Fallon Cook (00:37)
If you're a sleep deprived parent, you've probably wondered what really happens when you seek help. Well, in this episode, we're going to walk you through our entire assessment process, the step-by-step approach that allows us to tailor support for your baby or toddler and maximize your chances of success.
If you're exhausted and looking for answers, this episode is essential listening. We'll cover the key clues that can make sleep and settling easier for your family.
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 and we're the directors of Infant Sleep Australia. Laura, how are you going today?
Dr Laura (01:37)
Yes, I am alright. We have ⁓ swapped positions and I can't remember if we spoke about this last time but for the last few months you have been living in a state of ⁓ what's it unrest with the renovations and boxes everywhere ⁓ and things have settled. Yeah, now I'm in that position. I'm not renovating. I'm just ⁓ moving house and I have got boxes.
Fallon Cook (01:45)
You
Hahaha!
Yeah, it's your turn.
Dr Laura (02:06)
everywhere and there is dust everywhere and I am hugely allergic to dust so I'm walking around in this swollen hay fever-y ⁓ state all the time so and my voice is also a bit funny because of it so if anyone is hearing a difference in my voice it's just because I am in a cloud of dust because I'm packing so yes ⁓ yeah
Fallon Cook (02:16)
⁓ no.
You
you poor thing. Moving house is horrible. I absolutely hate
it. And what always amazes me is that you can be the cleanest, tidiest person ever. But when you start pulling furniture out, there's all that dust where you're just like, how did I not know this was here? And it's, it always horrifies me that actually I'm gross. My house is filthy. I thought it was clean. It's not. Yeah. Yeah. I blame it on the kids and the dogs.
Dr Laura (02:40)
⁓ yeah.
Yeah.
I blame it on the kids. I'm fine, it's just the kids. Yes.
And how are you going, Fallon? Thank you. ⁓
Fallon Cook (02:58)
⁓ good luck. Yeah, yeah,
no, ⁓ all good. Yeah, nothing much to report here, really. Just same old getting back into the swing of things. Yeah, I am starting to try and get my kids circadian rhythms back on track a bit again, because they have been up very, very late and they're sleeping in a lot. And I'm like, ⁓ this is going to suck when school is back from, yeah, next week, which is crazy. So, yeah, definitely.
Dr Laura (03:07)
Still in school holidays.
Yes.
Yes.
Mmm.
Fallon Cook (03:28)
got to start getting them up on time. My kids were saying last night, but it's so much harder to fall asleep earlier. And I was like, yes, and that's because you're sleeping in. So to correct that, we've got to get you up earlier and earlier so you can build enough sleep pressure across the day. And at that point, they just kind of zoned out and rolled their eyes like, ⁓ mom and their sleep thing again.
Dr Laura (03:31)
Yeah.
You
Yeah, mind-grown, they get so annoyed.
But I did overhear my daughter talking about sleep pressure to one of her friends recently and I was quietly quite proud.
Fallon Cook (03:55)
No!
that's hilarious. Something's rubbed off. that's funny. Well, we, ⁓ we get a lot of emails, don't we, from parents who have questions about what the process is like, you know, if they seek help, ⁓ for sleep and settling problems with us. And I was thinking about that and thinking, well, if so many parents want to know, let's do a podcast episode on it. Cause I think it is kind of interesting. And I know
Dr Laura (04:01)
Yeah?
Mmm.
Fallon Cook (04:24)
with my own kids whenever I've gone to seek specialist help, I'm often Googling and trying to find out like, what does this involve? Like, what's it to be like? Where are they based? You know, what's the process? ⁓ And we work with a lot of very anxious parents and anxious parents often really want to know, you know, what to expect as well. ⁓ And I'm also very aware that the process we go through is incredibly thorough and detailed. when parents tell us about the experiences,
Dr Laura (04:30)
Mm.
Yeah.
Fallon Cook (04:49)
when they've gone to various other services. We're often kind of surprised because we take that, that assessment of sleep and settling really seriously. We know that if we want good results, we've got to do it really, really well and be super, super thorough.
Dr Laura (04:57)
Yeah.
Yeah, and I think lots of families are, they can be a little bit taken aback about how involved it is when they come and see us, particularly the sleep diary, which I know we're going to talk about. But it is just so important to us to ensure that we're delivering the best service, that we have a really, really comprehensive understanding of the baby or toddler's sleep needs, who's in front of us.
Fallon Cook (05:15)
Mm-hmm.
Hmm.
Yeah, absolutely. I think that's a good place to start with that sleep diary because typically what we do is before we see you for an initial appointment or any follow-up appointments or even a coaching call for that matter, we always want to see a sleep diary and it's so important. And one of the ways I explain this to parents is
Dr Laura (05:49)
Mm-hmm.
Fallon Cook (05:53)
I want you to imagine your car is making a weird noise and you take it along to a mechanic and they're like, sure, I can have a look at this. But then you refuse to let them open the hood and actually check your engine. That's what it's like if you don't provide a sleep diary to us. We can't figure out what's going on. Much like your poor mechanic, it's gonna be like, well, yeah, can't sort out your car if you don't let me actually look at the engine. And that's what this is like. But I feel like a lot of parents don't quite grasp
Dr Laura (06:04)
Yeah.
Yeah.
Fallon Cook (06:22)
that because historically and even currently there are plenty of sleep services who don't look at a sleep diary at all and I think that can be really confusing to parents like but these other places don't require it to which I usually just say well do you want this done well or do you want me to be the mechanic who's taking some some guesswork where it's going to take you potentially months and months and months to guess the right approach or you know the right changes to make ⁓ yeah
Dr Laura (06:39)
Yeah.
guesses.
Mm-hmm.
Yes.
Yeah, no, that's, I love that analogy. It's so true. just as a mechanic might be able to have an educated guess at what might make a rattling sound, they, we will be able to take an educated guess at what might be happening, but we're not going to be able to.
Fallon Cook (07:06)
Mmm.
Dr Laura (07:14)
really ensure that everything is fully covered and is tailored specifically to your baby. So perhaps what we could talk about Fallon is what we actually look for in a sleep diary when we're presented with one.
Fallon Cook (07:20)
Mmm. Yeah.
Mmm. There is.
Yeah, there's a lot we look at. think first of all, you and I now are so well trained we can just glance in a sleep diary and kind of go, ⁓ yep, we know what's going on. We know what's going on here. So there is just looking at the pattern, the distribution of sleep across the past week tells us a lot. And the other thing I should stress too is we can't see that pattern if you've just kept notes. That's why we really need you to use one of our proof diaries. We need to see
Dr Laura (07:40)
Yep.
yeah.
Fallon Cook (07:57)
that distribution and you can't see a pattern or distribution in a Word document. That's a really common one. Parents will send us a Word document and they're like, here's my diary. we're like, no, it's not. Please go put it into one of our diaries. So that just looking at the pattern tells us heaps. But we are calculating things like the average sleep duration across the week, sleep onset latency. So in some diaries, depending on the format, we can get a sense of how long it's taking your baby to fall asleep.
Dr Laura (08:02)
Mm. Yes.
Yes! Yes!
Mm.
Fallon Cook (08:26)
Although sometimes we just talk about that within the appointment as well. Sleep efficiency, so how much of the night time are they spending in their cot or for toddlers in their bed? ⁓ Actually a sleep versus awake. Number of night wakes, we're looking at night feeding if it's been tracked. Things like false starts and split nights tell us a lot about whether the daily rhythm is really working and where we might want to tweak things.
Dr Laura (08:29)
Yeah.
Mm-hmm.
Fallon Cook (08:52)
the pattern of naps, the amount of time they're spending awake before bed. There's probably other things I haven't even thought of, Laura, but we're kind of looking at, yeah, early rising, definitely.
Dr Laura (08:59)
Yeah, early rising. Yeah,
if the pattern of wakes overnight is, well, there are certain patterns. ⁓ Is your little one waking up frequently in the hour or two before morning wake up time? When is their longest stretch of sleep in the night? What point of the night is that happening? Yeah, ⁓ any of the wakes at a predictable time.
Fallon Cook (09:09)
Mmm.
Mmm.
Yeah.
Dr Laura (09:28)
Yeah, we're thinking about, some of those wakes for some of the older children, could that be a night terror? Could that be a nightmare? What stage of sleep is that in the light sleep or the or the deeper sleep part of the night? Yeah, there's all sorts of things that we we can look at. We because we're so experienced at sleep. We've seen thousands and thousands of these diaries. Like you said, we can look at them and just go bang, bang, bang, bang, This is what we think is. Yeah, yeah.
