Fallon Cook (00:37)
Today we're tackling one of parenting's most exhausting curve balls, the low sleep needs baby or toddler. We're going to talk about managing life with a low sleep needs child and we're ditching the guilt.
We're dropping the pressure to fix them and getting into the real world strategies that are going to help you and your low sleep needs child thrive.
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 things going in that beautiful new clinic of yours?
Dr Laura (01:34)
are really well. I'm just loving it. It's the most beautiful space for families to come and see me. ⁓ And there's a room outside my main room so if you have really energetic toddlers who doesn't want to be running around, they don't need to be contained within the one room. ⁓
Fallon Cook (01:37)
Mm.
Dr Laura (01:57)
And it's just lovely. It's so beautiful. The reception staff are so welcoming and all of the pediatricians have made me feel really welcome and almost like I'm part of the furniture now. So yeah, it's great. And if people want to come and see me there, please do because it's such a lovely spot.
Fallon Cook (01:57)
Yeah.
Mwah.
Yeah, amazing. Oh, I love it. It's so nice that you've found this great home to sort of be within and make such a difference when it's a real child-friendly space, you know, where parents can just chill and their kids can be kids and that's totally fine. Oh, love it. That's so good.
Dr Laura (02:29)
Mmm.
Yes. Yeah, that's right.
Yeah.
Fallon Cook (02:39)
And we have had some coffees come through from Bree and Steph. So I wanted to do a quick shout out. Thank you so much Bree and Steph for shouting us a coffee. ⁓ We absolutely love it. It's really lovely. When those emails come through, it's like, so nice. Yeah.
Dr Laura (02:43)
⁓
Are we too?
Yes, really, really nice. So
thank you so much. We really appreciate it and appreciate the lovely words that come with them too. So yes, thank you, and Steph.
Fallon Cook (03:07)
Yeah, amazing. And, you know, we, had this ⁓ post on social media during the week about low sleep needs that kind of went crazy. We've got lots of people really interested in what we had to say. We're sort of challenging this, you know, idea that we sometimes see online from influencers saying, you know, there's no such thing as low sleep needs. ⁓ And I thought, well, excuse me.
Dr Laura (03:17)
Mmm.
you
Fallon Cook (03:34)
There is. So yeah, we spoke a few truths. ⁓ but it was, it seemed to get a lot of interest from parents and a lot of shares amongst tired parents, which is awesome. And it kind of tells us that that's what you guys want to hear a bit more about. So yeah, we were thinking that today we'll talk a bit more about low sleep needs babies and toddlers and how we can kind of manage that. And I think even if you do have a baby or toddler that has higher sleep needs by tuning into this episode, you're doing.
Dr Laura (03:35)
Yes.
Mmm.
Yeah.
Mm.
Fallon Cook (04:04)
your friends a favour, your friends who have a low sleep needs baby or toddler. ⁓ I think this is something that we all need to know as parents to be a little bit more empathetic to those around us who have babies or toddlers that just don't sleep the way our children might. So let's dive into what actually constitutes low sleep needs. Laura, what do reckon?
Dr Laura (04:06)
you
Hmm.
Yes.
Well, I would say that we need to look at the different age ranges.
when we're answering this question. So if we're thinking about newborns, for example, so that's the first three months we've really considered newborns. And the typical range of sleep for newborns is so wide, it could be as high as 19 hours per 24 hours, and it could be as low as 11 hours. So when we're thinking about newborns who are low sleep needs, it's those that are averaging between 11 and 13 hours per 24 hours.
Fallon Cook (04:46)
Mm.
Mm.
Dr Laura (05:03)
Then when
we're thinking about older babies, so four to 12 months of age, the typical range reduces slightly, but it's still wide. It's from 10 hours to 18 hours per 24 hours. And so if we're thinking about those babies with low sleep needs, really they're averaging somewhere between 10 and 12 hours per 24 hours.
Now with toddlers, the typical range for sleep needs is between nine hours and 16 hours. So those who would meet the criteria for being lower sleep needs would be averaging between nine and 11 hours per 24 hours. So those families who have those low sleep needs, babies and toddlers, ⁓
Fallon Cook (05:45)
Hmm.
Dr Laura (05:52)
are
parenting a lot more than those parents who have the babies and toddlers at the top end of those ranges that I just spoke about.
Fallon Cook (05:55)
Yeah.
Yeah, I think it can be so exhausting. There's a lot. Yeah, there's less time for rest when you're parenting a low sleep needs baby or toddler. I find it so fascinating that.
Dr Laura (06:09)
Yeah.
Fallon Cook (06:13)
You know, there's potentially between seven and eight hours of variability in total sleep needs, you know, from baby to baby. It's no wonder, you know, we hear parents say, my baby, you know, this is nothing like this one in mother's group that just sleeps all the time and mind's awake and wide eyed all the time. yeah, it's just.
I think we need to stop pathologizing low sleep needs because I think for so many parents, they're like, my gosh, I must be doing something wrong because my baby just isn't sleepy and just won't nap. And we get it drummed into us that sleep is so important. ⁓ But what I would say is sleep quality is important, but the amount of sleep you have, I mean, obviously it's important. We don't want sleep deprived humans. ⁓
Dr Laura (06:40)
Yes.
Yeah.
Mm-hmm.
Fallon Cook (06:56)
at any age, but ⁓ you know, babies and toddlers are very good at making sure they get the amount of sleep they need. And it's actually pretty rare that they're not achieving their sleep needs, but we'll dive into that a bit today and unpack that a bit more as well.
Dr Laura (07:05)
Mmm.
Yeah,
so we have kind of touched a little bit upon the challenges that ⁓ parents face who have low sleep needs babies, ⁓ so can you just talk us through what are the common challenges for low sleep needs babies?
Fallon Cook (07:28)
Yeah, I think a lot of parents will describe that their, you know, low sleep needs baby has a serious case of FOMO. They've got that fear of missing out. They're so energetic, but these babies seem to want to learn and engage and often move. So parents will say, ⁓ you know, they're a great baby. They're so happy and there's so much fun to play with.
Dr Laura (07:37)
Hahaha.
Fallon Cook (07:51)
But they just go and go and go and I'm tired and my baby's not tired. You know, so there's that challenge of kind of recognizing that, hang on. I've got a baby that actually is prioritizing learning and engagement and playtime over sleep and kind of then thinking about, how do you adapt the day to kind of suit those needs? I think that that can be challenging for parents who are often expecting a very sleepy baby who does long naps and it's not what they got served up. ⁓
Dr Laura (07:54)
Yeah. Yes.
Mm-hmm.
Yes.
Fallon Cook (08:19)
I think another really big challenge is that when a baby or toddler has a lower sleep need, it is so easy for the balance of day sleep and night sleep to just go wildly astray. ⁓ you know, it doesn't take much extra day sleep to just tank the nights, you know, for some of these low sleep needs babies, if they overdo the day sleep just a little bit, they're just not left with enough sort of sleep in the tank to actually have a good night. You know, if there are 10 hours sleep need,
Dr Laura (08:31)
Yes.
Mmm
Mm.
