The advice in this podcast is general in nature and does not constitute medical advice.
Always consult your doctor if you are concerned about your child's health.
We recommend always following the safe sleep guidelines.
In the spirit of Reconciliation, Dr Fallon and Dr Law acknowledge 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' path and present, and recognise that sovereignty was never needed.
You're finally starting to enjoy some longer stretches of overnight sleep, when suddenly your baby or toddler catches a virus, and before you know it, you're back to multiple night wakes and tricky settling.
Often when our little ones recover from illness, their sleep takes a surprising amount of time to return to normal.
I'm describing a well -worn path by generations of parents.
Today we discuss how to navigate sleep challenges during illness in your baby or toddler.
Welcome back to Brand new Little People, the podcast companion to the Som thoughtful pediatric sleep clinic programs created by us.
I'm Doctor Fallon Cook, and I'm here with Dr. Laura Conway, and we're the directors of Infant Sleep Australia.
Laura, it's been a couple of weeks.
We had a public holiday last week, and you've been unwell as well.
Yes, it has. Honestly, these bugs are really cutting people off at the knees.
I just got absolutely floored.
And I had to unfortunately reschedule some of my clients last week.
I did limp through some appointments with existing clients who were beautiful, so lovely and understanding as I croaked through the appointments.
Yeah, it's, it's really hard. And every time I one of us does get sick, and I think we just have a moment of thinking yet, it's really hard. We're so often hearing from families that they are sick or they're, you know, the parents are sick or the little ones are sick.
And when you have the personal experience and seeing how it impacts your sleep and how you're feeling during the day, it's just like a reminder that yet it's really very hard. And sickness does impact the whole family.
Yeah, yeah. It really does.
I can't believe how many bugs are going around at the moment.
We're definitely having a lot of families contacting the clinic saying I need to reschedule we're so crook and we had a lot of emails from Somvau members saying, can you please do an episode on illness we just have had one thing, after another, after another in our house and it can feel like you're just never gonna get sleep back on track again.
How did being unwell impact your sleep Laura?
Were you sort of having more naps in the day or how were your nights?
Yeah, I did actually have to have some naps in the day which I don't ever normally do.
And then, of course, I found that it was impacting my nighttime sleep, because then I knew full well that it wasn't gonna be taking the edge off my sleep pressure.
And so then I did find it a bit harder to fall asleep.
But also because I had sore throat and blocked nose and just waking up in the night needing to take more pain relief when it had worn off.
And then because I was taking on so much for making sure I was drinking so much to keep my fluids up.
That meant that I needed to get up more in the night to use the toilet.
So yeah, and then that makes you tired during the day, which means that you need a nap.
And then round and round it goes.
Yeah, so felt a bit more sleepy in general.
And yeah, my nights were more fragmented.
So that is what would be happening to little ones as well when they unwell.
Well, why don't we dive into that.
So why does illness have such a big impact on sleep for our little ones, our babies and our toddlers?
Well, when we are unwell, we need more rest and often more sleep too.
So we need to give our bodies time to fight the nasty bugs that have entered our bodies.
And that takes a lot of energy to do that and we simply have to rest in order to ensure that our bodies can fight the Lurggies.
Yeah. Yeah. And I think, you know, as you've sort of mentioned as well, for babies and toddlers, they have this really strong drive to just get a bit more day's sleep.
They, you know, often they're just not as active as they usually would be, and that can really have that flow -on effect into the nights like you described where it can just take you longer to fall asleep in the evening.
certainly for babies and toddlers, often they will start to wake up a lot at night, not just because of the increased day sleep, but also just they're feeling uncomfortable.
It could be pain, maybe they've got a fever, they're just wanting, yeah, that bit more sort of comfort and contact.
Yeah, and when we are feeling miserable, and particularly when babies and toddlers are feeling miserable, it's normal for them to want more comfort.
And it's normal for parents to want to give their sick children more comfort.
And so sometimes what we find is that babies who previously were falling asleep in their cot with minimal support, they suddenly want to be held or rocked to sleep, for example.
And that's quite a normal thing to happen.
And you'll never ever hear either me or you telling families that they must not offer that support to their sick children, because we do, children definitely do need more comfort when they are unwell.
What our job as parents is, is to ensure that we help protect the sleep that they are having, making sure they get more rest. And just knowing that this is a bit of a roller coaster that we need to ride and help little ones get out the other side.
Well, even as adults, we like to have more comfort when we're unwell.
Like, it could be that we, you know, get a hot water bottle or use the electric blanket or we want, you know, hot soup or a back rub.
You know, even as adults, we like that increased comfort and touch. So it makes sense.
Yeah, it does. Yeah.
And perhaps what we could be thinking about now, Fallon, is, um, if we're giving some advice to parents of babies who have mild viruses like head colds.
Kind of what would you recommend for keeping their sleep on track?
Yeah. So really mild viruses are really common. Like babies and toddlers are going to pick up a lot of them.
And when they are really mild, so there's not sort of a fever, there's no vomiting.
Like it's just a sniff or a bit of a cold.
Often things don't need to change a lot with settling.
And the reason I say this is because I've seen my share of families in clinic who the the minute the baby or toddler has a head cold they completely sort of throw out the window whatever settling they were using previously and they'll bring that baby or toddler straight into their bed, and so some parents will panic at a very mild symptom and they'll go to you know they might revert to co -sleeping which they might have worked really hard to actually reduce previously.
