Fallon Cook (00:37)
If I could tell new parents one thing, it would be to learn the science for pediatric sleep apnoea. You might think that sleep apnoea only impacts older men who snore, but sleep apnoea can actually occur at any point in the lifespan, in any gender, and when left untreated in babies and toddlers, it can have a huge impact on sleep quality.
and your child's broader wellbeing. Our sleep clinics focus on the behavioral aspects of sleep, but we always screen for sleep apnoea and refer on when needed. So let's learn the four key signs every parent needs to be on the lookout for.
Welcome back to Brand New Little People, the podcast companion to the Sombelle Paediatric Sleep Clinic programs created by us.
I'm Dr. Fallon Cook and I'm here with Dr. Laura Conway and we're the directors of Infant Sleep Australia. Laura, how have you been?
Dr Laura (01:44)
Yeah, I've been good. Thank you. Yeah, we've been having a busy time between us haven't we, with you and I, with what with the clinic and various things happening in our personal lives. I think you're living in just a tiny little shell of a house at the moment.
Fallon Cook (01:52)
Yeah.
Yeah,
yeah. The whole back of my house is currently missing. So now when I walk out to the kitchen, I can see the stars. So it's a little wild and people who have had a coaching call with me have probably heard a lot of the demo and the hammering and yeah, it has been pretty crazy and the usual kind of sick kids and just busy life. has been wild. β
Dr Laura (02:10)
Yes!
Mmm.
Yeah.
Fallon Cook (02:27)
So yeah,
our episodes have been a little more sporadic than normal just because we have a lot to navigate at the moment.
Dr Laura (02:33)
Yeah, yeah, but we β have a lot of questions that we will be answering β in today's podcast. So if you've been waiting for β an answer, β hopefully you will hear it in today's episode. And β if it has been missed just because of the β kind of chaotic nature of our lives at the moment, do just send us a reminder β and we will answer it in the next podcast.
Fallon Cook (02:54)
Mmm.
Yes, please do send that reminder because I, it's my fear. I always say, my God, what if a parent is waiting for us to answer a question and it's somehow slipped past us and then they think we don't care. We do care. We really do care. So yeah, if you haven't heard an answer to your question, please do send it again. We do our best, but yeah, the admin side of things can get a little bit hectic. But speaking about emails, we've got two really, really lovely emails. One was from Cath who sent in the most
Dr Laura (03:14)
Yes.
Yeah.
Yes.
Fallon Cook (03:31)
gorgeous video of her baby settling in the cot. It's so cute. She sort of is doing this really, really cute little flappy dance where she's smiling and flapping her little arms around. β And Cath was saying that lately her little one's been doing much better on just two naps each day that that change really, really helped. So
Dr Laura (03:35)
β yes.
Yeah.
Fallon Cook (03:54)
Thank you. When parents send photos and videos, my God, it makes my day. I love it. It's so nice kind of actually seeing the difference in these children. So yeah, please do share them with us.
Dr Laura (03:58)
Yeah, me too.
Yes, and this was a,
I'm thinking that this is a baby who used to not like the cot and is now very, very smiley and happy in the cot. So it's really wonderful to see. Yeah, so that was lovely to get that. So thank you so much, Cath. And I think we had another email that was lovely from, is it Fiona who emailed us? Yeah.
Fallon Cook (04:15)
Yeah.
Yeah.
Yeah, Fiona, who
sent in quite a few questions and, and emails over the last little while sent a really lovely email congratulating us on our 100th episode. And it's yeah, it is just so lovely. We appreciate you all so much just getting that feedback. makes such a difference. So if anyone else wants to stroke our egos, please send through your gorgeous baby photos or toddler photos and
Dr Laura (04:50)
Yes.
Fallon Cook (04:52)
β yeah, cause it is, it's so lovely. So rewarding. Hmm. Well, shall we dive into this week's topic? So this was the topic of sleep apnoea kind of came up in our social media channel and a few people were asking questions around what it is and how do I identify it? And I thought this is a really good topic to go into because even just before this episode started, we were kind of saying, yeah, we, we each had friends who, β
Dr Laura (04:55)
Yeah.
Mm.
Mmm.
Fallon Cook (05:21)
You know, who had babies and toddlers that probably had sleep apnoea, you know, they've had enlarged tonsils or adenoids or really loud snoring and other sorts of signs that really indicate that something's not quite right. But it's just been entirely missed. Sometimes for years, for years, these children have had really significant sleep problems that probably could have been resolved a whole lot sooner. So do we start with what is sleep apnoea?
Dr Laura (05:29)
Mm-hmm.
Yeah.
Yeah.
Mmm.
Yeah, absolutely. So sleep apnoea is a disorder where breathing stops and starts during sleep. Essentially, it's the airway, the airflow, sorry, being blocked in the upper airways. And the structures of the throat, they may be larger than usual, or there may be some other structural differences that result in the airway blocking. And this can result in poor quality sleep, daytime fatigue,
β and just general, a little bit miserable during the day. β It can also result in gasping, coughing during sleep, snoring, mouth breathing, etc. Yeah. β
Fallon Cook (06:32)
Yeah. Yep. And that probably brings
us onto those sort of four key signs that we really want parents to be on the lookout for. And these are things that I really think we need every parent to know to look out for these things, because these cases so often do get missed. β the first one I think is one of the most important ones. If you're noticing pauses in breathing during sleep, β it is never normal to have a baby or toddler just stop breathing for a period and then.
Dr Laura (06:57)
Hmm.
Fallon Cook (07:01)
begin again. So I think that's probably one of the ones that if if parents notice it, you're probably going to, to look into it and investigate further. What are some of the sort of common things that you pick up on that parents, β you know, saying in clinic Laura?
Dr Laura (07:03)
Mmm. Yeah.
Yeah, so snoring or noisy breathing during sleep, including sudden gasping for air. It's never normal. I know that in our culture, we will sometimes describe it as cute or funny, but it actually isn't cute or funny. And even though we may, yeah, or normal, yes. So I think the reason we think it's cute is because
Fallon Cook (07:33)
Mmm.
Or normal.
Dr Laura (07:44)
like you were saying in the intro, we associate snoring with old men. And so when we see a new baby snoring, everyone goes, that's so cute. But it's not. So anyone who's been to see me in the clinic will know that's one of the questions I always ask, is there any snoring or β mouth breathing or noisy breathing β during sleep? β Parents may often say that they child, β
Fallon Cook (07:50)
Yeah.
Mmm.
Mmm.
Dr Laura (08:12)
they sometimes do hear snoring or noisy breathing whilst their child has a respiratory illness. β And in that case, β it's probably okay, but because it's due to the just the mucus in the in the little pipes. But if you find that it persists when they are well, then definitely see your GP. Yeah, what other signs are there Fallon?
Fallon Cook (08:36)
Mm, I think that's a really good tip.
Well, I'd also say to parents too, some of them will say, yeah, they snore, but it's when they're in their car seat or when they're in the pram and their head has kind of slipped forward. So if it's just positional and pretty rare, I wouldn't be too worried. But yeah, snoring or just really heavy kind of noisy breathing. Yeah, it's a really clear sign that something is up.
Dr Laura (08:47)
Mmm.
Fallon Cook (09:00)
β but you touched on this next one briefly, Laura, it's, you know, sleeping with the mouth wide open, or they might also just have their head thrown right back. Cause that can help to kind of elongate and, and open up the airway. and usually in those cases, you'll see some breathing through the mouth as well. β and these can be signs that tonsils or adenoids might be enlarged and making it pretty hard to, you know, for them to be able to draw in air easily. β
Dr Laura (09:00)
Mmm.
Mmm.