Fallon Cook (09:41)
Yes, so much.
Yeah. Yep. We know what to do.
Yeah, exactly.
And for really tiny babies, sometimes we're even just looking at, is there a clear day versus night? Because in some little babies with day night confusion, they just haven't really established, they might have too much sleep in the day and be wide awake all night, or they might just have little tiny bits of sleep scattered across the full 24 hour period with no clear night versus day. And that tells us a lot about, yeah, the changes we need to make. So there is so much information we pull from a sleep diary before you eat
Dr Laura (10:16)
Mm-hmm.
Fallon Cook (10:23)
meet with us. There's a lot of work that goes into just looking at that diary and getting a sense of yeah the circadian rhythm, the sleep pattern before we even talk about everything else that's going on ⁓ and it's so important that we do both. You can't just look at a sleep diary and know
Dr Laura (10:25)
Yeah.
Mmm.
Fallon Cook (10:44)
what's going to be suitable for that child, we need to think about how are they coping at the moment. So that's what we're talking about really during that appointment with you. We're going to be exploring things like what's your child's temperament like? Are they just so easy going no matter what you do with them? They're like, yeah, cool. I'm happy to do that. Or are they super, you know, challenged by changes to their day? And when you try to change even a small thing, they're very, very reactive to it. Do they, you know, really tense
Dr Laura (11:09)
you
you
Fallon Cook (11:14)
to flip out very easily and this is from really tiny babies you know right well I'd even argue it's for adults as well you know are they going to adapt easily to change or is it really really tough on them because some parents will just say
Dr Laura (11:18)
Mm-hmm.
Yes.
Yeah and we're also, we are thinking
about that as well aren't we in the appointment? Like what can, what can the parents manage? How do you, how do you go?
Fallon Cook (11:32)
Yeah.
Yeah, because there are parents who will come to us and
say, I need help with sleep. But then they're like, no, I can't make any changes. They don't want to agree to change anything because it just feels too challenging for them. And in those cases, we often just have to take some very gentle, small steps towards, you know, the goals that they've got. ⁓ think as well, things like separation anxiety in older babies and toddlers, that's a really important thing to actually talk through with families and like how is that presenting and what
Dr Laura (11:45)
Yeah.
Hmm.
Fallon Cook (12:04)
the child struggling with and is it really separation anxiety or are they having a really big preference like actually they separate fine at daycare but it's just a bedtime they get really really riled up so unpacking that I think is really really important
Dr Laura (12:14)
Yes.
Yeah, and understanding from a family if they've tried to seek help beforehand from other people for their child's sleep. What went well? What didn't go well? If things went poorly, how did the parents respond? How did the children respond? How long were the parents persisting for?
And all of that information just helps us think through as we're asking those questions and hearing the answers, our minds are running overtime as we're thinking, right, okay, well, that would rule out X, Y and Z, but actually, that would probably work. This other approach might work. And actually, if we adjust that first, then perhaps they won't see that same behaviour. But we're always thinking through.
Fallon Cook (12:54)
Mmm.
Yeah.
Dr Laura (13:13)
what parents are telling us about their experience to date because we don't come, none of us ever end up at a meeting with a ⁓ health professional with a clean slate. We all come with experiences that have brought us to that place. it's, so we're not a one size fits all. We're thinking about the family as a whole and what's gonna be the best fit for the whole family.
Fallon Cook (13:27)
Mmm.
Dr Laura (13:42)
rather than just saying right okay you need to work on cot settling because that might not be a goal at all.
Fallon Cook (13:43)
Mmm.
Yeah, exactly. And I think we learn a lot about parent capacity when we're having these discussions, especially around what's already been tried and what their experiences have been like in the past, because so many of the families we see have
Dr Laura (13:50)
Mm.
Hmm.
Fallon Cook (14:04)
tried cot settling but never had sleep needs addressed. So they've had a child with really low sleep pressure who just can't settle for a couple of hours or something and they've been trying to work on cot settling and getting the most extreme behavior and often parents will say I'm traumatized from what we went through it was horrific and the thought of trying to put them in a cot ever again is just more than I can bear and in that case we spent a lot of time talking through the the difference it's going to make when we
Dr Laura (14:15)
Mm-hmm.
Yeah. Yeah.
Fallon Cook (14:34)
actually optimize that daily rhythm and we're only putting them down for sleep when they're truly ready. And then often it is a case of bringing in some new sleep associations before you even think about trying to put that child in a cot. ⁓ And it's so important to unpack these things. I do hear a lot of people saying, you know, like, look, I mean, we all know there's people out there who are very much just like sleep train all the babies, you know, and that.
Dr Laura (14:36)
Mm.
Mmm.
Fallon Cook (14:59)
is a bit of a blunt instrument to apply to a pretty complex population. It's not that easy. You can't just say, just sleep train all the babies. No, that's just not how this works. And I think babies and parents deserve better.
Dr Laura (15:01)
Hmm. Yeah. Yes, it is.
No, and if a baby or ⁓
absolutely, and if the main problem is actually a sleep pressure issue or a circadian rhythm issue, then that's what needs to be treated. We're not treating, yeah, it is using a hammer saying, everything has to be sleep training and cot settling. It doesn't. We have to look at overall what's happening for that child's sleep, what's their sleep profile like, and then what's happening for the family.
Fallon Cook (15:20)
Mm.
Yeah.
Mmm.
Mmm.
Yes, I often see on social media there be the odd parents saying
Oh, you know, they've got like an older toddler and they're like, sleep is still hard. We did everything. My child is just a really bad sleeper. They're never going to sleep well. We've had years and years of this, but we went to all the places. We did all the residential stays. We did all of these things. None of it worked. Our child's sleep is just broken. And I always just think, I bet it's not. Probably sounds really arrogant, but I'm like, I, you know, a lot of those services like early parenting centers don't even look at the sleep diaries. Like, I guess they've got their reasons for it. I'd love to hear more about
Dr Laura (15:53)
Mm.
Yeah.
Fallon Cook (16:15)
it because I feel like there's a lot of parents who ⁓ leave those services who can't maintain the progress because the daily rhythm isn't set up well for their child. I'd love to see early parenting centers start to ⁓ analyze sleep diaries and help parents more with that because no parent should be you know have a three or four year old and be saying their sleep's just broken it's horrendous we've had years of hell it's never gonna change you know we've done everything ⁓ horrible
Dr Laura (16:24)
Hmm.
Yeah, not at all. And then,
you know, we see children who are ⁓ primary school aged or even going into high school whose identity is tied up with them being bad sleepers. And they've been told always, you're always a terrible sleeper. At least now I don't need to sit with you as you go to sleep or
Fallon Cook (16:56)
Mmm.
Dr Laura (17:05)
At least now when you wake up in the night, you can just amuse yourself and you don't need me in the night. And it becomes part of that child's identity. And so when we're working with older children, one of the things is trying to change that, that that's not their identity. They're not a bad sleeper. But ⁓ none of the interventions that have been applied to them to date have ever looked at their unique sleep.
Fallon Cook (17:05)
Mmm.
Yeah.
Dr Laura (17:33)
profile and that's not the fault of the parents at all it's just the fault of the systems that don't ever look at the nuance around sleep so ⁓ yeah that of course there are going to be some children who do have sleep disorders that are a particular type of disorder that we can't we treat it then we
Fallon Cook (17:36)
Mm.
Mmm.
Dr Laura (17:59)
go into maintenance mode and there are some sleep disorders that just will need ⁓ readjustments that you're never going to be able to just let sleep go off the rails because there are yes that's right that's right so if you do have that's right and so that if your child has a
Fallon Cook (18:10)
Hmm, like a car that needs regular servicing to go back to that analogy. Some cars go off the rails a little quicker than others.
Dr Laura (18:24)
Delayed Sleep-Wake Phase Disorder, for example, that's a disorder that has a high rate of recurrence and so it's something that you just will have to keep on with. But there are appropriate evidence-based approaches to keep that service up to date so that, again, as a child gets older, you can be talking about, this is a sleep disorder that you have, it's not that you're a bad sleeper.
⁓ There are steps that we have in place to ensure that your sleep doesn't go off the rails ⁓ and you have the skills to do that. Anyway, gone a bit off track there because we're talking about babies and toddlers on this podcast. ⁓
Fallon Cook (18:55)
Hmm.
Mmm. Yeah, a hundred percent.