So if it is really mild, the cold, or illness your baby's got or your toddler's got, just pause for a moment and just see if you actually need to change anything about how they fall asleep.
Because if it's mild, often babies and toddlers are like, you know, I'm not feeling well and I want to go to sleep so get out of my space please.
I'm actually fine here.
You don't need to panic mum and dad.
So sometimes we can just pause and see how they go.
And sometimes they just don't need a whole lot of extra support.
But what I would say is, if you're thinking, okay, they are needing some more support to fall asleep, then start really small and gradually increase that support until you find that point that is working, I suppose.
So, yeah, it's not taking a baby who normally sleeps in their cot and putting them straight into your bed and starting co -sleeping.
It might be that if they're unsettled and not feeling well, that you go into their room and you sit there while they fall asleep and maybe do some shushing or humming.
And then if that's not comforting for them, it might be that you do a gentle back rub or maybe you give them a slow pat.
So you're sort of building up the amount of support just to find how much support do they actually really need to fall asleep?
Because it might not be that they need to be brought into your bed or to be fed to sleep or driven around in the car or any number of things.
They might actually be OK with something a bit more light touch. And that can just make it easier to keep sleep.
When they're in a familiar sleep environment, they're likely to get the best sleep possible.
So when they're unwell, if we can keep them in their sleep environment.
That can really help.
And that probably brings me on to my next point is, if your child is so unwell that you think, you know, I really need to keep a very close eye on them.
Rather than moving them out of their sleep space and into your bedroom, for example, always think about you being the one who goes to them because they, you know, their normal sleep space is what they're used to, they're probably going to get their best sleep there, you could set up a spare bed in the nursery if you need to be close by and keep an eye on them.
And that's definitely what I would suggest over bringing them into your bed, especially if they're having a respiratory illness.
You know, we want them in the safest space to sleep, especially when they are a little bit snuffly.
Yes, yeah, I often talk to parents about building a scaffold around their baby's sleep when their child is unwell.
So the lowest level is offering any pain relief, or other medication that your child needs.
The next step is adding in a little bit more sleep.
Do they need more daytime rest?
Do they need to go to bed a bit earlier?
Do they need to sleep in a bit longer in the morning?
And then we're thinking about what extra support do they need to fall asleep.
So yeah, always starting low.
And as you say, Fallon, just seeing how much extra support they need.
So You don't necessarily need to go to the top level of that scaffold.
Straight away it could be that actually all your baby does need is their back rubbed as they go to sleep.
And then that's gonna be much easier to come back from once they're better.
So, you just wanna build the scaffold up around your baby to just the level of extra support that they need when they're unwell and then start to dismantle it once they are better so you get back on track more quickly.
And what do you suggest to families where their baby or toddler might have a more serious illness like maybe they've got a fever, they've got rashes, they're vomiting, I mean obviously first thing is check in with your doctor.
Yes. Check that they are okay but when it comes to sleep what would you tend to suggest?
Yeah, so definitely keeping a close eye on them.
They're with them. If they're in a different room, if they are in a cot in your room then pushing the cot closer to your bed so that you are right alongside them so that you can listen to their breathing during the night, make sure that they are well.
Sorry, they are obviously unwell but making sure that they are staying safe during the night and knowing that they will wake up more often overnight because they are unwell but also because depending on what level you've gone up to have that scaffold and if they're really unwell, it may be that you're actually holding them to sleep in your arms, and then popping them down onto their own sleep space.
They're going to be waking up overnight when they do that systems check anyway and go oh, I'm not on in mum or dad's arms anymore.
So there'll be frequent wakings because they're unwell and also because they're waking up in a different place than where they fell asleep.
So being really close by to them just means that your sleep is gonna be protected to some degree as well.
Yeah. Great advice.
Yeah, and I think too, if settling does go way off track and I know this is a stress for a lot of families, like, oh I don't wanna kind of go back to old habits that we might have worked to get away from, sometimes they're just so unwell that we just have to go, well, that's just how, it's all I can do is give them the support that they're needing.
Just know that once they're better, you'll have confidence in reinstating whatever settling approaches used to work in the past, but you've got to wait until they're better.
There's just no point trying to work too hard at any of this if they're really unwell.
Yeah, that's right.
And I know that there are some parents at the moment who feel like they're going from one sickness to another to another, and they're really feeling exasperated and tearing their hair out, but when can I actually start?
When can I gain traction?
And I know it's a very frustrating place to be at and I wish we could say, yeah it's absolutely fine to continue working on sleep when your child is unwell, but we can't say that.
Which kind of does bring us on to the next point that we were gonna cover Fallon, which is what do we advise if parents have recently started a new sleep plan, should they ditch it or should they persist during the illness?
It depends so much on what the illness is.
So I think like I was saying earlier, if it's just a head cold, run of the mill head cold, I would say if you've got the confidence to do it, persist with whatever plan you're using.
But if it is something more severe, absolutely just pause the plan, wait until they're better.
that plan will still work when they're better.
Sometimes we just have to press pause on things.
Yeah, and I think as well, you know, if you've, yeah, there's always that sort of tricky point where I know a lot of families will say to us, well, we're, you know, we've just started a new sleep plan, we've just started to make progress.
Like, what do we do?
You know, the wheels have fallen off, they're sick, like, is it terrible if I change plans?
Not at all. It's just not, Sometimes it's just we just have to do the best we can do as parents.
