Dr Fallon (00:37)
You might have worked really hard to build your child's confidence falling asleep in their cot or bed at bedtime. But what happens if you still find yourself sitting in their room near their cot or bed until they fall asleep? Well, some parents don't mind doing this, but others find it really difficult, especially if they have other children to get to bed. And for some, their children continue to wake overnight wondering why their parent isn't still sitting beside their bed.
and insisting that they return. Cue parental exhaustion. If you want to reduce your presence at bedtime using gentle methods, this episode is for you.
Welcome back to Brand New Little People, the podcast companion to the Sombelle Pediatric Sleep Clinic programs created by us. I'm Dr. Fallon Cook and I'm here with Dr. Laura Conway. We are PhDs and sleep practitioners and co-directors of Infant Sleep Australia.
Hey Laura, how are you going?
Dr Laura (01:50)
Yeah, I'm good. Thank you, Fallon. I've started turning my attention to Easter, which is just around the corner. I can't believe it. Yeah. Yes, I have. Well, I was caught up with a friend this weekend and we just ended up in the Yarra Valley going to the chocolate factory. And that brought it home to me that Christmas, the Easter is just around the corner because there are lots and lots of eggs and bilbies and
Dr Fallon (01:56)
Yeah, yeah, you've been getting organised. I'm definitely not organised.
nice.
Dr Laura (02:19)
chocolate kangaroos and koalas and all sorts. Yeah. So,
Dr Fallon (02:24)
how nice. They have amazing cakes there because we've got a chocolate factory not far from us over near Dalesford and the cake there is to die for.
Dr Laura (02:32)
I didn't have a look at the cake, I was more interested in the ice cream and they do have lovely ice cream!
Dr Fallon (02:39)
Maybe we need to do a little chocolate factory tour. That could be our little Easter gift to ourselves.
Dr Laura (02:42)
Yeah, maybe we do. Yes, yeah.
How was your weekend, Fallon?
Dr Fallon (02:50)
Oh yeah, it was good. are getting ready to start our renovations this week. It was a bit of a shock when the builder's like, right, when can we get started? And I was like, Oh, well, when are you available? And he was like, well, how's Wednesday? What? Okay. So we've been busy all weekend, just like packing up our laundry and, you know, trying to just organize things as best we can, but it's definitely going to be a very chaotic few months.
Dr Laura (02:56)
wow.
Wow.
Dr Fallon (03:18)
so I'm going to apologize ahead of time to anyone having a coaching call. There might be a little bit of background noise happening or, I know someone local who does telehealth work often she ends up in her car out in the middle, you know, nowhere where it's nice and quiet, you know, when there's building works happening near her. So who knows, I could be joining you from just about anywhere for your coaching calls. Yeah, exactly.
Dr Laura (03:18)
Yes.
Yes.
Wherever you can't hear the nail guns going through the post.
Dr Fallon (03:48)
Yes, so it's definitely going to be a bit tricky to manage, but I know it'll be worth it when it's done. So I've just got to hang tight. Yeah.
Dr Laura (03:54)
Yeah, yeah, absolutely. And then that means that
your children will be able to move beyond room sharing with each other if that's what they so wish. So that would be wonderful.
Dr Fallon (04:05)
Yeah, they say
that's what they want, but I reckon they're going to miss each other more than they realize of my two younger ones are in the same room at the moment. And yeah, it's definitely going to be, you know, kind of factors into today's podcast episode. Actually, I know my youngest isn't so keen on falling asleep on her own. When my middle child was away for a few days, she was like, you're not going to like leave.
Dr Laura (04:22)
Mm.
Mmm.
Ha ha ha ha!
Dr Fallon (04:34)
Are you,
can you just like sit there while I fall asleep? and I was going to talk through, know, some of this sort of approach today, but with her, it just came down to saying, you know what, I've got some things I've got to do, but I'm going to come back in in a few minutes time and see how you're going. And what do know? She was sound asleep. yeah, anyway, so maybe we do turn towards the content of today's episode because that was a, a perfect little intro to it. but you know, we get, we get emails all the time about this, don't we Laura? And it's something that we do.
Dr Laura (04:47)
Mm.
Yeah, let's do so.
Mm.
Dr Fallon (05:03)
see quite a bit in clinic is parents saying, okay, I've done the hard work. You know, they used to be maybe cuddled to sleep or I was co-sleeping with them or, they needed a lot of assistance to fall asleep, but now they're actually falling asleep in their cot or their bed and I'm stuck in their room. How do I, how do I get out of their room? and you know, on the one hand we could, you know, and there were some children would just say, just, just leave, just leave the room. They might be completely fine, but
Dr Laura (05:05)
Mm.
Yes.
Dr Fallon (05:31)
For a lot, it's not that straightforward, which is what we want to dive into today.
Dr Laura (05:33)
No.
Yeah, that's right. And I think, of course, for very little babies, they really often don't mind one way or the other, if you're there or not, once you have supported them to fall asleep in their cot by themselves, they won't mind too much when you just walk away. But those
Dr Fallon (05:47)
Hmm.
Yeah. Often the parents
are more scared than the babies. Babies don't really mind too much if you're there or not, the little ones anyway. but as a parent, think, am I, am I allowed to just like, they're, they're going to sleep on their own. Am I allowed to just kind of leave the room now? And which case we kind of go, yeah, it's fine. They're asleep. for it. Yeah.
Dr Laura (06:03)
No. Yeah.
Yeah, just give it a go. Yeah, and often though
the babies just, whoop, yeah, they just carry on drifting off to sleep and they're, yeah, absolutely fine. And it's just the parents are shocked. But yeah, with older babies and toddlers, think it's probably, like you said, the very first thing to try is to, you need to try it first to wander away to see if it is an issue. So yeah, be brave and yeah.
Dr Fallon (06:23)
Yeah.
Yeah.
Yeah. Yeah. Yeah. Cause even some older babies,
they're just like, even if they've always had you there to fall asleep, we will get a lot of parents saying, I was busting for the toilet and I was like, I'll be back in a moment. You know, and I just went to the toilet and I came back and they were asleep and they didn't cry. They weren't upset. They just put themselves off to sleep. So yeah. So even older babies, sometimes they don't really care if you're there or not. but I would say it's probably the toddlers who struggle.
Dr Laura (07:01)
Mm.
Dr Fallon (07:06)
the most because they really know what they want. And if they want you there, they're really going to let you know about it. If you, you know, try and leave. Um, so I think today we'll focus mostly on the older babies and the toddlers where it tends to be a bit more of a tricky task. It's not always though. I don't want to terrify any parents. Like there are, there are plenty of toddlers and older babies who will just be like, yeah, whatever. See you later, mom and dad. I'm good. Um, but yeah, there will be some that do struggle a bit.
Dr Laura (07:06)
Yes. Yes.
Yeah.
Hmm.
Yes.
Hmm.
Dr Fallon (07:35)
And I think
one of the really big things that parents will say is, my child's got separation anxiety and that's why I can't leave the room. And, know, what do I do about that? But we always like to do a bit of a check-in, about, is it separation anxiety? Like, is it a genuine fear that they have here or are they just, having a very, very strong preference? And often with toddlers they know.
Dr Laura (07:58)
Mm-hmm.
Dr Fallon (08:00)
to have the same, you know, if I, even if I just want something different, even if I want the blue plate and not the green plate, if I absolutely let rip and really lose it, my parents might change what they're doing. So it can make it really hard to untangle. Are they frightened of me leaving or are they just annoyed that I'm trying to leave and they don't want me to? what's one of the ways that you would kind of check in on that Laura?