Fallon Cook (09:29)
And that can have a big impact on, on sleep. β and also speech development as well, because if there are kind of enlarged tonsils and adenoids, can, you know, it's interrupting airflow. Often that's also happening in the daytime as well. β so if your toddler's breathing through their mouth most of the time, definitely, yeah, worth getting that checked out. and then so,
Dr Laura (09:29)
Yeah.
Hmm.
Mmm.
Yeah, I just wanted to jump in there Fallon and say,
sometimes particularly with older children, ones that are in beds already, what we can sometimes see is that they get themselves into odd positions on the bed where they hang their head over the back or over the side of the bed of the mattress, so their heads kind of hanging off and parents come in and reposition them and
Fallon Cook (10:12)
you
Dr Laura (10:17)
position their head, their chin further down to their chest, β and tuck them back in and leave the room only for their child to reposition themselves again and tip their head over the mattress. The parents are inadvertently going in and closing the airways. β And then the child don't worry, the child will reposition themselves again, so you're not going to be causing your child to stop breathing. But it's just if you're finding that that's something that's happening for your older children.
Fallon Cook (10:27)
You
Mmm.
Dr Laura (10:47)
β then that is also a sign that β it's worth getting things checked out.
Fallon Cook (10:48)
Yeah.
Yeah, bit of a red flag. And
then the final thing I would say is if you're noticing any of those kind of three things, so pauses in breathing during sleep or noisy breathing or snoring or mouth wide open, or mouth breathing, and it's coupled with, you know, very restless sleep. So sort of tapping into what you said there, Laura, they might move around a lot in their sleep. β Or, yeah, just just be kind of constantly, I don't know.
Just restless, I guess. Parents often sort of describe it as, they never really stopped moving. Or if they're just seeming really tired, even after appearing to have had a lot of sleep overnight. That's another thing to look out for, know, excessive sort of daytime sleepiness. When you think why, you know, they've had a really good amount of sleep overnight. And of course, if you're worried, that's the other factor, you know, like if you think something's just not right here.
Dr Laura (11:20)
Hmm.
Hmm.
Fallon Cook (11:48)
And we see that in clinics sometimes like if parents and you know, they've got maybe a toddler who just keeps waking at night, no matter what we do, it's really, really persistent. There's no signs of sleep apnoea or any other physiological reason for sleep disturbance, but the parents are like, something is just a bit off. I'm just like, go, go get a referral, see an ENT, check it off the list. Like probably not going to be anything, but you're going to feel better if you have checked that out. But that's really when, you know,
Dr Laura (11:57)
Hmm.
Mm.
Yeah.
Yeah.
Fallon Cook (12:17)
If we've got no signs of sleep apnoea, β that would be kind of probably one of the last things we would do generally. We would be working on some different behavioral strategies, β you know, in the absence of any sort of symptoms of sleep apnoea. β But yeah, for some parents, it does get to that point where they're like, I've just got to leave no stone unturned.
Dr Laura (12:27)
Mmm.
Yeah.
And Fallon, why is it important to see a GP if you are noticing any of those signs that we've just described?
Fallon Cook (12:46)
Yeah, so your GP will refer you to an ENT, which is an ear, nose and throat specialist. And that ENT will be able to really check out β your child airways. They just have a really good look at things. Obviously not my field. So they have all sorts of tools and tricks up their sleeve. Maybe we should get an ENT on the podcast actually. That would be very, very interesting. β But the ENT can really work out, is there a problem? Does it need to be treated?
Dr Laura (13:06)
Yeah, it would.
Fallon Cook (13:13)
Um, and yeah, they often, they're just ruling something out. It ticks something off your list, you know, and you can kind of put it to the side and go, okay, that, wasn't a problem for my child. Um, or if treatments needed, obviously you're on the right pathway then. Um, but what I would say is don't be afraid to push for a referral. I see a lot of families who say they told their GP that the baby snores quite loudly and they were just like, Oh, you know, they'll grow out of it. Um, yeah, it's, it's nothing. Yeah. Some kids just do that.
Dr Laura (13:17)
Mm-hmm.
Hmm.
Fallon Cook (13:41)
So I think there's a bit of work to do in getting more GPs kind of up to speed on the fact that snoring is never normal. β And they should always be referred onto an ENT β to get checked out. There are cases where people don't show any signs. I'm talking about older adults though, don't show the sort of obvious signs of sleep apnoea, but they actually are having pauses in breathing all through the night. β So yeah, if you think something's up,
Dr Laura (13:48)
Mm.
Mm.
Fallon Cook (14:08)
really push your GP for that referral. And I wouldn't take a kind of let's wait and see approach. If your child's, you know, showing some of these signs and the otherwise well, yeah, they're not having a respiratory sort of virus or something. I would be just getting straight onto it. β Yeah, really important to move on on these things. And that kind of brings us to our next point. yeah, take a video. Yeah.
Dr Laura (14:09)
Mmm.
Yeah.
Mm.
Yeah.
And I reckon take a video. β sorry to just, yeah, take a video.
So if you are observing your baby or toddler snoring, take a video of it. You could take more than one so that you can demonstrate that, maybe it's a few across a week or a couple of weeks, depending on how long it takes you to get in to see your GP so that you can demonstrate that it wasn't just a one-off.
that it's something that has happened more than once. And that's just really helpful for your GP as well, because they will be looking for things that we don't as non medics, we wouldn't know about, but it's really helpful information for them. So that's a hot tip.
Fallon Cook (15:15)
Mmm.
Yeah, I'm
glad you thought of that Laura, because you're right. It's so good to be able to show what you're actually experiencing at home. β Yeah. And maybe let's talk about the potential impacts when sleep apnoea is left untreated. Cause I know we've each seen some cases where sleep apnoea has been left untreated for years and there can be some pretty serious repercussions.
Dr Laura (15:24)
Mmm.
Mm-hmm.
So if we think about just whilst it's happening, what we know is that babies and toddlers and children, anyone who has got sleep apnoea, they are going to be in a situation where their body wakes them overnight. If our body is not getting all the oxygen it needs, it's going to wake us up. So whilst the sleep apnoea is untreated, there's going to be ongoing night wakes.
And that means that the sleep quality that your child or yourself you will be having is going to be compromised because your child is going to be waking out of different stages of sleep and not getting the restorative sleep that they want. And then, that they need, sorry. And then that has a knock on effects into the day where they may have really poor mood.
because they haven't had all of the REM sleep, for example, that they need, which we know is really important for emotion regulation and memory processing and learning. So they can really be quite moody in the day. They may have some really extreme behaviors, particularly for toddlers. So they may be really hyperactive, β or they may be really, you know, have big outbursts and really feel things.
Fallon Cook (16:54)
Hmm.
Dr Laura (17:03)
strongly, which seems even more so compared to other toddlers a similar age. And oftentimes, once we address sleep apnoea, parents report that their child's behavior kind of settles down a little bit. What else do we see, β Fallon?
Fallon Cook (17:19)
Mmm.
Yeah, so we know that even just from our own research, Laura, if you know, if sleep is problematic over an extended period of time, you know, sort of going into the toddler years that there seems to be an association with language development. Obviously, if you're really, really tired, engaging in back and forth conversations that help to build children's language skills is a lot harder. And if your parents are exhausted as well.
Dr Laura (17:40)
Mm.
Hmm.
Fallon Cook (17:50)
They're just,
Dr Laura (17:50)
Yeah.
Fallon Cook (17:51)
you know, it's pretty hard to have those enriching language developing kind of interactions, β you know, when you're in that state too. And of course, if there are structural differences in your child's, you know, throat and that sort of thing, β that can just impact making different speech sounds and things as well. β
Dr Laura (17:56)
Yes.
Hmm.
Mm-hmm.
