We recommend always following the safe sleep guidelines.
In the spirit of reconciliation, Dr Fallon and Dr Law acknowledged the traditional custodians of country throughout Australia and the continuation of cultural, spiritual and educational practices of Aboriginal and Torres Strait Islander peoples.
They pay respect to their elders past and present and recognize that sovereignty was never ceded.
In 2021, Dr Laura and I published research that found an association between sleep problems during infancy and language difficulties across childhood.
Well, today you're going to meet our first podcast guest, the wonderful speech pathologist, Dr Kylie Smith, who's going to explain what typical speech and language development looks like for babies and for toddlers, how you can identify if your little one needs extra support, and tips for building language skills that you can integrate into your everyday life.
Plus, I'm going to answer some questions submitted by parents.
Music.
Welcome back to Brand New Little People, the podcast companion to the Sombel Pediatric Sleep Clinic programs created by us.
I'm Dr Fallon Cook and I'm actually not here with Dr Laura Conway this week because she's in the UK visiting her family.
So Laura, if you're listening in, we all hope you're having a terrific time.
So a lot of work is needed before we fully understand the connection that exists between sleep and language development.
But early signs suggest that it might be helpful for parents of little ones who struggle with sleep to just be aware of signs.
Their child might need some extra support with their speech or language.
So a couple of weeks ago Dr Laura sat down with Dr Kylie Smith, a speech and language pathologist with over 25 years experience, and she specializes in stuttering and complex communication needs.
Kylie also runs her own speech pathology clinic here in Melbourne, but Laura and I actually met Kylie many years ago now during our time at the Royal Children's Hospital campus.
So here's the interview.
Thank you so much for joining us, Kylie.
Thank you for having me.
So how about we start at the beginning?
What actually is communication in young children?
Well, when most people think of communication, they think about talking, so having a conversation.
And because babies don't talk, they may assume that babies are not communicating yet.
But communication is so much more than words.
It's essentially the system we use to share our thoughts and our feelings and our ideas and our needs and our wants, of which babies have lots of.
And this system can be either verbal or nonverbal.
So when a newborn cries or wiggles their body in a certain way or changes their facial expression, they're communicating with us, albeit in a very basic way.
Yeah.
So the early years are a time of enormous development in communication.
Within the first six months of life, babies can begin to coo and gurgle and babble and gesture to let you know how they feel and what they want.
Yes.
And I did my PhD looking at early child development and parent-child interactions.
And I spent many an hour looking at videos of babies and toddlers making eye contact with their parents and sharing attention.
And yeah, it's just, as you say, so much more than talking about.
All right.
So how about you tell us a little bit more about what typical communication development looks like in the preschool years?
Well, there's a wide range of what's considered typical.
So it's important to say that at the top.
But there are some useful milestones to consider when looking at child's development and communication.
So we need to think about not only how the child is communicating with us, but how they are understanding when we communicate with them as well.
So we've got to look at both of those areas.
So, even though children we know that children develop at different rates there are some key milestones to keep in mind.
Around 12 months.
We expect babbling first words and understanding simple gestures like hi and bye-bye.
Yes.
Cute.
Yeah.
By 18 months, most children will say between six and 20 words.
They'll copy sounds.
And we see the beginnings of pretend play.
So maybe using a banana as a phone.
Yes.
Oh, it's so cute.
That's a really lovely age.
Yeah, it is.
It's beautiful.
By two years.
They usually understand up to 50 words, follow simple instructions and can point to familiar objects.
So you might say, ball, point to ball.
And the baby might be able to, or the toddler by that stage might be able to point to the ball.
By three years, children are often using two-word phrases.
They can ask some simple questions and follow some simple two-step instructions.
And they have a vocabulary of 50 plus words with a mix of different sounds in there.
Yeah.
And there's a wide range of normal, like you were saying.
So I know that one of my children was really precocious with her language and was saying way more than that.
But my other child was much slower.
Yeah.
Yeah.
And they both developed absolutely fine.
Yeah.
That's exactly right.
By the time most children reach their fifth birthday, their communication can already be approaching that of an adult.
So it's quite incredible the development that occurs in those first five years of life.
For those people who might want more information on those milestones, the Speech Pathology Australia website has a summary of each age, from one through to five.
So that's a really good reference.
Fantastic.
We'll put the link to Speech Pathology Australia in the show notes as well for our listeners.
So what are some early signs that a child might need extra support with their communication?
I think if a child is not reaching the milestones that we just discussed, that might be a clue that they might need a little bit more support.