Fallon Cook (08:47)
⁓ baby and they have three and a half hours of day sleep and they're only looking for, what did I go blank? Six and a half hours. Come on, Fallon, do your math. Six and a half hours of overnight sleep. ⁓ chances are, I mean, that baby might sleep six and a half hours in a row, but then be wide awake and ready to start the next day at probably two or three AM in the morning. ⁓ or they're just going to wake up all the time overnight. So it's really, ⁓ lots of.
Dr Laura (08:55)
That's six and a half, I think. ⁓
Yes.
Fallon Cook (09:17)
Parents will say the challenge is trying to figure out like how much day sleep can they have without the nights being really tricky. ⁓ and the other really big thing, and I think this is where we see so many families coming in to see us with this problem. It's that if the low sleep needs isn't being catered to, so we're getting lots of time where there's low sleep pressure overnight, you know, we just haven't kind of figured out their daily rhythm. Then the number one thing is that any attempts for self settling or cot settling will not stick.
Dr Laura (09:23)
Yes.
Mm-hmm.
Mm-hmm.
Fallon Cook (09:46)
You might, if you're lucky,
Dr Laura (09:47)
Yeah.
Fallon Cook (09:48)
you might get a few days of progress, but it just, there's nothing you can do. You can try and be as consistent as you can be. But if their sleep, unique sleep needs aren't being met and catered to, you're going to get these long periods of time with really low sleep pressure where nothing is going to work. And that's something we see a lot, particularly after ⁓ sleep school visits where the sleep school has helped the family to learn how to settle their baby in a cot.
Dr Laura (09:50)
Mm-hmm.
Yeah.
Fallon Cook (10:14)
But then the daily rhythm is not catering to a low sleep needs baby. get home and they're trying to follow often a bit of a schedule that they've been given, but it just, it just doesn't stick. And you just can't, yeah, sleep pressure is too low in a low sleep needs baby or toddler. They can push back for hours and hours. And it's really unrealistic to think that any parent can be settling for that long without, you know, kind of losing their mind a bit. I definitely would have lost my mind.
Dr Laura (10:15)
Mm-hmm.
Yeah.
Yeah.
Yeah, it's
so hard when...
their parents are saying, well, I'm doing exactly what they showed me in the residential stay and I'm following all the advice, but those settles are taking an hour or two every nap. And if that child's on three or four naps a day, that's so demoralizing. And often the settling approaches that the sleep schools are giving are evidence-based. They're pretty ⁓
Fallon Cook (10:51)
Yeah.
Yeah.
Yes.
Dr Laura (11:15)
sound
approaches. They should work, but when they...
Fallon Cook (11:16)
They should work. Hmm Hmm
Dr Laura (11:21)
being used at a point where the baby isn't quite ready for sleep, it just leads to these really long settling times and a lot of upset for everybody. And it's just,
yeah, it's not sustainable and it's also just not necessary. if you feel that you're in this situation, you have come home from sleep school ⁓ and your child's what
the progress that they seem to make in those five days at a residential stay are just not sticking, then that may be the missing piece of the puzzle.
Fallon Cook (12:00)
Yeah, completely agree. think we've seen that a lot and from parents who say, yeah, I've just tried everything. And often I feel a bit heartbroken when they're describing months of working so diligently at their goals. And I just think, man, I would have given up that within a day and they've done it for like three weeks. And I think, oh my gosh, you poor things. Yeah, it's just, yeah, so tough. think parents are incredible.
Dr Laura (12:16)
Yes!
Yes. Yeah.
Fallon Cook (12:28)
how hard they can work at things when they're determined. But what can we do about low sleep needs, Laura? So maybe some strategies and how would we tend to kind of look at managing low sleep needs babies and toddlers?
Dr Laura (12:31)
Yeah.
Mmm.
So it's really important to cater to their true sleep need. ⁓
refer to the unique sleep needs chapter in Sombelle for guidance about how to do this and charts to help get started planning out a daily rhythm that is catered to their sleep needs. So for example, if you find that your eight month old has an 11 hour average sleep need, then cater to that by giving them 11 hours of opportunity to sleep. Don't try to give them 13 hours of sleep opportunity,
because they're very very unlikely to take that sleep consistently and that's where you will end up in a situation where you're spending a long time settling or you just give up and your little ones are waking multiple times a night.
really ensure you're catering to their true sleep need. That is the main piece of advice to support families who have realised that they do have a low sleep needs baby.
Fallon Cook (13:45)
Mmm.
Yep.
Yeah. I completely agree. I think that's so key. I often see families where, you know, there's a 12 hour sleep need, baby's having maybe two hours total day sleep, but then has a 12 hour block for sleep overnight. They're doing that good old 7pm to 7am and it's like, they can't do it. They can't do it. They're going to either push back at bedtime or wake a million times overnight or just be awake for a couple of hours in middle of the night.
Dr Laura (14:06)
Yeah.
Bye.
or start the day early?
Fallon Cook (14:19)
Yeah, yeah, yeah. Yeah, really early wakes. Yeah.
Dr Laura (14:19)
Yes, yeah, that's right. You cannot make a child sleep more than they need consistently. You just simply can't do it. In the same way that an adult, you can't make an adult sleep more than they biologically need. You know, when I do...
Fallon Cook (14:28)
Mm-hmm. Yep.
Dr Laura (14:38)
⁓ speak to parents about this in the clinic, Fowen, often a question that I am asked is how can we be sure that our baby truly is low sleep needs and not just sleep deprived? I'm assuming you hear that a lot as well. How would you answer that concern?
Fallon Cook (14:52)
you
Oh, yes.
Yeah. Yeah. And it's a really valid concern. And, you know, this touches on something you mentioned a minute ago about not being able to force a human to sleep more than what their actual true, unique sleep needs are. And a really good piece of research came out in 2021 by Feng Gu Po and colleagues. And it was a fantastic systematic review and meta analysis of randomized controlled trials. And it looked at
Dr Laura (15:00)
Mm.
Fallon Cook (15:23)
do sleep interventions actually change sleep duration in children aged from zero to five years of age? So it really digs into this question of can we increase sleep duration or not? And what do you know? No, we can't really. Some of the studies were showing, and this is a systematic review, so it's the best type of gold standard research where it looks across lots of different studies and kind of looks at results overall. And some studies showed a tiny,
Dr Laura (15:28)
Mmm.
Mm.
Thank
Fallon Cook (15:53)
increase of about eight minutes. So about eight minutes is all you might gain. I mean, it might be the best eight minutes of your day, but you know, we're talking, they're either found no change or maybe a slight increase, but you know, there are people out there claiming like, you know, you can do this special sleep training that I've designed and it's going to make your baby sleep for an extra two or three hours per day.
Dr Laura (15:55)
Right. ⁓
Yeah.
Yeah. Yeah.
Fallon Cook (16:18)
To that, I would say maybe you'll get one random day like that, but over the following days, they'll undershoot their sleep needs to compensate for that one very long day. So, yeah, so there's definitely research that indicates that we can't increase the total sleep time, ⁓ for the babies who are learning how to self-settle, cot-settle, like that. It's tends to be pretty steady. ⁓ but I think what's really important to consider is how are we completely confident? Yeah. Like, you know, if you were working with a baby with a
Dr Laura (16:24)
Yes.