You know, yes. Sometimes there's back to back illnesses.
I saw a family the other day who'd been trying for months to work towards some goals with sleep, but it just constantly kept getting derailed.
I think it was a toddler in the house bringing home every virus known to human kind, which was then very familiar to lots of parents.
And they were like, oh, you know, we're terrible.
We just keep, you know, rocking him to sleep.
We know that that's the cause of the problem.
and you know, we've, it's all us, it's our fault, it's our fault.
And I was like, no, you've done exactly what any good parent should do.
You have done what you needed to survive.
You have helped your child through illness.
Now they're feeling better.
And, well, you've turned up for an appointment to say, What do we do now?
Like everything's settled again, what's next from here?
And that's the perfect way to approach it, I think.
Yeah, gosh, it just, I was having flashbacks there, Fallon with when my youngest had just started daycare and I had just gone back to work after maternity leave. And there was just one sickness after another.
And I remember actually having to go, I was going back part time.
I actually had to reduce the number of hours that I was working contractually, because Because it was one sickness after another and my child used to have terrible respiratory illnesses and just as a family, we had to work out how are we going to make this work.
And we knew our knights were really disturbed because he was so unwell.
And we just had to sit down as a family and say, how can we support him to get better, support ourselves to get enough rest to be able to work.
So yeah, I do really feel for families who are in this position.
Yeah. It can have a huge financial impact.
Yeah. For some families, you just don't have the option of reducing work hours or taking a baby out of childcare.
You've just got to look the devil in the eye.
And soldier on and just know that eventually they've caught everything.
They have immune systems of steel and yeah, it will get a lot easier.
Yeah. Yeah. So hang in there if you are in the throes of illness, the right time for these, you know, working on sleep will come.
All right. So we have got two weeks' worth of parent questions to get through.
It is a lot. So we have put, well, rather you, Laura, have put a lot of energy into trying to really cut these down into succinct questions.
So if you send in a really huge look, sometimes parents do send us the most, I think we had 1000 word email the other day for the podcast. So please, when you're putting together your question I know you want to tell us everything, but we can't possibly read out 1000 words in the podcast. So please do try and keep your questions really short.
We've done our best to get the crux of the question clear for the podcast episode today.
But if we haven't quite managed to unpack all the complexities of your child, well, that's what Coaching Calls are for.
So please reach out and book in if you need us to do a bit of a deep dive together.
And just really quickly, before we dive into the parent questions, I wanna give a quick shout out to the amazing health professionals that tune into the podcast every week because they're trying to enhance their knowledge around sleep in little ones.
So amazing. And we know you send through a lot of referrals to our clinics as well, which is so, so appreciated.
And I just wanted to say, if you're a health professional and you'd like us to post you out some flyers for your clinic so you can distribute them to patients just reach out to us, shoot us an email sombell at infantsleep .com .au we know it's a lot easier to hand a patient a flyer to scribble down your URL so if that's helpful just reach out and we'll send you through some stuff in the post. Yeah awesome all right Laura so the first few questions they're all kind of about starting cot settling.
How about if, maybe I'll start with Jessica.
So Jessica has a 12 -week -old who's actually nine weeks corrected and they're taking two to four hours to settle at night with patting, shushing, and bouncing.
Gosh, that sounds like hard work.
They're not following a strict schedule yet and are reading the baby's cues, which is pretty good.
Nine weeks of age, that's what you'd want to do.
Yeah, tracking shows their baby averages about 14 hours of sleep, and is managing about an hour and a half awake maximum.
Jessica is unsure whether to stick with the 14 hour sleep average and hope the baby adjusts or to allow more sleep.
They're also wondering if a shorter wake window before bedtime might help and whether to start cot settling now or wait until a loose schedule is in place.
Hmm. So Jessica, you're right in the trenches, you're in the thick of it, you've got a very little baby.
You're just learning who each other is.
And you're just beginning.
You're just starting out on the journey.
You're tracking your baby's sleep.
If your baby is averaging 14 hours of sleep per 24 hours, then that's the sleep need that they currently have. So I wouldn't be thinking about when you're saying, should I stick to the 14 hours average or try and increase it, you can't increase the amount of sleep that your child needs.
It doesn't sound like you're at the moment you're not following a strict schedule, which again is, is appropriate when they're so little.
I'd be thinking about does your baby have appear to have a clear distinction between day and night at this age, I'm suspecting they are because you're talking about nap times and overnight sleep.
And I would just be thinking 14 hours worth of sleep per day.
Let's just see how we're going to split that across the day in the night.
That length of time, two to four hours to settle at the start of the night, yeah, that would be exhausting.
Which does also make me think, if it's taking up to four hours for them to fall asleep at night, maybe the wake windows, you're saying they're managing well on an hour and a half, but actually that last period of time awake might actually be a bit longer than that.
I'd probably be thinking, earlier on in the day, those awake periods might only be an hour, but later on in the day, at this age, maybe an hour and a half, possibly two at a push would be as long as you would want to go.
And just working on, in the early evening, bringing stimulation down low, having the house nice and in dim light, having some calming music playing, ensuring that you're trying to stay calm as much as possible at bedtime, swaddling your baby, listening to some music in headphones to keep yourself calm whilst you're patting and shushing your baby and beginning to be really a little bit more consistent with the settling approaches that you're using at this age.
So perhaps you could look at beginning to reduce the bouncing and just looking at just the patting and the shushing in your arms and knowing that you can be right in the middle of the peak of crying as well at this point.