But it's important for parents to remember that for children under three, If their only delay is with the talking but everything else is developing as it should be and it is within the normal range, most of these children will catch up and be using language, typically by the time they're four.
Exactly as you described with your situation with your son.
So some red flags to watch for include if your child doesn't understand simple words or phrases by around 18 months.
If they lose words or stop using sentences that they previously had, so a regression in their communication.
Or if they have concerns about how their child responds with them or the world around them.
Okay.
Stuttering is also something to be aware of, I should mention, in young children.
Stuttering can start suddenly or gradually, usually between the ages of two and four.
Which is probably a lot younger than many parents realize.
I think a really important point there as well is about starting the sudden onset of stuttering.
I think that can be quite shocking for parents as well to know that a child can be developing language typically and there'd be no evidence of any issues with fluency, and then a child can suddenly wake up one day and be stuttering.
Yeah, so it really can catch parents by surprise when that happens.
Yeah, absolutely.
So can you explain a little bit more about stuttering?
Do we know why it happens?
Yeah.
We still don't completely understand what causes stuttering, but we know there is a genetic component and there is a difference in the way the speech and language areas of the brain work.
So stuttering can present in lots of different ways and it can fluctuate and it can change.
A lot of people may be familiar with the repetition of the sounds or the syllables, but maybe less familiar with the prolongation, so the stretching out of sounds, or the blocking, which is where no sound is produced at all.
So it's important to highlight that the stuttering is not caused by anxiety or parenting or a specific event, and it's not copied off others as well.
That seems to be a concern that comes up quite a lot in clinic and parents will say they have a sibling who stutters or there's someone at childcare that stutters and they're worried that that's why their other child might be stuttering.
Oh, interesting.
Yeah.
So stuttering typically starts around the time that children are putting those first words together.
And while many will recover without therapy, we can't predict who will recover and who won't.
So early intervention is really generally recommended for stuttering.
Okay.
So it's not a wait and see situation.
Yeah.
Getting an assessment with a speech pathologist is step one.
And from there, it may be a wait and see scenario.
But I think always getting a little bit of advice around that from someone who knows what they're talking about.
Yeah.
Okay.
And just now thinking about how parents people who are listening to the podcast can support their child's communication development at home.
Do you have any ideas of what they could do?
Yes.
Oh, great, Lops.
Talk with your child.
Young children understand much more than they can say.
Yeah.
So one of the most powerful tools is something we call serve and return, which you may have heard about.
That was my PhD.
So like a tennis match of a conversation.
Observe that and then keep the interaction going.
And this builds connection, and it builds vocabulary and confidence and it works across all ages and stages.
Yes.
Oh, wonderful.
Can you give an example of serve and return in action?
Of course.
Imagine your toddler points to a dog and says, woof, that's the serve.
And you respond with, yes, doggy.
Woof.
That's the return.
And then your child might say, doggy, woof.
And then you can keep it going with doggy, woof.
It's a big doggy.
So with older children this serve and return might be an opportunity to help model some correct grammatical expressions.
Thank you.
So, for example, if your child says, I built a tower, you might say, well, you built a tall tower.
So you're showing them the right grammar while keeping the conversation natural and encouraging.
And I'm thinking about the families listening who have little babies, and that time where you spend a lot of time changing nappies on their nappy mat.
And with little babies when you're changing their nappy, you can be using that time to make the eye contact.
Absolutely.
Yeah.
Yeah.
I'm just thinking of babies on the change mat and the little shaking of their legs or the cooing or the yeah, as I mentioned before the wiggling of their body in a way that's trying to get your attention and then to get you to do it.
So that's them serving and then you can return.
Yeah, really beautiful.
And we know how important those interactions are for language development.
And yeah, kind of taking those otherwise boring relentless tasks that you have with babies and making them a little bit fun and trying to really enjoy and add some quality time.
Yeah.
All right.
Now thinking about books.
We get asked a lot of questions about books in clinic, particularly in relation to bedtime routine.
Can you tell us a little bit about books and how reading can help language development?
Yeah, books are brilliant tools.
I think probably the most important thing I can say about books is it's less about reading every single word on the page and more about the interaction.
So just as we were describing about following your child's interests in an everyday interaction.
It's the same with a book.
Follow their interests.
What are they looking at?
What are they pointing at?
What are they saying?
And then you can give them a word.
If they don't have the words, you can build on what they're already saying.
You can ask them a question about it and just have a back and forth conversation about what they see or what they say.
And that's where the learning really happens.
Yeah, I know sometimes families will say to me in clinic oh, it's not much point reading a book because they they're not interested or they, you know, they just get bored or they just want to put the bored book in their mouth.