Dr Laura (08:11)
Mm-hmm.
Mm, yeah.
So I always ask parents to think about how their child is behaving and functioning across the whole day. Are they able to play independently at points during the day? Of course, age appropriately. We're not expecting a toddler to be able to play independently for half an hour, an hour or longer. But can your child play independently for a few minutes?
Are they happy for you to go out of their sight I often ask parents in clinic, are you able to go to the toilet by yourself without your toddler coming like screaming after you or, you know, needing? We have some toddlers who their separation anxiety is so strong that they are sitting on their parents lap as the parent is on the toilet because they just need to be attached to their parent the whole time. And if that's happening,
Dr Fallon (08:56)
Hmm.
Yeah.
Hmm. Yeah.
Dr Laura (09:16)
that you can't go to the toilet by yourself in the day without them getting upset and needing to be with you. If you take them to the playground and they're not that interested yet in going off and exploring by themselves, they want you to hold their hand as they walk up the steps and go down the slide with them. And they really find it very hard to go and explore without you right by their side. Then that's really quite a good indication that they do actually have separation anxiety.
Dr Fallon (09:17)
Mmm.
Hmm. Yeah.
Yeah. And I think a really important distinction is that there are lots of toddlers who are clingy, who just want to keep close to a parent and kind of know where you are and their preferences to be near you. There's a difference between that and being fearful and anxious about that separation. So I often say to parents, okay, they might want to follow you everywhere.
Dr Laura (10:02)
Mmm.
Dr Fallon (10:08)
but if, know, if they're distracted with something, are they fine with it? Like, is it, are they having a fearful reaction or are they just cranky? Like, often childcare drop off is another good way of knowing, you know, cause if parents say, yeah, they hate it when they separate from me at bedtime, but at childcare drop off, they wave goodbye. Say, see you mom and run off happily into the room. Yeah. Yeah. Yeah. Or just couldn't care less. Yeah.
Dr Laura (10:16)
Mm-hmm.
Yes.
Or don't even! Don't you love the ones that don't even? Can you get a whitching off?
Dr Fallon (10:33)
That's it. If you're only seeing it at bedtime, it's not separation anxiety. It's going to be more, but they've got a really strong preference to keep you close. And that distinction is important because if they are fearful and anxious and it's true separation anxiety, we're not going to push it. We're not going to try and, you know, rip the bandaid off and have you leaving them alone. That's not going to help at all. It's going to make it worse. But if it's more to do with them having a strong preference, we can be a little bit.
Dr Laura (10:42)
Yeah.
No.
Mm-hmm.
Dr Fallon (11:00)
bit more confident, I suppose, in how quickly we move and in setting, you know, a firm plan, having some boundaries and really, you know, sticking with that plan. so yeah, you got to think about that. If you think, yep, every single separation, they're frightened and worried. yeah, you definitely want to take things pretty slow. which kind of brings us into that strategy side of things. I reckon we could talk through sort of four.
Dr Laura (11:04)
Hmm.
Mm-hmm.
Mm.
Dr Fallon (11:26)
main strategies you can use if you are struggling to get out of your child's bedroom at bedtime. The first one is what I call the just leave, the just leave strategy, which is where you you just you just want to see how it goes. Like is it so often parents will say I'm so surprised they actually just did totally fine without me in the room. I thought I was going to be in for weeks of gradually removing my presence but actually they were fine. So it's always worth a try but it's pretty unlikely that will work with a child that has separation anxiety.
Dr Laura (11:51)
Mm-hmm.
Hmm.
Dr Fallon (11:56)
so if you're really sure that they've got separation anxiety, then I wouldn't even bother trying this. It might just trigger more anxiety. it's probably not going to work and you'll need a more gradual option, but under that, just leave category really comes with what I was saying earlier about my youngest. It's, know, if you're sure they're not anxious, then really think clearly about what is it you're going to tell them, how are you going to do this and have confidence in your voice. And also put on that no nonsense parenting voice.
Dr Laura (12:02)
Mm-hmm. Yeah.
Dr Fallon (12:25)
It's not a mean voice. It's definitely not yelling, but it's just very clear instruction. So it could be, I've got to go and pack the dishwasher, but I'm going to come back in and check on you soon. And so it's, you know, kiss and cuddle and then I go, no, no. And you were like, I'm going to be back in a minute. And then you go, you leave for a couple of minutes. and a child who's going to cope well with this isn't going to get overly upset. They're going to lie there, wait for you to come back again. You might find you don't even need to go back there. Just fine. They put themselves off to sleep, but if they don't then go back in, show them that you do come back.
Dr Laura (12:40)
Mm-hmm.
Yeah.
Dr Fallon (12:56)
you know, do the same thing again. I've packed three things in the dishwasher. I'm to give you another kiss and a cuddle. I've got to go and keep packing the dishwasher now. So you sort of explaining it. You've got something to do. You are coming back. and a lot of children, when they hear that, okay. Mom or dad is no nonsense. Now they're telling me they're going to do this. It's not, I just need to go. I think I'll go and do, can you just wait here a moment? It's no, it's just, I'm going to do this and I'm coming back really super clear.
Dr Laura (13:06)
Mm.
Dr Fallon (13:23)
Cause if toddlers hear you wavering that little bit, like, it okay if I just go and they're just going to be like, no, no, it's not. Thank you for asking mother. No, you are not to do that. And then you entering that argument territory, which no one wants to be in, especially at bedtime.
Dr Laura (13:29)
No.
Yes. Yeah.
Yeah. So that's, think, as you say, that's a really good place to start. If you have a toddler who doesn't have separation anxiety, just try, try to leave, just leave, see if it works, see if your toddler is okay with it. And then you might be surprised. But if you have a toddler that that hasn't worked for
Dr Fallon (13:48)
Mmm.
Dr Laura (14:03)
or has got separation anxiety, then another approach is a very gradual reduction in your presence at bedtime. And this really is the best approach if you do have a child with separation anxiety. And essentially what you're doing is sitting on a chair in their room, or if you want to sit on the floor, that's fine. Just often a chair is a little bit easier on us parents with sore backs.
Dr Fallon (14:12)
Mm.
Mmm.
Dr Laura (14:32)
And just over a period of time, we don't want to rush it. You just move the chair or where you're sitting a bit further away from their bed or caught a little bit every night or so until you're really close to the door. It's sometimes referred to as camping out where what we're doing is just helping your toddler gain a little bit more confidence, falling asleep with that bit of
further distance and separation from you. And then you will get to the point where you're able to then move the chair to the doorway, just outside the doorway. And you go so slowly that you're just gradually building their confidence and it feels okay to them. So very, very slow, but often best for those with separation anxiety.
Dr Fallon (15:03)
Mmm.
Mmm.
Yeah. Another option as well. just a variation on that, that a lot of families like is to take a basket load of, you know, clean, dry washing in at bedtime in their room. And while they're falling asleep, you're just standing there and you're folding the clothes. You might even be putting some away in the cupboard. So this isn't going to work well for the ones who just get really super distracted, but the ones who kind of just, they need to hear you moving around and doing something. They kind of get some comfort from that.
Dr Laura (15:50)
Mm.
Dr Fallon (15:50)
it
can be helpful because you can be wandering around their rooms or getting a little further away to put the jumper over there on that pile or, you know, you're just sort of doing so. And it's not such a focus on you go to sleep while I sit here and watch you do it. Like it's just, for some toddlers, it just seems to work a bit better. And then eventually it might be a week or two in, you'll be like, I've just got to pop dad's jumper on his bed. And you just wander off and do that and come back. So yeah, it's just another, another gradual option. one of my. Yeah.
