All Things Sleep

Surname Charlotte? Tritle. Everybody asked me that don’t worry. Right it’s so you’re setting up it just says live on zoom. Right we’re on. I think we’re on Facebook. Hello everybody. Hi everyone. So hi and welcome to this live Q and A session. I’m Ellen DeCicco and I work for the community and food feeding team which is part of the health visiting service here in Lancashire. This live Q and A is brought to you today in conjunction with our partners the Anja app which is previously known as LatchAid. Anja is here to provide every parent with the practical and emotional support they deserve and to be their companion on the overwhelming journey into parenthood. Using smart technology they provide parents and parents to be with vital support on their breastfeeding and parenting journey anytime, anywhere via their unique app. The Lachey name lives on as the unique three d breastfeeding support tool in the app. Search Anyababy in your app store to download today and access a free upgrade to the premium features for five months simply by entering your Lancashire postcode. So from any of us joining us today we have Charlotte Treatol, I’ve said that wrong I’ve got Charlotte’s title, sorry Charlotte is an IBCLC and Annoy Specialist with years of experience as a peer support to a leader of a breastfeeding group that’s the West Craven Breastfeeding Friends in her hometown of Barn Oldswick, Pendle. She works for several baby care and infant feeding organisations and works with the Holistic Sleep Coaching Programme’s Clinical Director and Sleep Coach Lindsay Hookway. So tonight we want to talk about all things sleep. We know that sleep is often such a challenging area for parents and you can hear a lot of conflicting advice. So hopefully tonight we can dispel some myths and share with you some evidence based information to help guide you. So I would now like to hand over to Charlotte. Hi thank you Ellen and thank you for having me it’s great to be here. Yeah, I’ve worked with families for years now and primarily in breastfeeding support, but anybody who’s worked with families in feeding or any of that early parenting support, particularly early parenting in the first few years, sleep and feeding and just adjusting to parenthood is they all kind of go hand in hand, don’t they? And the amount of times people have said I really need some feeding support, I’m having all these problems with feeding and please help me and then actually feeding is going really well and it turns out that the parents are maybe just a bit unhappy with how baby’s sleeping, even if that’s totally normal. So it’s a conversation that we’re having all the time. Parents are always thinking about sleep, wanting to know how they can get more sleep. And it’s one of the things that people get warned about, isn’t it? As soon as you say you’re expecting a baby, people say, well, that’s it. You’ll never sleep again. Enjoy your sleep while you can. And all those cliches that we hear all the time. And yes, we know that sleep can be disturbed and fragmented during pregnancy, during postpartum and well into childhood. We know that and there’s lots of really good biological reasons for that. And so you know for newborn babies it’s really really important that they wait through the night to feed regularly. So we’re thinking about milk regulation if they’re breastfeeding. Want to make sure that they’re getting lots of feeds in so that mom’s milk supply can match the demand, but also because they’ve got super tiny tummies they need to feed really often so they don’t end up you know too hungry and they you know the blood sugar is dropping and all that stuff. We want to make sure that they are happy, healthy, warm, fed, comfortable and ultimately going to grow from all that milk that they’re consuming. And the same can be said for bottle fed babies. They will still wake frequently through the night and and will want to feed little and often that is what is biologically normal for a baby to do those short sleep cycles wake up a lot check that mom and dad are around, am I still safe and can I have something to eat, please? So part of you know, talking to families in this way is just normalizing. Yes, you are going to be awake a lot through the night. And there’s lots of ways that you can go back to sleep very quickly. There’s lots of ways that you can support good sleep hygiene and good sleep cycles in your baby. You cannot train your baby to sleep. It’s a biological function. It changes, adapts, matures and becomes more complex as they get older. So I think you want parents kind of have a bit more understanding of what’s going on biologically with sleep. Can, even if sleep is still frustrating, knowing why it is can make a huge difference because I don’t know about you, but for me with my first, I just thought I was doing everything wrong. Just thought I must be a terrible mom because he won’t sleep anywhere but on me and people keep telling me that I’m not allowed to do that. And I’m going to spoil him and I’m going to get a rod for my own back. And, you know, just all really negative things. And I thought, well, if I can’t put him down, then I can’t get anything done. And it was only really once I learned more about normal baby behavior that I was like, well, actually, probably not really supposed to be getting much done right now. Supposed to be resting, caring