Fallon Cook (18:11)
But also there's changes in growth and development. So if your child's got really enlarged tonsils or adenoids and they always have their mouth open all the time, it can actually change how the facial shape develops as well. And of course, having pauses in your breathing, it's putting a lot of strain on a little body too. And there's some evidence that sleep apnoea creates an increased risk for SIDS episodes too. So it's a pretty horrible picture that we're painting here, but.
Dr Laura (18:22)
Mmm.
Mm.
Mm-hmm.
Fallon Cook (18:39)
I think it helps to really underscore how important it is if you're noticing some of those signs to just get it checked out and rule it out. You don't want to get three or four years down the track and be like, my toddler's preschooler is wild. They're really struggling to settle in, you know, at childcare or kindergarten, their language is behind, no one can understand what they're saying. You know, you don't want to get in that situation where everything has become incredibly difficult.
Dr Laura (18:39)
Yeah.
Yeah.
Fallon Cook (19:06)
If we can identify these things really early on, there are treatments available and you can get the expert support that you need. So let's rehash what those four things are. think we've got number one is are there pauses in breathing during sleep? They can be pretty hard to notice. So you might not even notice that one, but they might be happening. Is there snoring or noisy breathing during sleep? It's probably the easiest one to pick up on.
Dr Laura (19:12)
Yeah.
Fallon Cook (19:29)
Are they sleeping with their mouth wide open or their head thrown back or always breathing through their mouth or often breathing through their mouth? And any of those things sort of coupled with that restless sleep or seeming really tired in the daytime? Or are you simply just feeling like something's a bit off? And that would be a good reason to any one of those things are a good reason to see your GP, get a referral to an ENT. And hopefully you'll rule out any problem, but if treatment's needed, well,
Dr Laura (19:46)
Mm.
Fallon Cook (19:57)
Yeah, you're off on the right path to getting that treatment.
Dr Laura (20:01)
Yeah. Awesome.
Fallon Cook (20:03)
Awesome. Awesome is our go-to word, think transitioning between one segment to the next. Let's do it. We've got a lot to get through for parent questions. So let's just fire through them because I think over 102 episodes now we've, we've talked about a lot of these things before, so I reckon we're going to get faster at answering them.
Dr Laura (20:06)
It is! Yeah, it is! So shall we move on to parent questions now, Fallon?
Yes.
Okay.
Yes.
I think we will. So let's start with Emma's question. So Emma has a five and a half month old whose sleep has dramatically improved using the quick fade approach. They've gone from feeding to sleep and not transferring until one or two in the morning to now settle. Yeah, that would have been hard. And now Emma's baby is settling in the cot between 730 and eight and sleeping until 730 in the morning with just one overnight feed.
Fallon Cook (20:37)
Yay!
β ouch.
Ugh, I die. β
Dr Laura (20:57)
Well done Emma, that's awesome. However, Emma says day naps remain difficult. Her baby often refuses to nap in the cot, even with one to two rounds of quick fade. If she persists, β her baby just screams and they usually need to nap in the pram or the car instead. And the baby falls asleep easily in this way. Emma asks, how can they help their baby nap in the cot during the day?
Fallon Cook (20:57)
Great.
look, I would say this is a case where nighttime sleep has become so good and such high quality that this baby just doesn't have a lot of sleep drive during the daytime for those naps. So if they would rather not be napping, β when they're put in the cot, they're just gonna be pretty reactive to that. β so I would say if they're napping on the go in the pram or the car at the moment, that's not a problem at all. I mean, it's not for me, but I'm the one doing it, but
Dr Laura (21:33)
Mmm.
Hmm.
Mm-hmm. Yeah.
Fallon Cook (21:49)
But I mean is
if, if you're actually really happy to do that, you absolutely can just keep doing your naps on the go in the pram or the car. if you're really like desperately wanting, β at least, you know, one nap in the cot during the day, I would, you know what I would probably just wait a little. Cause I would say when they transition from three naps down to two with much longer time awake, that sleep pressure is going to be a bit higher. I suspect this baby is still on three naps.
Dr Laura (22:15)
Mmm.
Fallon Cook (22:20)
β that sleep pressure will be a lot higher when they're awake longer. And then you just want to replicate that nighttime sleep environment for their nap. So make it pitch black, do a miniature version of your bedtime routine. And you'll probably find that that's when it will come together and they will do that nap in the cot. β but well done, Emma. It's sometimes this happens. The nights becomes so gloriously good that then the nuts feel a bit tricky. β and it's fine to manage it with the pram or the car. β and eventually it will, it will come together.
Dr Laura (22:27)
Hmm.
you
Yeah.
Yes.
Yeah, great. β Okay, so we have a question from Katie next. Do want to read that one out?
Fallon Cook (22:51)
Awesome.
from Katie. Yeah,
so Katie's eight month old still takes three naps a day. Well, that's pretty old for three naps. And he's a catnapper. Okay, so usually just 30 minutes for a nap. Occasionally for another caregiver, Katie's baby will nap for 60 to 90 minutes in the cot. Isn't that always the way? But just not for Katie. Poor Katie. β Why do they do it to us? So Katie says,
Dr Laura (23:16)
Yeah.
Yeah. Yes. And all the other
caregivers are saying they're not a problem for me.
Fallon Cook (23:27)
Yeah, what are you talking about? They nap fine. β poor Katie. Okay, so Katie says her baby wakes happy after short naps, has four to five hours awake before bed and sleeps well overnight from 8pm to 7am with just one feed. And Katie would like to know if her baby is sleeping well overnight and not showing signs of needing the nap transition, dropping down naps, should she encourage dropping a nap simply due to age? And if so, how should she?
Dr Laura (23:29)
Yeah.
Fallon Cook (23:56)
it.
Dr Laura (23:57)
I reckon that the reason that Katie's baby is continuing to have the catnaps is probably because her baby is ready to move to two naps. And if you move to two naps more consistently, Katie, your baby is probably more likely to have longer naps for you as well as for the other caregivers. So look, if it's working okay for you and you don't mind the fact that she only catnaps for you,
Fallon Cook (24:08)
Mmm.
Mmm.
Dr Laura (24:26)
keep her on just the three naps for now. But I'm saying she but I'm not actually sure if it's any they maybe I should use they. So if β they are happy on the three naps, you're happy on it and the nights are still good. There's no pressure for you to move to β fewer naps. However, if you start to feel that it's not quite working for you, you would prefer to have longer naps, then I would say
Fallon Cook (24:35)
Hmm.
Dr Laura (24:55)
pick a day when you're going to make this transition. Keep your baby awake a little bit longer in the morning before you put them down for their first nap and β see if then with that slightly longer time awake in the morning, they can actually link a cycle in their cot. And then again, push a longer time awake before you put them down for their second nap. Again, you might find that then they may do one.
Fallon Cook (25:14)
Mmm.
Dr Laura (25:25)
longer nap. Again, they might link to sleep cycles. If then there is just way too long, six hours, say before the start of the night, and you know they're not going to be able to manage it, then give them that 15 or 20 minute power nap just to get them through into a bedtime. And then the next day, try again. You should find that then with those longer stretches awake, the longer naps begin to stabilize. Is there anything else you would add, Fallon?
Fallon Cook (25:43)
Mm. Yeah.
Hmm.
Only to not expect it to be instant. I think a lot of parents make that mistake. They go, well, one day I did try to go to two naps to see if that nap longer and they didn't. So that's not the problem. And it's like, no, no, you've got to, got to do it for a few days to really see if those naps will consistently, lengthen. And, you know, if they're mostly having like three short naps, they're probably not going to do a heat more total day sleep. might just be a one hour nap in the morning and 30 minutes in the afternoon. β and.
Dr Laura (26:04)
Yeah.
Mm. Yep.