I love it when we go off track though. feel like that's the most interesting
bit. All right, so back to that sort of sleep and settling assessment. If you've got a baby and a toddler, we've talked about this really comprehensive sleep diary assessment that we do before every appointment. I've talked about how during the appointment, we're thinking about the child's temperament, their mood, separation anxiety. We're also looking at things like parent goals and that's really key. It's not for us to tell you what your goals are. Like it's up to us to
Dr Laura (19:34)
Hmm.
Fallon Cook (19:36)
to
give information, to give you advice that we think is going to help improve sleep based on what we come up with in our assessment, but it is up to parents to make a call on what steps they want to take. ⁓ And this happens all the time. I think it was just last week, I had a family where they're feeding to sleep, the toddler's managing it really well, they didn't really want to change it yet. So we just talk through what they might do when they're feeling ready to change that. So they just, they know, you know.
Dr Laura (19:47)
Mm.
Mm-hmm.
Fallon Cook (20:02)
They've got all information. I think that's the key, isn't it? We want to empower parents with the information. They can make the call ⁓ that works for them. That is just so important. So we're really taking all of this information. It's a lot of information. Like you were saying earlier, Laura, it's like our brains are working a mile a minute. We probably look super calm and chill in your appointment, but actually we're doing all these kind of mental gymnastics, like ruling out this, need to ask about that. Let's check in about this. ⁓ We also forgot to mention we are talking through different physiological factors.
Dr Laura (20:04)
Yeah, that's right.
Yeah.
You
Yes.
Fallon Cook (20:32)
⁓ and symptoms that could mean we need to look into a referral app to look at physiological causes for sleep problems. That's a really important part of our assessment as well. Something we definitely don't want to miss. But all of this information we gather is funneled into the sleep plan that we create for you. So that's kind of how we work it. We didn't want to go in with any assumptions. I'm thinking right back to when we started our work in this field, Laura, we never wanted to go in with these assumptions thinking, okay, yep, we're going to do this with every baby. It's always been
Dr Laura (20:33)
of course, yeah.
Mm.
Fallon Cook (21:02)
very much a meeting with the parents to kind of understand what they're wanting, what they're needing, doing this SORA assessment and then really working from nothing up. I don't know if that's a great way of describing it but you know not going in with assumptions around what we have to do but really letting it be a genuine meeting of parents and practitioner to come up with the plan that feels manageable for them and makes sense with what we've seen in the assessment as well.
Dr Laura (21:05)
Mmm.
Yes!
Fallon Cook (21:32)
And
I think that's so key because there's no point in giving parents a sleep plan where they're just like this sounds horrific I don't want to do it or I'm not ready for this. What's the point? You know, we want you Yeah to have a good plan that feels like a good fit
Dr Laura (21:35)
Absolutely.
Yeah, yeah, yeah.
Yeah, it's not like a teacher-student ⁓ relationship when you work with us. We come as a team member to work with you. It's not didactic. We ⁓ listen to you. We ⁓ absorb the information that you've given us in the ways that we've just described. And then together we discuss with you.
what a future or what the actual plan might look like and what changes might be best left until later and what the future of your child's may look like. yeah, it's definitely, is that called bottom up? I think bottom up approach rather than a top down approach.
Fallon Cook (22:28)
You know, it's one of these things that I'm very embarrassed
to admit I never quite understood the difference. So I don't know. It is what it is.
Dr Laura (22:35)
⁓ yeah, well I'm probably misusing
it too. You can tell we're not corporate people. ⁓ We come from a... we're science nerds. As my kids like to tell me, Mum, what did you do for fun when you were little? I bet you just used to go to the library. You're such a nerd. ⁓ Yeah, I'm like, yeah, and all the best people do. Or did. Yeah.
Fallon Cook (22:40)
Yeah. ⁓
Nothing wrong with that. How dare they?
Yeah,
true. All right, the other question we get around is, you know, from parents' law is around coaching calls versus an initial appointment. Like how do we apply this assessment process differently depending on if it's an initial appointment, which is 50 minutes long, it's our most comprehensive appointment versus a coaching call, which is just for Sombelle members, it's 25 minutes and it's a bit quicker. ⁓
And I think probably straight off the bat, the initial appointment means following that entire detailed assessment process that we just spoke through. Like, so you get sort of everything ⁓ with that. In a coaching call, there's less time. We still assess your sleep diary, but we're kind of assuming you've got a bit of a rough plan figured out and we're just kind of coming in and making some tweaks, checking that it fits. For some cases, we do have to try and pull together a whole plan in the 25 minutes. ⁓ It kind of depends on where parents are at, I guess.
Dr Laura (23:37)
Mm-hmm.
Mm-hmm.
Yeah,
yeah, that's right. So sometimes it can be that in a coaching school, parents have already decided what approach they want to use, but they have some questions about how can they modify it based on their household setup, or, you know, is it appropriate to do X rather than Y? And of course, when people come into the clinic to see us, who aren't some Bell members, they won't
necessarily know the range of approaches that we have, whereas Sombelle members normally do. So in a coaching call, we'll just, we could just touch on a more leaning towards those gradual approaches or the quicker ones and we can use the names of the different approaches. Whereas with a an initial appointment, we just assume that ⁓ you're coming in without that knowledge. And so then we might do a little bit more of a
Fallon Cook (24:34)
Mmm.
Dr Laura (24:48)
a quick description of the number of approaches that we think might suit you and then dive into ⁓ a particular one that feels right for you and go into much more detail about that. yeah, it really, yeah, one is very quick and a coaching call we tend to think of as, can book as many, standalone, you can book as many as you want. You can have as many coaching calls as you like, but often it's just around the tweaking around the edges.
Fallon Cook (24:59)
Mmm.
Mmm.
Dr Laura (25:17)
whereas an initial appointment, the assumption is that you're going to have follow-up appointments as we see how things have gone. So there's more of a long-term relationship is ⁓ assumed when you're booking in for an initial appointment, whereas for a coaching call, might just be that one-off and then we don't need to see you again.
Fallon Cook (25:18)
Mmm.
Mmm.
Hmm.
Yeah
And the reason why we don't offer coaching calls to anyone, like they are only for members, is because the people joining coaching calls who are members, they've just got this great breadth of knowledge and understanding. We can hit the ground running. You can't do that with someone who's completely new and knows nothing about our approaches, might not really know a lot about sleep or settling. It really requires a lot more time and more thorough assessment. But definitely we get a lot of Sombelle members who book in for the initial appointment, the 50 minute appointment anyway,
Dr Laura (25:55)
Hmm.
Mmm.
Fallon Cook (26:09)
They're like, no way, I want 50 minutes to really dive into this and I want your full assessment and I want, I just want everything. Cause at the end of an initial appointment, we provide parents with a sleep plan that we, we sit down and create them after the appointment on the same day. So we actually put together a really detailed sleep plan. Some of them are very long, usually several pages or so. And so there's plenty of Sombelle members who are like, no, I want that.
Dr Laura (26:30)
Mm-hmm.
Fallon Cook (26:33)
as well alongside my my Sombelle membership which is awesome and we love those appointments because those parents are really clued in and yeah they've already thought about their goals and and everything. ⁓ So yeah if you've a Sombelle member and you're like okay I've got a really tricky sleeper or I've got a ton of questions I want to ask ⁓ and you're just thinking I just want to meet with Alina and Laura or one of our practitioner team and just have them kind of do all that work and all the thinking and create that plan for me then you can absolutely do that.
Dr Laura (26:34)
Mm-hmm.
Yeah.
Fallon Cook (27:03)
not a member you've also got the option of booking in for an initial appointment and we can just take you through ⁓ everything in during appointments and that's a little bit of a pricier option but you know for lots of families they just really prefer to work one-on-one for the whole thing and that's fine as well.
Dr Laura (27:09)
You
Yeah.
Fallon Cook (27:19)
So yeah, I hope that answers
Dr Laura (27:20)
Yeah.
Fallon Cook (27:20)
some questions. I think that that was a really lovely little discussion around sort of how we do things, because it is different to how other people do things. It's certainly very, very thorough process. ⁓ And I think in just talking that through, it's probably given a lot of parents a lot of clues around, yeah, I've never thought of that for my child, or maybe I need to think about the, yeah. So hopefully that gives you some, some ideas of things you can think through if you are struggling with sleep. I'll chuck a link in the show notes as well for, for appointments, if anyone's looking
Dr Laura (27:28)
Mm.
Hmm.
Yeah.