So if you have a partner thinking about swapping in and out with each other, so that you've managed to stay calm at bedtime.
And, yeah, would you add anything else to that, Fallon?
I'd just say at 9 weeks of age, focus on a similar bedtime, a similar wakeup time, look at if it's two or four hours to fall asleep at bed time, then pick what average time they usually fall asleep and start to settle them at that time.
And think of cot settling as being something to practice, you don't have to be super rigid.
Just practice it when you can.
Maybe at bedtime, it's just too hard, but at other times in the day, it feels easier to practice.
And that's about all I would suggest really working on at such a young age.
Just know it's going to get a lot better soon, Jessica.
Yeah. Michelle has a toddler, 22 -month -old who naps for two hours a day and then sleeps from eight until seven overnight.
Michelle says that cot settling is still a work in progress because her toddler has a strong feed to sleep association and also experiences separation anxiety.
Now, Michelle's main question is about planning, they're going away on a trip where there's gonna be a two hour time difference.
And that's just in a month's time.
So they're not sure whether they should work on cot settling now, or wait until after the trip?
After the trip, 100%.
I would wait until after the trip, because when you're traveling, it can be really handy to do a feed to sleep.
You know, if there's separation anxiety, they're not going to want to be sleeping too far away from you either.
So you'd want to keep that porta -cock close.
So yeah, I'll just wait till after the trip.
Yeah, I think that's a nice, easy answer.
Yeah, definitely. Morgan has an eight and a half month old baby who wants and Morgan would like help to move away from feeding to sleep, co sleeping and contact naps which they've been doing for the past five months.
Morgan is returning to shift work in two months and feels some urgency to make changes.
They previously tried the supported accelerated approach but stopped part way through.
they weren't sure of their baby's sleep needs as they're contact napping, they want to start cot -settling again but wonder if they will cause setbacks by attempting cot -settling at bedtime and then bringing the baby into the bed after two unsuccessful resettles.
The old question of how do we do this?
I mean I think I know what you're going to say Laura, it's you either go all in or you don't like it's got to be just yeah yeah once you make the change stick with it.
Yeah, your baby for the last five months has been feeding to sleep, co -sleeping, and having all of their naps on you Morgan.
So any change that you make now is going to feel really big and very different to your baby and they probably aren't going to be too happy about it.
But there's good reason for you to make these changes, not least because you're returning to work.
So yeah, I would absolutely, if you decide to make the change, stick with it.
Don't resort to co -sleeping during the night.
They're so clever at this age that, yeah, if you change what you do, they just go, oh, okay, if I get really, really wild, things might change and often we just see a big escalation in crying.
So definitely be consistent, but definitely work on the daily rhythm before you make that change.
It doesn't matter. just track whatever sleep they're doing, even if they are contact napping track that sleep it's going to give you the average and I would say in a tricky case like this where there's a big change to make, work on the new daily rhythm for a week really strictly, really let that sleep pressure build before you go to make that change and it will help that change to be you know still going to be hard, but it'll be much sort of a smoother transition often they adapt much more quickly.
Yeah and you can also think about stopping the feeding to sleep first if you want and just cuddle them to sleep and do everything you can first to stop the feeding, to sleep and then move on to the cot settling after that.
So daily rhythm, stop the feeding, to sleep and use any other patting, bouncing, cuddling and then move on to cot settling or you can do both of those two things, stopping feeding to sleep and cot settling at the same time.
Hmm. Good plan. I like it.
Okay. Our next questions, we've had two people write in who are both using the slow fade approach and they have questions about restarting when they've previously stopped using cotsettling.
So Dana has a five month old and they have recently stopped breastfeeding to sleep, which is great.
And they've built in other sleep associations like white noise, shushing, patting, gentle rocking, whilst continuing to co -sleep.
Now Dana wrote in to say that they had attempted the second step of the slow fade approach just once.
And they did it for just five minutes.
And after that, they fed their baby back to sleep and returned to co -sleeping.
And on that night, they found their baby woke more frequently than usual.
So Dana asked, is it usual for sleep to get a bit worse before it gets better they start the cot settling process, or might they have missed something important?
Definitely when we change how we settle babies for sleep.
Sleep can feel worse at first when you change anything really with babies, like anything can just cause a bit of a change in in their behaviour.
So yes, it's normal.
So step two of the slow fade approach, which you're starting to settle them in the cot with lots of hands -on support whilst they're in the cot.
It's been tried for five minutes and then they breastfed their baby back to sleep and returned to co -sleeping.
So it's a bit like the last question where I would say, just to avoid confusion in your baby, go all in or don't go in.
Like you've got to make a consistent change because as babies get older, they get very clever And they re working out how does the world around me work.
And we don t want your baby to think, Oh, if they put me in the cot, all I ve got to do is just stay awake, maybe cry a whole lot for five minutes.
And then they give up on that silly idea and I m back in their bed.
And so there you know, some babies might slowly get used to being in their cot and start falling asleep there.
But I d say the majority will just start to escalate really hard as soon as they re put in the cot thinking, Well, the harder I cry, the you know, the I'm potentially going to get out of here.
And that can be really horrible for families where they've got a baby who the minute they're laid down they utterly scream.
I would just think, if you're going to do it, give them all of that support in the world, aim to stick with it, definitely pick them up for breaks, give them cuddles, help them calm, but then it's back to the cot.