Dr Laura (16:03)
Yes!
Yes.
Yeah. And you know what I love about that, Falon?
Sorry to jump in. What I love about that is when you do get to the point where you're leaving the room, when you leave the washing basket in the bedroom, it's a visual cue to your anxious toddler that you are coming back because they can see that there's all these clothes still in the laundry basket. So they know that you are going to be coming back.
Dr Fallon (16:20)
No.
Yeah. That's such a good point, Laura. thought you were going to say, you know, the really good thing about this is that you end up having done all that washing you didn't want to do. That's the other positive. And look, another approach I absolutely love, we use this a lot in the clinic. And if you're a Sombelle member of the toddler program, you can download the full steps for this. We call it parental fading. So it works really well with, with toddlers.
Dr Laura (16:46)
That is a positive, yes.
Dr Fallon (17:05)
It's where you're basically, and please do read through the steps because you've got to apply it really carefully, but you're basically, sitting down in your chair or whatever, wherever you would normally be at bedtime. But before your child falls asleep, you say something like, I forgot my water bottle or phone or whatever. I'm just going to get it. I'll be right back. But you plant an item just outside their bedroom door. You get that item. So you might disappear from their line of sight for one second, two seconds, maybe.
And then you come back in and sit down and you might say to them, Oh, you waited so nicely. That was a great job. You know, so they're feeling really proud of themselves. That can work so well with a child with separation anxiety, where essentially what we need to do is we need to build their confidence at being alone very briefly. So we do have to get them used to separating from you, but we want to do it in a way where they have the opportunity to build their resilience and confidence with that. Um, in not an overwhelming way, you're not going to leave for five minutes. It's just a few seconds so that you can show them that.
Dr Laura (17:53)
Mmm.
Dr Fallon (18:01)
Yes, I do leave sometimes, but I tell you I'm coming back and I do come back and it's never too long that you're getting really stressed out about it. and I love this approach because it's often just, it starts with one second of you not being in their line of sight. Often two weeks in, you can leave for five minutes because they've had that chance to build those skills and to realize they can keep themselves calm waiting for you to come back. And in that five minutes, they fall asleep.
Dr Laura (18:09)
Hmm.
Yeah.
Dr Fallon (18:27)
So,
you know, even though it's as you're starting out tiny, it really quickly grows into something bigger where, you know, they're feeling really confident and that often flows into the rest of the day for the ones with separation anxiety. Parents will often say, childcare drop off so much easier now, know, everything's gotten a whole lot easier. So I love that approach because it's not just working on just the bedtime, but actually the whole day.
Dr Laura (18:43)
Yes.
Mm.
Yeah, it is a lovely one. And it just feels so kind. And we get a lot of positive feedback from families when they've used that approach, that how well it's worked and how they have just really enjoyed seeing that confidence blooming in their toddler. Yeah, it's lovely. Mm.
Dr Fallon (19:00)
Hmm.
Yeah, yeah, it is really
lovely. And then the other approach that is also in Sombelle, it's better for the older toddlers, sort of two years plus, is using the reward chart approach. So this is a good one for toddlers who are going to respond better to being motivated to do the right thing. But I hear so many parents say, no, we tried a reward chart, it doesn't work, didn't work for us, no good. And then we find out that they've
Dr Laura (19:19)
Hmm.
Hmm.
Mm-hmm.
Yeah.
Dr Fallon (19:36)
What they had said to their child is, if you sleep in your bedroom on your own all night, no calling out, you know, you don't need me at all. Then you get a scooter. So they're going for like the ultimate goal, the biggest, hardest goal for a huge reward. But actually your child just isn't ready for that. They're just going to feel like they have failed and we're just increasing sense, the sense of failure in that child. Then often they absolutely crack it, want nothing to do with a reward chart because it's just made them feel.
Dr Laura (19:55)
Yeah.
Mm.
Hmm.
Dr Fallon (20:05)
stupid and inadequate and yeah, that can go really bad. Yeah, yeah, yeah.
Dr Laura (20:07)
Yeah, it's just been too hard. Yeah.
Yeah, so it's about breaking the goal down into achievable steps, isn't it, Fallon? So that they... tiny steps so that your toddler can easily achieve the first goal, then can get a really high value reward. High value to them, I often say in clinic, it's not high monetary value. We're not talking about a pony. Yeah, or a Ferrari, nothing like that.
Dr Fallon (20:17)
Yeah, tiny steps.
No Ferraris!
Dr Laura (20:35)
you know, we're thinking a matchbox car or a accessory for a teddy bear that they have or you know, something like that, that is they just love. And so they have a goal that they can definitely meet, then they get the awesome reward for meeting that goal. And then they're really motivated.
Dr Fallon (20:43)
Mmm.
Mmm.
Dr Laura (20:57)
because they can see that they can do it and what it feels like to do it. And then you move on to the next goal, which is a tiny bit harder, but it would have been really hard as a first goal, but it's much easier as a second. And then you come in with the brilliant rewards again, and then you just step it. So you're stepping up the goals and the rewards.
Dr Fallon (21:03)
Yeah.
Yeah
Yes. I love it. Yeah.
Cause you're building their capability and their, you know, their ability to handle these things and understand how the world works. I think it's such a great approach and definitely read through the steps. It's something where you don't get many shots at a reward chart. That's what I will say. if you sort of set it up wrong a few times in a row, they're just going to push back whenever they see a reward chart and it won't work.
so do read through the steps really carefully. Keep those goals tiny. Like if your child needs you to sit on their bed, for now, then don't try and make them have you stand outside their room. Maybe you're just sitting on a chair right beside their bed. You know, like it's so easy, so slightly different that they don't care. and you'll actually find you make faster progress having tiny goals than if you sort of aim too high all at once.
Dr Laura (21:55)
Mm-hmm.
Yeah.
Yeah, absolutely. And if you're having to lie
beside them as they fall asleep and you think getting onto a chair is too big a step, which it is for some toddlers, then your first step is just you're sitting up beside them on the bed. Like you can go as granular as you need to for your child and for your family. So just think, yeah, you know your child best. So you think through what that starting point is going to be.
Dr Fallon (22:13)
Mmm.
Yeah.
Yeah, definitely.
Dr Laura (22:34)
and then you can map it out from there.
Dr Fallon (22:36)
Yeah, good
advice. All right. And there's a few little things we want all parents to be aware of when you're tackling this kind of, you know, trying to move out of their room before they're asleep. The first one is, you know, so often parents will say, I'm terrified to try and leave the room because you've got no idea how big the emotions are of my toddler. You know, my toddler is the most strong-willed, the most fiery toddler.
You know, I'm, and parents are frightened. They're frightened to have a firm boundary with their toddler. But what I would say to that is this, you were the parent and you shouldn't feel like your toddler has more control over things than you. You're not asking them to do something unreasonable. I would talk through these very gentle steps that you can take, you know, towards you not being present. Even in
Dr Laura (23:10)
Hmm.
Mm-hmm.
Dr Fallon (23:27)
the cases where there is separation anxiety, you can still make gradual changes. And these are not unreasonably difficult changes for your child to experience. They might really push back and be really cranky that you're trying to change things, but you're not, you know, making them, you know, go to sleep in a dungeon. They've got a beautiful warm bed. You're right there. It's okay. So have really clear expectations. You put some thought into it. Don't just suddenly come up with a plan at bedtime.
Dr Laura (23:34)
Mm-hmm.
No.
Dr Fallon (23:56)
put some thought into what the framework's going to be, what are the rules going to be, so that you can be very clear, but very kind and respectful. There is no need for any shouting to happen at bedtime from a parent. It is not conducive with good sleep. If you're finding yourself getting angry, you need to go and take a bit of a moment to calm yourself down again. But I would just say, really aim not to get into negotiations with your toddler.