Fallon Cook (26:20)
Yeah, so yeah, good luck, Katie. β Yeah, hopefully that will all come together. I think, yeah, you're right, Laura, as they move on to two naps. β All right, do want to read out Leah? Yeah.
Dr Laura (26:26)
Leah.
Yeah, so Leah has an 11 month old who still breastfeeds to sleep for naps, bedtime and for overnight wakes. Leah is using a new daily rhythm, which has seen a reduction in the overnight wakes. Now, β her baby is waking just once or twice a night rather than three to five times. Well, thank goodness for that Leah.
Fallon Cook (26:53)
Yeah.
Dr Laura (26:55)
Yeah, gosh, that would be hard 11 months old still waking five times a night. You'd be shattered Leah. Leah writes that bedtime is between nine and 930. Wake up is between eight and 830 and her baby has two hours across two naps. Leah wants to know if it is normal for an 11 month old to still feed overnight, especially β as her little one has allergies and is making slow progress with eating solids.
Fallon Cook (27:00)
Mmm.
Dr Laura (27:25)
And she has a second question, which is, when should they move their baby to their own room? And should this be done before or after their baby learns to fall asleep independently?
Fallon Cook (27:40)
this is so interesting. So let's start with the feeding question. Is it normal for an 11 month old to still feed overnight? I mean, yeah, there's loads of 11 month olds who will feed overnight. They don't need to usually like if weight gains fine and they're well on solids. β you know, usually we would say, look, they don't have to feed overnight. And if they're waking up kind of expecting a feed, it might be worth starting to wean down those feeds and we probably would see that child.
Dr Laura (27:45)
you
Mm-hmm.
Fallon Cook (28:09)
sleep longer stretches at night time once the feeds stop. But if they've got allergies, then that's a whole different kettle of fish. How severe are the allergies? Like one of my children had very few foods they could eat at all. So they needed to be having bottles overnight for, I don't even remember now, I've erased it from my memory, but a very long time because it was essential to him meeting his caloric needs.
Dr Laura (28:11)
Mm-hmm.
Yeah.
Fallon Cook (28:37)
If we're
talking about being allergic to one or two different things, β probably you don't need to keep night feeds. So I think it's a, it's a question for your pediatrician or dietitian, whoever's helping you manage those allergies. And if they're slow with the solid foods, you've really got to talk to the same specialist, pediatrician or your dietitian about are they slow to learn how to eat solid food because
Dr Laura (28:49)
Mm-hmm.
Fallon Cook (29:03)
they're feeding overnight and they just don't have much drive. They're not overly hungry. They know they can get calories later by feeding overnight. So why should I try to learn this very complicated, tricky thing? Because eating is actually a pretty big skill to learn. β Or is it that, you know, they actually can't take on more calories through solid foods, in which case your dietician or pediatrician might say, yeah, keep the night feeds a bit longer. So really, it's not a question that I can answer. I think it's really going to be very dependent on the individual child. β
Dr Laura (29:07)
Mm-hmm.
Mm-hmm.
Hmm.
Fallon Cook (29:32)
And you know what, who cares if it's normal or not too. Like if you want to feed a couple of times overnight, like it's, it's fine. β but yeah, if it's something you're wanting to reduce, β and you're dealing with allergies or problems with solid foods, chat to your healthcare team about what's appropriate to do. β and then the next part of that question, should they move their baby to their own room and should this be done before or after learning to fall asleep independently? you know, I, I don't think there's a really clear cut.
Dr Laura (29:39)
Yeah.
Yeah.
Fallon Cook (30:02)
answer to this one. So sometimes, I would say already Leah's baby is a little bit of a unicorn baby because they're feeding to sleep all the time and only waking. β Was it two? It's twice overnight. Yeah. Yeah. So that's amazing. There are multiple times that that baby's waking up and instead of going, my God, I'm not feeding anymore. They're just going, I'm not feeding anymore, but I don't really care. I'm gonna
Dr Laura (30:03)
you
twice. Yeah, once or twice, sometimes just once. So yeah, that's, yeah, really, really great.
Fallon Cook (30:27)
self-settle. So this child is self-settling multiple times per night and already has some independent β settling skills in place. β So that should give you some confidence when you do go to make that shift to independent settling, you know, all of the time. β Is it better to do it when they're in your room or in their own room? Generally, if parents are feeling ready for it, I would say pop them in their own room because it's sort of like they go, where am I?
Dr Laura (30:33)
Yeah.
Mmm.
Fallon Cook (30:52)
new room, new rules, they're not knowing what to expect. If there has been any co-sleeping, well, now the shared bed is out of sight, out of mind. β So that can often be, you know, a really good reset to just put them in this new sleep space, still giving them loads of support and you can even sleep in there with them if you want to. But yeah, sometimes that can actually be really helpful with that transition. And I think so often families don't realize how often, you know, parents are waking the babies and the babies are waking the parents.
Dr Laura (31:06)
Mmm.
Yes.
Fallon Cook (31:20)
and then they sleep in different
rooms. Everyone's like, whoa, I got the best sleep of my life because, you know, we weren't waking each other all night. So that's another thing to consider as well. So I hope that that answer gives you, gives you some guidance and something to think about Leah, but yeah, what would you say, Laura?
Dr Laura (31:26)
Yeah.
Yeah.
Yeah. Yeah,
especially Leah, if you do decide alongside the pediatrician and or dietician that the breastfeeds overnight can go. It may be easier if you are in the different room from your baby overnight, because they're not then coming up into light sleep at their usual feed time and going, there's mum, right there. I can see her. Hello. Can I have that feed now?
Fallon Cook (31:51)
Mmm.
Mmm, I can see her!
Dr Laura (32:05)
So
instead, they were coming up into light sleep going on. Nothing's changed since I went to sleep and, you know, more likely to then sleep pressure, put them into their next cycle. So yeah, you may find it's actually a little bit easier if β your boobs are in the eyesight of your baby overnight, if you decide to drop those overnight feeds. I'd also say Leah that if it's working for you, it does sound like you do have a unicorn baby.
Fallon Cook (32:25)
You
Yeah.
Dr Laura (32:34)
You don't have to work on independent settling at this point if you don't want to. Of course there will come a time where you may not want to be feeding your baby to sleep and that's perfectly reasonable as well but don't feel pressured into making that change if you aren't ready for it at this point in time. β
Fallon Cook (32:34)
Mmm.
Hmm.
Yeah, I think that's great advice. All
right, so now I've got a question from Jacinta who has a six and a half month old baby girl who self settles within five to 10 minutes, sleeps just under 11 hours overnight and for two and a half hours a day across three naps. She wakes one to three times overnight, usually requiring a short feed before quickly returning to sleep. Jacinta has tried two approaches to reduce the night feeds.
Dr Laura (33:12)
You
Fallon Cook (33:22)
She's tried scheduled feeds and dream feeds and both caused long resettles and disrupted naps. Mood was up and down and wake time was variable. She writes that hands-on settling was not effective. So she'd like to know when dropping night feeds disrupts sleep, how much catch up sleep in the day is appropriate without affecting nighttime sleep pressure?
Dr Laura (33:34)
you
Mm.
Fallon Cook (33:47)
And
how can she reduce night feeds without causing split nights or early wakes given that hands-on settling seems counterproductive?
Dr Laura (33:56)
Hmm. I think these two questions are really closely linked. If when you are looking to reduce those feeds overnight, and you're making the choice to do it rather than your baby making the choice to do it, we have to remember that we're taking something away from them that they want, they don't need it β at six and a half months, I'm assuming just into your
Fallon Cook (34:02)
Hmm.