And I will often say well, it's about exposing them to the book and just being able to open the book in the right way and turn the pages, and even if you're just looking at one page and then you close the book and that's it, that's um a lovely thing to do each day.
I think um, parents don't need to worry about following the rules with books.
Um, I can see, sometimes I see parents getting frustrated if their child is going to the middle before reading the first pages or, as you said, holding it upside down.
It's all okay.
It's about the interaction and exposure and routine.
Yeah, wonderful.
When should a parent seek professional help from a speech pathologist?
If you have any concerns about your child's communication skills at all either their understanding or their use of language, or their social communication, their interaction skills or stuttering it is always good to speak with a speech pathologist.
It doesn't automatically mean that your child is going to need speech therapy, but it will give you a clear understanding of where they're at and how best to support them.
And I think, for all of our families listening.
They all want to do the best thing for their little one.
We all love our babies and toddlers and preschoolers.
And you know in the same way that they're listening into this podcast too.
Ensure that their baby's sleep health is as good as can be.
They will be wanting to ensure that they are doing everything they can to promote good language development and communication development.
So yeah, if in doubt, speak to a speech pathologist.
Which takes me on to my next question, Kylie.
Where can families find a speech pathologist if they find themselves in this situation where they want expert help?
Speech pathologists work as part of the public health system and privately.
So you can check with your local community health service to see if they have a speech pathologist in their team.
For private speech pathology, people can search through the Speech Pathology Australia website.
There's a find a speech pathologist and you can put in either what area of specialty you're looking for, if it's something specific or age range, or your local area, and it can point you in the right direction of a speech pathologist.
All right.
So, before we wrap up Kylie, is there one key message you'd love parents to take away from this episode?
Yeah, I think to the point you were making before, communication develops in everyday moments.
So you don't need fancy flashcards or apps or to spend any money on anything.
All you need is warm, responsive interactions.
You're tuning in, following your child's lead and enjoying those little conversations, and they are doing so much more than you think.
Yeah.
Oh, that's wonderful.
Thank you so much for joining us today.
I really enjoyed it.
Thank you for having me.
So there you have it.
Thanks so much, Laura and Kylie, for that lovely interview.
If you are local to Melbourne and you're looking for a speech pathologist, be sure to look up Dr Kylie.
You can find her online at drkyliesmithslp.com.au and we'll pop a link in our show notes as well.
We're going to be having some more guests on the program in future, which will be really really exciting.
So now you've got just me, just me answering your parent questions that have been submitted over the past fortnight.
So I hope you don't get tired of the sound of my voice and I'll do my best to get through these nice and quickly, because there are quite a few this week.
Alright, so let's start with Eilish.
Eilish has a 14-month-old baby boy who sleeps around about 11 and a half hours per 24 hours.
He does about 10 and a half hours overnight, sleeping from about 730pm to 6am, and then he has two 30-minute day naps.
Some mornings he wakes from 5am and stands up and cries when they try to resettle until 6am.
He rarely links day sleep cycles, waking at 30 minutes and less napping in the pram.
And if he's in the pram, he can nap for up to two hours.
Eilish also mentions that different caregivers use varying settling approaches.
So Eilish asks, is it worth persisting with resettling until 6am, even if he stands up and cries?
Should intervals be shorter?
And besides a later bedtime, what else helps with early waking?
They're keen to extend naps so he can sleep longer at midday.
I really love this question.
Probably the first thing that jumps out at me is that at 14 months of age, it really is time for this little guy to move to just the one day nap.
And that is probably why this baby or toddler is having a lot of difficulty sleeping until 6am when he's having those two naps.
It's just taking the edge off that sleep pressure.
And by evening the sleep pressure just might not be there anymore for him to go through right until morning.
And if he's sometimes having a longer nap in the pram, it only, you know, takes for that to happen, you know once, twice a week, and that can really throw out the night.
So I would probably work on the daily rhythm before you start to really push him to sleep into that 6am mark.
I would try moving to just one day nap of one hour duration at midday.
That's likely to really help improve the night.
He'll be much more tired at night.
He'll sleep for longer.
And before you know it, he'll wake up that bit more refreshed and he'll probably power through the day on the one day nap.
It can be quite a tricky change to make.
But I think you've got the evidence there Eilish, that You know he's showing signs that he is ready.
Once you've got that daily rhythm in place for a few days to a week, that's when I would standardize your settling approach.
If there's some variability in how he's being settled to sleep, that can be pretty confusing and it can cause night waking to continue and other settling difficulties.
So that's the point at which I would standardize your approach.