Dr Laura (24:17)
Mm-hmm.
Dr Fallon (24:22)
They will try to, they might say to you, no, I want another story. I want another drink. I need to do this. I want you to do that. If you keep going, okay. Okay. We'll just, you know, one more of this, one more of that. Then it's bedtime will just be a negotiation that goes on and on. And it can turn into a three hour ordeal. I've worked with families going through this every night, spending three hours trying to convince them that they've got everything they need. And it's time for sleep. If right from the get-go, you approach your toddler's bedtime.
Dr Laura (24:33)
Yeah.
Mm hmm. Mm hmm.
Dr Fallon (24:52)
with the, through the lens of, okay, we've done our bedtime routine. We have all these lovely, warm, caring things that we do, but now it is sleep time. And you, when they say an extra book, say, sorry, we do two books of bedtime and we already did them. Now it's time for sleep. You know, if you keep holding that boundary firm and kind, you'll never end up with bedtimes that go on and on and on with all sorts of wild things happening. I've had parents make their kids extra meals or go and make a smoothie.
Dr Laura (25:19)
Yeah.
Dr Fallon (25:22)
Or like watch a TV show when we're starting to do things like that, it's a very hard place to come back from. Hard to convince your toddler that they don't need those things anymore.
Dr Laura (25:28)
Yeah.
It is, and sometimes toddlers behaving a little bit like a conductor in an orchestra at bedtime, pointing to different places in the room that they would like mum or dad to sit as they fall asleep. And when you are starting to change how they fall asleep in terms of where you are, it's important that if you have made the decision that you are using camping out or parental fading or your first step is sitting at the end of the bed,
Dr Fallon (25:40)
Mmm.
Yes.
Dr Laura (26:01)
that you don't negotiate on that. That is the first step. And if your toddler is then pointing to different places in the room and expecting you to get up and move around the room to sit wherever they want at that particular moment in time, it's going to be hard to make progress. say, no, I'm sitting here, I'm fine here, and you're safe in your bed. And being just firm and kind that there's no other places that
Dr Fallon (26:03)
Mmm.
Mmm.
Dr Laura (26:28)
you're going to sit, you're not the puppet that is going to move wherever their finger points. That's, you know, we're just taking, I don't know what that little stick is called, that someone in the orchestra has to, you know, when you wave the stick. Anyway, you're toddler, you're taking that, you're taking that away. And you are just not negotiating. This is what's happening now.
Dr Fallon (26:45)
Yeah. We'll call it a stick.
Yeah.
Yeah, 100%. I would say to, know, make sure you're not moving too fast. I think we've mentioned that a few times, but just take your time, especially if you've spent months working on having them actually fall asleep in their bed without, you know, all this sort of hands on support. You don't want to try and then sort of rip the bandaid off really fast and have it.
kind of blow up in your face where they're just suddenly like, well, no, no, no, no, I want you to be constantly hands on touching me to sleep now because you kind of freaked me out when you tried to leave for 10 minutes the other night. Like just take it slow. Don't want to undo progress, especially if there's separation anxiety, you just don't have an option. It has to be a slow process where they can build up that confidence.
Dr Laura (27:31)
Yeah.
Mm. And then if you need to put a safety gate on their bedroom door, to restrict their movements at bedtime and overnight to ensure their safety and to stop them following you out of the room, that's also a perfectly reasonable choice to make. Your job as their parent is to keep them safe. And therefore, if that is what you need to do, that's perfectly appropriate thing. And you can read more in the
Dr Fallon (27:56)
Mmm.
Dr Laura (28:08)
in the programme about the different types of times that you could use a safety gate.
Dr Fallon (28:14)
Yeah, definitely. Safety gates are great because the door's not shut. So your child still feels like they're kind of connected a little bit with the rest of the house. but yeah, no one ever thinks their toddler is going to get up in the night and turn the oven on until they do. yeah, you, as a parent, you're exhausted. There are times when you're in deep sleep and a tornado wouldn't wake you up. So you think you're going to hear your toddler if they wake up in the night, you might not. So a safety gate is a really good way of just having that peace of mind and knowing they're okay.
Dr Laura (28:27)
yeah.
Mm.
Mmm.
Dr Fallon (28:45)
Awesome. I love this discussion. It's stuff we go through all the time in clinic and I hope that our podcast listeners really enjoy hearing a bit of a dissection of how you can approach those trickier bedtimes when your toddler or older baby just doesn't want you to leave. Yeah. Well, we've got a lot of parent questions to power through today. So let's just like hit the ground running. We can do it. Should we start with Lee?
Dr Laura (28:52)
Yeah.
Great. we have.
Okay, so
yeah, so shall I read it Fallon? Okay, so Lee's toddler is 25 months old. She's waking every morning between five and 530 after self settling from seven p.m bedtime. And Lee says, whilst this is far from ideal, she's sleeping through the night. So we're coping with those early mornings. The problem arises around nap time.
Dr Fallon (29:14)
Mm. Yep.
Dr Laura (29:38)
Lee says she looks tired at nap time, but can take up to an hour to fall asleep. And often they have to have a break in the middle of the settling. And then they try again. She then will sleep for about 40 minutes, wakes up is really unhappy, has to be resettled by Lee in order to have another 40 minute stretch of sleep. So Lee's question is, how do I get her onto a nap routine?
Dr Fallon (30:04)
Hmm.
Dr Laura (30:07)
so that she'll do the same thing every day. And will this help her sleep past 5.30 in the morning as well?
Dr Fallon (30:15)
Hmm. Yeah. So she's getting close to an age where, soon enough, she'll be dropping that nap altogether. The fact you've got early starts and tricky settling for the nap means it's time to trim it. I'd be looking at what time she actually falls asleep for her nap and don't try to put her down before them. So she might be showing some tired signs, but probably the case that her body is feeling a lot of physical fatigue, but maybe the sleep pressure actually isn't there yet until whatever that time is, she would typically fall asleep for her nap.
I would just let her nap for 40 minutes and then get her up and get on with the day. She will probably add that sleep to her night. You'll start to get that little bit more of a sleep in. Yeah. Would you add anything to that, Laura?
Dr Laura (30:56)
No, I don't think so. think it just sounds like she's taking a long time to fall asleep. let's still you could do something a little bit quiet, rather than herring around if she's looking a bit tired. But, you know, ultimately, she's taking a long time to fall asleep. So just do something chilled and quiet for an hour or so before you actually put her down for that nap.
Dr Fallon (31:01)
Yeah.
Yeah, yeah,
good thinking. Jessica emailed in and says, our daughter is coming up on 12 months and is showing signs of readiness to drop to one nap, but she'd like some advice on how to do it. Do we recommend a cold turkey approach or if we recommend a 10 or 15 minute power nap in the afternoon to get her through to bedtime, how long roughly should there be between the nap and bedtime?
And she says, alternately, if you recommend bringing bedtime earlier, what would be an appropriate time if bedtime is currently 8pm?
Dr Laura (31:53)
Hmm, okay. So yeah, Jessica, probably similar. You're probably seeing some similar signs to what Lee is seeing. So often, children can drop down to one nap from around about 12 months of age. And then it really comes down to
you know, the child in front of you. So I know in Jessica's longer email, she said once she tried to do the power nap, but then bedtime was a disaster. And they just don't cut, yeah, had the power nap and then didn't fall asleep until nine at night. So it was a complete disaster.
Dr Fallon (32:23)
some of them just won't cope with that power nap. Yeah.
