonder if perhaps that's the next step that Lena needs to take with her baby. So she wants to transition away from bed sharing for him sleeping in the cot and
Dr Fallon (46:52)
Mmm.
Dr Laura (47:09)
So she's getting him to sleep in her arms and then putting him in the cot. That's not quite cot settling. It's definitely sleeping in the cot, but not going to sleep in the cot. So that would be what you need to work on. So we might have answered some of her follow -up questions. Her second question is, I'm still doing feed to sleep contact naps in the day. Is that okay or am I making nights harder for him?
Dr Fallon (47:20)
Yes, and that can make all the difference in the world.
Hmm. Look, there are some families that will do contact naps in the day and then an entirely different settling approach at night. And it can work, but I think in Lena's case, it's not working and it probably is contributing to those nights being really hard. Cause he's thinking, well, sometimes I'm allowed to do that. You know, why can't I do it now? And he doesn't understand that there's different rules at different times of day. I know it's really hard. And I think if I was working with Lena, I'd be asking lots of questions.
Dr Laura (47:55)
Yes.
Dr Fallon (48:05)
But all I will say is decide on one approach and just use that one approach. Avoid that confusion for him. In a few weeks time, if everything's going beautifully, occasionally having a contact nap won't matter, but in the short term, it might be better to avoid them so that he doesn't feel that confusion and he understands that when you start to settle him, that's where you're settling. That's how it's gonna go.
Dr Laura (48:17)
Hmm.
Yes. And listen, I think you've probably answered the next question, which is, if I bedshed again for a few nights, would it ruin all my progress? She says, I'm holding strong on the cot settling for nighttime, but it's very taxing on my sleep. So yes, I think, like Fallon has just said, choosing one approach and being consistent with it is going to be much kinder and more consistent for your baby.
Dr Fallon (48:55)
Yeah.
Dr Laura (48:56)
If you sometimes bring him into your bed overnight and sometimes don't, he's just not going to know why sometimes that happens. And he might be looking for the magic, the magic button that he needs to press that means that you'll bring him into his your bed overnight.
Dr Fallon (49:04)
Yeah.
Yes. And then you just get a lot of crying. I would also say Lena, be really sure that he's in the right daily rhythm. Because if you're, if you're still getting a lot of night wakes and you've done some work on settling, could it be that sleep pressure isn't high enough or the daily rhythm is just a little bit off. That's actually making it really, really hard. So just make sure you've worked through that unique sleep niche chapter and definitely work through the chapter called the psychology of
Dr Laura (49:27)
Mmm. Mmm.
Dr Fallon (49:37)
because that's going to explain a lot to you around the factors that are going to contribute to it taking a really long time for a baby to adapt to cot settling. You might find that quite helpful.
Dr Laura (49:49)
Yeah, and Lena's final question is, I'm also trying to get him to sleep in his own room. Is that too much for a Velcro baby? She calls him a Velcro baby at this age. They're just in an adjacent room. And Lena says that she goes to him as soon as he calls
Dr Fallon (50:06)
that's an interesting question.
You know, I'm kind of stumped because I could be talked into either way. I think if he gets a lot of comfort from having you nearby, you might have an easier run if you just set up a spare bed beside his cot in his room and you can just kind of reach over and reassure him as you need to. And he might find that really comforting. So it could make the cot settling and the persistence with cot settling a lot easier overnight.
Dr Laura (50:29)
Mm.
Dr Fallon (50:30)
But then on the other hand, for so many families, it does go so much better when there's a little bit of space between the baby and the parents. You're only in the next room. Yeah, I'm really on the fence with that one. I think it would depend a bit on his temperament. Is that what you'd say, Laura?
Dr Laura (50:42)
Yeah. Yeah. Yeah. I think it comes back to Katie's question at the beginning where she had found that her baby settled more easily when she walked away. And that suits his temperament. But perhaps for Lena's baby, since she describes him as a Velcro baby, and that's her terminology, it's sweet analogy, maybe he would actually cope better with you by his side.
Dr Fallon (51:06)
Hmm.
Mmm.
Dr Laura (51:13)
It really does come down to temperament.
Dr Fallon (51:17)
Yeah. good luck Lena. It sounds like you're dealing with a lot, but just know that, you know, he's six months old and once they make this big adjustment, everything improves. It gets so much easier. and it sounds like you're doing a stellar job. So keep up the awesome work and send us an update. We'd love to know how things are going. And as with any of our families, if you're really stuck, there are coaching calls. So if you just think, I think I'm on the right track, but I'm doubting myself a little bit sometimes.
A coaching call can help to just get rid of all of that uncertainty. We make sure you've got a really clear plan and we know that we're setting you on a path to success. So do keep that in mind. And the last email we have Laura is from Amanda who has three questions. Amanda's 14 month old daughter has around about an 11 and a half hour sleep need.
Dr Laura (51:48)
Yeah.
Dr Fallon (52:10)
She's gone from waking four to seven times per night and needing to be fed or rocked back to sleep to now waking one to four times a night just briefly. So good move in the right direction, that's really good. She takes five to 15 minutes to fall asleep independently at the start of the night at about 8 p and she wakes up around 6 a She has a midday nap of one hour 20 minutes to one hour 40 minutes.