If you're deciding to make that move, just make the move and stick with it for every settle, so that it's not confusing.
You're likely to see faster progress.
Yeah. Yeah. Okay. And our next question is from Eleanor.
She also wants to transition away from breastfeeding to sleep and co -sleeping.
But she's finding that her baby startles awake and cries inconsolably upon being transferred to the cot, even when she's fast asleep in Eleanor's arms. Eleanor is returning to work soon, and her baby will be going to daycare.
Previously, she has tried to use cot settling.
It sounds like from what Eleanor described, it was a slow fade approach. She just didn't name it in the email.
But she found that because her baby woke up every time she was placed into the cot, she was feeling really lost about what to do next.
So yeah, I a similar theme, isn't it, Fallon, that it's, Yeah, it's really tough.
And some babies are really sensitive.
So for Eleanor's baby, they you know, some babies will even kind of it's like they hover in light sleep, because they know that you're going to try and put them in the cot, and they don't want to go in the cot.
So the hover in light sleep, the minute we go to place them down, they spring awake, and we're back to square one, we're settling again.
And it's really, really, really tricky.
Eleanor, I'd definitely be reading through the Sombell chapter on the psychology of sleep.
So really understanding what that experience is like for your baby as well.
And then what I would say is, if you can't put them down asleep and have them stay asleep, then it really comes down to putting them down awake and helping them fall asleep in the cot.
I would say that you might have liked to have done it that more gradual way, but sometimes our babies just say no, no. I'm too sensitive to that, that's not the right fit for me.
So sometimes parents wanna do something, but then the babies are just not on board with that at all.
And we have to think, what does my baby need?
So if your baby's very sensitive, I would be not trying to get them asleep in arms and then put them down, if that's not working, I'd be thinking, okay, I need to put them down in the cot before they're asleep, give them all the hands -on support, take lots of breaks if you need to, but keep persisting with that until they're asleep.
And after a few settles, They'll just expect to fall asleep in their cot and you're over that crucial tricky hurdle.
But it just takes it just takes that real commitment.
And I fully understand some parents aren't ready to do that.
They're finding it too daunting.
You know, sometimes we just wait for the right time when we are feeling really really ready to persist with those changes and to support our babies through it.
It might mean getting some help from family or friends with settling or you know, booking in for a coaching call is also a really good idea if you want to think about making sure we've really optimized sleep pressure so that we have the easiest possible time with those changes.
Because some babies are just so sensitive.
They just need very, very careful thought around how we make those changes.
Yeah, yeah. And Eleanor, there's, if you do look in those, or when you do look in the module on settling approaches, read through the variety of approaches that are there.
And the case studies.
Yeah, absolutely. Good point, Fallon.
And know that Sombel isn't just one approach. There are a number of approaches.
And so have a read beyond the one which was your preferred one and then look to see of the other ones listed which of those feel manageable for you.
Read the case studies, listen to more of these podcast episodes as well, a lot of episodes on cock selling.
And also all the modifications in Sombal as well.
There's lots of modifications in there so that you know, if you've got a baby that's a little bit like this, this, you know, this little tweak might help the process to go more smoothly.
So yeah, definitely explore some of those.
Yeah, awesome. All right.
We have Lauren who has a 19 week old 19 weeks, how many months would that be, Laura?
so that's four and a half then five, yeah nearly five.
So Lauren's baby has a history of allergies which caused significant discomfort and led to extensive rocking and bouncing to sleep.
He has a 12 and a half hour sleep need and naps for three and a half hours across three naps.
They started working on cot settling in a bassinet and are now moving to a cot.
Their baby only manages 20 minute naps in the cot and does one three hour stretch at night when placed down asleep but otherwise wakes every hour.
What can they do to increase the sleep duration?" Okay, so Lauren has probably got a – I would imagine and having had a child with allergies and you were the same too, Fallon – you've gone through the wringer and you have gone through experiencing really intense crying that's been linked to pain.
So it can be very hard to even once those problems have been resolved and you know that your child is no longer in discomfort it can be really hard to listen to any form of crying because you're almost at PTSD from that terrible time in the early days.
So I would be thinking through again which of those cot settling approaches is going to be the right approach for you, it sounds like at the start of the night, you're holding your little one to sleep in your arms first and then putting them down into their cot.
And yeah, you've got this added confounder of moving from the bassinet to the cot, which is perfectly appropriate at this age because that's when most babies do need to be moved out of a bassinet for safety reasons.
So one of the ways that we do increase the sleep duration is to work on helping and supporting a child go to sleep independently in their cot so that when they come up into light sleep and they do that systems check they see that nothing has changed since they went to sleep.
I would be thinking which of those approaches is going to suit you best, Lauren.
Pick one of those, start to use it at the beginning of the night and then use it overnight to resettle your baby when and the baby's waking and isn't due to have a feed, and then using it for the naps.
Because once a child can go to sleep start to do longer stretches overnight with lower sleep pressure.
Cause it sounds like Lauren's baby is doing three hours of deep sleep and then is waking up once the, finding it harder to maintain this sleep in the lighter sleep stages.
Once your baby is able to do those longer stretches overnight and has that practice of doing the longer stretches overnight, they're more likely to be able to link their cycles for their naps as well.
So you might start to find that the nap duration increases during the day as well.
Did you have anything else to add, Fallon?