Dr Laura (34:25)
Your baby is on solids, weight gain is fine, et cetera, and that's why you're reducing the fees overnight. So some babies, when we look at taking away some night fees that they no longer need, will really protest about it because they don't want that to change. They like it. And so then we can find that the settles, the resettling can take quite a long time because
They're thinking, come on, surely anytime now the fee is going to come. And if we then let them sleep in in the morning and give them catch up sleeps to make up for the time that they were awake, then it does disrupt.
that sleep pressure regulation the next day, because it's like we're to fill that proverbial bucket with water and we keep poking holes in it. the bucket is the water going in is the sleep pressure. Every time we're giving a baby extra catch up sleep, when we're trying to change something about how they sleep, we're just poking a hole in it. And so that would mean that the next night your baby is still going to have the reserves to
Fallon Cook (35:28)
Mmm.
Dr Laura (35:35)
protest really loudly when again you don't give them a feed and then that can really start to chip away at your confidence too because you know it's appropriate for them to have fewer feeds overnight but they don't want to drop that feed you're pushing ahead they then are awake for a long time you then let them sleep in in the morning and then we're just on this merry-go-round that everyone wants to get off so I would actually say
Fallon Cook (35:44)
Mmm.
Mmm.
Dr Laura (36:03)
If you've made that decision to drop the feeds that's appropriate for you and your baby, then try and avoid letting your baby have long sleep-ins or catch up sleeps so that you can try and hold that wake up time steady in the morning. Potentially you might put them to bed a little bit earlier that night, but not loads earlier because we normally find that when sleep pressure is just right, normally it only takes a couple of nights for your baby to learn that there's
Fallon Cook (36:26)
you
Dr Laura (36:33)
there are only X number of feeds overnight now, or there's no feeds overnight now. But it only happens that quickly if we hold things steady. Yeah.
Fallon Cook (36:37)
Mmm. β
Yes,
yeah, yeah, I 100 % agree. I actually think we have to be quite militant on sticking to that schedule in those first few days because yeah, otherwise there is that slippage where we just are in this cycle of, it takes me forever to resettle them without a feed overnight. Then they have this catch up sleep and then the next night's just as bad. You know, if we are really militant with the timing, you know, even if you woke up for three hours overnight, we're getting up on time.
We're pushing through the day on as close to our normal rhythm as we can when, yeah, within two or three days, they've dropped the feeds, they're done and they're sleeping longer at night because their drive to sleep is so strong. So it's one of those cases where it's like either go all in or don't touch it until you're feeling ready to go all in. Because if we keep allowing that little bit of catch up sleep, like I feel Jacinta's pain. is really, really hard to keep going.
Dr Laura (37:23)
Mm.
Yeah. Yeah.
Fallon Cook (37:39)
so might be a case of just going, we've got these three days. I've got some extra supports around me at this time. I'm going to go all in on my daily rhythm. You know, we're going to drop down to one feed or whatever it is you're dropping down to, or maybe you're dropping the final feed and just do it. β and it's the quickest way through. β it's a great question though, Jacinta, thanks for submitting that because I think that it's something that catches out a lot of parents, you know, we, we go, they had a bad night. We definitely need to let them catch up on some sleep. β but yeah, can actually make things so much harder.
Dr Laura (37:39)
Yeah.
Yeah.
Mm.
Fallon Cook (38:08)
in the long run.
Dr Laura (38:09)
Yeah, yeah, for sure.
And since your baby doesn't like really hands on settling, you're likely to need to use the supported accelerated approach so that it's your baby isn't getting irritated at your hands on patting when they're going, but I want to feed pick me up. I can imagine that would be really aggravating for them. So yeah, hold steady on that timing, use a more hands off approach.
Fallon Cook (38:25)
Mmm. Yeah.
Dr Laura (38:35)
β and have the support around you and you'll be out the other side within just a few days.
Fallon Cook (38:41)
Yeah,
you've got this Jacinta. We've helped so many parents out of this particularly tricky little ditch that parents fall in sometimes. So you can absolutely get through this. Let us know how you go.
Dr Laura (38:48)
Yeah.
Yeah.
Okay, our next question is from Annie who has a very little baby. So she has an eight week old baby girl. So congratulations, Annie. And Annie says that she sleeps well when held or in a carrier, but in the bassinet, she wakes after 40 minutes. She settles well initially, but after 20 minutes begins grunting, straining and crying until waking fully.
Fallon Cook (38:58)
β lovely.
Yeah.
Dr Laura (39:19)
They have resorted to shift sleeping at night to hold her for longer stretches. that's really hard. So Annie asks, firstly, how to tell the difference between active sleep and true unsettledness? And secondly, should they keep encouraging bassinet sleep at this stage or try something else? Good questions there.
Fallon Cook (39:27)
Hmm.
β yeah, this is
fantastic question. So she's sleeping well initially, but after 20 minutes in the bassinet starts grunting, straining and crying until she fully wakes at that 40 minute mark. That is such a great example of in light sleep babies can be so noisy. They can be asleep and still cry and do all sorts of things. So
Dr Laura (40:06)
Mmm.
Fallon Cook (40:07)
It is totally normal. And how you can tell the difference between active sleep and true unsettledness is if they're really unsettled, if there is something wrong, β or discomfort, pain, hunger, et cetera, they will cry and they will at that point, open their eyes. They will be so much more active in their upset, I suppose, β over whatever it is that's bothering them.
Dr Laura (40:31)
Yeah. Yep.
Fallon Cook (40:35)
it's really common for this to happen because it's, you know, it's just a shift from being, β generally, you know, held really close and having a lot of firm pressure around them to being on their back and the pressure is just on their back. and it just takes some adjusting too. So with what you describe, β Annie, I wouldn't be saying, β no, don't do bassinet settling. I'd say keep practicing it because you're making some inroads here. It's great that she's doing a full sleep cycle in the bassinet.
Dr Laura (40:49)
Hmm.
Mm-hmm.
Fallon Cook (41:00)
I actually think that's brilliant. Some babies will do 10 minutes or they just won't even transfer at all. You know, just can't even get them in there. So I think that's really good. And you could build your day around her having, um, you know, just, um, maybe more naps, shorter naps, if you really wanting to practice the cot settling and that would be, um, totally fine. Um, and then in terms of, should they keep encouraging bassinet sleep at this stage or try something else? Um, I would very strongly recommend that you keep.
Dr Laura (41:01)
Mmm. Yeah.
Yes. Yeah.
Yeah.
Fallon Cook (41:30)
on with it. And the reason I say that normally I'd be like, well, it's up to you. And what do you feel like doing? But I get a bit of a shiver when I hear parents say that they're, β you know, taking turns at night to hold the baby to keep the baby asleep. Because that is when β accidents happen. And as parents, we've got to look after your well being your sleep quality, your mental health. I haven't met a parent who is, you know, doing that kind of shift we said all the time.
Dr Laura (41:43)
Yeah.
Mm.
Fallon Cook (41:57)
where they might be, you know, holding the baby for hours, trying to stay awake or sitting in a chair or something who has good mental health. Because as humans, you have to have good sleep to have good mental health. Like you can't really, you know, have one or not the other. β So that makes me concerned about the parents, but it does make me really concerned β about Annie's baby because we never think we're going, it's like with driving, no one who crashes their car because they fall asleep with the wheel.
Dr Laura (42:05)
No.
Yeah.
Mm.
Fallon Cook (42:24)
ever thought that they were about to fall asleep at the wheel and crash their car, or we would be waking ourselves up. You don't know when you're suddenly going to drop off to sleep. And that's what makes it really, you know, quite dangerous. So I would say in this case, I would go all in with the bassinet settling, practice it a lot, because after probably a week of doing all the settles in the bassinet, keep resettling in the bassinet overnight, build the support around you that you need to survive that very tricky week.