Fallon Cook (27:49)
for one. ⁓ You can go and sort of learn a bit more about those. Excellent Laura we've had a couple of coffees come through which is really nice so thank you to Brooke who bought us a coffee that was so so lovely and also thank you to Jean who bought us five coffees and also left a lovely lovely message. Do you want to read this one out Laura?
Dr Laura (27:53)
Mm.
Yes.
Yeah,
yeah, so Jean says, Hi, my name is Jean. I'm a mum with a beautiful six month old boy and a huge fan of your podcast. I'm not a member, but I have to say this. Thank you for your podcast. It has helped me get confident with my baby's sleep. Because there is a lot of information in your podcast, it taught me where to look when my baby has trouble sleeping. And I also know I can get help from you guys when I need it. This makes new motherhood less panicky.
Bit of a silly thing you guys might find funny and we did. When I started listening to the podcast as an Asian person I kept thinking why the heck did they name the program Sambal which is an Asian spicy sauce? It's not until later that I realized it's Sambal.
Fallon Cook (28:41)
I love this.
I love that. I wonder if they were thinking, maybe it's cause like the, some of these babies are pretty spicy, you know, like they're crying a lot and they're cranky. ⁓ I love it. That is so funny. When I go to edit the podcast too, it is crazy the number of ways. So the podcast software, ⁓ like automatically creates a transcript and, ⁓
Dr Laura (29:03)
That's so funny.
Yeah.
Yeah
Fallon Cook (29:25)
captions and things like that. The number of ways it goes to spell Sombelle is crazy. it's sometimes it's Sun-Vell and all sorts of weird things. So I can understand if the AI that listens in and transcripts, transcribes it all, can't figure it out. Parents have got no hope.
Dr Laura (29:25)
yeah.
Yes!
No,
so funny. Yeah, I think back to that time, I can actually picture where I was standing when we were on the phone to each other deciding on the name, which we have spoken about in another podcast. I'm thinking, could it be ⁓ misconstrued for another name? And of course, we're only thinking about in the English language. So we didn't think about what it might mean in other languages.
Fallon Cook (29:56)
Yeah.
Yeah.
Yeah, yeah. I remember where
I was too. I was driving and I had you through the car, Bluetooth I think and yeah, we were tossing up different names. So funny, isn't it?
Dr Laura (30:18)
It is. Okay, yeah, thank you.
Fallon Cook (30:18)
Amazing. Well, yeah, thank you, Brooke. And thank you, Jean, as well. That's
so lovely. And if you've been tuning in and you want to buy us a cuppa, we will put the link in the show notes. We always, always love it and appreciate it. So we've got a bunch of parent questions to get through today. And some of these have been, you know, from parents who've been waiting since early on this month. So thank you so much for your patience. There's, yeah, a bit of a backlog we've had to get through, but some really terrific questions in here. Maybe we'll start with
Dr Laura (30:29)
Mmm. Yeah.
Fallon Cook (30:48)
Kim who has a five month old baby boy. They've started to use the quick fade approach for settling for cot settling. He was a big contact napper and escalates crying when put down after briefly holding. ⁓ He used to sleep roughly 9.30 PM to 9 AM, but they've shifted him to 7 PM to 7 AM. And he now often has a difficult 5 AM wake up where he's grisly and hard to resettle. They don't have blackout blinds. So wonder if light may be a factor. He naps around
9 to 10 a.m. 1130 to 1230 p.m. and 330 to 4 p.m. with the last snap 30 to 60 minutes.
Their bedtime routine can stretch to an hour with bath and books and he's still in an arms up sleep sack. So Kim has a few questions. Can they adjust the quick fade timings or how holding is done? Is the 5am wake ⁓ circadian rhythm or light related? Can bedtime routines be too long and should they change to arms out now or wait until cot settling is established?
Dr Laura (31:52)
All excellent questions, Kim. So I would say, yes, bedtime routines can be too long. I'm just going to answer this in a haphazard way, Kim, but so I'm not taking those questions one at a time. yes, generally, if your bedtime routine is stretching to an hour, it may be getting a little bit on the long side.
We do tend to think about bedtime routine being everything from the bath onwards though. So yours is an hour including the bath, but really from the time that you get your baby out of the bath, we want that to be done and dusted within 25 or 30 minutes. ⁓ Just because as babies get older before you know it, that's taking two hours. We want to keep that ⁓ nice and succinct and generally ⁓ relatively predictable.
⁓ Should you move to arms out now or wait until cot settling is established? At five months of age lots of babies are rolling at this point so if your baby is rolling then absolutely the arms need to come out for safety reasons regardless of whether you're doing cot settling or not. ⁓
Fallon Cook (32:59)
Hmm And even if they're not great
at rolling like they can just randomly do it and at this age Yeah, I'd be like I'd just get rid of that ASAP
Dr Laura (33:08)
Yeah, yeah, and there are
tips on how to do unswaddle babies in one of the Sombelle chapters. The 5am wake up. Listen, just looking at what you've described, your baby used to have about 11 and a half hours overnight and you've changed to 12 hours and then each nap is potentially having three hours worth of daytime sleep. So that's 15 hours all up sleep opportunity.
Fallon Cook (33:36)
Mmm.
Dr Laura (33:37)
Could well be that their sleep needs have dropped and they are beginning to run out of sleep pressure by five. And that may be why that wake up is persisting and they're quite grizzly and hard to resettle. Of course, always think about the low hanging fruit first. So if you do feel that light's coming in, then think about using blackout blinds. There are the sleepy Sundays.
you can attach to the windows or otherwise look at putting towels and ⁓ or other fabric over your curtains to try and make it dark but I suspect that ⁓ it would be sleep pressure ⁓ given that that's 15 hours worth of sleep for a five month old that's quite high. Final question can you adjust the quick fade timings or how holding is done?
Fallon Cook (34:28)
Mm. Yeah.
Dr Laura (34:34)
The key is that you are 100 % predictable. So, and also think about working your way through the steps in the quick fade. So, yes, I'd be patting your baby for a certain amount of time, then doing the pickup for a time that feels right for you.
before putting him back down but ultimately we really want you to be getting on to the later steps where you're not having to do as much holding. If you're finding it hard to do that then I suspect, I'm tripping over my S's there, I suspect the sleep pressure is not quite high enough and that's why you're finding it hard to get through the steps. So that's my whistle stop tour of an answer for Kim. Did you have anything to add, Thalen?
Fallon Cook (35:18)
Mmm.
Yeah, yeah. You did good. Only to
say she's saying that he's crying escalates when she puts him back down after doing the cuddle. And look, so many parents say to me, look, we just stopped picking up for the cuddle because if we just kept patting, they calmed down by picking them up. It actually just kind of made them really cranky. And they were much happier if I just kept them in the cot and kept going with the padding until they slept. So that's something else to consider as well, Kim. Excellent.
Dr Laura (35:39)
Mmm.
Yes.
Hmm,
Fallon Cook (35:50)
Good luck, Kim, and reach out for some support if you need it.
Dr Laura (35:51)
yeah good luck. Yeah, so Nicole has a nearly three year old boy. So he was an excellent sleeper until he turned two and now bedtime has become very challenging. He wakes around 5.30 a.m. He has a nap from 12.30 until two and goes to bed at half past seven.
He naps well and independently, but bedtime can take 30 to 60 minutes with intense crying or stalling and needing a parent to be in the room with him until he falls asleep. He also wakes overnight every second night, sometimes briefly, but sometimes up to 45 minutes. They have had some major life changes, including a new sibling, moving house, a daycare change and... ⁓
Nicole has been accommodating for those changes, but is feeling that now they really need to do a reset. So Nicole says, or asks, do they cut or keep the nap? Is a nightlight or reward chart helpful for overnight wakes? And how do they create a circuit breaker to get back to easier bedtimes and independent sleep at night?
Fallon Cook (37:08)
Hmm. Yeah, I would start with the nap because that could be the kind of circuit breaker like a bit of a reset to the daily rhythm. So 100 % Nicole, you've got to work through that unique sleep needs chapter if you haven't already. Work out what's the average sleep duration per day over the past week and that's really going to help you build out the daily rhythm. I'd be pretty tempted because he's nearly three to I'd be tempted to cut back the day nap make it
Dr Laura (37:11)
Mmm. Mmm.
Yeah.
Mm.
Fallon Cook (37:34)
bit shorter so that you've got a bit of a longer night and you should have much higher sleep pressure at bedtime. If
Dr Laura (37:34)
Hmm.
Mmm.