And hopefully you'll see things come together nice and quickly.
Okay, we also have Emma.
Emma has a two-and-a-half-year-old toddler who has long struggled with sleep.
She says, I like that phrase.
The toddler ninja walks into their bed overnight.
Emma says they often don't notice that they're there until the morning and after years of padding back to sleep, they find co-sleeping easier.
Emma asks are they setting themselves up for future issues by letting the toddler stay in their bed?
And do other parents experience stealthy toddlers and what strategies help?
I really, really love this question.
Okay.
So let's unpack it.
To begin with, if you are really happy having your toddler co-sleep with you, of course you can do whatever you like.
So if you're enjoying that, absolutely.
You could just keep doing it.
There might come a time where you don't enjoy it anymore.
And then of course you can work away from it.
If you're thinking that it's time to stop, then I would say well, for starters yes, you're not alone.
There are plenty of very stealthy toddlers out there who are very good at creeping around in the nighttime.
I would say putting a safety gate on their bedroom door is key.
The reason for that is, well, for starters, it's going to protect them.
They're not going to be wandering around the house potentially tripping over something or falling down the stairs.
So it's for safety, but it also means they can't move from their rooms.
If they wake up overnight, they're going to have to call out for help for you to let them out of the room.
And so if you are wanting them to stay in their own bed well, at that point you just take them back to their bed again.
Your bed's no longer accessible?
Um, so that's how i would tend to approach it.
Um, you know, are you making a rod for your own backs?
It remains to be seen like i think a lot of parents really worry about that.
Um certainly, as children get bigger um, and if they get to an age where they can climb over a safety gate, it can become a little bit more challenging to keep them in their own bed overnight.
It's when we sort of turn towards things like using reward charts and things like that.
So it really depends on your goals, Emma.
If it's working for you for now and you just can't be bothered changing it, I think just keep on with what you're doing.
But if you're wanting to have your bed back, then I would start with a safety gate and returning them to bed.
And there's a whole bunch of approaches, obviously in SOMBAL, for how you're going to respond in the night to that.
Awesome.
Let's move on to Nicole.
Nicole has a four-month-old baby boy who self-settles for all naps and bedtime.
He sleeps around about 14 hours per 24 hours, doing about 11 hours overnight and three hours worth of naps.
Nicole says naps remained 30-minute cat naps.
He wakes cheerful but becomes grumpy within 30 to 60 minutes, needing to be held.
Resettling succeeds only in arms after around about 30 minutes of effort.
And she says that unpredictable nap lengths make routines really tricky.
So Nicole wants to know, why can he self-settle at the start of naps yet not link cycles?
Will linking cycles happen naturally soon?
And how should they settle him in the cot if he cries and spits out the dummy?
Okay, so there's a bit to unpack here.
One of the things I'm thinking is that if he's having three hours in total day sleep and he's just having 30-minute catnaps, That makes me think he's having about six brief naps per day.
And if that's the case, Nicole, it's definitely too much.
Sometimes they can get caught in a cycle of tiny nap, tiny wake window, tiny nap, tiny wake window, and they never seem very happy for very long.
And that's because they need to build up a lot more sleep pressure and be awake for longer.
And then it makes it easier for them to have a longer nap.
So at four months of age I'd be thinking about trying to make sure he's on four naps, but potentially moving down to three naps very soon.
I wouldn't be worried about the length of those naps.
So it's still really common at four months to be doing a lot of cat napping.
But And it might just be that with some practice certainly with longer time spent awake between naps and a bigger buildup of sleep pressure, and just with practice often that's when they will start to link sleep cycles for their naps.
And then you also asked a question around how to resettle him in the cot if he's crying and spits out the dummy.
I mean, you could think about whether the dummy is useful or if it's being more of a hindrance.
He's still maybe three months away from being able to find and replace the dummy himself.
And I would say, if he's upset going into the cot, have a think about what approach you're using to settle him.
Make sure it's super consistent.
So he's realizing oh there's not a lot of point in getting really worked up because you know mum or dad or another caregiver is still around.
They're just doing the same very boring, repetitive reassurance.
Sometimes standardizing that approach is what really leads to a reduction in crying.
Yeah, so hopefully that gives you some good little pointers on things that you can try.
I think it can be really tough to be in a cycle of short nap, short wake time, short nap.
You feel like you're just forever trying to settle them.
I would say just really start to stretch out the time between naps.
And if you're really struggling to get that daily rhythm kind of in order, reach out.
We can always do a coaching call and take a close look at what's happening.
Okay.
Let's move on to Lisa.