Just that it can be confusing if you hold your baby to sleep, put them down at bedtime and they do a big, long stretch. It can feel like, how they fall asleep mustn't be the problem, but actually babies will have a big, long, deep stretch of sleep at some point in the night.
Usually, it is at the start of the night and that's where we want it to be.
And it won't matter how you necessarily settle them at bedtime they probably will have a few hours of sleep in a row before they start to come up into light sleep and do that systems check.
So yeah, absolutely.
I would say go all in on the cot settling with whatever approach you choose because yeah, nights will improve and then naps will improve and it'll all come together.
Amazing. So nap transitions was another hot topic with parents.
I'm aware we've got so many questions Yeah, get three Laura.
So we're going to weas through these.
Lauren and Nick have a seven and a half month old who transitioned to two naps a day a fortnight ago.
Since then, their baby's been waking every one and a half to two hours overnight and needs resettling.
Whereas before they were sleeping for a seven hour stretch, followed by two or three wakes before 6 15 a .m..
Their sleep duration has reduced by an hour to their baby's self -settles at bedtime.
They are wondering if they drop the third nap too soon, if it's common for babies to self -settle but struggle with resettling overnight.
And if they should aim to add the lost hour back into total sleep somehow.
Okay. No, I wouldn't be trying to add back in that lost hour of sleep.
I think that it's probably not lost, it's just simply your child's sleep need has changed and has reduced.
So I would be reassessing the sleep need and seeing what it is now and maybe wake up needs to be brought a little bit earlier, or bedtime a little later, for example, sleep needs do reduce over time.
And so we're not trying to get a seven and a half month old to continue to sleep the same amount that they slept when they were four months old.
For example, it just doesn't work like that.
It's like trying to keep them in the same clothes.
We have to adjust to changing sleep needs.
At seven and a half months, that's a perfectly reasonable age at which to drop down to two naps from three naps.
So I wouldn't be worrying that you've dropped it too soon.
I think that probably your baby simply has had a change in sleep needs and that sleep profile.
So I would persist with the two naps and not think about reintroducing a nap at this point.
And I think probably just tightening up that daily rhythm in line with the current sleep need is going to help reduce the number of wakes overnight.
So your baby should go back to doing those longer stretches like they previously did.
Yeah, when they can self -settle, but they're not wanting to during overnight wakes, it usually does come down to timing, just needing a few tweaks, doesn't it?
Yeah, it does. Our next nap transition question has come from Katie, who has a younger baby, 6 and 1 2 months old, who only naps for 30 minutes at a time, so a little catnapper.
So Katie recently tried to move her baby to two naps a day.
um, but then her baby only had an hour total daytime sleep and was started having more wakes overnight.
But Katie says that she's found that when her baby has three naps a day, she actually sleeps really well overnight.
So she wants to know should she persist with the two naps or should she revert to three?
Yeah, I would revert to three.
That's really good evidence Katie that three naps is still working really well for your baby.
So yeah, I would revert to three then you might find in another few weeks you know it's time to go to two and that she'll manage it better then.
So yeah I think stick with three It sounds like it works pretty well.
We've got some questions about early rising.
Kim has a seven month old baby boy and has noticed habitual early wakes around 4am over the past four days.
Kim is looking for guidance on how to troubleshoot these early wakes.
He has two naps a day is on two meals and the room temperature is fine.
This idea of habitual waking I find really interesting.
I know a lot of people talk about that.
I think it's got a lot more to do with timing.
But anyway, what do you think, Laura?
Yeah, look, it's been four days.
So it could be that maybe your little one is about to come down with something, for example, I'd be always looking to see is there something that is persisting?
So if you're continuing the same daily rhythm, nothing else has changed, your baby's begun to wake up at four AM for a few days, just wait to see, I wouldn't change anything immediately.
I would wait for at least a week to see if it's hanging around.
And before I would even count it as habitual or a new behavior, because it could be that something else is happening.
But if you find it has been more than a week and your baby hasn't come down with any illness is mostly fine in himself, then I'd be looking at making some changes to the daily rhythm.
And it may be that he's already on two naps, so we wouldn't want to be reducing the frequency of the naps at this point.
Two naps is perfectly fine for a seven month old, but perhaps looking to ensure that not too much of that sleep budget is being used up during the day.
And, you know, one of the things you could think about doing is if the second nap of the day is quite long, that means that it's pushing close to bedtime.
Just looking to reduce the duration of that second nap or making sure that there is, depending on what your baby's sleep needs are, but four hours perhaps awake before the start of the night to help build that sleep pressure so that your baby can maintain their sleep until four in the morning.
And beginning to, you know, in consultation with your nurse, you're probably having an MCH check around this age or maybe next month, just ensuring that you're continuing to introduce solids at an appropriate pace in the daytime so that we can rule out that he's waking hungry at four in the morning.
I think that's good advice.
MS. FISKE Christina's early rising issue is with a slightly older baby, 11 -month -old, previously slept through the night, but after being sick for a couple of weeks then began waking at 3 a .m. The 11 -month -old is now fully recovered, but that early waking has persisted for the last week.
They've been using a consistent resettling approach with patting and shushing, but it takes Christina's baby about an hour to return to sleep after waking at three.
Occasionally, they've tried to co -sleep to help the settle but even when their 11 month old comes into bed with them, the baby still lies awake for an hour at that time.
So Christina is asking for help.
Her baby is currently on two naps a day totaling up to about two hours.
What do you them, Fallon?