Fallon Cook (37:41)
You're saying bedtime 7.30 PM. If he's falling asleep at 7.30 PM after having spent, you know, 30 to 60 minutes trying to settle him, then you just need to make it that you only put him in the cot at 7.30 PM when he's actually falling asleep. If you're saying bedtime 7.30 PM, but then it's 30 to 60 minutes trying to get him to fall asleep. So he's sometimes falling asleep at 8 PM. Then hate to tell you this, but 8 PM is your bedtime. Unless you cut that nut back. If you cut the nut back,
Dr Laura (37:57)
Yes.
Mmm.
Yes. Yes.
Fallon Cook (38:11)
might be able to get it slightly earlier bedtime. So definitely we only want him being put in the cot when it is time for sleep. Sorry when he is ready for sleep. I'm setting myself in circles aren't I? Focus Valid.
Dr Laura (38:14)
Yeah.
Yeah.
Yes.
Fallon Cook (38:27)
Um,
all right. And so he's also got some overnight wakes. Sometimes they're 45 minutes. So you've got split nights coming in. So it really is another clue that the daily rhythm is a bit out of whack and needs some tweaking. So work out what the unique sleep needs are. I would start by cutting the, uh, trimming down the nap rather than cutting it entirely. Cause with an hour and a half, you could certainly cut it in half to 45 minutes. And that might help for a little while. Pretty soon you probably will need to drop it though. Um, then, you know, is a nightlight or reward chart helpful? That is.
Dr Laura (38:37)
Yeah.
Yeah.
Mm-hmm.
Hmm.
Fallon Cook (38:57)
very big question done back in a podcast. A nightlight may be helpful if you think they're, you you're seeing evidence of nightmares and they're really frightened of being in the dark. A nightlight might help. A reward chart.
Dr Laura (39:00)
Yeah.
Fallon Cook (39:11)
I would lean towards it probably not being the first approach I would go to because he's just had all these big life changes. So he's probably feeling quite unsettled, a little unsure about things. And if there is bit of fear or anxiety there, there is no reward on planet earth that is going to make him go, well, I'm scared, but I want to freddo from in the morning. No, a frightened child is just going to want you. There's no reward that can override that. So I would be looking at maybe the advanced accelerated approach.
Dr Laura (39:22)
Mmm.
Yeah.
Yeah.
Fallon Cook (39:41)
approach
with you sitting nearby in the room for the first week or so before you start to leave the room or it is a bunch of different things you could do so I'd probably look at those approaches more than the reward chart ⁓ but it does sound a little bit complicated so if you need like this is the sort of case where a coaching call is a really great idea because we can kind of really quickly figure out what the best approach might be sort of depending on where this child is at ⁓ what would you add to that Laura?
Dr Laura (39:47)
you
Yeah.
Yeah.
Yeah, I would think that it's highly likely that changing the nap in some way is going to make everything easier. Changing the nap, moving bedtime to the time that he's normally going to sleep is going to be life-changing and just having a way to be really respectful of the major life changes that he's gone through to
Fallon Cook (40:21)
Hmm.
Mmm.
Dr Laura (40:38)
increase his confidence at falling asleep independently and of course that's covered in some bells so yeah going relatively ⁓ carefully so that he does feel supported and look that when when they ask is there a circuit breaker to get back to easier bedtimes i would say the circuit breaker is going to be doing something around the timing that is going to be the circuit breaker yeah
Fallon Cook (41:04)
Yeah, yeah
and remembering that when sleep pressure is higher in the brain there's no space for anxiety so if you've got a child who's a bit unsure about being on their own when we optimize sleep pressure often those anxieties reduce a lot it just kind of opens the door for change. Good luck Nicole.
Dr Laura (41:12)
Hmm
Mm-hmm. Yeah. Yeah.
Fallon Cook (41:22)
Hailey has a 16 month old toddler girl who since starting daycare she's had frequent viral illnesses with ongoing sleep disruption. When well her average sleep need seems to be around 11 and a half hours with a one hour nap, a 7.30 p.m bedtime and a 6 a.m wake up. However when unwell she often wants to nap for two to two and a half hours despite being playful and otherwise okay. Hailey has started the Sombelle program but is dealing with start,
Dr Laura (41:30)
Aww. Yeah.
Fallon Cook (41:51)
stop-start progress due to illness. She's wondering should she cap the naps during mild illness or allow longer naps? If day-sleep increases should bedtime shift later? And how flexible should sleep expectations be during frequent daycare illness?
Dr Laura (41:55)
you
gosh, I really wish I could wave a magic wand for parents with little ones at daycare. It's just, well I see some very, it's not funny, there's some good memes around. Parents just handing over their bank accounts to childcare centres and getting back viruses in return. It's really hard. Yeah. ⁓ Okay, Hayley.
Fallon Cook (42:12)
Mmm.
Mmm.
Yeah, it's hard.
Dr Laura (42:36)
If your little one is just mildly unwell, I probably wouldn't be ⁓ adding extra sleep. I would only be adding extra sleep if it's actually if she's properly has a fever really seems unwell. And I'd also be thinking about adding just enough extra. So for that nap, rather than it being an hour and suddenly going to two and a half hours, really I'd be unless it's the flu or RSV or something really awful.
Fallon Cook (42:49)
Hmm.
Dr Laura (43:05)
I would be thinking maybe adding an extra sleep cycle in there. ⁓ know, yeah, 30, 40 minutes extra and then maybe bringing bedtime a little bit earlier rather than making such big changes to the nap that everything else falls over. Also, if you are increasing the
Fallon Cook (43:10)
30-40 minutes or so. ⁓
Dr Laura (43:29)
Day sleep, so you said if day sleep increases should bedtime shift later? Well, no, the only reason you should be increasing the amount of sleep your baby is having during the day is if they are unwell and therefore you probably would want to keep bedtime the same or move it bit earlier if they are unwell. So, yeah, I hope that answers that. How flexible should sleep expectations be during frequent daycare illnesses?
Fallon Cook (43:46)
Mmm.
Dr Laura (43:58)
relatively flexible but I think probably going from the one hour to two and a half hours daytime nap is probably a little bit too flexible and it does sound like it's hard been hard for you to make any progress so I'd be thinking yeah an extra sleep cycle for the nap and possibly half an hour earlier for bedtime unless it's something a really awful illness where it's fever yeah what do you think Fallon?
Fallon Cook (44:07)
Hmm.
Mmm.
I that's good advice. Yeah, I think prioritizing
keeping your bedtime and wake up time fairly predictable and any variability would be in the naps. I think that's a good way to think about it. So then once they recover, you know, with bedtime and wake up time being kind of signposts for the circadian rhythm, things shouldn't have drifted so far off track that it's hard to get them back on track again. ⁓ But yeah, it's just, it's tough when they're in the trenches with daycare illnesses, but it doesn't last forever. And I often say to parents,
Dr Laura (44:31)
Hmm. Hmm.
Yeah.
Mmm.
It is. Yeah.
Fallon Cook (44:52)
By the time I start primary school, they've got like these galvanized immune systems that can fight off anything. they do, they catch bugs and they just get over it really fast because their bodies know what to do. So there is a payoff. You just got to hold on tight until you get there.
Dr Laura (45:02)
Yeah.
Yeah okay
so Jess has a four month old baby boy, his sleep has been excellent but worsened right at four months which is triggering Jess because her older child has long-term sleep struggles. This is kind of what we were talking about as well taking a family history when we see families like not only what has happened we ask not only what's happened for the current child but any other children.
Fallon Cook (45:29)
Mmm.
Yeah.
Dr Laura (45:36)
what were the experiences? ⁓ So Jess says that her four month old has recently dropped from five naps to four and she's wondering whether to move towards three naps. He's showing readiness signs but is struggling to consistently link sleep cycles for the naps. So she's been extending the naps by feeding or holding when needed and then transferring him back to the cot. So Jess's questions are, is it better to protect naps
length even if that means assisting or should she prioritise cot settling and accept shorter naps for now and should she stay on four naps with a reduced total day sleep rather than moving to three?
Fallon Cook (46:23)
I love this question. It perfectly highlights. Why we have those discussions with families. So given there's a history of having a really hard time with the older child's sleep, me. I'm guessing Jess just wants sleep to be as good as possible, as quick as possible and to move through this. So at four months, the sleep has likely become tricky because now this baby has really strong preferences for what happens when they fall asleep. So I would lean towards not
Dr Laura (46:25)
Mm-hmm. ⁓
Yeah.
Yeah.