So Lisa has an almost eight-month-old baby boy who recently weaned, night feeds and sometimes sleeps through the night.
But nights can vary anywhere between zero to four wake-ups.
For day naps, he has a one and a half hour nap and then a 30 minute nap later in the day.
And Lisa says the middle wake window is the hardest because he struggles to stay out for three hours, even though the last wake window can stretch to five hours.
So Lisa's unsure if dropping to one nap is right, but she does want steadier nights.
And she asks how can they encourage more consistent overnight sleep without overtiring him or reducing daytime sleep too much?
Okay, this is a really great question because he's only eight months old.
So definitely we don't want to drop to just one nap yet.
It's probably a bit too early.
But with that variability in the overnights, I think something's got to change.
I think maybe the nights can be so tricky.
You know, four wakes is quite a lot for an eight month old.
Some of those four wake nights are going to mean that he's waking up, having not had good sleep quality.
And I think that's what could be leading to him struggling to stay awake for three hours in the middle of the day because he's eight months old.
So three hours shouldn't be too hard at this age.
But I think the nights are tricky.
It's leading to him being more tired in the daytime.
But of course, if he's overdoing the day sleep, it leads to another tricky night.
And it's that horrible cycle that we often talk about on this podcast.
So I would say let's not drop to one nap, but let's try two shorter naps.
So it could be, You know, even just doing, you know, an hour for that first nap and then 30 minutes for the second nap, and just put a lot of energy into keeping him awake, keeping him busy, you know lots of stimulation get outside to really help stretch him through.
And then within a few days of reducing that day's sleep, we should see nights improve.
He'll wake up more refreshed because he's having really consistently good nighttime sleep quality.
And then hopefully we'll see that he powers through the day a bit more easily.
But good luck, Lisa.
It sounds like you're in a bit of a tricky spot.
And if you do need extra support, please reach out.
Okay, we are powering through.
Now we've got Rihanna.
So Rihanna's nearly 11-month-old baby girl has around about 11-hour total sleep need and is rocked or cuddled before being placed in the cot.
She wakes one to two times before her parents' bedtime, so early in the night, and at least twice overnight for feeds, often ending up in their bed.
She says teething is frequent and Rhianna manages most wakes.
So Rhianna has a few questions.
She says, should they wait for teething to settle before starting cot settling?
Any tips for wind after the bedtime feed?
And how to involve a reluctant partner in night settling?
Okay, so we've got a lot to unpack here.
To start with, I would say an 11-hour total sleep need at 11 months of age really tells us that Rihanna's little girl has a low sleep need.
And that can always be really tricky to manage in terms of making sure they don't overdo the day sleep so they can have some good consolidated nighttime sleep.
We've got some evidence there of false starts.
She's waking one or two times before her parents even make it into bed.
And then, you know, quite a lot of overnight feeds.
And with her coming into your bed Rhianna, I'm guessing that her sleep pressure is probably low and you're really struggling to get her back in the cot.
So what that tells us is that there's definitely a timing issue here and a sleep pressure issue.
There's multiple signs that sleep drive isn't super high overnight, and that's what's causing her to be so wakeful and probably also contributing to her wanting two overnight feeds at least two overnight feeds.
So I would say there's some work to do on the daily rhythm.
At 11 months old, my suggestion would be it might be two 30-minute day naps.
So she's having an hour total day sleep.
That gives you sort of 10 hours of sleep in the bank that you can aim for overnight.
So that could be maybe an 8 p.m. bedtime and a 6 a.m. wake up.
It's just a suggestion.
But work through the unique sleep needs chapter before you even try to change much about the settling.
Just nail that daily rhythm so she's got really nice high sleep pressure overnight.
We're not giving her too much day sleep and then having these really, really tricky, fragmented nights.
Once you build up that sleep pressure so a few days to a week of just working on that daily rhythm Then if you go to change how you settle her, you should have an easier time of things.
So if she's being rocked or cuddled until she's drowsy or asleep, then certainly she's waking up in the night and thinking well, where are you?
I need that same help again.
Thank you very much.
She's probably also feeling quite motivated.
She knows there's some feeds that can happen overnight as well.
So there's a few factors contributing to those night wakes.
Once the sleep pressure is nice and high enough, I would choose an approach that you're going to use for every settle that involves her falling asleep in the cot.
So she wakes up overnight.
She's still in her cot and she should be able to just put herself back off to sleep.
So that's how I would approach it.
I would then also pretty quickly reduce those overnight feeds as well, because she shouldn't need them anymore at 11 months of age.