Yes.
Fallon Cook (16:47)
11 hour sleep need, right? We want to be so sure that we're not depriving them of extra sleep that they might actually need. So to be sure of that, we're always looking at mood is one of the first things. So are they horrendously tired all day long? Look, it really normal if you're trying a new daily rhythm, they might be horrendously tired all day long and you might have to give it a week for them to settle in and actually know if it works. So the odd day where they're really cranky, I'm not so worried about, but
Dr Laura (16:54)
Mm-hmm. Mm-hmm.
Mm-hmm.
Mm-hmm.
Mm-hmm.
Fallon Cook (17:15)
If they're truly low sleep needs, they'll be happy as anything on their tiny little bit of sleep. They will power through the day. Parents will say, no, they wake up, they're fine. They're raring to go. Like that's your sign that the amount of sleep they're getting is actually working for them because a chronically sleep deprived baby or toddler is constantly just a disaster. They're so difficult. They're never really very happy. It's really, really challenging. So that's one thing we're looking at.
Dr Laura (17:18)
Yeah.
Mm-hmm. Yeah.
Fallon Cook (17:40)
But we're also always checking for medical factors that could be impacting the total amount of sleep that they can achieve. So a baby or a toddler that's suffering from sleep apnea, where they're constantly being woken and having really poor sleep quality, they might struggle to meet their total sleep needs because there's a biological factor that's impacting them from doing so. Same for things like if we're seeing a lot of signs of pain and gut irritation, that can start to really impact.
Dr Laura (17:47)
Mm-hmm.
Fallon Cook (18:10)
that total sleep amount as well. So we're checking for those sorts of things. And I would say most importantly, when we're working on, you know, building these daily rhythms for families that really fit these unique sleep needs, what we often aim to do is we get the daily rhythm sorted, sleep pressures cooking along beautifully, then we might be working on cot settling if that's the family's goal. Once we've made that progress with cot settling, you know, everything's going well, all goals are achieved.
Dr Laura (18:12)
Mmm.
Yeah.
Mm-hmm.
Fallon Cook (18:38)
We will always say to families, okay, now we're going to try and add more sleep in and let's see what happens. So in every sleep plan we ever write, we're always saying, if you had a couple of weeks, it's been really lovely and settled. Add 30 minutes more to that daily rhythm and just see what happens. Do they take it and you know, great. Like if they do brilliant, or do they then start to be an absolute disaster at bedtime, bedtime suddenly taking 30 minutes or
Dr Laura (18:42)
Mm-hmm.
Mm-hmm.
Yeah.
Yes.
Fallon Cook (19:04)
They're waking up for around about 30 minutes in the night, or they're waking really early. Like, do they actually take the sleep and are they happier for it? Or are they just not taking that sleep and actually waking up at other times? So that's how we approach this with our scientist hats on. We do, you know, think about, ⁓ that, that daily rhythm and the sleep needs in a bit of a scientific way. So if everything's going well, we're absolutely going to trial adding that bit more sleep and really testing to make sure we've got.
Dr Laura (19:07)
Yeah.
Yes.
Mm-hmm.
Fallon Cook (19:32)
or every baby and every toddler getting the maximum amount of sleep that they can without giving so much opportunity that the wheels fall off. Yeah. ⁓ Hmm.
Dr Laura (19:40)
Yes, yeah I think that's great Fallon. It's good about
we meet the baby where they're at, we ⁓ address the goals that the family has, be that moving them from a bassinet into a cot or from a cot into a bed or whatever the goals are.
based on their current average sleep duration and then once we've met those goals we then trial adding more sleep in but we go really gradually. If you have a very low sleepiness toddler that only has a nine hour sleep need for example we'd be suggesting that you trial adding more sleep in in a much shorter amount so 15 minutes because that 15 minutes relative to their total sleep need is a lot versus 15 minutes for a toddler that's got a
Fallon Cook (20:12)
Mmm.
Yeah.
Yeah.
Dr Laura (20:29)
14 hour sleep need. there will be, you if you come and see us in the clinic, we'll have some slightly different advice depending on how low your child's sleep need is. But we just, yeah, meet them where they're at, address the goals, and then add in extra sleep opportunity in increments that are suited to your child. And we see how much extra we can add in.
Fallon Cook (20:38)
Mmm.
Mmm.
Dr Laura (20:54)
and see if that improves mood, behaviour ⁓ without ⁓ the night time falling over.
Fallon Cook (20:54)
Yeah.
Yes. And it's not uncommon, I think for families that they follow up appointment to say, ⁓ I'm not touching that daily rhythm. have finally nailed it. And my kid is sleeping brilliantly and they're as happy as anything all day. I do not dare touch that daily rhythm. We're keeping it. And I'm like, okay, you know, they're managing, they're happy. You're happy. I'm happy. Yeah. Can be, can feel a bit scary to dare to tinker with something that's working well. That's for sure.
Dr Laura (21:09)
Yeah.
Yeah.
Yes. Yes.
Fallon Cook (21:31)
But look, just as a final note, I just want to really impart to parents that, you know, there's, I often see families that say, we went to all these other places or other people and we would just kept being told that we just have to try harder. We have to try harder to make this daily rhythm work, you know, and it's something that's age-based and.
Dr Laura (21:31)
Yes.
Mmm.
Fallon Cook (21:54)
because some of the schedules we've seen families put on like, you know, there's going to be four hours of day sleep and 12 hours overnight, like just absolutely bananas stuff. And these poor families are just, when their families go back to the people who gave them that advice and say, you know, it's not working. They're just told, you've just got to try harder. You know, got to do it longer. You've got to do like, and these babies are often screaming. Yeah, exactly. These babies are screaming for hours in the middle of the night. So frustrated because they're not tired enough to sleep.
Dr Laura (22:01)
⁓ Yeah.
Yeah, you must be doing something wrong. ⁓
Fallon Cook (22:23)
And parents are pulling their hair out and being told, you know, you're just not getting it right. You need to try harder or, maybe they're over tired. Give them even more day's sleep. You know, it is maddening. And I think a lot of those people giving that advice don't know how. Unaffected that advice is because rightfully so those parents never go back. They just don't go back to those people when they're being told, you know, you've just got to keep trying. the thing I want parents to know is if you.
Dr Laura (22:24)
Yes.
Yes.
Yes. Yes.
Fallon Cook (22:52)
have tried some kind of schedule and you've just thought this doesn't seem like the right fit for my child. Like this is just too hard. Then it is. you know, believe your gut feeling and chuck that schedule in the bin. ⁓ you know, there are a lot of people out there who know nothing about low sleep needs and how to manage it, who know nothing about the circadian rhythm and you know, how to really assess and kind of modulate sleep pressure and shape up a good daily. They just don't know anything about it. They just know.
Dr Laura (23:02)
Mm-hmm.
Yep. Yep.
Mm-hmm.
Mm-hmm.
Fallon Cook (23:21)
that can put a baby in the cot for it to settle to sleep. And that's all that they're going to keep talking about. So I would say for so many families, it's actually really understanding sleep pressure and unique sleep needs that fully brings their child's sleep together properly. So if you feel like you're not getting advice that's really tailored to your child, chuck it out and don't be scared to look elsewhere. Because I just think the worst thing is when families, and sometimes they do, they come to us with a three or four year old and they say,
Dr Laura (23:26)
Yes.