Dr Laura (52:21)
Yeah, well
Dr Fallon (52:35)
Recently she's been, she has sometimes been able to sleep an additional 15 to 30 minutes in the morning. So Amanda's questions are, does the additional morning sleep indicate a higher sleep need than initially calculated? there's lots of things to consider there, isn't there?
Dr Laura (52:50)
Hmm. Yeah. there's lots of things to consider. Amanda, well done. Brilliant for moving from four to seven wakes a night to just between one and four. And the wakes being much shorter than they used to be. I would actually, before we start thinking about adding a bit more sleep to the morning time, I'd be really trying to
your daughter down to even fewer wakes than that because still you know some nights there being four wakes at 14 months of age that's a lot and I would be thinking let's just hold that wake up time steady just for about a week so that you can see if you can start to get more nights where she's only waking once or hopefully not at all and then look at seeing
she's having consolidated good restorative sleep overnight. Can you let her sleep in a little bit longer and it not reintroduce nightwakes? And if, if she can, brilliant, do that, do it in 15 minute increments, given that she's got quite a low sleep need of 11 and a half hours, I'd be moving wake up perhaps to 6 .15 for a week. See how you go.
then move to 6 .30, see how you go. But if she starts to wake up overnight again, then I would be going, right, no, we've got it right.
Dr Fallon (54:16)
Yes, it's such a great way just to test what are the limits, how long can, yeah, how much sleep can we get? It's such a good idea to be so methodical and just one little test at a time. Yeah, yeah, good advice. Amanda also asks, when my daughter is cared for by family, her nap schedule varies, sometimes leading to two naps with the second one ending at around 3 .30pm.
Dr Laura (54:22)
Mm.
Dr Fallon (54:41)
These days result in more night wakes and a longer wake of 45 minutes to an hour. So split nights become apparent pretty quickly if there's a second nap. So she wonders, is this variability in day sleep causing these issues or is it random?
Dr Laura (54:47)
Ooh. Yeah. Yes.
I would say it is the variability in day sleep causing those issues. 100%.
Dr Fallon (55:04)
100%. Yeah, yeah, it can be a tough conversation to have with family who, you know, often we feel like we can't give too much direction to family members who are being generous enough to care for our kids. So a little gentle conversation around how tricky the nights can be on those days, and maybe giving them some strategies to keep her awake so that she just has the one nap. They might need some tools, maybe it's a coloring, 14 months, maybe not coloring in book, but
Dr Laura (55:20)
Mm -hmm.
Yeah.
Dr Fallon (55:30)
It could be something new and novel that they can give her or play with her to help it just be the one nap. And finally, she says, when her daughter wakes at night, she cries, sits up or stands in the cot and requires assistance to lie back down. Is this normal and will it resolve over time?
Dr Laura (55:37)
Yeah.
Hmm. Yes, it is normal for babies and toddlers to stand up when they wake overnight. What we generally advise is not to rush in straight away to lie your daughter back down, because it's only with practice that she's going to learn to be able to get herself back down. And if you run in too soon, she's never going to be practicing that skill.
What we want is for her to get a bit bored of standing up because then she finds she has to wait for a couple of minutes for you to come in. Well, that's just really boring. And when we know her sleep pressure is high, she's going to be so tired that she's going to go, well, what's the point? I'll just stay lying down, put myself back to sleep.
Dr Fallon (56:25)
Yes.
Yes.
Yeah, absolutely. At the moment, she's probably thinking, this is great. If I wake up, I spring up and mom comes in and she gives me this little cuddle and puts me back down. So yeah, you're right. They almost need to feel a little bit of frustration, like, I've stood myself up. This is kind of annoying. I'm tired. Where's mom? Yeah. It just only has to be a few minutes, but then they just go, actually it's pretty boring. Not worth doing. it sounds like you're doing a fabulous job, Amanda. You've come so far.
Dr Laura (57:03)
Yeah.
Dr Fallon (57:05)
few little tweaks and you're going to have a great sleeper on your hands. Just to close off this episode, I want to say a huge welcome to all the new Sombelle members. It's been another full -on week with so many new members and it's just so fantastic to be welcoming new families. We have had the most glorious, beautiful emails come through from families who...
have taken the time to tell us how much Sombelle has changed their lives and how much they appreciate our time and the podcast and the support that we give to families. We've been absolutely flat out in our clinics as well. We just want to say how very grateful we are for that feedback. You've got no idea the difference it makes after a tough day in clinic to open the email and have people saying wonderful things. It's just beautiful.
Dr Laura (57:49)
Yeah.
Dr Fallon (57:55)
We appreciate all of you so much and you're all just doing such a fantastic job. If you love our podcast, please hit that subscribe button. Give us a five star review. We'll love you forever. And we're putting lots of work into our social media account. Gosh, it's a lot, but we're working really hard to bring you really good useful bits of information on social media. So go and follow us on Facebook or Instagram.
Dr Laura (58:07)
Hahaha!
Dr Fallon (58:22)
or tick tock even we actually sometimes show up there too. so yeah, thank you everyone for listening in. And if you're a song bell member, remember that you can submit your questions. You're not alone. you know, if you've signed up and you're feeling a bit overwhelmed, what is it that's overwhelming you? Let us know. And we can talk about it on the podcast because we're here to make sure that everybody gets what they need. gets better sleep. and we're always here to listen and, yeah, to help.
So have a great week everyone and you'll hear from us again next week.
Dr Laura (58:54)
Thanks everyone, bye