Yeah, look, I would say, when you when they wake up, and you give them whatever support you think might work, and nothing works, they're just awake for an hour.
That's a split night.
So I would say probably a drop in sleep needs has coincided with illness.
And this happens a lot too, parents like, no, no, they were just sick.
And it's like, no, they've also dropped some sleep as well.
So I would just do a reassessment of the total sleep that that baby's averaging, and then adapt that daily rhythm.
And then we'll probably see it all come together and that split night will disappear.
Hopefully without having introduced some new expectations.
So that's always the thing I'm thinking is, if your child suddenly starts to wake, you know, for an hour in the night, try not to do anything very exciting or new or, because that can sometimes perpetuate the waking.
I think, oh, it's great.
When I wake up at 3am, might have maybe a random extra feed or a cuddle in mum's bed or song.
Yeah, yeah. Yeah, yeah.
So yeah, adapt the daily rhythm, and I think you'll find that things get back on track hopefully pretty quickly, Christina.
Yeah. Awesome. Okay.
I think some of those answers are going to apply to some of these next questions as well.
Oh, really? Yeah. Let's have a look.
So we've got some toddler questions now.
Mae has a 20 -month -old who sleeps 9pm to 6 .45am with one 60 -minute day nap.
They have one or two split nights a week when he needs a parent with him despite independently settling at bedtime.
He has an occasional early wake and sleep gets worse a few days before illness.
So they're wondering how to manage constant fluctuations.
Yeah. Really tricky.
At 20 months, we may...
it's highly likely your toddler is going to need to continue to have a nap for the time being.
So I would be, and I know in the longer email that Mae sent through, there was some discussion about sometimes that wake up time is a little bit variable in the morning.
Particularly if he's had a split night, he might have a bit of a sleep in.
So I would be, yeah, I'll just be ensuring that the - Knit that in the mud.
Yeah, knit that in the mud so that the wake up stays really constant.
And that when the day starts at a consistent time, despite what's happened overnight, it does just help the body clock and the circadian rhythm really just know when the day starts and it helps the rest of the day fall into a more predictable daily rhythm.
Sometimes if the occasional early wakes start happening more frequently it may be that 6 45 is just a little bit too late for your child and they may actually want to be waking a little bit earlier in the So have a think about whether 6 .45 is happening most of the time or not.
If it's more like 6 .30 or even 6 .15, then I would be saying, well, that's your new wake up time and stick with it.
With the 60 minute nap, just again, having a think about whether your toddler has or how long their sleep cycle length is.
If it's a 30 minute sleep cycle, in general, you could reduce it to one sleep cycle.
But you know, if it is 45 to 60 minutes, then just there's not much you can do about that nap duration at this point.
It's really just ensuring that bedtime and wake -up are reasonably consistent.
And you're not letting your little one have longer sleep ins due to having those split nights because unfortunately whilst it helps in the moment, it doesn't help long term.
Mm. Yeah, good advice.
I really like that.
Angela has a two -year - and three -month -old who's recently been waking overnight.
She sleeps eight until six or six thirty and naps for an hour and a half.
Sometimes she falls back to sleep quickly in the night when Angela lays next to the cot and other times, although she falls asleep, she wakes again an hour later.
and when this happens, she tends to sleep in later the next morning.
So Angela asks, are these night wakings a sign that the nap needs to be shortened?
Could be. A few things kind of go through my head.
So definitely wake up on time in the morning.
So just like you were just saying, Laura, if they wake a lot overnight and we let them have a sleep in, we're just saying to the circadian rhythm, sure wake overnight as much as you like because we'll just catch up on sleep later on.
And I can just kind of keep it going.
So definitely wake her up on time in the morning.
And then I'd be thinking, yeah, it could be that the nap needs to be shortened, because they're over two years of age and a lot of toddlers at this point are starting to drop a nap.
So you might want to think about trimming down the nap and seeing if that helps.
And then finally, if she's, you know, if you're there, when she falls asleep, and then she goes for a sleep cycle, does a systems check and oh, Mum's left. She might be calling out, just thinking, Well, where did you go?
Get back in here. Why do you have anything else to do, Mum?
What are you doing here on my floor?
So you could just think about, like once you've addressed any timing issue, if you think there's one there, then start to reduce, phase out that presence, lie a bit further away, or something like that.
Because that could just be one little part of the equation.
But yes, good luck, Angela.
I reckon a few little tweaks there and things will come together really nicely.
Courtney has an 11 month old who's having split nights, lasting about an hour after returning from a trip overseas.
So it could be a bit of jet lag there.
During split nights, their baby lies quietly, eyes open, but gets upset if they leave the room before she's back asleep.
She has two naps capped at an hour each, bedtimes 8 or 8 .30 pm, and they tend to get up about 7 a .m. Courtney's calculated the sleep need at about twelve and a half hours and wants to know why we think she's having split nights, is it sort of the time difference and the jet lag?
Is she ready to drop a nap or are the naps too long?
Yeah, so Courtney, like Fallon's saying and like you're wondering yourself, there's a chance that she, your little one has some jet lag.
Normally that resolved after a week or so of being back home.
So one of the things, if Courtney had sent your email a couple of weeks ago, you might have found that this is resolved already if it was jet lag, but if it hasn't resolved, then, yeah, I would be thinking your little one is probably getting, starting to show us that she's gearing up to drop down to one nap a day, probably not quite there yet, but it's certainly on its way.