And if you think she's waking up kind of expecting a feed, then gradually reducing those night feeds until we don't offer them anymore can just be a really good way to ensure there's nothing remaining.
That's making her feel motivated to wake up and call out overnight.
So to actually answer Rhianna's questions now, because I've gone off down the garden path.
Don't wait for teething to settle before you start cot settling.
Babies have a lot of teeth that come through and so do toddlers.
They can almost always be teething.
And if we wait until teething is done, you know, it's a really long wait and a lot of broken nights.
So use Panadol and Nurofen to manage the pain and just push on.
You're still going to be around, still giving lots of support.
Just because they might have some discomfort, it doesn't necessarily mean that they need to share your bed.
I would be thinking.
Manage it with pain relief, provide other sources of comfort, but aim to keep her in the cot.
Wind after the bedtime feed, I'm not worried about at all.
Babies that are 11 months old can absolutely handle their wind themselves.
They know how to burp.
They know how to get out gas.
So I wouldn't be worried.
That's something, you know, you might think about in a very tiny baby, but not at this age.
And how to involve a reluctant partner in night settling.
Okay.
I feel like, I don't know, threaten some divorce papers or something.
It's really tough if you've got a partner that is not wanting to be so involved overnight, because you are both essentially working full-time jobs.
One of those jobs brings in money, but the other one is ensuring the wellbeing and the safety of your family.
So two really important jobs and night waking should be shared between parents, unless there's a very, very good reason.
You know, it really should be shared equally.
I think it's time to sit down and have a really honest conversation that starts with you talking about how difficult you're finding things and that you're not feeling like you're getting this support that you need overnight.
Talk through what your SunVal plan is that you've created.
And I always hate telling women that they should delegate tasks, because then we're just still carrying the mental load.
But Sometimes that's the only way forward is for us to go, here are your jobs.
Please do these jobs.
Make my load a little lighter.
So if you've drawn up your Sunbelt plan, maybe it's a case of Okay.
When she wakes up and she's not due for a feed, you're going to go in and this is exactly what you're going to do.
So you're delegating roles.
You might also choose one of the faster approaches so that you can potentially both you and your partner can take a few days off work and kind of go to ground where it doesn't matter if you're up all night.
You know, working on resettling.
You can nap a bit in the daytime when your baby naps, or get some extra support from family and friends if you need it.
So I hope that helps, Rhianna.
I think there's a lot of work there to do, but just really take one day at a time.
Just focus on the task in front of you in any given moment.
And before you know it, you will start to get that traction with her sleep and things will come together.
If you want to have a chat though, I'm totally here to support you for that too.
And you can book a coaching call.
Okay, then we have Brioni.
Brioni, I think.
Brioni has a six-month-old baby boy who wakes often at night.
He's easily distracted from nursing.
Brioni describes him as a FOMO baby. but he's eating solid food really well.
He has a total sleep need of about 12 and a half hours per 24 hours.
He prefers 20 to 45 minute cat naps, and he has four of these per day.
They try for three naps plus a bridging nap if needed.
He self-settles for naps, but resettling rarely works and nights include three feeds plus several other wakes, and from 3 to 4 am he wants hands-on settling.
Oh my gosh, Bryony, that sounds so tough.
You poor thing.
Okay, so Bryony wants to know what adjustments could help a busy, easily stimulated baby to consolidate naps and sleep more steadily overnight.
Yes.
Okay.
All right.
So what I would suggest first is to just do a really big push to get onto three naps, with no bridging that um, because he's six months old and really soon we would want him to be moving to two naps.
So it's totally reasonable.
But to push him onto three naps even if they are quite short naps, they won't be for long.
As you're starting to stretch out the time that he spends awake, that sleep drive is going to build up.
And since he's got self-settling skills, we will probably start to see him use those settling skills to link together sleep cycles.
But for now, I'm not worried about that.
I would be aiming for three naps.
It might end up only being about an hour and a half total day sleep if he's just having 30-minute cat naps.
But that's going to leave you with an 11-hour window overnight for sleep.
So you could potentially put him down at 7.30 p.m., get him up at 6.30 a.m., something like that.
And that would be a really good idea, because moving to that kind of schedule that really fits his sleep need is going to drive up that nighttime sleep pressure.
I am sounding a bit like a broken record now, aren't I?
But you're going to see that increase in nighttime sleep pressure.
And that's what we need to see, because he's got multiple signs there that sleep drive overnight is a bit too low.
He's waking several times.
Three feeds is a lot for a six-month-old as well.
And then for a whole hour in the night, he's needing constant hands-on settling.
So we've got some evidence there of split nights and definitely excessive night waking.