for the baby, feeding, and keeping him safe and holding him and, you know, sleep. We sleep when we can, you know. Yeah. So it’s really important though that, you know, do acknowledge that lots of parents do struggle with sleep. Some parents would describe the experiences, you know, traumatic, they’re in a crisis, you know, something has to change, something’s got to give. And you know, there’s some really, really big feelings and some really negative things that can happen around sleep. And we know that not getting enough sleep can impact our health and well-being overall. We want to be really sensitive to that and make sure that you know if families do need support with getting their babies to sleep, that that is a possibility. And there’s lots of gentle ways to do it with not thinking about, let’s just leave the baby to cry and you go somewhere else. Because we know that most parents don’t want to do that. Most parents do want to be responsive to their babies. Do you want to find something that is consistent that is sustainable and that matches their kind of parenting style and isn’t really harmful to the baby. And it’s thinking about, you know, is it a problem for you or is it just something that you’ve heard might be a problem? Are you hearing messages from other people that are saying you shouldn’t do it just like I did, know, we shouldn’t do this, we shouldn’t do that, but actually is it working for you? Are you happy? Are you getting enough sleep? If so, do we really need to change anything? So there’s lots and lots of conversations to be had, lots of different avenues to go down, and I know we’ve had some really great questions from people submitted already, which I’m really excited to go over. But I think the first thing really, I know I’ve touched on it a little bit before, is to just go over what’s normal. So we, you know, we need to reassure parents that your baby should be working through the night and they probably are going to for some time. Seventy percent of children wake up one to three times per night, at least in the first two years. And at least one of those wake ups will be to eat something will be to feed and you know to breastfeed or to have a bottle if they’re hungry or thirsty. Or just just for comfort, know we know that babies like to be close to their parents. So that is really, really normal. 70% is a huge amount when actually lots of parents get hung up on the maybe one or two babies that they know peripherally who a unicorn who are sleeping seven till seven, not a pink part of them. And of course, if your baby naturally is a long sleeper, and they’re not unwell, and they’re safe, you don’t need to change that. It’s absolutely fine. But most babies are waking very frequently and want to be close to their parents through the night. That makes sense biologically because we are mammals. We are a species that are required to care for our infants for a long time until they become dependent, independent. They are dependent by nature. We carry animals, so we’re meant to carry them and keep them close to us. And if we left them alone in the middle of the night and they started making lots of noise, then they’re kind of telling predators, I’m here, you know, and it would, you know, they very quickly be at risk. So we still have that really ancient part of our brain that’s telling babies to stay alive, stay safe, and to signal to their parents when they need them and those needs through the night. And even through the day, you know, nap times and at any time. We know babies need us and they will signal to us when they need us by crying or making noise or fussing around. So all of that is totally normal. So I don’t want anybody to, who’s listening, who’s watching to think, well, my baby’s still waking up four times a night or whatever and thinking that’s not normal and it needs to change. And it is within, totally within the realm of normal for babies to be waking really frequently until at least two years old. But how many of us have got older children who wake up, you know, least once after we’ve put them to bed or, you know, maybe wake up really early? You know, there’s lots of different patterns for children and I don’t want that to feel really negative. Don’t want to always think, oh God, it’s like it’s a sentence, know, we’re going to be stuck with this for years and years. Because everything in parenting is seasons, you know, you have really good, positive long periods of time where everything’s going really nicely and then you have times where things are more challenging. Where your children are developing growing and their feelings are becoming more complex, their abilities are becoming more complex. All those different things can impact sleep. And that’s all normal and phases do pass. You know, we go through them and we can be equipped with some tools to manage those difficult times as well. So hopefully that’s given everyone a really good overview about what is normal for especially for young babies. But let’s have a look at what people are worried about. Let’s see if I can try and tell them So Charlotte, I think you’ve partly answered this, but I’m quite interested in this question. So this question is from a lady called Jennifer. Our 20 old is waking around two hours. We have a feed activity nat routine in a day which roughly takes about two hours a cycle. Could these be linked? We