Fallon Cook (46:53)
assisting the naps to be longer. Look this is my gut feeling if I had a conversation with Jess we might come up with something different but I'm just thinking what I would prioritize what's likely to improve sleep in the quickest time frame is for the baby to absolutely master cot settling so it's not waking up at night getting a fright
Dr Laura (46:59)
Yeah
Fallon Cook (47:11)
because it's no longer in your arms anymore. So if you're going to really prioritize cot settling and get self settling happening, then we don't want to be making any naps longer by trying to do some feeding or holding to sleep because that's going to be so confusing. So I would lean towards potentially staying on four naps, but just if they're short naps because he wakes up quickly in the cot, hasn't figured out how to link sleep cycles, that's fine. If his mood's fine, it's all fine. And with that practice of only settling in his cot, really quickly he will link those sleep cycles.
Dr Laura (47:36)
Mm-hmm.
Fallon Cook (47:41)
So there might just be a temporary thing of having four brief naps before he moves on to three naps and one of them might be a bit longer. So that's probably how I would work it because Jess has had a hard time with her older child in the past and her priority is probably going to be just getting sleep sorted ASAP. If that wasn't the case, I'd be saying, well, you know, it's entirely your call, you know, and how you want to play things. There's nothing wrong with assisting a nap to be longer. But if your goal is to really
Dr Laura (47:42)
Yeah.
Hmm.
Hmm.
Fallon Cook (48:11)
master self-settling it's probably going to confuse your child a bit so yeah that's where it really does come down to parent goals and yeah what their capacity is and what they're wanting to change.
Dr Laura (48:13)
Yeah.
Hmm.
Yeah, yeah, I think that's a great answer. Good luck, Jess. You should start to see if you follow Fallon's advice, you probably will see within about a week or so your four month old will start to link maybe one of those naps, sleep cycling one of the naps and therefore it was going to be easier for them to move to three naps.
Fallon Cook (48:28)
Mmm.
Mmm.
Yeah, and you might give it bit of a push. You
might think, well, nights have gone so well, then still having brief naps, but I'm just going to push for three naps. So you're starting to space them out more. And with that higher sleep pressure, you should see that longer nap. Yeah, come about. Awesome. All right.
Dr Laura (48:53)
Yeah.
Mmm, yeah.
Fallon Cook (49:01)
Angela has an 18 month old boy and since she was away for several nights having a new baby, he's been very distressed at bedtime and shows separation anxiety during the day. At bedtime, he stands and cries until a parent sits in the room, after which he falls asleep and then sleeps right through the night. Amazing. He's on one nap, usually for two hours with about 11 and a half hours overnight. On shorter nap days, Angela puts him to bed earlier, but her husband
Dr Laura (49:04)
Mm-hmm.
Hmm.
Hm, yeah.
Fallon Cook (49:31)
feels bedtime is harder when they do this. Should they keep sitting by the cot or start changing the approach? Is an early bedtime on short nap days helpful or unhelpful? And are they creating a long-term habit or responding appropriately to separation anxiety?
Dr Laura (49:34)
Hmm.
All right, well Angela, congratulations for having baby number two. I think that you are responding appropriately to separation anxiety. So your little 18 month old has had a big, big change in his little life with a new sibling. And it doesn't sound like... ⁓
having you sitting by his cot at the start of the night is actually causing any problems overnight when he wakes up and sees that you're not there so he doesn't care he goes back to sleep yeah so he'll have all of those biologically normal wakings overnight and if a child has got a sleep association that is problematic then they when they have one of those normal biological wakenings they will then go where's mum or dad gone they're no longer on the chest
Fallon Cook (50:18)
Yeah, he doesn't care. He's back to sleep, which is great.
Dr Laura (50:38)
but that's not happening in your case. So that ⁓ to me says that we don't need to work on that element of how he falls asleep for his sleep health, but that's not to say that you don't work on it for your family functioning. Because when you are looking after a little baby as well, and there may be some nights Angela where your partner's not home and you're managing your baby and you're 18 month old, then it can be really tricky to need to sit by the cot. ⁓
Fallon Cook (50:38)
Mmm.
Hmm.
Dr Laura (51:07)
until your 18 month old falls to sleep. and again, this is us looking at the whole family. So if you do want to change how your 18 month old is falling asleep, you could go with a really gradual approach like the parental fading approach, where you're being really respectful of the separation anxiety and going as granular as you need to. Or you can
Fallon Cook (51:27)
Mm.
Dr Laura (51:35)
I think actually I was going to say, you can do something. I suspect that that's probably going to be the best approach or you can do advanced accelerated, but that might lead to an escalation in his distress at bedtime. So I probably would go with the parental fading if you feel like you need to do it. ⁓ In terms of your question around the naps and bringing bedtime earlier, I think if you're experiencing that when he has a short nap and you bring bedtime earlier, it actually makes bedtimes harder.
Fallon Cook (51:40)
Mmm.
Mmm.
Dr Laura (52:04)
I would just stop bringing it forward. I would in fact consider whether what you do is alter the length of that nap. Maybe you think about rather than it being two hours, you could have an hour and a half to try and stabilize bedtime if you're finding that more often than not, he isn't able to achieve the full two hours during the day. If he always manages an hour and a half, maybe that's your new nap duration.
Fallon Cook (52:07)
Mmm.
Dr Laura (52:33)
and then you stabilize bedtime, bringing it a little bit earlier. What do you think, Fallon?
Fallon Cook (52:39)
No, I think that's that's really good advice. I think ⁓ yeah, could be some little tweaks to the daily rhythm that push up the sleep pressure at bedtime that also helps reduce that bit of anxiety around a parent being there at bedtime. So yeah, I think that's a good way to approach it how you've described.
Dr Laura (52:52)
Mmm.
Good, all right, now is it my turn to read out? Yes. Yeah. So Mariah has a six month old baby boy. ⁓ Sleep has been really challenging since birth with long awake periods, a strong morrow reflex, nap refusal, and what Mariah describes as an early sleep regression. Luckily, since starting Sombelle, things have improved. The naps have become easier. Settling takes about five minutes.
Fallon Cook (53:03)
I think so. Yeah.
Dr Laura (53:28)
and he's had some better nights. Phew, I'm glad to hear that Mariah. She says, however, he has a strong negative association with the cot and the bedtime routine. Currently, he's often rocked until he's drowsy, put down and then brought into bed later in the evening after multiple wakes. Dad is often unavailable overnight and the baby doesn't settle well with him anyway.
Fallon Cook (53:31)
Yeah.
Dr Laura (53:54)
So Mariah asks, which cot settling approach is best for a baby with strong negative associations? How can they move away from co-sleeping while staying responsive? And how do they support independent settling when only one parent is usually available overnight?
Fallon Cook (54:12)
Wow, these questions, they're like quite involved. Okay. Now I'm just going to come up with a two minute response. this is, it's a tricky one. Look, I would say there's a few things I'm thinking. ⁓ absolutely check in on that daily rhythm. ⁓ it sounds like quite a lot of waking.
Dr Laura (54:13)
Mm. Yes, I am.
Yeah.
Mm.
Fallon Cook (54:35)
and I would want to be really confident that daily rhythm is very precisely fitted to this child's needs so that they're only being put down when they are genuinely really tired and really ready for it and that makes everything so much easier and I wouldn't proceed with making any changes until that is absolutely locked in. Now...
Dr Laura (54:35)
Mmm.
you
Yeah.
Fallon Cook (54:56)
He's got negative associations with the cot and bedtime because of past experiences he's probably, you you've been trying to settle him when sleep pressure wasn't there. So he's just found it very, very frustrating and he's still reacting, expecting bedtime to be really frustrating. The only way he's going to realize bedtime is no longer frustrating is by continuing to work on that daily rhythm so that there's always high enough sleep pressure. So he realizes, this place is okay. I don't spend hours here awake and crying anymore. I actually just fall asleep really quickly. But that requires parents to really
Dr Laura (55:04)
Hmm.
Mmm.
Hmm.
Hmm.
Fallon Cook (55:25)
in building confidence in their child and it requires parents to have confidence and believe that their child can manage these changes. So sometimes we are so worried that, they don't like it, they don't like it and we really hesitate and we're quick to pull them out of that environment which is kind of sending the message to our baby, yeah this place is horrible, that's why I'm quickly getting you out of here and we're not persisting with anything too long. So I always encourage parents to just think about, your actions showing your baby
Dr Laura (55:35)
Hmm.
Mmm.