Mm-hmm.
Fallon Cook (23:51)
Here's all this shockingly bad advice I've had for three or four years that hasn't worked. I'm a shell of myself. I haven't, I can't work. I can't drive the car cause I'm so tired. You know, almost burnt down the house because I fell asleep with something on the stove. Like it can get really dangerous. Do not let that happen to you. And don't let that be your experience of parenthood during these first few incredibly precious years that we don't get back. So yeah.
Dr Laura (23:55)
Yeah.
Yeah.
Mm-hmm.
Yeah.
Yes, I couldn't agree
more Fallon and those older children who I see whose identity has become tied up and being a bad sleeper. You know, I'm a poor sleeper and it just becomes part of their identity and we then we're unpicking that. And if that has happened to you, don't just know that we can unpick it. ⁓ But yeah, I can help you. But it's...
Fallon Cook (24:29)
⁓ yeah.
Yeah.
Yeah, go see Laura. She'll help you.
Dr Laura (24:48)
Yeah, we don't want our little ones to think that they are a poor sleeper, that that is part of their very being. They may just have lower sleep needs, they are bright, they just need less sleep than other children their age. And ⁓ it's just not hasn't been well recognized in the past, but the tides are.
Fallon Cook (25:04)
you
Dr Laura (25:09)
turning, things are starting to change and so if you're feeling that this is ringing a lot of bells and you're not already a Sombelle member, do join Sombelle, check out the unique Sleep Knees chapter.
Fallon Cook (25:11)
Yeah.
Dr Laura (25:24)
and then if you need further help you can have coaching calls with us or you can come and see us in the clinic if you're not Sombelle members you can come and see me in Melbourne if you live in Melbourne or otherwise over telehealth and there's you know a whole group of us who can help you.
Fallon Cook (25:42)
Yeah, everyone on our team has been really trained in unique sleep needs. was so important to us that that had to be the case. ⁓ Yeah, amazing. Well, let's dive into some parent questions and.
Dr Laura (25:49)
Yeah. Yeah.
Fallon Cook (25:56)
You know, if you've listened to this episode so far and you've thought, I've got a question about low sleep needs, do let us know. Cause I think this is a space where we both need to do a bit more work in Laura, you know, around really talking more about low sleep needs, unique sleep needs, how we cater to these things. ⁓ because you're right, there has been a really positive, ⁓ change online where we're starting to see more people be across this type of thing.
Dr Laura (26:07)
Hmm. ⁓
Fallon Cook (26:19)
⁓ so yeah, I'd love for parents to tell us what, what do you want to know? ⁓ and we'll definitely answer those questions. ⁓ but yeah, let's dive into some parent questions as always. We've got absolutely tons. So let's start with Meta who has an 11 month old son with a 12 to 12 and a half hour sleep need. ⁓ he's currently on two naps and is now falling asleep with shushing and minimal padding.
Dr Laura (26:27)
Yeah.
Yes.
Fallon Cook (26:47)
He wakes once or twice overnight and Meta just replaces his dummy and lies him down and he's back to sleep in seconds. So well done. She says, yeah, he also wakes briefly around 5.30 to 4, 5.45 AM, needing the dummy again to get to 3 to 6 AM. She says his nap cycles vary between 35 and 40 minutes and Meta has four questions.
Dr Laura (26:56)
Yeah, excellent.
Hmm.
Fallon Cook (27:16)
I'll read them all out and then we can unpack them. So the first is, should she remove the dummy now while she can still support him with padding or keep fading her presence first? Is the 5.30 AM waking a sign of a morning lark or will it resolve once he can fall asleep independently? Oh, I love that question.
Dr Laura (27:33)
Mm-hmm.
Fallon Cook (27:33)
How
important is getting his sleep cycle length right given it varies and is it true that the short nap should come first on a two nap schedule due to a so-called melatonin hangover? ⁓ I love these questions. All right, let's pick this. Let's start with the melatonin hangover Laura.
Dr Laura (27:44)
Yeah, they're really good. Okay.
Yes,
no, it's not true. You can structure whichever nap is short and whichever nap is long, however suits your family. What we often see is that babies begin to have their longest nap earlier on in the day and they have their shorter nap in the afternoon because that helps with
having enough time to build sleep pressure high enough by the start of the night for your little one to go to sleep easily and to maintain their sleep for long periods overnight. So it's absolutely not true that there's a melatonin hangover ⁓ that means that the short nap should come first. So that's my answer to that question. If we go on to your next one about the sleep cycle length, but if you're
Fallon Cook (28:40)
Mm.
you
Dr Laura (28:48)
your son's sleep cycles tend to be between 35 and 40 minutes then I would just be thinking if you're trying to time the naps and they haven't and it's a short nap just wake him up after 40 minutes has passed if he hasn't woken up himself and then a longer nap would be two of those but you know it might be that he wakes himself a little bit before the 80 minutes you normally get quite a clear understanding if your child
really dislikes being woken when they've just entered the next sleep cycle. Some babies just have experienced that sleep inertia really strongly and will just really be unhappy for about half an hour after you wake them, even if they only had an extra five minutes, whereas others don't really worry. So I wouldn't worry about being really strict unless your baby is like that meta. And then I'll try and stick a bit more closely to it.
5.30am waking, I suspect that that may resolve once you have weaned off the patting. The fact that he's going back to sleep with the dummy at that point and is able to maintain his sleep until six is just telling me that his sleep pressure is getting a bit lower. He's a little bit more aware that he's waking up and you're not there beside him, patting him. So yeah, I wouldn't be ⁓ ringing the bell that this is a morning lark.
at this point. And finally, should you remove the dummy now?
Look, we generally suggest holding on to the dummy if your little one is really loves it after the age of six months, hold on to it until they're of an age where you can actually explain to them where the dummy is going unless they've got recurrent ear infections or there's other medical reasons why they can't have that dummy. So I probably would just.
put lots of dummies in the cot to help him find his dummies overnight rather than trying to get rid of it. If you do want to stop using it meta and that's a parental choice that you're free to make then yes this will probably be the time to do it whilst you're still offering him some hands-on support because he probably won't like it very much. How did I go Fallon?
Fallon Cook (31:07)
Hmm.
you nailed it, Laura. You totally nailed it. I completely agree on the dummy. Like if there's a medical reason to get rid of it. Yeah, absolutely. It's got to be done. But if not, yeah, scatter plenty around the court and ⁓ give him enough time to find them himself in the night. Because often parents go, they dropped the dummy. I'll run in and quickly replace it. Let him feel a bit frustrated. Let him try to do the work of finding where the dummies are. And then often they just get better and better at quickly finding one and putting it back in. ⁓
Dr Laura (31:10)
Hahaha
Fallon Cook (31:36)
Yeah, I think those are fantastic questions and really good answers.
Dr Laura (31:40)
Great. Okay, on to our next question, which is from Jess.