Yeah, it's a good sign
they're really ready for one nap too, isn't it?
Dr Laura (32:35)
Yes,
yeah, it is. So I think, look, general, if you try a power nap, we really want your child to be awake for at least two hours after having a power nap before they go down at bedtime. But in Jessica's case, I think that you've tried it, it led to a really hellish bedtime. So we know it's not the right fit for your toddler. So I would be doing the
cold turkey approach. Yeah, and just doing that one, moving to one nap, getting as close to bedtime as you can. It may be that she doesn't get to eight o'clock the first few times that you do this. She goes down a bit earlier. She's down at 7.30. So be it. That's okay. Just every day. That nap will move a little bit later, closer to the middle of the day, which means that bedtime will start to move towards the time that you currently have it at.
Dr Fallon (33:06)
Yeah.
Hmm.
Dr Laura (33:34)
Would you add anything else, Fallon?
Dr Fallon (33:34)
Yeah, I think
that's really good advice. Sometimes we just have to bite the bullet and know that that first week is going to be a bit tricky, a bit up and down, but you've got the signs there, Jessica, that she's ready for it. So good luck.
Dr Laura (33:47)
Yeah.
All right. Now we have an email from Zoe. So Zoe has an almost eight month old with a 13 and a half hour sleep need. And she's moving away from feeding to sleep. So she currently self settles for her naps and is able to sometimes fall asleep unassisted at bedtime as well. Her naps can total anywhere between one hour and two hours a day.
and she's sleeping from 6.30 at night until six in the morning. What started to happen recently though over the last few weeks is that she's beginning to wake a couple of times overnight. She's often waking about an hour after bedtime and then escalating really quickly getting very upset. So Zoe asks three questions. I think maybe I'll just read them out altogether Fallon and then we can address them in one lot.
So Zoe says that, understood that false starts are due to sleep pressure issues, but she is tired and awake for a long time before bed, which Zoe described as four hours. So she says, what else could these false starts be from? She also asks what could be the reason for her hysterical crying when she wakes up overnight?
Dr Fallon (34:43)
Okay.
Dr Laura (35:04)
And then she also adds that she's noticed that when her baby goes to sleep on her back, she tends to spend a lot of time drifting off and startling awake again until she rolls over and eventually falls asleep. She says, is this normal to happen at her age as it seems new?
Dr Fallon (35:23)
Okay, so, lots of babies this age find a position that they want to sleep in and it takes them a bit to figure out how to kind of get in that position and then they feel a bit more ready to go to sleep. But it does sort of raise that question mark of is she tired enough if she's lying there for a while and kind of taking a while to drift off. I'm also thinking to...
Dr Laura (35:35)
Mm-hmm.
Dr Fallon (35:47)
You know, if naps are between one and two hours, she's sleeping from 6.30 PM to 6 AM. Um, I guess I just kind of think, you know, that's a bit of variability between one and two hours of day sleep. And if it varies backwards and forwards, you know, each day, what can often happen is that the amount of sleep pressure there is at bedtime is kind of going up and down and could be a bit all over the place. Remembering that any one night could be influenced by a whole week worth of sleep prior.
Dr Laura (36:01)
Hmm.
Hmm.
Dr Fallon (36:17)
so it won't necessarily be like, if they have two hours, this day, then bedtime is going to take longer or they're to wake more often or whatever. can play out across a longer time course. but look, I would say it's, it, the false starts probably kind of are to do with sleep pressure. If she's not starting the night with a good long stretch of sleep, of deep sleep, often it means something is a little bit off.
Dr Laura (36:22)
Mm.
Dr Fallon (36:39)
So I would, I'm thinking Zoe, just tighten up that daily rhythm a little bit, work out maximum number of naps. What is the maximum amount of day sleep that she's going to have? and then really stick to that predictably so that you're just consistently having, you know, quick and easy bedtime and no false start. And you're getting that good long stretch of sleep at the start of the night. with the hysterical waking, so waking up really upset, look,
Dr Laura (36:43)
Mm.
Hmm.
Dr Fallon (37:05)
we could go into, know, what are night terrors and all of that, but I would say just read up on night terrors in Sombell to learn more about that. They're pretty uncommon in babies. So if this was a toddler, I'd be thinking, maybe it could be night terrors emerging. They often do start at the beginning, know, early stages of the night. I think in Zoe's case, it's much more likely this is a baby who sometimes self settles and sometimes feeds to sleep. So if
Dr Laura (37:12)
Mm-hmm.
Mm.
Dr Fallon (37:31)
There's that ambiguity on how I fall asleep. Often babies will just wake up going straight to a really strong cry thinking that's going to get me a feedback to sleep. That's what I would prefer right now. So often we see them be really reactive when they wake up. So it might just be time to go, okay, we are just going to be settling to sleep in the cot from now on. And then you're very likely to see that the settling just gets easier. The wakeups are far less, you know, full of the drama and the crying. It won't be a surprise to wake up, you know, in her cot and not in your arms.
Dr Laura (37:42)
Mm-hmm.
Yeah.
Dr Fallon (38:01)
and you might
find that all of this kind of comes together.
Dr Laura (38:04)
Mm. Yeah, I think that's really good advice, Fallon. just really, yeah, look at stabilizing that nap duration, Zoe, because that's going to help at bedtime and continuing to do the cot settles so that she's not so hysterical when she wakes up going, where am I? I was in Mummy's arms before. Yeah, what on earth? We don't want babies to be waking up and...
Dr Fallon (38:13)
Hmm.
What happened? How dare you!
Dr Laura (38:32)
being that upset because something has changed since I went to sleep. sounds like you're doing a really good job. So you're nearly there. So yeah, best best of luck and let us know how you get on.
Dr Fallon (38:37)
Hmm.
Yeah.
Yeah, definitely. Yulin and Mwasi have written in with similar questions about their toddlers changing sleep needs. So I'll read out both questions and we'll answer them together perhaps. So Mwasi noticed a significant improvement in their toddlers sleep at 16 months around the time that she started walking and finished teething.
Dr Laura (38:52)
Hmm. Yeah. Okay.
Hmm.
Dr Fallon (39:05)
She said, was like a switch going off. Day sleep increased by 30 minutes and there was 30 minutes more sleep happening at night. I'm so glad for Moisi. She has had a tricky time of things. it's like music to my ears. So Moisi says she goes straight to sleep at 9pm. No crying, doesn't need any hands on support. And Moisi is curious if increased physical activity and the end of teething can contribute to better sleep and whether these milestones lead to longer and more restful sleep in toddlers.
Dr Laura (39:16)
Yeah.
Dr Fallon (39:34)
Yulin asks if sleep needs can increase with teething her now one year old seems more tired when teething. What do you reckon, Laura?
Dr Laura (39:41)
Hmm.
Look, there can be just variability between children. So we do know that with sickness, children often like adults and babies will need to sleep more if they are sick because their bodies need to recover. If you have a child who really experiences teething as a painful and unhappy event, then similarly just that feeling the pain during the day can be tiring.
And so therefore they may be a little bit more sleepy in the same way that we are as adults. If we're dealing with a pulled shoulder or, you know, something hurts, we've sprained our ankle. We generally are just more tired because so much attention is going to the thing that's hurting. So yes, Yulin, you may find that your baby went teething does need to sleep a little bit more. For many, that's not the case. So it's only for those who seem to be really bothered by their teething.
Dr Fallon (40:11)
Hmm.
Hmm.
Mmm.