So when we build up that higher sleep pressure, maybe work on that daily rhythm for a few days to a week and then decide okay, how are we going to settle him overnight?
I would decide on maybe moving to two overnight feeds.
Decide roughly what time you're going to offer them and make sure he's going back in his cot awake after those feeds, and just use the same approach for the resettles.
I would say that that's your best way forward.
Maybe at some point longer naps will emerge, but you know, let's wait and see what happens.
Some babies just love a cat nap and that's all they ever do, especially the FOMO babies.
And hopefully, being a FOMO baby, it won't be too hard to keep distracting him and keep him awake a bit longer in the daytime.
So good luck, Briony.
I look forward to hearing how you go.
All right, we've got two more questions.
I feel like we're flying through these.
I think I'm realising that Laura and I probably yabber on way too much when we discuss all these cases.
All right, so...
Courtney has a 14-month-old baby girl who now settles herself to sleep beautifully.
Wow, amazing.
Courtney says recently she shifted from around about 12 hours of sleep per 24 hours down to about 11 and a half hours sleep per 24 hours.
She says bedtime has long been 8 to 8.30 p.m., And she wakes up at 6.30 to 7 a.m.
She has a one and a half hour nap at around 11 a.m.
And a long second wake window, about seven and a half hours awake before bed.
And the morning wake window is only about four to four and a half hours.
So Courtney asks, are sleep needs genetic or unrelated to parents' own needs?
I love this question.
It's a really good one.
Look, I'm not a geneticist.
I'm not super across the genetic research on this one.
But I do know that there is an association where it looks like, you know, parents who have low sleep needs tend to have babies who have low sleep needs.
We always hope that parents of higher sleep needs don't have a low sleep needs baby, because I think those parents really, really struggle with that kind of mismatch.
And But it's not a perfect relationship.
It's not, you know, one low sleep needs parent means a low sleep needs baby.
You know, there's always a bit of variability there.
But so often in appointments when I say oh, your baby's got low sleep needs, someone will stick their hand up.
Often it's the dad saying, oh, that's me.
I've never really needed much sleep.
You know, they're sleeping just like I did.
Or sometimes parents will say oh yeah, I was talking to my mum the other day and she said when I was a baby, I barely slept and I dropped my naps.
Really young.
So there does seem to be some sort of genetic link there.
Courtney also asks, yep, they definitely do.
Courtney's worried that hers might keep dropping until she only has a very short nap or none, at a very early age.
Look, it's possible.
Sometimes they drop some day sleep but they add it to the night because they're not needing to drop their total sleep needs but they are ready to be awake for longer in the daytime.
And other times they do just drop the day sleep and they don't add it to the night.
We never quite know which way it's going to go.
So what I tend to say is if you drop some sleep from the day, add it to the night.
As long as the nights are going well, add it to the night and see how they go.
If they start to be really wakeful overnight, we might be aiming too high and we might need to actually just trim a bit of sleep from the schedule.
Courtney also asked is an 8 to 830 pm bedtime too late for a baby, given research suggesting a 7 pm bedtime supports memory and brain function?
I would say that that research is pretty small and not accurate.
You know, there hasn't been enough research looking at this for us to think that we need to change.
You know bedtimes for every baby.
Certainly we know that if every baby went to bed at 7pm, there'd be a lot of them waking at 4am and you know, having very tired parents.
And of course, parent fatigue flows into baby wellbeing as well.
So I wouldn't be worried.
I settled, their bedtime works for them, then you've hit the nail on the head.
And also remember that in some cultures babies and toddlers don't get a bed until 10 or 11 pm at night, and that's considered really normal.
And instead, they take much more day sleep.
And those babies are perfectly fine.
So don't worry.
It's fine to just focus on your baby.
Research does look in averages and doesn't mean that it applies to everybody.
And finally, Courtney asks is it normal for wake windows to differ so much from the morning versus the afternoon, and will they even out eventually, or will that sort of nap start to stretch later in the day?
Look, it's normal for the second wake window to be a bit longer than the first.
Courtney, you're describing quite a big difference.
But again, if that suits your toddler, and then you know why change it really.
Like if it's working well for her, then it's completely fine.
I would just keep on with it.
You might find that yeah, the nap does start to push a bit later, because maybe she's just not ready for sleep so early anymore.
And then you might find you need to trim down the day nap a little bit, or it does start to impact bedtime.
But I think really it's a case of let's wait and see.
Sounds like you're doing a great job of catering to your unique little girl.
And that's brilliant.
That's what we want all parents to be doing is thinking about what works for their little one.