She has a five month old son who was on four naps and she's been trying to move him to three. He was having lots of false starts and waking every two hours overnight. And she found that by moving his bedtime from seven until six, things have improved, but he's now waking at 6 a.m. instead of 6.30. So Jess wants to know, could that long wake window...
at the end of the day have been causing the night wakings and also an additional question of what's the best approach when a baby starts rolling onto his tummy overnight and can't yet roll back independently.
Fallon Cook (32:25)
Hmm. Yeah. So look, I would say no, a long wake window in the lead up to bedtime won't tend to cause night waking. and it sort of depends. I mean, there's so many different factors. It'd be interesting to sort of know a bit more about the full daily rhythm. ⁓ but it does sound a bit like in moving from four to three naps, this baby has just moved more sleep from the day into the night instead. which is fine. But yeah, if you're getting the early wake up.
Dr Laura (32:51)
Hmm.
Fallon Cook (32:55)
I mean look 6am might not be a problem for you Jess but it would just be a case of shuffling everything a little bit later. So you might start to move bedtime a little bit later so that wake up time comes a bit later and you could ⁓ just approach it like that. The best approach when babies start to roll onto their tummy and can't roll back at five months of age if they can't confidently roll both ways then if you notice them roll over you just need to put them back on their back.
Dr Laura (33:08)
Mmm.
Fallon Cook (33:21)
to keep them safe. This is definitely the time to do another check of the sleep space, make sure there's no loose items, no blind cords, nothing in there that could pose a risk. And very, very soon, your baby will be able to roll both ways. And then when they roll over, you can just leave them and they'll find whichever position they find most comfortable and that's fine. But until they can roll both ways, you've got to just keep putting them back on their back if they roll over.
Dr Laura (33:21)
Mm-hmm.
Fallon Cook (33:49)
But yeah, it does pass pretty quickly. So there will definitely be some interrupted nights when they start to practice their rolling in the cot and it's very tiring, but often it is just a week and then they kind of, they've got the memo. They, they know how to stay in their sleep position or otherwise they're rolling both ways and you know, you can't stop them. They're off. Would you add anything to that one, Laura?
Dr Laura (33:55)
Yes!
Yeah.
Yeah,
no, I think that's great advice. Yeah, hang in there Jess. It's a rocky ⁓ period of time when they get stuck because they can't roll back yet. Lots of ⁓ tummy time in the day, lots of practice ⁓ of helping them.
Fallon Cook (34:25)
Yeah.
Dr Laura (34:31)
move both ways during playtime and they can start to use those skills overnight when they're in their cot. ⁓
Fallon Cook (34:39)
Yeah,
and it can be really tricky moving from four to three naps as well. And at this age, they're starting to have a lot longer awake before bed, you know, it be three or four hours or so, which is a big challenge for a lot of babies and it can be a really rocky time. ⁓ But hopefully that all comes together nice and quickly for you, Jess.
Dr Laura (34:54)
Mmm.
Fallon Cook (34:58)
⁓ Angela has an 11 week old boy currently on around five naps of varying lengths with one overnight feed and sometimes a second feed at around 5.30 a.m. He occasionally wakes around 4 a.m. uncomfortable from wind but she doesn't feed him then. Her question is should she start calculating his sleep needs and building a daily rhythm now or wait a couple more weeks?
Dr Laura (35:16)
Mm-hmm.
what a great question, Angela. I would start to ⁓ log his sleep now and just get a sense of where on that range of sleep that we spoke about earlier he sits. Is he at the higher sleep end? Is he at the lower sleep end? Or is he just smack bang in the middle? That will give you a sense of how you want to divide that sleep across the day and the night. At 11 weeks of age,
Fallon Cook (35:26)
Mmm.
Dr Laura (35:51)
your son's circadian rhythm system will be maturing and that
will begin to start to start to have adult-like sleep architecture in their cycles overnight. So it is a really good age to begin to get that grasp of how things ⁓ are going to settle down. You're almost through, almost but not quite through that really ⁓ busy first three months of age.
But yeah, I would ⁓ start to have a think about what you want the day to look like. ⁓
The naps are of varying length at the moment. If that's something that you're happy to go with, then carry on in that fashion. But if you'd like to begin to bring in a little bit more predictability in the day, then maybe you'd start to think about perhaps capping the longest nap at two hours or whatever is going to be appropriate for your little one sleep need, just so that you can start to get a bit more of a predictable daily rhythm.
Angela. ⁓ Good luck, let us know how you get on. Would you add anything else, Fallon?
Fallon Cook (37:02)
Mmm.
Yeah, yeah,
I think just in really little babies, I often say to parents start with just a bedtime and a wake up time that you really stick to closely because often that regulates the daily rhythm enough that then naps start to fall into a predictable pattern. You can see how that goes. And then you might say, okay, I do need to put a cap on the day's sleep. And you can decide what that is based on what the unique sleep needs are.
Dr Laura (37:17)
Mmm.
Fallon Cook (37:29)
that can be a nice way to approach it because yeah, once he passes 12 weeks, should be building sleep pressure. The longer he's awake, you don't have to worry so much about them becoming overtired. ⁓ and that's when you can start to be a little bit more rigid with that daily rhythm to keep things on track if you need to. ⁓ yeah, love that question though. It's a good one.
Dr Laura (37:44)
Yeah.
Kirstie's written in, it's another little boy. ⁓ So her little boy is 19 months old and Kirstie writes that he has low sleep needs. He's on one nap. He wakes between 6.20 and 6.40 in the morning. His nap is around 12.45 and he sleeps for about an hour and a half at that nap. It can start anywhere between 12.45 and 2.45.
⁓ and his bedtime is 7.30 with lights out around 8. He's great at overnight independent sleep, Kirstie says, but naps have become a major battle over the last two to three weeks. He's screaming, he's crying, he's taking up to an hour and often ending up sleeping on Kirstie in the nursing chair.
He's also started waking as early as 10 past five, two or three days a week. Kirsty. Gosh, yeah, that sounds hard. So her question is, should she push his nap later to around 1 p.m. to build more sleep pressure? Is he overtired or not getting enough sleep overall or is something else going on?
Fallon Cook (38:48)
Ahem.
Hmm.
All right. So, ⁓ definitely not worried about overtiredness. If he's fighting the nap, it's not going to be overtiredness. It's going to be that, you know, potentially sleep pressures had a bit of a drop lately. It sounds like he's, you know, having these.
Um, yeah, has been having brilliant nights. I'm assuming that he's self settling really well. So when we think about the day nap, if he's really pushing back against it, um, you know, sometimes it can just be preference. They're like, no, I don't want to stop what I'm doing and have a nap. Um, but he's probably got the skills to self settle for that nap, but he's, yeah, he's pushing back for a reason. So. You know, thinking about 7 30 PM bedtime, you know, there has been a 6 30 AM wake up. So it's 11 hours plus an hour and a half of day sleep. That's 12 and a half hours.
Dr Laura (39:34)
Mm. Mm.
Fallon Cook (39:47)
It's not a low sleep needs toddler. If 12 and a half hours is the actual average. ⁓ But what I'm thinking is that Kirsty is probably describing, you know, if he's waking early some mornings, ⁓ pushing back on the nap, I would say he's had a drop in his total sleep needs. So I'd be really curious, Kirsty, to know what that sleep need has dropped off to. So now that he's waking early and pushing back on the nap, what does that look like? ⁓ So I track his sleep for a week and see what it kind of comes up with.