Dr Laura (40:39)
Now in terms
of Moisi wondering if that increased physical activity can lead to better sleep. Look, for some children, they, like we've spoken about before, their sleep needs can change and they often decline, but for some it does actually go up a little bit when they start to do more things because their body is just a bit more tired from running around, which is why we always suggest when your child is sleeping well,
Dr Fallon (40:54)
Yeah.
Dr Laura (41:09)
Always seeing if you can add more sleep. Bring bedtime a little bit earlier or wake up a little bit later because you never know your child might achieve more sleep at each developmental stage, particularly when they can go to sleep calmly. They might actually then be quite happy just to lie in bed in lighter stages of sleep where previously they wouldn't have been so happy doing that.
Dr Fallon (41:12)
Yes.
Hmm. Yeah,
it's a great answer. I'm so glad for Moasi because so often the low sleep needs baby stays, the low sleep needs a baby. But we do see in the research, there is sort of one, we don't know why, but one set of babies, a small percentage where the sleep needs increase over time. And it might be just that they're getting, you know, better at putting themselves off to sleep. Moasi's baby definitely is doing a great job of that. And I often say with those, the ability to fall asleep unassisted.
It's a bit like a muscle. The more they practice it, the better they get at it. And sometimes sleep pressure might be lower than usual, but they're like, you know what? Yeah, I'm a bit tired. I'm just going to have another sleep cycle. They're better at being able to do it even when that sleep drive is a little low. yeah, so I'm, yeah, very happy for Mwasi. I think that is a really lovely outcome. and it really speaks to you. Sometimes we don't know exactly what path babies are on with their sleep needs. And like you say, Laura,
Dr Laura (42:14)
Mmm.
Yeah.
Mm-hmm.
Dr Fallon (42:28)
Um, if you're thinking, oh, our schedule has been great nights of wonderful, but they're a bit tired in the day. Just try adding a little bit more sleep in same time every day for a week. And do they cope with that or does their night fall apart? You'll have your answer and you'll know, you know what you need to do. Yeah.
Dr Laura (42:41)
Yeah.
Yeah,
great. We have two questions now, which are both about dummies. So one from Belinda and one from Chloe. And I think what I'll do, Fallon, is read them both out just like you did with Yulin and Moisi's questions. So Belinda writes in with an update. Her fourth baby has arrived. So congratulations, Belinda. And so far, he's been an excellent sleeper.
Dr Fallon (43:00)
Yeah.
Yay! Yeah.
Woohoo!
Dr Laura (43:13)
That's really good.
He's using a dummy for sleep, but Belinda is concerned that it may be creating an unhelpful sleep association. So he sleeps well during the day and he wakes just twice at night. But the second put down in the night, she's finding he's becoming a little bit more fussy. The dummy helps, but her baby sometimes knocks her out, leading to frequent wake ups.
So she's wondering if the dummy is providing more stimulation than soothing and whether the dummy is a helpful sleep tool or is in fact in their case creating a sleep association that's going to disrupt sleep. Yeah, go ahead. Yeah.
Dr Fallon (43:56)
do you, do you mind if I jump in and just answer Belinda's just
cause I think otherwise I'll forget half of Belinda's question. look, I would say, you know, sleep is going pretty well at the moment. You're noticing the fussiness after that second wake in the night, he's knocking the dummy out quite a lot. And you want to know if it's, you know, creating a sort of negative sleep association. I think, you know, this is probably, don't know exact age, but this is a newborn baby.
Dr Laura (44:01)
Mwahahahaha
Dr Fallon (44:24)
thinking, think about the whole day. If that dummy, you've got three older children, if that dummy is a lifesaver, because those times when it's going to take you a little bit to get to the new baby, you know, you can pop the dummy in and it buys you a little bit of time before you get to them. I would say, hold onto it. Dummies aren't all black and white. Like I know there are people out there who say, get rid of dummies, never ever, ever, ever have one. And there are others who say, yes, give them a dummy. I'm very much in the middle there. I think you've got to look at the individual situation. And when you've got other children,
Dr Laura (44:44)
Mm-hmm.
Dr Fallon (44:52)
I know it can be very hard. it's possible to keep the dummy and still have a good sleeper, but they do have to get to that point where they can replace the dummy themselves. And that could be many months away. So if you're just thinking it's not worth it, it's not that much of a help. Sleep's really interrupted. Get rid of it earlier rather than later. that's, I hope I'm not confusing the heck out of poor Belinda, but I really do think you've got to almost write your list of pros and cons like.
Dr Laura (45:01)
Hmm.
Mm-hmm.
Yeah.
Dr Fallon (45:18)
Is it really helpful at other times and worth keeping around or do we just get rid of it? Cause your baby, if you get rid of it, they will develop other ways of soothing themselves. They'll probably bring their fingers up to their mouth or, you know, you'll have to go back an episode to the, the self-soothing episode to learn about those behaviors. yeah. Would you add anything to that Laura?
Dr Laura (45:28)
Hmm.
yes. Yeah.
No, I would. No, I wouldn't. I think that's a great answer. And you know, when you've got a very young baby under six months of age, that's really when if you are going to get rid of a dummy, that's ideally when you do it when they're still quite young, and have yet to really become very attached to that dummy. So yeah, have a think. I think that's a good idea, Fallon, to do a pros and cons list and decide whether you
Dr Fallon (45:51)
Mmm.
Mmm.
Dr Laura (46:04)
whether you're actually getting the benefits from it, Belinda. So then we've moved on to Chloe's question about the dummy. Now her baby is now nine months old. Now he was born Prem at 34 weeks and spent five weeks in NICU. So what a rough journey, Chloe. And I hope that he's now doing well. So of course at nine months old, he's actually
Dr Fallon (46:25)
Mm.
Dr Laura (46:32)
probably more like seven and a half or eight months old corrected age, because we use corrected age in that first year when it comes to sleep. So Chloe says he luckily loved a dummy and I'm grateful that he did. But now she's wondering if it's the reason that he wakes up every 20 minutes in the early morning hours. So Chloe is five days into the quick fade approach. She did note that she hasn't yet worked out his sleep need.
But she said that the quick fade approach has helped him to move out of their bed and into the cot. And the number of times that he's waking overnight has also halved from up to eight to now three or four times. So that's awesome. However, he still wakes every 20 minutes in the early morning hours. So Chloe says, should I take the dummy out of the equation? And if so, what's the best approach to take?
Dr Fallon (47:29)
Hmm. So waking every 20 minutes, that means he's not doing a full sleep cycle. So I'd actually think that sleep pressure is getting too low towards morning. So definitely look at that daily rhythm because there'll be a few things there you can tighten up. So look at that unique sleep needs chapter. Look at the example daily rhythms. Find one that fits your child's unique sleep needs. And then we should see that that sleep pressure isn't getting so low in the morning that he can't kind of do a full sleep cycle.
Dr Laura (47:36)
Mmm.
Mmm.
Dr Fallon (47:57)
So that will definitely go a long way to helping to reduce those night wakes. might not actually be the dummies the problem. It could just be the sleep pressure. At, you know, nine months of age or even seven months corrected, you should be able to replace the dummy himself by now. You might need to do a bit of practice. So read up on that in the Sunbell program as well. If you decide to get rid of the dummy, it will be tricky because it's going to be something that he's really relying on to calm down to get to sleep.
Dr Laura (48:00)
Hmm.
Hmm.
Hmm.
Dr Fallon (48:26)
But if you think it's more trouble than it's worth and you've worked on sleep pressure and you're really quite sure you want to get rid of it, the only way to get rid of it is to get rid of it. There's no, there's no halfway point. I'd love to come up with some lovely gradual approach to help ease the experience for parents, but it's either they've got it or they don't. And so you really just have to go cold turkey and see what kind of other behaviors they'll use to soothe themselves. So good luck, Chloe. I'm hopeful that you'll adjust the...