thought it might be down to the four month regression although she has been following this pattern for around five weeks so far. I find this an interesting question Charlotte because of the regression word. Because I never really I’m not massively into the regression idea and I’m interested to hear what you think about it. Yeah, and actually I think it’s quite a sort of I don’t say trendy because but it’s that kind of, know, it’s very popular at the moment. It’s very big, you know, if you search sleep issues, you know, Instagram, anything, you know, there’s lots and lots of information about sleep regressions out there. So Lindsay will say categorically at four months there is no there is no evidence at all that there is a regression at four months. So that’s part one of this this sleep regression issue. The other thing is that the word regression is something that’s used in pediatrics to refer to children who have lost a skill that they previously had. If your baby was walking and walking really well and then suddenly stopped walking and you know did not get up to start walking, that would be considered regressive behavior because they obtained a skill and they’ve lost it. And that is a red flag for needing support from healthcare providers seeking medical advice. Sleep is not something that babies are very, I mean they’re skilled at doing it as babies, but they’re not like adults. We, you know, we’re thinking about, know, a good baby should go to bed at 07:00 and maybe wake up at midnight for a feed and then be asleep again until 07:00 and that’s it, you know, we know that that’s not true. So what the problem with the sleep regression is, is that it’s kind of telling parents that your baby’s perfectly good at sleeping. They’ve been sleeping really, really well. And a lot of them will have been, but now they’re going to have terrible sleep and there’s some people out there who are sleep trainers who will say that your baby will never sleep well again or will never sleep independently unless you sleep train at the time of the four month sleep regression. So there’s lots of really terrible stuff happening out there that can really worry parents. Regression, you know aside the word aside, you know we nothing goes backwards with sleep at this point. It kind of feels like it because you’ve probably enjoyed your baby having a fairly frequent feed sleep wake cycle. Until then, some people haven’t some people have you know very chaotic feed sleep wake cycles and again that’s that’s quite normal. There might be other issues, you know we might have feeding issues, we might have issues in the family and you know there might be lots of different things going on that might impact how well a baby slept until that point. For argument’s sake, let’s say this baby slept really well after the initial newborn phase, first sort of six weeks, and has been sleeping in nice cycle and then gets to three to four months and suddenly the parents feel like everything’s gone to part, everything’s upside down, baby’s working all the time and they’re not just waking, but they’re waking and they’re really fussy and it’s harder to get them back to sleep or they’re waking what seems like really suddenly and it’s quite distressing for everybody. That happens because your baby’s brain is growing so much, you know the difference between a three month old baby and a four month old babies is quite you know it’s quite big. And the cognitive abilities that they have you know we’re talking about rolling and moving and being so much more observant of their environment. Babies are just absolute sponges. They’re taking so much information all of the time. So at the sort of three to four months mark that the development is quite rapid and quite intense. With that their sort of sleep cycles start to try and mature a little bit as they do, you know, but there’s no real solid evidence that it happens bang on four months. Some babies it happens three to four months. Some babies it happens much, much later. You might have parents come in and say, we’ve had lovely sleep until now and then they’ve got to five months. And I don’t know what’s going on. I don’t know what’s going wrong. And actually, know it’s it’s pretty normal for sleep to be fragmented or disturbed or disrupted throughout that period and try and take it as a good sign. You know your baby’s growing, developing, learning a lot more about the world and what they need from us is to be responsive at night the way we are during the day. So for this moment in particular, you know at 20 old having a baby that’s working every two hours is really normal and. It might feel quite intense for you, especially if it’s been going on for some time and you think actually quite like to have a much longer period of consolidated sleep. It’s normal, you know, it’s probably not to compare, but some people will be saying the same thing about a baby that’s working hourly at this point. And there’ll be people who have babies that are working four hourly or three hourly. And it’s it’s kind of down to what’s manageable for you. And it sounds like you know, you’re responsive to your baby’s needs with the sleep and waking and playing and all that kind of stuff. If, if your baby is, if you’re finding it difficult because the baby is waking every two hours, then what can sometimes help is just breastfeeding baby or feeding them and