Dr Laura (40:03)
Mmm.
Fallon Cook (40:15)
And it might be that we need to adjust that daily rhythm. Maybe aiming for an 11 hour window overnight is too much now. ⁓ And maybe, I don't know, for example, sleep needs have dropped to 11 and a half hours. ⁓ If he's going to have an hour and a half day nap, maybe we can only realistically expect 10 hours overnight. So I definitely have a close look ⁓ at that total sleep needs and where they're sitting at the moment and then adapt it. Because if the night needs to be a bit shorter, ⁓
Dr Laura (40:22)
Mmm.
Mm-hmm.
Mm.
Fallon Cook (40:44)
There'll be more time awake before that nap and you'll probably find it'd be settling a lot more easily for the nap. The other thing is sometimes toddlers are just little rotten rat bags temporarily and they just suddenly go, I don't really want a nap. And they just have this little phase where they go, I'm just going to scream like a banshee at nap time for a bit. Um, and sometimes you just got to ride it out. It might be that you do some naps in the pram or the car, just for a few easy wins and to give yourself a bit of a break, Kirsty.
Dr Laura (40:48)
Yeah.
Yeah.
Yeah.
Fallon Cook (41:11)
And then when they get past that little bit of a phase and if the daily rhythm is a good fit, hopefully things will get back, you know, on track and the settling will get easier again. So do a nap on the go if it gives you a bit of a get out of jail free card. That can be really helpful. Have I missed anything there, Laura? What would you add to that one?
Dr Laura (41:25)
Yes.
No, I don't
think so. Yeah, I would be looking at his behaviour. Once you've worked out what the bedtime and the wake up time is going to be, the exact time of the nap doesn't matter whether it's starting at 12.30 or 1.00, as long as he's having a nice long stretch before the start of the night.
that's fine, you know, at this age probably around six hours or so awake before bedtime is normally sufficient. So it's more about just working out how long that nap should be in relation to his total sleep need, which I do think probably has dropped recently. Yeah, so I'd often like to try and keep a little bit of a longer nap at this age just so that we can hold onto the nap for a bit longer. Because, if you do
Fallon Cook (42:11)
Mmm.
Mmm.
Dr Laura (42:21)
move
it down to one sleep cycle and he's not yet two then there isn't so far to go when the sleep needs change again. Really at that point we're looking at dropping the nap so if you can try and keep the longer nap for a little bit longer it just gives us a bit more wriggle room further down the track but that will depend on what his sleep need has has come up has reduced to Kirsty. Good.
Fallon Cook (42:40)
Hmm.
Yeah, all right. Well, next
question is from Annie who has a six month old daughter who averages around 13 hours of sleep per day. She has around 10 and a half hours overnight and two and a half hours across three day naps. One hour for the first nap, an hour for the second and 30 minutes for the third.
Bedtime is 8pm and the usual wake up time is 6.45am, though she's recently been waking between 5 and 6.15am on some mornings. Could be another one who's got a drop in sleep needs. could be ready for two naps. She says she's also having increased night wakings due to rolling onto her tummy. there's definitely some common themes here. And Annie's got several questions.
Dr Laura (43:17)
Yes. Yeah. Yes.
Yeah there are! I'm getting stuck.
Fallon Cook (43:32)
Yeah. So will
the rolling wakeups resolve on their own once her daughter can confidently roll back? Yeah. We can answer that one straight off the bat. Yep. They will. ⁓ she says if early waking continues, should she transition to two naps rather than adjusting bedtime or wake time? Yeah. So I'm answering these for you, Laura. Yep. Good plan. Yep.
Dr Laura (43:39)
Yes. Yeah. Yeah.
Yes, yes, bet. Yeah, no, I'm just yeah, definitely. Yeah, I would. Yeah.
Fallon Cook (43:56)
And she says, should she try reducing total daytime sleep first? If the first nap is only 30 minutes, should she extend the second nap to compensate or stick to the planned rhythm, even if total daytime sleep is reduced that day? And if moving to two naps, should total daytime sleep stay the same or also be reduced?
Dr Laura (44:16)
Okay, I would say increased night waking, early rising. Annie is almost certain that your daughter is ready to drop down to two naps. That last nap is only half an hour anyway.
at the moment so it's not like it's a really long nap she's already her body's already showing us that she's reducing the length of those naps ⁓ in the day to drive up sleep pressure by bedtime so our bodies are very clever and intelligent ⁓ things ⁓ so I would be looking at probably dropping at that 30 minute last nap moving the first two naps a little bit later
so that that final wake window isn't too long. And whether that 30 minutes that she's having for that third nap goes into the nighttime sleep or whether it just softens the ether is really going to depend on what her sleep needs are now. So
Fallon Cook (45:20)
Mmm.
Dr Laura (45:27)
Yeah, I guess I'd need to see a sleep diary to be able to advise you really confidently. My sense is if you were to move to two naps that are an hour each and then try adding that extra half an hour to the nighttime sleep so that you can try and get her through into a reasonable time in the morning, again, that would probably be...
without seeing the full diary the way that I would tend to go. If you feel that you've tried that for a week and just two hours worth of daytime sleep, she's just not functioning well, then let her perhaps that first nap be an hour and a half and the second nap just be an hour and then adjust bedtime and wake up accordingly.
Fallon Cook (46:12)
Hmm. I think
that's a good plan. It's so true. Like at this age, sleep needs are often on a sharp decline. So it might be that she's dropped some sleep needs and you can just get rid of the 30 minute nap. But if not, then yeah, it might just be reshuffling those 13 hours across. Yeah. Two naps and overnight. Um, Hmm. Yeah. Good, good questions. Any, think Annie's on the ball with this one.
Dr Laura (46:30)
Yeah.
Good.
Yes. Now Rosie and Dan have written in and they have six month old twin girls who are happy catnappers. Their sleep cycles had shortened from between 45 and 50 minutes about a month ago to around ⁓ 26 to 28 minutes. ⁓ I love it when they're very specific like that. ⁓ But they have now moved their girls to their own bedroom.
Fallon Cook (46:55)
Mmm.
Dr Laura (47:04)
and they've got blackout blinds on the windows and have found that that has led the sleep cycles to stabilize at 38 minutes.
So they have two questions. They want to know whether letting them play in their cots in the new room is a good idea for building positive associations. And secondly, how important is it that every caregiver, so mum, dad, grandmother, aunt, and the occasional other carer does the exact same bedtime routine?
Fallon Cook (47:38)
Great questions. All right, so that first one on letting them play in their cots in the new room ⁓ to build a positive association with the new cot and the room, I'm guessing too. That's one I kind of, I'm an Aaron and it's very much dependent on the family I'm seeing. So last week, I think it was, I saw a family with a really little baby that just would absolutely scream every time they were laid flat.
So in that case, was like, let's do a lot of practice of laying flat in the cot, but having other positive things happen like reading a story or singing a song, because this baby just really needed a lot of support to realize that if I'm on my back, I'm still safe. I'm still okay. You know, it can actually be fun and pleasant.