Dr Laura (48:33)
Yeah.
Yeah.
Mm.
Hmm.
Dr Fallon (48:54)
timing side of things that sleep pressure will come up and you'll be like, yeah, we can keep the dummy. He loves it. You know, it's not causing a problem anymore. so yeah, good luck to both of our parents worrying about dummies. All right. So next we have, who do we have? I should be paying more attention. We've got Christina. Okay. So Christina asks, will my baby ever stop crying at sleep time? gosh.
Dr Laura (48:59)
Mmm.
Yeah.
Yeah.
Christina, think is next.
you
Dr Fallon (49:23)
Her baby's 12 months old and she's worried that he's developed a negative association with going to bed. He cries during the pre-sleep routine and when placed in the cot. Since moving to his own room at 10 and a half months, he developed some separation anxiety and settling became more difficult with crying and standing up in the cot. Christina used the quick fade approach and wanted to transition away from being in the room so much. Well, this episode is going to be quite relevant then.
Dr Laura (49:42)
Hmm.
Yes.
Dr Fallon (49:51)
She
says, but he began sitting up playing or grizzling and would take upwards of 20 minutes to settle. She wonders if it is possibly a sleep pressure issue, but writes when I tried pushing out his nap time, so he was awake almost four hours. I did this for about a week and it didn't seem to help. So Christina's questioning whether they've created a pattern where their baby thinks they have to cry before settling. and what they can do. she wants to know what they can do to help their baby go to sleep a bit more calmly.
Dr Laura (50:20)
Yeah, it can be really hard when you do have a baby that cries at bedtime, even when you're right there with them. It does often lead us parents to think is there something wrong and to want to try to reduce that crying. So like we've spoken about in the past, some babies do simply cry as part of their getting ready to go to sleep process. It's like a way where they
They know a transition is coming. Some babies just don't like those transitions.
Dr Fallon (50:53)
Hmm. They just don't like it. Yeah. They don't like getting
in the car. They don't like going in the car. They don't want to sit in the high chair. Yeah. Can be tough.
Dr Laura (51:01)
Yeah, that's right.
And they just cry. And it's just their way of expressing that they don't like it. But then they manage to do it. And it's fine. You're loving to them, you're kind to them. And they get through it. And with practice, it can reduce. there is a chance, Christina, that your baby maybe doesn't like the transition of falling asleep, doesn't like that feeling. I actually am
Dr Fallon (51:11)
Mmm.
Dr Laura (51:29)
curious that I'm curious about what the daily rhythm looks like for your one year old, because you're describing that you've tried to push his nap time out so that he's awake for four hours before bed. almost, yeah, almost four hours. So not actually so when you've tried to stretch your 12 month old, it's to almost four hours, so not quite four hours. So I would actually be thinking that
Dr Fallon (51:44)
Yeah, almost four hours.
Dr Laura (51:57)
that might not be quite enough time for your 12 month old to be awake. And we particularly kind of combined with what you described about he's sitting up and playing or just grizzling in his cot. That makes me think he's not quite ready to go to sleep. Yeah. And even though you tried that nearly four hours for a week and it didn't lead to any changes, I think
Dr Fallon (52:04)
Hmm.
Not ready.
Dr Laura (52:27)
this probably might make you take a gasp, but you actually need to do a little bit more. You need to do more like five hours.
Dr Fallon (52:31)
You
Yeah. And it makes
me wonder like if there's two naps happening, this could be a baby that's ready to go to one nap. Cause I don't imagine that with almost four hours, you're really just doing one nap. Like it's got to be two naps per day. Could also be that it's not about making the distance between the last nap and bedtime longer, but it's about trimming down some day sleep. I mean, there's a million things that could be a little bit off with the daily rhythm.
Dr Laura (52:41)
Ooh, yes.
No. Yes.
Hmm.
Yes.
Dr Fallon (53:00)
But yeah, definitely be going through that unique sleep needs chapter, identifying your child's unique sleep needs and building out a daily rhythm that is really focused on meeting those needs. And that should iron things out.
Dr Laura (53:07)
Mmm.
Yeah, yeah, I think so. it should then, you should be finding that when you pop him down into his cot, it's not taking upwards of 20 minutes for him to fall asleep. He's not trying to play or grizzle or reconnect with you because he's not quite tired enough. So you should find that that length of time for him to fall asleep drops, whether he cries or not, it's just going to depend on how he is around transitions, but it's not something to worry about, particularly when you're right there.
Dr Fallon (53:24)
Mmm.
And just for anyone listening,
yeah, 20 minutes is kind of what we're thinking about in terms of settling time. If it's longer than 20 minutes, they're not ready for it. If it's less than 20 minutes, we're spot on. So yeah, I think it's a good, good number to have in mind. If it's taking longer than 20 minutes, you might need to do some adjusting to things. We also had Sophie write in who's a parent of an 18 month old who's struggling with unpredictable sleep.
Dr Laura (53:52)
Yes.
Yeah.
Mm-hmm.
Dr Fallon (54:07)
frequent night wakings lasting one to four hours. my goodness, those are some serious split nights. And she's having tantrums during sleep. They've introduced a more structured wind down routine, which has shown some improvement, but sensory soothing techniques are often needed to help their toddler settle. Occasional co-sleeping has occurred and gas pain and bowel movements seem to impact sleep quality.
Dr Laura (54:11)
Mmm.
Dr Fallon (54:32)
They're wondering why their toddler experiences prolonged night wakings with tantrums, how they can improve sleep and whether ongoing gas pain at this age is normal or could it indicate a gut health issue? Well, this is like a whole podcast episode. need to go down all the different options here, but we'll do our best to do it quickly. But Sophie, it might be that a coaching call is needed in your case because it does sound very complicated.
Dr Laura (54:44)
Yeah it is.
Yeah!
Yeah, it does. Look, my starting point is if you think that there's something problematic around her gut, then speak to your medical doctor to get that checked out. And once we've ruled out any gut issues, then we can really go, all right, it's a behavioural sleep issue, and we can be then confident in changing things. the other thing I would
Dr Fallon (55:15)
Mmm.
Dr Laura (55:23)
want to just jumps out at me is this wording of tantrums during sleep. Fallon that makes me think night terror, or sleep terror. I'm just curious about that wording, Sophie, if you are finding that your toddler is seems to be waking up screaming and but doesn't see doesn't appear to recognise you, the recognise that you're there, then
Dr Fallon (55:30)
Hmm.
Dr Laura (55:51)
have a look at the chapter on other module on sleep terrors, because it may be that it is a sleep terror. And if you try to intervene, it can lead to an escalation in the behaviors that your child is demonstrating and also causes them to last longer. So we want to make sure that if it is actually a night terror that you are just responding in the appropriate way.
Dr Fallon (55:55)
Hmm.
Mmm.
Dr Laura (56:20)
and it is actually out of her control. So the word tantrum as well is there's a lot of negative connotations around tantrum, but if it's a night terror, she doesn't know what she's doing. And normal approaches that you would use to sue the child who's having a tantrum are not appropriate. Yeah. And if failing all that, so for sure that it's not anything wrong with her gut, you've had her checked out by the doctor, you think it's not a night terror because it doesn't tick the boxes that are described in the module in Somme Bell.
Dr Fallon (56:32)
Mmm.
Dr Laura (56:50)
then I'd be really thinking about the occasional co-sleeping that may be this wonderful reward and a little carrot being dangled in front of your toddler in the middle of the night. If toddlers sometimes know, or sorry, if toddlers know that sometimes they can come into bed with mum and dad in the night, then they're more likely to keep waking for it and to really protest strongly. Yes, yeah.