Fallon Cook (55:55)
they're confident, they're capable, they can do this? Or are we inadvertently kind of saying to them, yeah, you probably can't do this. It is a bit too scary for you. So just trying to think about that a little bit. Sometimes that helps parents to just go, no, of course they're fine. Their cot is safe. They've been here before. I'm right here with them. They're okay. We can stop for breaks whenever we need to. There's lots of cuddles. There's lots of support, but you just keep persisting with it. Because by persisting, you're showing your child, this is fine. This is safe and it's okay. And it's actually lovely because I'm right here with
Dr Laura (56:04)
Mmm. Mmm.
Hmm.
Hmm.
Yep.
Fallon Cook (56:25)
and we're singing and patting and whatever it is that you've decided to do. It just takes some persistence. If you keep backing off when they cry harder they take that as a sign that okay yeah this this place is horrible ⁓ and I shouldn't be here. So which approach is best for this baby? That's it's it's the approach that you can stick to consistently I would say.
Dr Laura (56:28)
Yeah.
Yeah. ⁓
Yeah.
Fallon Cook (56:47)
That's really the truth of it. It's the approach that you think, ⁓ yeah, that feels manageable for me because the approach that is consistent is absolutely the approach that is going to work.
Dr Laura (56:53)
Mm-hmm.
Fallon Cook (56:58)
In terms of moving away from co-sleeping while staying responsive, course, switching from co-sleeping to not co-sleeping, big, big change. You're definitely going to stay responsive. Often for these parents, I suggest that they because the parent bed, if the parent bed is within sight of the cot and you're going to try and keep them in the cot, they're going to rage because they can see where they want to be right there and you're not putting them there. So sometimes parents find it helpful to set up the cot and a spare bed in the nursery. So it might be that they
Dr Laura (57:06)
Mm-hmm.
Yes.
Fallon Cook (57:28)
moving out of the parent room or just into a different space, you're still gonna be sleeping nearby, but it's a different bed and I would use a different pillow, different doona, so it looks very different, smells very different. ⁓ And then when they wake up and they see it, they're not really expecting to go into that bed. And that can help a lot because then the place where they'd rather be is not visible, it's kinda out of sight, out of mind. And that can be really helpful, especially for older babies as well. ⁓
Dr Laura (57:30)
Mm-hmm.
Mm-hmm.
Mmm.
Mm-hmm.
Fallon Cook (57:53)
And then in terms of with only one parent being available overnight, how do they support independent settling? That's where choosing the approach is so important. It's got to be something that you can manage, even if it is just you doing all of the settling overnight. ⁓ You know, just from hearing all of this, I'm thinking something like...
Dr Laura (58:06)
Mmm.
Fallon Cook (58:12)
maybe the quick fade approach so Mariah could have a spare bed right beside the cot and be constantly giving hands on support while her baby gets used to only falling asleep in the cot.
Dr Laura (58:19)
Mmm.
Fallon Cook (58:23)
and then you can phase out that support when you're ready. There's so, I could say so much more, but I've got to dial it in because I know we've got three questions left and we're quickly running out of time. But Mariah, I hope that's helpful. And if you need more support, yeah, please book a coaching call because I'm sure there's lots we could talk about and work up something that works really well for you.
Dr Laura (58:24)
Mm.
Yeah. Yeah. Yes, we are.
Yeah.
Fallon Cook (58:44)
Alright, so let's jump into Grace who has a three-year-old girl. ⁓ Grace says her three-year-old doesn't nap. She wakes up at 630 a.m. each day and has a consistent 730 p.m. bedtime and she settles independently. It's like the Holy Grail. Well done, Grace. Although she does say recently she started waking every second or third night at around 1 a.m. and needs resettling. It's usually just a quick cuddle and it works. Sometimes it takes a little bit longer. Why might a previously settled priest
Dr Laura (58:59)
Yes!
Fallon Cook (59:14)
schoolers start having recurrent 1am wakes and could this be nightmares or something else? It sounds really normal doesn't it? Like yeah... yeah...
Dr Laura (59:21)
It does. It sounds really normal. Yeah, it is quite
common for three year olds to wake up once a night. The fact that it's just a really quick resettle with a cuddle is great. Sometimes it takes a little bit longer, but it doesn't sound like it's anything that is blowing out of the realms of typical sleep behavior for a three year old. If it becomes...
Fallon Cook (59:35)
Thank
Hmm.
Dr Laura (59:46)
really tricky grace then I'd think about having some kind of reward system so that your daughter gets a sticker and a little gift in the morning for not having called out overnight. You could consider giving her giving her teddy a cuddle as part of the bedtime routine so that when she wakes up in the night your daughter knows if she cuddles her teddy it's got a mummy cuddle in it.
and that might encourage her to roll over and go back to sleep but the fact that it's just quite infrequent and it's a quick resettle doesn't say and she's not upset so she's not upset and crying and taking a long time to resettle so that rules out nightmares ⁓ yeah I'm not thinking that it's anything that is it's not shouting sleep disorder at me currently
Fallon Cook (1:00:21)
Mmm.
Yeah.
Mmm.
Mmm.
Yeah,
yeah, same. think all you might need to do is make sure it's really boring and minimal stimulation when you go in there. You know, wait a few minutes and see if she can resettle herself. And then if you do need to go in, you know, try and get it down to just a phrase of I'm here, it's time to go back to sleep and see if you can be hands off. You know, maybe it's not a cuddle, but you're just working on just giving some verbal reassurance or some, you know, comfort, some physical padding or stroking or something ⁓ in the bed or cot and just aim to keep it really low key. Because if
you start to rush in and pick up then often they're like well if I keep fussing I can cut a longer and maybe I'll do it two times but it starts to dial up so yeah hopefully by just
Dr Laura (1:01:19)
Yes.
Yes and look sometimes
this is an idea of the cuddle bucket which I think I might have spoken about before where you have a picture of a bucket and during the day your little girl colours the bucket in every time she has a cuddle and you say good your bucket's all full now you don't need cuddles overnight and so in the night when you go in just to reassure her you can say remember your bucket was full of cuddles you don't need any more now so that again is a behavioral approach that you can use.
Fallon Cook (1:01:46)
Mmm.
Dr Laura (1:01:50)
But yeah, hopefully it ends soon, great. But if it starts to worsen, just double check that daily rhythm and make sure that she's not motivated by those interactions in the night. ⁓ All right, now Gabrielle has written in, she has an eight month old baby boy. He has a low total sleep need of around 10 and a half hours ⁓ and it's chronic catnapper.
Fallon Cook (1:02:04)
Yeah, I think that's a great plan.
Dr Laura (1:02:16)
He's on three naps around 25 to 30 minutes each and won't nap longer unless held or in the car. A later bedtime of around 9 p.m. gives him the best night time stretch of sleep, but it makes a two nap schedule impractical. Despite reducing the total day sleep and implementing other strategies, he still wakes at least five times overnight. Gabriella, poor thing.
So Gabriella wants to know, should they keep pushing towards two naps despite them being short naps ⁓ and frequent wakes? Or is there a different approach needed to help consolidate both naps and the nighttime sleep? that's a tricky one.
Fallon Cook (1:03:02)
Mmm.
Yeah,
look Gabriella, thing. It's really really hard to have a baby with such a low sleep need. It is really really challenging. And I know from, I did read over the longer email the other day when it came through, this is something Gabriella's really been working really hard on and finding it really really hard to get to two naps. Look there are a few things going through my mind. If I was having an appointment with Gabriella I would really want to assess that there's not any snoring, noisy breathing or mouth breathing happening.
Dr Laura (1:03:12)
Yeah.
Mmm.
Fallon Cook (1:03:34)
especially during sleep because it just sounds like they're very very tired in the daytime so I definitely want to explore that and make sure there's not something else going on ⁓ no other symptoms that could be ⁓ contributing to things but look overall my feeling and I know Gabriella probably just doesn't want to this at all ⁓
Dr Laura (1:03:34)
Hmm.
Hmm.
Yeah.
Fallon Cook (1:03:55)
But there's not an eight month old on this planet who, you know, who can have three naps and, you know, be waking five times overnight and for that not to be because of the third nap. the third nap, three naps for an eight month old, it's just, it's rarely, rarely, rarely would work. Most eight month olds absolutely cannot have three naps.
Dr Laura (1:04:07)
Mmm.
Fallon Cook (1:04:18)
I think what I'd be trying to do is plan out a few days where you've got a lot of support around you, a lot of distractions. You might even go and buy a tub of brand new toys, you know, to open so that you've got good distractions on hand. I wouldn't be going in the car or going out anywhere because you want to avoid accidental naps. And I would be pushing really hard to get to a two nap schedule. ⁓ because that higher sleep pressure is going to help reduce those night wakes. And when that happens, he's going to wake up more.