Dr Laura (48:14)
Mm-hmm.
Yes.
Fallon Cook (48:22)
⁓ But that was a rare example of that. think generally what we know in sleep science is that we want to build a really strong association between, know, when I'm moving to my sleep space, I fall asleep. Not, move into my sleep space, I play for a while, I have a feed, I sing a song, you know, and then I fall asleep. We want to keep that association pretty tight. I would say at six months of age, they're probably not going to care too much about where they sleep. They often don't really notice a lot of difference when they go from like a bassinet to a cot.
Dr Laura (48:40)
Yeah.
Fallon Cook (48:52)
or sleep in another room. ⁓ So look, my short answer would be I wouldn't be too worried about ⁓ having to do a lot of playtime in the cots. Like you could maybe put them in there so they can see what it's like, but I think it's gonna make a really big difference. It's definitely ⁓ not essential. ⁓ In terms of how important it is that every caregiver does things the same way ⁓ in terms of settling.
Dr Laura (48:53)
Hmm.
Fallon Cook (49:18)
I would say for you know if if your babies are living with the same two parents those two parents should do it the same way because otherwise if one parent does it a bit different often babies will get really cross until that other parent appears because they're like this is my preference if you both do it the same then there doesn't end up being that parental preference but
Dr Laura (49:25)
Mm-hmm.
Yeah.
Yes.
Fallon Cook (49:38)
For other caregivers that are there occasionally, like grandparents, aunts, uncles, daycare workers, even, it doesn't matter so much. Babies realize that different people have different settling approaches. It would be different if one of those caregivers, maybe if it's a nanny who's there five days per week, so doing most of the settles, we would want that nanny to settle the same way. But if it is just every now and then, like show me a grandma or a granddad who doesn't want to snuggle their grandbaby to sleep, let them do it. ⁓
Dr Laura (49:50)
Mmm.
Yes. Yes, yeah.
Fallon Cook (50:08)
you're at a point
of change where you're suddenly working on cot settling and they've only ever had contact naps, well maybe it would make sense to not let grandpa cuddle the babies to sleep ⁓ just for a little bit while they're adjusting to that change. But once they've made that change every now and then, it's totally fine. I wouldn't be too worried. Is that what you'd say, Laura?
Dr Laura (50:17)
Yes.
Yeah, yeah,
yeah, absolutely. Yeah, yeah, I think you've answered that beautifully. Yeah.
Fallon Cook (50:32)
Mmm, good. All right, we're getting there. I've got a few more to go. This one is from Amy who has a 15 month old boy who has never slept through the night and relies on a bottle of milk to fall asleep. She tried the quick fade approach giving him his bottle outside the room, but he cried for an hour without settling and she ended up feeding him to sleep. Her question is how does she move forward when he needs the bottle to fall asleep?
Dr Laura (50:36)
Yes.
Oh Amy, you're in a spot where lots of other parents have previously been. It's really tricky. You've got a toddler who never slept through the night, has always fed to sleep and you are now wanting to change things and your toddler is not going to want to change things. So it makes sense that he was really upset when you
tried to settle him just with patting in the cot because you're the one who wants to make the change not him and so what is going to be really important for you Amy is to decide whether now is the right time to change how your toddler falls asleep because
Fallon Cook (51:34)
Mmm.
Dr Laura (51:45)
there's going to be a little bit of a battle of wills. You've chosen an approach which is very hands on, which is ⁓ no doubt appropriate to your family. And so you're right there with him. You're supporting him to fall asleep in a different way. And
he will want to have the bottle instead. And so your job is when you feel ready is to persist with not giving him that bottle to fall asleep because otherwise we're just reinforcing that behavior. He learns, this is weird. So now mum will put me into my cot. She'll pat me for half an hour. I'll get really upset about it. And then she'll give me the bottle. All right, game on. That's what we'll do. ⁓
Fallon Cook (52:34)
Yeah, and then we get that big
escalation in crying and it goes on and on.
Dr Laura (52:38)
Yeah, big escalation in
crime because he thinks, okay, well, maybe if I start crying really intensely and really loudly much sooner, then we can just cut out this and go back to having a feed to sleep, which is what I've always done. And I don't see what the problem is. Yeah, obviously, he doesn't think quite like that because he's only 15 months old. But I think it just can be helpful to think about what is exactly happening, Amy, when you are trying to change how your toddler falls asleep.
Fallon Cook (52:49)
Hmm
Hmm
Dr Laura (53:06)
So if now
does not feel like the right time, because you will need to persist with whichever cot settling approach you use and to persist until he falls asleep without reverting to giving him the bottle. So if now doesn't feel the right time, then I just would just put a pause.
on starting. If it does feel like the right time I would
Fallon Cook (53:28)
Yeah.
Dr Laura (53:31)
make sure that you have all of the supports around you in place. Think about having some noise cancelling headphones so that you can keep yourself calm as you're supporting your little one to fall asleep in his cot. And think about when you're going to do the cuddles, pickups, the resets, the circuit breakers so that you can keep your control like
Fallon Cook (53:39)
Mmm.
Dr Laura (53:56)
contain yourself and ⁓ control your own anxiety around changing how your little one's falling asleep and also then present as calm and confident to him. Also make sure that you have ⁓ looked at the unique sleep needs chapter so that you've worked on that sleep pressure first so that when you do come in to change how you settle your son to sleep, he's really tired at that point and doesn't have the stamina to
Fallon Cook (54:07)
Mmm.
Yeah.
Dr Laura (54:26)
resist for a long long time before he falls asleep.
Fallon Cook (54:28)
Yes, I agree. I think
with it taking an hour to settle, I feel like that daily rhythm probably hasn't quite been fitted. And it's really important to work on that for a week and really ensure that sleep pressure is nice and high when you go to do that first settle. And if you do need to take a break and you think, okay, I'm just going to stop for a bit. Some parents do what Amy's done and they just go, I'll just feed to sleep. This isn't going well. That's the point where I would say just stop and wait because you can still offer that feed.
But before he falls asleep, take the bottle and go, come on, we're falling asleep in the cot and then go back to that cot settling approach. You actually give him lots of examples that you can still have a bit to drink, but we're not falling asleep on the bottle. We are going to fall asleep in the cot. And then that's just a huge amount of learning that happens. So he needs realizing, okay, I can still have a feed. I can still have a cuddle. I can have a break, but gee, mum means business. We really are doing this. And when it is, you know, really clear to a toddler, they adapt much quicker. ⁓
Dr Laura (55:10)
Mm.
Hmm
Yes.
Fallon Cook (55:26)
Yeah. So I sort of agree with you, Laura, if you're going to go all in, go all in Amy, ⁓ and get through it nice and quickly. But yeah, it's tough. If you need to have a chat about how things are going, please book a coaching call. This is the sort of situation where we can really make sure everything's fine tuned before we dive in. All right. We're going to have to race through these last three questions, Laura. ⁓ we've got one from Claire B who has an eight month old daughter with a sleep need of 12 and a half hours. They can self settle.
Dr Laura (55:26)
Yeah.
Mm-hmm.
Yeah.
Yeah.
Hmm.