With a 12 and a half hour sleep need, I'm just wondering if she's having about 11 hours overnight and then an hour each. That's closer to 13 hours worth of sleep that she's being offered each day.
So about half an hour more than she is averaging, and so perhaps what she's demonstrating that she doesn't need half an hour of that sleep by being awake in in the middle of the night for that duration.
So I'd be looking at tightening things up a little bit, either keeping the two naps at an hour each and then just making bedtime more consistently 8 .30 rather than eight, for example, and seeing how that goes and keeping that nice steady wake up time in the morning.
If that doesn't resolve in a change in those overnight wakes, I would perhaps look at reducing one of the naps, probably the second nap, to one sleep cycle, and that might be half an hour and see how things then go.
So you've got two options there.
You can look at stabilizing bedtime, moving it to half past eight and keeping the naps the same, or you could look at reducing one of the duration of the second nap in particular.
I know, it's good advice.
Okay. And our last question is from Joanne who has a 13 -month -old low sleep need, only an 11 -hour average sleep duration, but it varies from 9 to 13 hours each day.
So they would like to bring bedtime earlier.
It's currently not often until 11 .30 at night or later.
When they have tried to bring bedtime earlier, there has been chaos.
They thought that the end of daylight saving might help.
And that resulted in changes for about four days and then the wheels fell off.
And they've also tried to bring it earlier by 10 or 15 minutes every few days.
And again, they haven't found that it has resulted in lasting changes.
What do you reckon, Fallon?
I reckon they need to see you, Laura, with your expertise in circadian rhythm and using LITE to adjust circadian rhythms. This sounds a lot like something called delayed sleep -wake phase disorder, where it's not super common in really little ones.
It gets more common as they get older, where the whole circadian rhythm has shifted really, really late, and it can be really hard to bring that earlier.
So typically, what I would suggest is exactly what Joanne says they've tried.
That would be bringing bedtime and wake -up time and nap time sort of 15 minutes earlier every few days or so, and just kind of shuffling it along that way.
Um, you know, you could certainly try that again, Joanne, it should work, but the fact that you're saying it hasn't worked and it's really made things difficult, um, just makes me think there's something else going on there.
So, look, I would probably say you need to see someone about it because, um, yeah, it does sound unusual.
Yeah, that is unusual.
Yeah. I think that is quite, it's very unusual for a 13 month old not to be sleeping to, in Joanne's email which was longer, it was 11 .30 until 1 .30, so a bedtime can be really, really delayed.
So that is very unusual.
That fluctuation as well, in how much sleep your toddler is having from day -to -day, sometimes being nine hours, sometimes being 13 hours, that's a really wide variation, too.
Yeah, it makes me think there is, you know, some babies or toddlers will have a heap of sleep for a couple of days, and then hardly any for a couple of days.
And so they're kind of going up and down and up and down.
Yes, we have to bring it to that midpoint.
So if 11 hours is the midpoint, we give them 11 hours of opportunity.
So yeah, and look, this could be a case too of just really needing to keep the wake up time on track.
Sometimes parents try to bring bedtime earlier and they just let them sleeping as long as they want.
And so of course, yeah, and then it falls over.
Yes. So you know, if you were, if you want to try this, Joanne, without seeing, seeing me or Fallon, I'd be thinking about you know, if 1130 is usual bedtime, then think about 11 hours on from that, that's your wake up time.
And then starting from actual starting point and then you bring wake up and bedtime earlier in 15 minute chunks every few days.
Yes, but you'd have to account for day naps, 13 months old, allowed for one day nap in there.
So whatever you've got left out of that 11 hour budget after the day nap, if it's an hour day nap, we've got a 10 hour budget overnight.
Yeah. Yeah. It's an interesting one.
I wish we had more time to discuss that Kate.
But unfortunately we don't.
So look, just to finish off this episode, we have an awesome opportunity.
If you happen to be one of our first listeners to this podcast, then you might be in time for our baby sleep webinar for babies four to 12 months of age.
It's happening tomorrow night, which is Tuesday the 17th of July at 8pm.
I'm delivering this webinar for the Raising Children Network.
I love Raising Children's Network.
It is a fantastic online resource and it's entirely free to join this webinar and it's a real Q &A type session.
So we're gonna be diving into lots of questions from parents.
Yeah, I would say if you've got a baby in the age group, just come along.
It's a really, really great night.
If you can't make it on the night, you can listen to the recording afterwards.
So jump on and register for that one.
There's a link in our show notes if you would like to buy us a coffee, we absolutely love it when parents jump on and buy us a cuppa.
It's a lovely way to, you know, to say thanks if we've been of assistance to you.
Lots of people listen to the podcast and get lots of great tips.
And of course, if you're having troubles with sleep and settling with your baby or toddler, check out Sombal.
It's a resource that we are incredibly, incredibly proud of.
We just, we're meeting on the weekend when we Laura planning all sorts of very cool things for our programs over the next six months or so.
Which I can't tell you about yet, but I can't wait to tell everyone about on the podcast. It's going to be really cool, but yeah, if you're needing support, do you have a look at those programs?
We also run sleep clinics, if you prefer to just work one -on -one with us, that is an option as well.
Yeah amazing, have a great week everyone and you'll hear from us again next week!
Thanks everyone bye!
If you need help with your baby or toddler's sleep or settling, you need Sombell.
Sombell is Australia's first online paediatric 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 or visit sombell .infantsleep .com .au