So, yeah, good job, Courtney.
Okay, lucky last.
We've got Natasha.
So Natasha has a 14-month-old baby boy and she's new to the Sombel approaches.
Natasha says, during day naps, after waking briefly at the end of the first sleep cycle, he usually resettles.
But the second cycle is very active with rolling, face rubbing or stretching every few minutes.
This makes it really hard to judge when he's truly asleep again, and they worry about letting him sleep too long because of that activity.
Natasha asks how should they navigate an unsettled second sleep cycle during naps and decide when to end the nap without cutting needed rest short?
Okay.
This is a really interesting one because it does make me wonder is this 14 month old you know really actually getting into another sleep cycle, or are they kind of doing what I like to do on the weekends?
You know, when you wake up in the morning and you're like I'm pretty wakeful.
But I think I'm just going to roll around in bed a bit and enjoy being in my comfy, beautiful bed.
It could be that he just really likes having that quiet time to just lie there and enjoy it.
So look, what I would say is it's kind of impossible to answer without seeing it.
I would focus on that unique sleep needs, chapter track his sleep and just do the best you can to get an average.
If he's seeming like he's sort of asleep, sort of not asleep, it can be really hard to gauge it.
So just do your best guess.
When you come up with what that sleep average is per 24 hours, then you can start to develop your daily rhythm that fits his sleep needs.
And once you've got that daily rhythm, it becomes a little clearer that after this amount of time we definitely have to wake him and get him up and move on with the rest of our day.
And then it sort of takes away some of that guesswork around when they're really awake.
And I would be looking at the length of that first sleep cycle.
If it's 40 minutes, for example, and you are going to try and aim for two 40-minute sleep cycles or an hour 20, then if you've got that allowance in your daily rhythm, then just simply get him up at an hour 20.
You know, it takes away that guesswork, because the second sleep cycle should be the same length as the first one.
I hope that makes sense.
But I think yeah, just working on the daily rhythm is going to help.
You know you get more clarity.
And with the day, naps work in increments of whatever his sleep cycle length is, and then it removes that guesswork.
And if we're, you know, building some good sleep pressure on that daily rhythm, Odds are he will have more settled sleep across the whole period of that nap as well.
All right.
So I think that brings us to the end of all the parent questions.
I'm feeling like I've run a marathon and I've really stupidly done this without even having a cup of water or a cup of tea in front of myself.
But that's all right.
Got there in the end.
So, to finish up today, I want to announce as well that I've just added an enhanced support chapter to each of our SOMBAL programs.
I wanted to do this because parents often reach out to us on email asking about what appointment they should book.
What's the difference?
Now I've made that really super clear.
So...
When you log into SOMBAL, you'll see there's a chapter now called Enhanced Support.
I've put a couple of little stars around it so it's really easy to find.
Within there, it talks about what an initial appointment in our clinic is.
That's kind of our deluxe.
So you know where we do all the hard work for you and develop your own beautiful plan.
And it also talks through what consultations.
Coaching calls are, which are a slightly more light touch option but often just perfect for Slumvale members who have already done a lot of the work in building their plan.
And we've also got some lovely little hello introduction letters from each of our practitioners so you can get to know each of us um a bit better as well.
And you can also book in straight from sombel and i'm super proud of myself guys, because i had to use actual code to do this.
So go and check it out just to make me feel good, because i'm quite impressed by my own um learning and managing to actually embed our booking system in sombel.
It just makes it easy for you guys, so it's all just under one kind of roof, um.
So yeah, if you're needing support, we've kind of streamlined that, so it's super easy to book in.
And if you've got questions, shoot them through to us.
It's sombel at infantsleep.com.au.
We have our lovely Crystal, our amazing admin support.
She can answer your questions or if there's something tricky, she will send it through to me or to Laura when she's back to answer.
I also want to say huge thanks to Therese and to Liz who bought us coffees recently.
If you're a listener and you'd love to buy us a cuppa, you can do so.
I'll pop a link in the show notes so you can do that.
And if you need help with sleep and settling and you're not a SlumVal member, well you know where to find us.
Go and check out SlumVal or come and see us in the clinics.
We're always here to help.
So thanks everyone for tuning in.
I hope you've enjoyed this week's episode and you'll hear from me again in a couple of weeks time.
Have a great week.
If you need help with your baby or toddler's sleep or settling, you need Sombel.
Sombel is Australia's first online pediatric sleep clinic program for babies and toddlers aged zero to three years.
It contains all the best resources from the sleep clinics at Infant Sleep Australia so you can rest easy and soak in your child.
To find out more, click the link in the show notes