Dr Laura (42:26)
Mm-hmm.
Yeah.
Yeah.
Mm-hmm.
Fallon Cook (42:52)
But
then you've got a baby who's like, oh yeah, I'm fine here. My parents have supported me. I've gotten used to it. It's not unfamiliar to me. I know it's safe. I'm comfortable. It's all good. And then all that risk just goes away because this baby's always sleeping in a safe place. And we've got two parents who will eventually be better rested once we get through that transition. And what I would also just add to this is if that just feels like too much for Annie,
Dr Laura (42:55)
Hmm.
Yeah.
Fallon Cook (43:19)
this is where I would reach out to an early parenting center and get some supports in to help you with that settling. β Because for some parents, know, trying to weather that transition to settles in the bassinet or the cot, β it exceeds capacity and it's not your fault. It's just a product of the circumstances that we're all parenting in, or so many of us are where we don't have, always have the supports that we need around us. And sometimes these hurdles can feel, you know, a hundred meters high and
Dr Laura (43:34)
Yeah.
Hmm.
Fallon Cook (43:49)
you know, we just do need that enhanced support to get through.
Dr Laura (43:53)
Yeah, I think that is such a compassionate answer, Fallon. Yeah, like you, when I hear a family is resorting to shift work overnight to hold a little baby to sleep, my heart goes out to them, but it does send a shiver down my spine as well. And this is the reason why those early parenting centres are available. It's for these really tricky situations that some families find themselves in.
Fallon Cook (44:05)
Hmm.
Hmm.
Dr Laura (44:22)
There's no shame in reaching out to them to get some real hands-on support for you whilst you support your little one and continue to be the best parents that you can be. So let us know how you get on Annie. It will get easier and there are supports out there for you.
Fallon Cook (44:44)
And what an amazing parent the links that Annie and her partner are willing to go to for their baby to help that baby get good sleep. I think that is, it deserves an honorable mention that you would even do that. Like, yeah, how incredible. It's amazing. Parents are amazing. They don't realize it often enough, but you are. All right. Well, we also heard from Dana. Dana has a seven month old baby boy who they successfully moved from co-sleeping to cot sleeping at night.
Dr Laura (44:50)
Yes!
Yeah. Yeah, they are. Yeah.
Fallon Cook (45:14)
using the Ferber method. Okay, so it's not a sombell method, the Ferber method is something quite different. But Dana says it's not been successful for their day naps. So she wants to know, can they use the supported accelerated approach for naps without confusing their baby since Ferber is already used overnight? Or could they switch to supported accelerated for both naps and nights? What would you recommend Laura?
Dr Laura (45:40)
I would recommend just switching to the supported accelerated for both. Yeah, because you have tried to use the Ferber for the naps and it's just not working. We want there to be one consistent way for your baby boy to go to sleep. So let's just pivot to using the supported accelerated. It's the intervals between the
Fallon Cook (45:43)
Same.
Mmm. β
Hmm.
Hmm. Yeah. I would only want to add to that, that typically the Ferber method, you know, it's just so quickly just extinguishes any support to fall asleep that usually those babies are just like, right, they're self settling. Always it's, you know, done. Hard and fast and done. So I would just check in on that daily rhythm. Like I just think, why, why aren't, you know, like they've got the skills. Why aren't they doing it?
Dr Laura (47:15)
Mmm.
good point. Yes. Yeah.
Fallon Cook (47:25)
So just, yeah, check in on the daily rhythm, Dana, because, you know, if they're seven months old, they should be on two naps. So if they're still having three, I'd just drop down to two. β yeah. And just making sure they're not over, you know, that that daily rhythm makes sense for their sleep needs could be really crucial. And then you might just suddenly find, they're actually fine settling in their cot and they draw on the skills they've already got to do it. So yeah, something to think about.
Dr Laura (47:28)
Yes!
Yes!
Yeah, so maybe actually that's
your first step Dana, double check the daily rhythm first, move to two naps if your baby isn't already on two naps. If they are on two naps, just double check that you're not putting them down a little bit too early β for those naps β and then β continue to use the approach that has worked at night. Try that for a few days. If that doesn't work, then switch to the Supported Accelerated for naps and nighttime.
Fallon Cook (47:55)
Mmm.
Mmm.
Yeah. And I think
it's a great idea to standardize the approach once you do figure out that daily rhythm. Um, no matter what you do, it's just good for babies, toddlers, kids, adults, probably too, to just, you know, know that these are the same cues that mean it's sleep time. yeah. Oh, good luck today, now.
Dr Laura (48:20)
Mm.
Yeah.
Yes.
Good.
All right. Yeah, good luck. Now we've got a question from Shannon. So she's on day two of the Supported Accelerated Approach with her little boy who has been protesting for one to two hours at bedtime and during night wakes. She describes him as a determined sleep fighter and feels confident. It's protest rather than distress. But the prolonged crying is making her doubt whether to persist.
Fallon Cook (48:53)
Uhhh!
Dr Laura (49:03)
She wants to know at what point should she alter, pause or stop the approach. β
Fallon Cook (49:10)
These questions
this week are like on fire. They're such good questions. one to two hours at bedtime and during nightwakes. I just think that's too long. There's something not right there. Like even though this baby is described as really liking fighting sleep, you know, it's such a long time that if you are getting them up on time, you know, in the morning and
Dr Laura (49:14)
Yeah, they are.
Yeah. Yeah.
Fallon Cook (49:37)
powering through the day and then at night time you're still having these troubles. I just think it's sleep pressure. Something is too, too off there for that to keep going. Although it is only day two of the supported accelerated approach. So we would expect there to still be maybe some tricky settles, but I would say generally on day two, you shouldn't really see, what would you say? I would say usually the settles aren't taking longer than 30 or 40 minutes. Like most of them would be 15, 20 minutes, maybe tops. So.
Dr Laura (49:53)
Mmm.
Yes.
Yes,
I frequently hear 20 minutes for the second night, the first settle of the second night, 20 minutes. That first time that you use it on the first night can be long. On average it's three quarters of an hour but some babies will do a two hour. I mean that's rare but it can happen. Yeah, there's sleep fighters out there. We need to have a trophy. We can create some Sombelle trophies that will send the sleep fighters.
Fallon Cook (50:07)
Hmm.
Mmm.
β The sleep fighters! This baby fought sleep
the hardest.
Dr Laura (50:34)
Yes. β So for the sleep
fighters out there, they might have a really long settle on the first night and maybe one or two long settles overnight. But then ordinarily the bedtime settle on the second night is shorter, often here 20 minutes, half an hour. Maybe for a sleep fighter, it might be 45. But I wouldn't be expecting it to still be two hours bedtime on the second night. So
Fallon Cook (50:47)
Hmm.
Mm-hmm
Hmm.
And by the third night, generally settling is really quick. Like five to 10 minutes is not uncommon. Obviously it varies a lot. So if you'd like, no, my baby took 12 minutes or 20 minutes. Don't freak out. It's totally fine for there to be variability. But, β yeah, I think something is just a little off there, but Shannon, sound so determined. Well done on just persisting. It must've been a tricky couple of days. And I wonder how things are going now. Cause I'm sure this email didn't arrive.
Dr Laura (51:03)
β yeah.
No. Yeah.
No.
Fallon Cook (51:30)
today. curious to
hear Shannon, let us know how you're going. β And yeah, I think you have a have a look at that daily rhythm. There's going to be something there that we can tweak.
Dr Laura (51:38)
Yeah. And just to
give the answers about when do you alter pause or stop the approach, we build in those circuit breakers or the resets every half an hour or so. at bedtime, you would use the approach for let's say half an hour. Then if your baby isn't calming, pick them up, walk around the house with them, get them entirely calm, get yourself calm, and then you go in and you start again.