Dr Laura (1:04:18)
Hmm.
Hmm.
Mm.
Hmm.
Fallon Cook (1:04:47)
refreshed from a lovely night of consolidated sleep and he's very likely to power through the day totally fine on those two naps making it through to bedtime totally fine. But you're in that horrid cycle where the nights are horrible so he's trying to play catch-up with extra day sleep which leads to horrible nights and it's just it's honestly the worst cycle to be in. It's so hard. It's so hard to get out of it but it can be done it's like adjusting to jet lag we just have to push through it's gonna be tough but get lots of support around you. Work out
Dr Laura (1:04:49)
Mm-hmm.
Mmm.
Yeah, it is.
Hmm.
Fallon Cook (1:05:17)
what days you're going to do it and just go all in on making it happen. That is my gut feeling. Maybe if we met for an appointment we would come up with something else. I don't know. It does sound particularly tricky. ⁓ But that, you know, from that information that that's my kind of thinking. Do you agree with that Laura?
Dr Laura (1:05:21)
Yeah.
Yeah.
Yeah,
yeah, I do. You might want to have a chat with your GP or your health nurse before you get going. Particularly if there are any, even if there's a sniff of a red flag around eczema, gut irritation, or unusual breathing. yeah. And once you get the all clear from them, then go ahead.
Fallon Cook (1:05:49)
Mmm.
Math breathing, noisy breathing, mmm.
Dr Laura (1:06:04)
But if look, if all of that, if you're not hearing anything and seeing anything, then yeah, I would, yeah, I 100 % agree with your suggestions, Fallon. But Gabriella, if you want to have a coaching call to talk it through, then absolutely do because parents who have low sleep need babies are having a whole different parenting experience from those who have babies with average and above average sleep needs. So you're parenting for so many more hours every day.
Fallon Cook (1:06:30)
Hmm.
Dr Laura (1:06:33)
So at the end of two years you're probably parented for six months longer than everyone else.
Fallon Cook (1:06:34)
Yeah.
Yep, you'll be feeling it for sure. Yeah, I
think that's really good advice. And lucky last we have Sophie who has a nearly six month old baby girl. She generally needs about 11 and a half hours of overnight sleep. She's on three naps, usually 40 to 45 minutes each, sometimes closer to 35 minutes. Bedtime is 7.30pm and wake up is around 6am with a 10pm dream feed and one overnight feed at 1am. They stopped feeding to sleep
just after four months and settle with padding and shushing. The dummy was removed last week, which helped, but now she resists settling with dad and wakes very distressed after her first night's sleep cycle. Pickups don't calm her, so mum feeds her back to sleep. Once resettled, she sleeps well for the rest of the night and is otherwise a happy baby. So why is this first sleep cycle wake up always happening? How do they fix evening settling so bedtime isn't so drawn out?
And how can dad reliably do bedtime as mum prepares to return to work?
Dr Laura (1:07:44)
All great questions Sophie. It is another meaty one. your daughter might well be six months old now, given that I know that you sent this in a couple of weeks ago. So she may well be ready to drop down to just two naps, particularly because the false start. Yeah, so that is a false start. She's waking up after one sleep cycle.
Fallon Cook (1:07:46)
Another meaty one.
Mmm. The full start really screams it, doesn't it? Mmm.
Dr Laura (1:08:12)
and is really crying loudly. So that suggests to me that the sleep pressure is just not quite high enough at the start of the night. Excuse me. And potentially she's when she's resisting her dad putting her down again, that's a sign that the sleep pressure is not high enough because she's got the energy to resist dad settling at bedtime. So I would be thinking about dropping that that third nap.
Fallon Cook (1:08:34)
Mmm.
Dr Laura (1:08:42)
moving to just two naps a day, having a close look at the unique sleep needs so that the bedtime and wake up are appropriate. Because you're saying she needs 11 and a half, does she need 11 and a half hours overnight or is that the average amount that she's having? I'm a little unclear what her overall sleep need is and I'm sorry Sophie if you did include that in the original email. But double check that the daily rhythm
Fallon Cook (1:09:09)
Hmm.
Dr Laura (1:09:11)
really matches what she's actually having and not what you'd like her to be having and that is likely to help her dad settle her and help stop that false start at the beginning of the night and then once you've made those changes to the daily rhythm making sure that both you and her dad are doing exactly the same thing at bedtime
so that she learns that it's team parent. ⁓ Nothing changes if dad does it versus mum does it. At the moment what she's experiencing is that ⁓ ultimately she'll get a feedback to sleep which you have otherwise managed to wean which is brilliant but she's learnt that when dad comes in to settle her if I really... ⁓
cry a lot, then I will get a different settling approach. I'll get that feed to sleep. So ⁓ making sure that you are both doing exactly the same thing. And if since you've stopped the feeding to sleep, don't reintroduce it because it's confusing for babies once you've moved away from that.
Fallon Cook (1:10:08)
Mmm.
Mm.
Yes.
I think you're
absolutely spot on. think as well with the padding and shushing to sleep, test it out on your partner as well. Like are you padding the same? Is one of you doing a heartbeat rhythm and the other one's doing this really fast constant kind of rhythm? Make it identical. So practice on each other. How are you going to pat? And the shushing, are you going shh shh shh shh and dad's going shh.
Like just try and standardize it so that your baby's just thinking, this is exactly the same. Nothing's changing. ⁓ And then don't forget to phase it out. Don't get stuck on padding and shushing all the way to sleep. That needs to be phased out as well. ⁓ If you really want to galvanize those nights and have a sleeping really well in the long run.
Dr Laura (1:10:46)
Yes. Yes.
Yes. Yeah.
Yeah.
Fallon Cook (1:11:04)
⁓ Excellent. Well, thank you so much to all the parents who sent in these fantastic questions. Because some of them were meaty. I can't believe we got through nine of them. Like we almost could have dedicated an episode to some of those. yeah, you have.
Dr Laura (1:11:11)
Yeah they were! ⁓ You kept us on our toes! Yeah we could! And we don't really,
we don't read these ⁓ necessarily until we are here recording so we are really thinking on our feet aren't we? Like, Yeah.
Fallon Cook (1:11:24)
Yeah, we definitely are. ⁓ But no,
we absolutely love our Sombelle members. We love that you're submitting these great questions because like ⁓ with Gene who bought us the coffees and left that great message, there are plenty of people listening in who aren't members who haven't seen us in clinic, but they find the answers to the questions really helpful and gives them guidance. And I know there are people who say you need to monetize that, but...
Dr Laura (1:11:49)
Yeah.
Fallon Cook (1:11:50)
I hope that we can always be doing work where for parents who have mild problems, they get the help they need and they're on their way and it's great. Like that's, we always want to be putting something really good back out there ⁓ into the kind of ⁓ parenting sphere, I suppose, which can be so muddied with so much misinformation. So yeah, thanks to the parents who submitted those awesome questions. If you are needing further support, I'm sure you probably figured this out already, but we have appointments and a sleep clinic.
Dr Laura (1:12:00)
Mmm.
Yeah.
Fallon Cook (1:12:20)
You can now book in for an initial appointment with me for a couple of years. I wasn't doing these. wasn't taking new families, but I am again now and that's via Tally Health. no matter where you are, provided you're not in the USA or any of its territories, then I can see you for an initial appointment.
⁓ And Tally Health works just as well as in person. ⁓ Laura, you have some availability really soon actually, which is surprising. Next week in Malvern in our brand new, beautiful, amazing clinic, you actually still have some spots available and I know they're not going to last long. So if you're listening to this, ⁓ the episode's just come out. ⁓ Just know that you can see Laura next week if you're in Melbourne. ⁓ So yeah, definitely go and check that out. We'll put some links in the show notes. And of course, if you're just thinking, ⁓ this program sounds
Dr Laura (1:12:49)
Yes.
Fallon Cook (1:13:06)
I want to give it a crack go and do it We've got a bit of a sale on at the moment to make it a bit easier for families to afford because the cost of living is completely nuts Yeah, you can go and check that out too. And just lastly if you love what we do Please leave us a review give us a five-star rating. Make sure you hit the subscribe button in your podcast app It really helps us to get out there and in front of more parents and buy us a cuppa If you want to would always love it. We love our coffee Thanks everyone for tuning in
Dr Laura (1:13:08)
You
Yep.
Yes.
Fallon Cook (1:13:36)
and have a fantastic week!
Dr Laura (1:13:38)
Thanks everyone, bye bye.