passing them on to partner who can sling them or cuddle them or whatever while you go up to bed early evening. So before that midnight kind of dead of the night night shift starts anytime before then and get a few hours of consolidated sleep for yourself so that when you do go to bed and you are being waken every two hours, it might not feel as intense because you’ve had that little bit of consolidated sleep. It doesn’t always work for some people in the evening, sometimes the morning is a better opportunity. And you know, you’ve got a partner or other family member who can support you know, if you get to sort of 05:00 in the morning and I’m done now and we don’t have to start the day till 08:00, you know, the baby to the partner and they can take over for a couple of hours and you can just catch up. It doesn’t always work. Know, some babies are very, very strict about the type of sleep that they get and two hours might just be the absolute maximum for that baby before they need to be back with mom. So partially just to reassure you that it is normal, not doing anything wrong. Those sleep cycles will start to increase with time and with age, so hang tight. Everything will improve over time. And like I said earlier, everything’s just these peaks and troughs. So you’ll have some good times and some not so good times. But when it’s really, really difficult, just try and think about how different the baby is at this stage compared to how they were when they were born and how much they’ve developed and changed and all the peaks and troughs that you’ve been through since then and know that you’ve you’ve gathered so many tools in your toolkit already That you’ll you’ll get through it. Alright, hopefully that helps. So another thing that I think we hear a lot when we’ve got small babies and people have told us we should be doing is should I put my baby down to sleep drowsy but awake? This is quite hard to do after a breastfeed this person’s name. I knew you were gonna say this one. It’s actually a pet peeve of mine, this drowsy but awake thing. It comes from some really unresponsive parenting teachers, really. Some people who, I won’t name names because I don’t want anyone to rush off to Amazon and start searching for their books. There are certain types of parenting educators or baby experts who will say that your baby needs to sleep independently, which means you need to put them down drowsy but awake, which means they will then, you know, in, in this perfect world that babies live in, in these, in these people’s heads, You put the baby down nice, nice and calm on the cot and they will just drift off to sleep. This does happen for some babies. It’s not completely impossible for some babies they will absolutely happily be laid down and just fall asleep. And that’s totally fine. If that works for your baby, that’s really cool. What actually we find is that parents think they have to put their baby down jazzy got a leak. And what happens is they put the baby down, and then the baby cries and then they pick the baby up and then they put the baby down and they’ll end up doing a cycle of putting picking them up and putting them down and they’re not babies getting more and more frustrated you’re getting more and more frustrated back starting to hurt your arms starting to hurt and actually there’s nothing wrong with breastfeeding to sleep. If that’s what you want to do and if your baby will go to sleep breastfeeding, go for it. It’s again, it’s totally biologically normal. It’s what you, it’s designed that way. Know, it’s very comforting for babies to breastfeed. It’s nice and warm and snuggly. Get loads of oxytocin. Breast milk contains tryptophan, which is a precursor to melatonin. So it makes babies sleepy, you know, and being comfortable and calm with mom and knowing that they feel safe is one of the factors that helps them go to sleep. Cots tend to be bigger spaces. They might be a bit chilly. They’re very firm compared to mom’s arms and all being all nice and cozy and squished in mom’s body or in a sling or whatever. And you know it’s very different environment and and you don’t have to put your baby down drowsy but awake. That is the very short answer. No, you don’t have to do it. If your baby’s really responsive to it, do it. If not, skip it. Find something that works for you. Would you say Charlotte as well that sometimes of the day babies will maybe have a lie down and feel that they want that rest and then it might not be the same case through the night you know. Absolutely, absolutely. You know we have to be responsive to our baby’s cues. You know, there’s a lot of there’s a lot of apps that talk about, you know, different cycles for your baby and that they should be doing this, that and the other. And what they are is the more data you put into them, the more predictable they become. So then they start sending you push notifications and saying your baby’s probably ready for a nap now. And it’s not because the app knows anything better than you do. It’s just that you’ve put enough data in that says that your baby will probably go to sleep around this time of day because that’s the pattern that they’ve got into. The problem with that is that we then start thinking that the app knows more than we do as the parent. And that is absolutely not the case. And sometimes the app might tell you that your baby shouldn’t have so many