Fallon Cook (51:52)
Mmm.
Dr Laura (52:06)
β and go again for another half hour and then do another reset or circuit breaker if you need to. β And keep going until they go to sleep and go back to sleep overnight. For the daytime naps, that's when you can try β for a period of time and then say, you know what, we're going to finish this in the car or the pram, β or we'll try again in an hour. But at nighttime, we just keep going with those circuit breakers built in.
Fallon Cook (52:36)
Hmm. Yeah. Very good. All right. We also have Danielle, who says she has a baby boy who has two one hour naps, sometimes longer bedtime at 8.30 PM and wake up at 6.30 AM. He still feeds twice overnight, but resettles quickly within 10 minutes. Occasionally he wakes up set at 10.30 PM and takes about 30 minutes to be resettled using the supported accelerated approach.
Dr Laura (52:37)
Yeah.
Fallon Cook (53:06)
His wake times before bed range from three to five hours and he manages really well. So Danielle is wondering if there's anything they should adjust to reduce the night waking.
Dr Laura (53:18)
β It sounds like things are going really well, Danielle. I would be looking at...
creating a more consistent awake time before the start of the night, I would say. So if it's three to five hours, I'd just be looking at making that a standard duration. I'm not actually sure how old Daniel's baby is, but I'm guessing under 12 months because he's still on two naps, or maybe around 12 months. So I'd be looking at that last wake window being consistent duration.
Fallon Cook (53:35)
Mmm.
Dr Laura (53:59)
so that his sleep pressure is hitting the same point by bedtime each night. And then that's going to help him be able to maintain his sleep more consistently overnight and stop having as many wake ups. If it's just if you want to reduce the feeding overnight, the other thing and that actually that awake time before bed is standard already, then I would be
Fallon Cook (54:16)
Mmm.
Dr Laura (54:28)
deciding on which or thinking about is he ready to drop down to two from two feeds to one feed, picking a day that you're going to say right from today or from tonight rather, it's only going to be one feed β and say that will be the first time he wakes up after 1am, for example. And then every time he wakes before 1am, just use that supported accelerated approach.
then give him the feed when he does wake up around 1am and then use the support accelerated until morning. What we sometimes see for some babies is that they, if they know that there's that feed coming, they will keep waking for it. And similarly to what how we answered one of the other questions earlier. Normally, it takes just two nights for a baby to learn that the there is there are fewer number of feeds overnight.
Fallon Cook (54:55)
Hmm.
Mmm.
Dr Laura (55:23)
So if it's that you want to drop from the two feeds down to one feed, that's how I would go about, first of all, checking the daily rhythm. Secondly, just making your decision that today is going to be the day that you move to one feed and then stick with it. And once you've moved to one feed, after three nights, you can drop that final feed. Would you add anything else, Felon?
Fallon Cook (55:44)
Hmm.
Yeah. I just think that some babies, most babies really, probably all of them, they don't really know what the time is. So when they wake up overnight and often at around 10 30, they've had a stretch of deep sleep and then they're kind of coming up into the lightest stages of sleep. And they're just like, maybe it's a feed time. I don't know. I get some feeds at night. I may as well try and find out what happens. And so for as long as there are any night feeds often, sometimes they'll just, yeah, keep waking thinking, well, maybe it's time for another one. Um, so it could be that.
Dr Laura (56:09)
Mmm.
Fallon Cook (56:11)
reducing the night waking comes down to, you know, gradually reducing those overnight feeds. yeah.
Dr Laura (56:20)
Okay, good luck, Danielle. Let us know how you get on. Let's move on to our next question from Kirsty. Kirsty has a nine month old baby boy. And she's got some interesting questions about sleep cycles. So she asks, is it possible that her son's sleep cycles vary? For example, the first sleep cycle of a nap could be 35 minutes and then the second sleep cycle could be 38 minutes.
or even nap one has a 35 minute sleep cycle and then that two has a 30 minute cycle. And then her nexus. Yeah, okay, let's do Yeah, okay, let's do that one.
Fallon Cook (56:56)
Hmm. Should we do these questions one by one or? Yeah. Cause I
would, I would say to that one, it doesn't matter. There's going to be variability because when you're in light sleep, often doesn't take much to wake you. yeah, there's often that little bit of variability in how long the sleep cycle is simply because, you know, was there a noise? Was there an itch? Was there a little bit of light over there?
Dr Laura (57:09)
Mmm.
Yes.
Mmm.
Fallon Cook (57:19)
did something kind of prompt them to wake up. So I wouldn't be worried if it seems to vary a little bit. We're only talking a few minutes, you either side.
Dr Laura (57:25)
Yeah. Yeah.
And I think this is going to be that answer will relate to the second question. So Kirsty asks, do sleep cycle lengths vary depending on where a nap is taken? For example, a pram nap sleep cycle, could it be different to a cot nap sleep cycle? And she wonders if yes, could that be due to being woken in light sleep by background noise, and then resetting the clock in a way?
And she's interested in β how she would know when to wake him to maintain our daily rhythm. β And I think that's, yeah, you go.
Fallon Cook (57:55)
Mmm.
Yeah, yeah,
similar kind of answer, but sleep cycle lengths don't vary depending on where a nap is being taken. β It's just a case of, there something waking them? So some parents will say, you know, if they're, what's like the earlier one, if they're being held, they'll sleep for 40 minutes if they're in, longer I think it was, but as an example, if they're being held, they'll sleep for 40 minutes, but if I put them in their bassinet, they spring awake after 20 minutes.
it's just that they are being bothered by, hang on. I'm not where I was. And it's enough to kind of wake them up. β so how would you know when to wake the baby to maintain our daily rhythm? I would just look at the average, you know, what's the average sleep cycle length and aim for roughly that and be good enough.
Dr Laura (58:36)
Mm.
Mm-hmm.
Yeah, and in this instance, it might be that it's 35 minutes and yeah, good enough. And just be thinking about, yeah, that they could well just be being woken out of that light asleep a little bit sooner when they're in the pram because there's interesting noises. And that may be why you're seeing that it's napping for a little bit shorter in the pram, for example.
Fallon Cook (58:53)
Mmm.
Mmm.
Mmm.
Dr Laura (59:16)
Kirsty's next question is, it normal for babies to move around in their sleep, even when not transitioning to the next sleep cycle? Her son does this a lot. β And that, again, she finds it hard to determine when would be the best time to wake him up.
Fallon Cook (59:34)
Hmm. I'm just looking at the age nine months old. Look, I would be concerned if there wasn't a stretch of time of pretty still sleep. There are always babies that will be out lies with this, but generally when we're in deep sleep, we're very still. So if it is just constant movement, then I'd be like, Ooh, are they snoring? Do they have noisy breathing? I'd be actually thinking about the sleep apnoea side of things.
Dr Laura (59:46)
Hmm.
Mm.
Yeah.
Fallon Cook (1:00:01)
Why are they so restless and what's going on there? So, β you know, they could be still for the first half of the sleep cycle and then rolling around all over the joint for the next half. β I wouldn't be necessarily worried about that because babies can be super active as they go into lighter stages of sleep. β But similar answer to before, suppose, look at the average sleep cycle length and just go with that in terms of determining when you might wake him up.
Dr Laura (1:00:01)
Yes!
Hmm. And again, this next question just is resonating your answer to the last question. She says, is it normal to show a lot of tired signs throughout a large chunk of the awake time, but still be able to be playful, smiling, interacting with toys, crawling around and pulling up to stand? He'll often play with his ears and rub his eyes. β but she avoids trying to put him to sleep too early to avoid a potential long settle if it's not his usual nap time.
Fallon Cook (1:00:58)
Mmm.