Yes. Okay, so.
Fallon Cook (55:56)
They normally wake once overnight for a feed. She says when her daughter gets a cold, it often leads to ear infections and nights become very disrupted. She tends to need to be held upright, wakes frequently and cries for long periods. So her question is, how much should the daily rhythm be adapted during illness when overnight sleep can drop to as little as five hours? Should she offer extra daytime sleep, a later wake time or an earlier bedtime? And if so, how much?
Dr Laura (56:17)
⁓
gosh, yeah really hard Claire. When you've got a little one with persistent ear infections I'd always be recommending you speak to your GP about whether a referral to an ENT would be appropriate just to see if there's any reason why those the infections are heading to her ears and when that
that infection is impacting her sleep so much, then yes, you would need to offer her extra daytime sleep for sure, and let her sleep in longer in the morning. We all have those illnesses where we feel revolting and we...
find it very hard to stay awake at bedtime until bed, our usual bedtime. And we just go up to bed earlier and we sleep during the day when we wouldn't normally. And it's appropriate to do to give that extra sleep to your daughter when she's that unwell. If she needs to go on antibiotics for the ear infections, that may also make her tummy sore, which again may interrupt her sleep further. So if she's that unwell, I
wouldn't
be trying to put a figure on it. It's just ensuring that she's comfortable as much as possible during the day and night. If it's just a mild illness, then you don't need to go wild giving loads of extra sleep. might just be in bedtime half an hour earlier, possibly one extra sleep cycle during the day. But then you wouldn't need to do anything more than that. given that
she's that upset with these ear infections which are horrible then yeah I would be just taking your foot off the brake and waiting until she's better before you come back in and put in place your daily rhythm that you previously worked out before she became unwell. ⁓
Fallon Cook (58:17)
Yeah, I think that's
a great answer Laura. It's tricky managing illness, that's for sure.
Dr Laura (58:22)
Yeah it is. Now Rachel and Scott have emailed in, they have a toddler who's 25 months old and he averages 11 hours and 15 minutes, including an hour and a half nap. Bedtime is eight o'clock and he settles independently at bedtime but wakes between one and four most nights. It's only on the very rare occasion that he sleeps through but still wakes up around five.
When he wakes in the night, he becomes very upset and they end up sleeping with him on a spare mattress on the floor. Their questions are, how do they break this middle of the night habit without it becoming a prolonged battle? Would reducing his nap to one hour help him sleep through more consistently? And what approach would work best for a toddler at this stage, Fallon?
Fallon Cook (59:13)
Yeah, great questions.
So I think the daily rhythm is a hundred percent where we would start. If he's only averaging 11 hours, 15 minutes, and an hour and a half is being taken up with a nap, then we are being left with nine and three quarter hours. See, I can do the maths. Nine and three quarter hours of sleep that he's looking for overnight. So if he goes to bed at 8 PM, then it would kind of make sense if he is waking at
Dr Laura (59:19)
Yeah.
Yes. ⁓
Yes.
Fallon Cook (59:42)
Trying to do the maths again. 5.45? 4.45. Yeah. Yeah. So it, yeah. So it makes sense that he's cycling between waking up for a long time in the night or just sleeping through, but waking really early. So I would adapt that daily rhythm. I think you're on the right track with, you know, he's over two years of age now. Um, start to dial back that day nap to just one sleep cycle.
Dr Laura (59:45)
Yes 545. No 545 yeah.
Mmm. Yeah. Yeah.
Fallon Cook (1:00:05)
which probably is going to be about 45 minutes. And that's
going to leave you with a lot more sleep budget overnight. You'll have what 10 and a half hours. So you could do an 8pm bedtime, 6.30am wake up as an example. So I think, definitely the answer lies in that daily rhythm. What approach would work best? Look, any of the Sombelle approaches, if he's in a cot, I'd probably look at something like the advanced accelerated approach. If
⁓ Yeah, so they've got a spare mattress on the floor and he's coming on to that. So if you want to keep him in the cot, I'd probably look at the cot settling approaches, ⁓ keep him in the cot a bit longer. Yeah, but I think honestly those changes to the daily rhythm should really, really go quite a long way.
Dr Laura (1:00:40)
Yes.
Mmm.
Yeah.
Yeah, because he's sometimes sleeping through. So when the sleep pressure is high enough, he's able to maintain a sleep until morning. So yeah, you'll probably find that once that sleep pressure is nice and high with that shorter nap, he's less likely to wake up and want to come onto the mattress with you and pick an approach where you say, no, no more sleeping on the mattress overnight. This is how we're going to respond instead and stick with it. And toddlers learn very, very quickly. So yeah, I think you'll be at the other side.
Fallon Cook (1:01:02)
Mmm.
Dr Laura (1:01:23)
quite soon Rachel and Scott so good luck.
Fallon Cook (1:01:27)
Yes. Good luck. Lucky last is from Reinet who has an almost six month old boy who's always cried intensely before falling asleep. Even when drowsy and calm during settling, crying follows before he drifts off. Since starting the Sombelle program, she's already seen fewer night wakes, but her question is, is this pre-sleep crying what she's seen described online as powering down crying? Is it a real thing? And how should she approach guiding him to cot settling given this pattern?
Dr Laura (1:01:30)
Mmm.
Huh?
yes, look some babies do simply cry as they are transitioning from being awake to being asleep and being asleep to being awake. It sounds like it's pretty quick when it happens, Reinet, so I wouldn't be worrying that anything terrible is happening. And yeah, in terms of which approach you would use to
guide him to fall asleep given that pattern. I would be looking to see if you were to go with a more hands-on approach. Does that seem to lead that
crying behaviour to last a bit longer. If it does, then I would be using one of the more hands-off approach, like the Supported Accelerated, for example. But if you take your hands off him and then that seems to lead to an escalation in the crying, then stick with the Quick Fade approach. So really be driven by what you're seeing in what happens to that crying, whether you're...
your hands are on him or not but it's absolutely nothing to worry about, right?
Fallon Cook (1:03:07)
Yeah, so true. Some babies, they just cry with any transition. ⁓ Really, really common. And often it does reduce over time. Well, thank you so much to all the parents who sent in absolutely fantastic questions this week. We so appreciate it. If you're struggling with sleep and settling and you're not a member of SOMBEL, it's a great time to join, especially if you're struggling with night waking. We've got an amazing night waking masterclass. If you think maybe you're not quite catering to your baby's unique sleep needs or your toddler's unique sleep needs, or maybe you're
Dr Laura (1:03:14)
Yeah.
Fallon Cook (1:03:37)
but a low sleep needs child, Sombelle is absolutely designed to help you figure out how to cater best to your child's needs, something we're really proud of.
and if you need extra support, we're here for it. We've got our clinics and we can hold your hand and guide you through. If you love our podcast, please leave a review. Give us a five star rating, hit subscribe. And if you'd like to buy us a coffee, ⁓ like a couple of lovely mums have done lately, I'll pop a link in the show notes. So, ⁓ yeah, go buy us a cuppa. always love it. Love our caffeine. Don't we, Laura? All right.
Dr Laura (1:03:52)
Yeah.
We sure do. Thanks everyone.
Bye bye.