Dr Fallon (57:15)
Mm, to wake up roaring. Yeah.
Dr Laura (57:19)
So have a think
about whether that's something that you want to continue or not if you decide that you don't want to co-sleep then it's absolutely just stop so that it's very clear to your toddler that it's not going to happen.
Dr Fallon (57:31)
And
I'll just add to that quickly that those long night wakes are 100 % due to a daily rhythm problem. One to four hour night wakes are split nights. There's something off with the daily rhythm. If they're on two naps, they have to go to one nap. And I'd be looking very closely at the timing of things because adjusting that daily rhythm should resolve those really long wakes. But it does sound very complicated. So Sophie, if you're needing some support, book a coaching call. Cause I would say you're a
Dr Laura (57:54)
Hmm.
Dr Fallon (58:00)
Laura, we've got three more parents to get through and we are just about out of time. So we've got to power through these ones. think we're going to break a record for longest episode ever.
Dr Laura (58:02)
Mm.
okay.
Okay, so
we have Louise who has successfully eliminated night wakings for their nine month old by capping the naps at two hours and now their baby is sleeping 10 hours overnight. But the baby is really tired in the morning, often falling asleep whilst feeding and struggling to stay awake until the first nap. So Louise is wondering if these short snoozy naps during feeding should be counted towards total sleep needs.
whether the level of morning tiredness suggests a need for an earlier bedtime or more self-settling time upon waking and how to better manage the nap transitions when their baby still seems very sleepy in the morning.
Dr Fallon (58:54)
Hmm. My quick answer to that is if you've had a week or more of really great nights, your child's really well overnight and they seem tired in the day, add 30 minutes more sleep to the schedule for a full week and see if they can manage it. Definitely count any snoozing during feeding as count it towards that total sleep as well.
But that would be my quick answer is, yeah, if they're still tired and nights are great, try adding a bit more in and if nights fall over, you've got your answer and you can revert to the old schedule again. Excellent. Sarah wrote in, she has a 13 week old, exclusively breastfed, happy and healthy baby. She has two goals. One is to have less wakeups or fewer wakeups overnight. And her second goal is to work on cot settling, which she hasn't started yet. Her baby's sleeping 8pm to 8am.
Dr Laura (59:23)
Yeah.
Dr Fallon (59:44)
to allow for feeds and has four 40 minute cat naps. I'll read these out one by one Laura. Is it normal for her baby to still wake every one and a half to two and a half hours overnight for a feed? Or is there anything that Sarah can do to extend out these stretches of sleep?
Dr Laura (1:00:01)
Of course, when babies are already small, they have teeny tummy, so they need to feed frequently overnight. But needing feeding every hour and a half is unlikely unless you have been told by your doctor that your baby does need to feed that frequently overnight. often around this age, three hours between feeds during the night is more typical.
sometimes even longer, four hours, five hours for some babies. So I would be certainly looking at other ways that you could be resettling your baby when they're waking after just an hour and a half, because it is very unlikely that they are going to be hungry at that time. So yes, you certainly can be ensuring that you have a right, an appropriate daily rhythm for your little one to help her do those longer stretches.
Dr Fallon (1:00:48)
Hmm.
Dr Laura (1:00:59)
and then picking one way to resettle your baby when they wake up and are not due a feed.
Dr Fallon (1:01:07)
Yeah, perfect. Sarah says she's often so sleepy during the day leading up to nap time. I have to distract her or even wake her up to keep her from falling asleep before her nap. I thought this might have meant that I had miscalculated her unique sleep needs, but a recalculation with this recent week's sleep has, to Sarah's surprise, seen a reduction from 13 and a half hours closer to 12 and a half hours. And she wonders what our advice is on that one.
Dr Laura (1:01:17)
Hmm.
Very, very common for sleep needs to fall quite quickly, certainly in the first three months of life. And then that continues to decline, can be quite steep declines up until six months. then often it can then start to taper off. But children's sleep needs do continue to decrease as their bodies get used to and need to be awake for longer in order to grow and develop.
in all the ways that they need to do. So I wouldn't be concerned that the sleep needs have dropped. I think you're right in that trenches at the moment, Sarah. You're actually just coming out of that very little baby phase. You're heading towards the four month mark. And so it's going to be really important at this point to be thinking about how you are settling your baby. You haven't yet started working on cot settling, but now is the time that
your baby is going to start to be more aware of cause and effect, what's going on around them. so working on that daily rhythm and looking at a daily rhythm that's in line with a baby with a 12 and a half to 13 hour sleep need rather than 13 and a half hours to 14 hours. And then picking a settling approach that gives you other options and other tools to move away from feeding so frequently overnight is going to be really important for you. So you really need to do both of those things.
to start to stretch out that sleep overnight. Anything else that you'd add, Fallon?
Dr Fallon (1:03:04)
Now that sounds like really good advice, Laura. All right, lucky last question is from Jasmine, who is preparing to drop nighttime breastfeeds for her son who's turning one at the end of March as Jasmine is returning to work soon. He currently has two short night feeds of less than eight minutes each, sleeps in his own room and eats three meals a day with breastfeeds as snacks. She's looking for guidance on the best method or strategy to begin the
process of dropping nighttime breastfeeds and seeking reassurance and confidence before starting this transition.
Dr Laura (1:03:38)
Yeah, big change in your life. going back to work. So yes, it's great that you are preparing yourself for that transition. Within the Sombelle program, we do have modules where we talk through three different approaches that you can use to drop those feeds overnight when you're ready. So I would go and have a read of those three approaches and decide which one suits you best.
Often we think about, we wouldn't necessarily go cold turkey. Your child is having two feeds overnight at the moment. So I'd be looking to first of all, move to one feed overnight. And, you know, perhaps thinking I'm not going to feed my baby until after 1am, for example, and use a different settling approach before 1am.
and then offer the feed and then use that same settling approach if he wakes again after that. And then when you're ready, you can drop that final feed. There's a little bit more nuance in the Sombelle module about reducing the volumes. So have a good read through of that to make sure that you're fully prepared, your partner's on board, if you do have a partner so that he or she can help.
do the resettles when you aren't offering a breastfeed overnight. If the other non breastfeeding parent can do that, that often helps the baby respond a bit more quickly.
Dr Fallon (1:05:03)
Yes.
It does, makes
a yeah, it makes a big difference in helping things go a bit more smoothly, that's for sure. Amazing. Well, thank you to all the parents who sent in these fantastic questions. And a huge thank you to Catherine who bought us three coffees in the past week, which is just so, so, so lovely. If you would like to buy us a coffee, the link is buymeacoffee.com forward slash infant dot sleep and there's a link in our show notes as well.
Dr Laura (1:05:15)
Hmm.
Dr Fallon (1:05:36)
If you love our podcast, please leave us a review, subscribe to the podcast as well. And of course, if you're having troubles with your baby or toddler's sleep or settling, the Sombelle programs are here for you. If you join today, you'll be submitting your question to the podcast next week. Sombelle is packed full of video lessons, great resources. It's really just the best of our pediatric sleep clinics distilled into what I think is the most powerful, wonderful program. I'm very proud of it.
Dr Laura (1:06:03)
Yeah.
Dr Fallon (1:06:04)
So if you're needing
that support, please reach out. We also have our clinics where we do telehealth appointments all over the place. So, you know, we can support you in multiple different ways. So thanks again, everybody, for tuning in and you'll hear from us again next week.
Dr Laura (1:06:18)
Thanks everyone, bye bye.