Dr Laura (1:00:58)
And I'm
thinking that, yes, if we didn't know that he was always moving around in his sleep, I would be answering that going, yeah, look, some tired signs and boredom signs can be really closely linked. And if your baby can be distracted and is mostly content during their awake time, then there's nothing to worry about, mostly. But in this instance, I am wondering if perhaps he...
if he is very restless in his sleep and that is having an impact on the quality of his sleep, maybe that's playing out in his awake time where he does seem tired for a long time. β
Fallon Cook (1:01:39)
It's definitely worth checking, but I think
it's something about, you know, being quite engaged, interacting with toys. If he was really tired, I just feel like that would probably start to suffer. You know, often people say, I know they're tired because they get so clumsy, you know, and then they get frustrated at their clumsiness and that sort of thing. yeah.
Dr Laura (1:01:55)
Yes, and cranky and a bit grizzly,
certainly not playful and smiling.
Fallon Cook (1:02:02)
Yeah. Yep. So it's definitely something
to think about. Like, yeah, if you're thinking he's not quite right during the daytime and he's super restless, this was the perfect podcast to submit that question, We're already talking about these things. So I hope that helps. It's a really good little dive into sleep cycle links in that little set of questions. We probably could have made that an episode, I reckon.
Dr Laura (1:02:12)
Yes. Yeah.
Fallon Cook (1:02:23)
Laura wrote in,
Laura has an eight month old that has a very regimented sleep routine that works really well. So she has
a 12 hour and 25 minutes sleep need and goes to bed at 8pm, wakes up at 6.30am in the morning. She has two naps in the day, one for an hour and another for 45 minutes. And Laura wakes her up from both. She's thriving and a very happy baby. So despite being sort of woken up from naps and nighttime sleep to kind of keep things on track, she sort of seems to be getting sufficient sleep. She's quite happy.
So Laura is wondering at what age would you stop being so regimented with regulating the total sleep needs and just let them kind of wake up at the time that suits them.
Dr Laura (1:03:13)
Well, I would do it from about now, Laura. So essentially, once we have our little ones in a good daily rhythm, so we can let off the break and say, let's see if they what happens now, if we don't wake them in the morning at that set 630 time, for example, you don't need to go wild. if they're still asleep at 8am, you probably things are really going to fall over. But you could say, let's just see.
Fallon Cook (1:03:16)
Mmm.
Dr Laura (1:03:43)
it what if I didn't wake her at 630? What time would she wake naturally? Maybe she'll wake up at 635 or 640 or you know, seven. And then you go, okay, let's see if we do that for the next few days. Does sleep stay on track? Does she still continue to maintain her sleep overnight? And if she does, brilliant. But if you find that things start to fall over,
Fallon Cook (1:03:44)
Mmm.
Mmm.
Dr Laura (1:04:07)
she starts to take a long time to fall asleep at the start of the night again, or throws the naps off, or she starts to wake up overnight again. Then you go, β OK, we actually have to be a little bit stricter with this little one. So always what we're doing is when we first design that daily rhythm, we're basing it on the sleep needs that we first calculated the first time we started observing their sleep. We then create the daily rhythm. We then
Fallon Cook (1:04:19)
Mmm.
Dr Laura (1:04:36)
bring in any settling approaches that we need to do. We then see the improvement in sleep and after a week or two of excellent sleep, then we just go, let's just relax things a little bit and see what happens. Most of the time we've got it right straight away, but sometimes there are children who will sleep a little bit longer. And sometimes there are children who, no, it wouldn't go the other way at that point, because we would have tightened it if things hadn't worked. So it's always worth just giving it a go.
Fallon Cook (1:04:49)
Mmm.
Mmm.
Mmm.
Dr Laura (1:05:06)
And you may find Laura that you're eight months old does sleep in for a little bit longer. It might only be 10 minutes more and they're fine. β
Fallon Cook (1:05:13)
Mm. Yeah.
And if you do get to that point where you think, maybe we could trial just adding a bit more sleep back in relaxing in a bit. I would say don't relax everything. Like I really would pick one time of day where you say, okay, I'm going to let them have maybe an extra 15 minutes or something like with a sleep in, just let them go 15 minutes longer for a week and see how things go. β give it some time, see if they adjust. And I really like Laura's question because there are some babies where
I often describe it as some babies seem to have these circadian rhythms that are really resilient, where we get them into a pattern and then they just, they're off and away and they just maintain that pattern and things are pretty great and pretty predictable without a lot of effort and without having to be really regimented. And then there are other babies where they have these slippery sliding circadian rhythms where the minute we try to just let them have a little bit extra sleep, everything falls over.
Dr Laura (1:05:47)
Mm.
Fallon Cook (1:06:08)
Like the nights just turned terrible and it's like how it's 10 minutes or 15 minutes of sleep. Like what is happening? But it's like the circadian rhythms are just desperately trying to break loose and then they'll just turn to absolute chaos. So it depends a little bit on the kind of baby you've got and same with toddlers, same with children, same with teens. Some of them you can just, they'll just fall into a rhythm and others you have to be really, really, you know, watching it and kind of keeping an eye on it because they can be that slippery. So yeah.
Dr Laura (1:06:08)
Yes. Yep.
Yes.
Yeah.
Mm-hmm.
Mmm.
Yes.
Fallon Cook (1:06:38)
We have just had the best questions this week. I know I say that a lot, but I think there's just been a really lovely set of questions that have touched on some really great things that we, yeah, maybe some things we haven't actually talked about before, which is kind of amazing at episode 102.
Dr Laura (1:06:50)
Mmm.
Yeah,
someone asked us recently.
Fallon Cook (1:06:55)
Someone said to us the other day, yeah, yeah.
β How are you finding anything new to talk about? And it's like, well, we just answer the parent questions. Like this always a different angle or yeah, but no, it's great. All right. So let's wrap this up. like we said earlier, if you have sent in a question to the podcast and we haven't answered it, please just remind us, send it through to us again, because we certainly don't do it on purpose. It's just a bit of, bit of chaos lately.
Dr Laura (1:07:04)
Yeah, that's right.
Mm-hmm.
Fallon Cook (1:07:22)
β don't forget that we have our night waking masterclass that's available in each of the song bell programs has a night waking masterclass. So if you're struggling with night waking and you remember, β go and watch it. and somebody did ask why we don't have subtitles on that video. And it really just comes down to my technological ineptitude. β I just could not, technology was doing weird things to me that day.
Dr Laura (1:07:41)
No
Fallon Cook (1:07:46)
but I do have a plan to somehow figure out how to get subtitles on it without other elements of the video, β doing completely random spurious things. β anyway, I might have to call on my tech savvy husband to help me with that one, but, it will come because we know the value of subtitles. β especially when you're holding a sleeping baby and you don't want the noise on, β
Dr Laura (1:07:56)
Yes.
Yeah.
Yes.
Fallon Cook (1:08:10)
If you'd like to buy us a coffee, please do. There's a link in our show notes. We always love that. And of course, if you're listening along and you're struggling with sleep or settling, song bar programs are super comprehensive. We also have an amazing team of sleep practitioners and you know, it's, there's a lot of availability right now. We've got new practitioners on board who are opening up new appointments all the time. So it's probably one of the easiest times to get an appointment with us. In the past, it's taken three or four months β at some point. So.
Dr Laura (1:08:31)
Mm-hmm.
Mm.
Mm-hmm.
Fallon Cook (1:08:38)
If you're needing
Dr Laura (1:08:38)
Mm.
Fallon Cook (1:08:39)
that real one-on-one support, we're totally here for that. check out the link in the show notes, but otherwise that's another episode wrapped up Laura.
Dr Laura (1:08:48)
Yay awesome, thanks so much everyone, bye bye.