naps at this age. They should only be having two naps at this age and your baby’s still having three naps and then you think, oh my god, what am I doing wrong? But actually you’re just following your baby’s cues. Everybody is absolutely fine. Baby’s sleeping like a baby and you are happy to follow their cues, follow their routine and that’s Okay. Know it will it will change and there’s a lot of talk about wake windows. Wake windows I find can be really prescriptive and I know we’ve had some questions that have mentioned these wake windows and following babies wake windows and I think. Actually if you’re following your baby’s cue and they’re telling you that they are ready to sleep, then that’s all you need to know. If your baby’s been awake for two hours or three hours or whatever number of hours and then you think Oh my God, you know that that’s that’s the wake. That’s it. We’ve got we filled the wake window. I now need to get this baby to sleep And the baby’s fighting and clearly does not want to go to sleep or is getting up and down or, you know, really distracted when feeding. And you know all those kinds of things. They’re probably not actually ready to go to sleep yet. So those wake windows can be really prescriptive and actually forget to look at the baby and their individual needs. And you know, like I said, sometimes they might have a little nap, shorter nap than what they used to. And some parents will then spend the next hour trying to get them back to sleep when actually they’ve had a fifteen-twenty minute nap. They’re perfectly fine. That sleep was totally restorative and they’re just ready to get on with playing and exploring and doing whatever else it is that they want to do. And I would really urge parents that to be reassured that short naps can be restorative. Babies can get good, good solid sleep even from a short amount of time. Your baby will tell you if they’re still tired and they will be unsettled. If you try and put them down to play on the floor and they’re crying and they’re reaching for you, then they probably want to go back to sleep. They probably want to be cuddled and held and fed and taken back to sleep. If you put them down on the floor and they crawl away and go and find their toys, they’re probably fine. And that doesn’t mean that the next nap’s ruined or that the night sleep’s ruined. It just means that that sleep was shorter than the last one. It’s it’s fine. I always think it’s the same with feeding. Look at your baby and not the clock, because your baby is going to give you the most valuable information about what it is that they need and if you’re the main caregiver and you’re with them all the time you can be really really in tune to those needs. This has brought up another interesting thing in my mind Charlotte about being, so for one thing I’ve had parents in the past who’ve seen that their baby should be having a certain prescriptive amount of hours of sleep in a twenty four hour period but also I’ve heard people saying oh they’re overtired they’re over So that’s two questions really. Depending on their age, like newborn babies need around seventeen hours of sleep a day, or that’s kind of the top end sort of fourteen to seventeen hours sleep a day. And they’re like cats newborns, just sleep most of the time. And that’s fine. You might have a baby that’s like fourteen hours and be totally fine. You might have a baby that sleeps eighteen hours and is totally fine. We’ve got to look at everything holistically. We’re looking at the whole picture, you know, is the baby happy? Is the baby healthy? Are they developing? Are they growing? Are they feeding well? Do they have any other things that we need to be conscious of? Know, have they got any allergies? Do they have eczema? Are they are they tongue tied? Do they have reflux? Are there any other things that are potentially impacting way that baby sleeps? And do we need to look at those things first? Because if it’s if it’s one of those things, it doesn’t matter what we do about sleep because those things need to be addressed as well. And often you know sleep is again a symptom of medical issues and it’s not necessarily sleep itself that’s the problem. It’s symptomatic of something else that’s going on and will either resolve itself in time as the condition improves or with whatever treatment is given or it will remain as is normal for a baby or child with that condition. Yes, we can be really prescriptive about how much time the baby needs to sleep, and there is a really good chart. I think it’s from the National Institute of Sleep and I can get a copy of it for you, but it’s. Essentially, it kind of breaks down what research shows is the average each age and stage and the the kind of parameters are quite wide, so you know, like I said, newborn might need between fourteen and seventeen hours. That’s a good three hours difference. We’re looking at, you know, some of the and that’s just the average. There will always be outliers and will always be some babies that need slightly more or slightly less and there’ll be some that are just bang on average all the time. And of course they might change as they go through developmental changes, as they are poorly, as they’re teething, after immunizations, after a holiday, after some big life change, you know, after changing the way they feed. Like there’s lots of different things that influence how long the baby sleeps for. And we need to look at that sleep in a twenty four hour period. And if your baby’s kind of getting that average amount, whether it’s the top end or the low end, it’s fine. And actually, if your baby again is happy, healthy, following their centile, eating well, developing well, then the sleep is is probably normal, even if it is difficult or frustrating for you as a parent. You know, that just comes down to needing more support around the family or just some quick fixes for good sleep hygiene or changing the sleep environment or changing the way we try to get sleep or when you try to get sleep. Not following those prescriptive sort of times and weight windows and things. And the other thing that you talked about was overtiredness. So babies not getting enough sleep or babies who are not going to sleep at the right time. And over tiredness is a bit of an odd one as well, because it’s really, it’s talked about a lot and actually what would probably mean is that babies are tired and they need to go to sleep and we talk and that’s normal. Babies are very grumpy when they need to go to sleep just like adults. I mean, I am, I’m very grumpy if I need to sleep, particularly in the morning. But over tiredness is kind of it’s probably over diagnosed. It’s probably something that people worry about a lot that they really don’t need to because babies will just fall asleep if they’re tired at certain ages. Know, I mean, how many times have you seen videos on Instagram of babies just falling asleep in a high chair while they’re still eating a banana? You know, they will go to sleep if they’re tired enough. And, and most of the time babies do need to be supported to sleep. And that’s totally fine. But you will find that babies will just drop off to sleep. And I think parents worry more about over tiredness than they need to. And I think if you’re following your baby’s cues, they’re very unlikely to be overtired. They might be a little bit cranky if they’ve not had their nap at the usual time or if they’ve if they have had a short nap and they wanted a longer nap. I know sometimes my little one will wake up from a nap and appear totally fine and then ten minutes later is like actually I need to go back to sleep. And that’s it, know, we just got him back to sleep. And that’s okay, know, you if you’re happy to be baby led and you can be baby led, then those things are absolutely fine. But obviously some families do have to be a bit stricter about when and how babies and children go to sleep because they might be at work, they might have other responsibilities, and so you know we do need to look at everybody’s individual circumstances when thinking about how to support sleep. Over tiredness is something I think that parents worry about more than necessary. So something that you said in there, Charlotte, I will go back to the questions in a minute, I’m interested, is about the good sleep hygiene. So in terms of, I suppose that changes over time with age and things and or does it? Yeah yeah. When you’re talking about good sleep hygiene what I know it’s probably a massive umbrella term but what do you sort of mean? What do you mean? There’s there’s lots there is lots and lots of things and the main thing for for young babies and for young children is lots of broad spectrum daylight. So during the day, you know, talk about, you know, naps should be in daylight, know, don’t close the curtains, don’t make it quiet, don’t change day into night. You know, we want to and that that also helps newborn babies develop circadian rhythm that helps them learn when day and night is. But sleep hygiene is making sure we get loads of daylight, making sure we’re outside getting fresh air, doing loads of activity. You know, children need to be stimulated. They need to be made tired. Know, people find it hard to fall asleep because they’re sedentary. Lots and lots of people have very active brains, but their bodies haven’t been physically active and therefore they’re a bit fidgety when they go to sleep. Certainly that’s really common in adults. So it’s really common in children as well and babies that perhaps aren’t getting enough time just running around. Lots and lots of activity during the day. And then when we’re thinking about nighttime, we’re thinking about making sure that it is nighttime so that the difference is very clear. It’s nighttime now with screens off and as far as possible I can and I know that parents always hate this because screens are such a huge part of our lives. And I get it, you know, and they can be really necessary for lots and lots of people who have, especially if you’ve multiple children that you need to attend to. So I’m not telling anybody that they should never watch TV at night or should never use an iPad or should never use a screen. But for most people, sleep hygiene involves turning off screens and not being exposed to blue light before bedtime, at least an hour, but for very young children two hours is is a bit more towards two hours is more optimal. We we always have these jokes don’t Certainly in heteronormative families that dad comes home from work, gets the kids all riled up when they’re just getting settled ready for bed, and how frustrating that can be. Actually, if you’ve got a dad that comes in and just causes chaos with those children and wants to play with them, then it’s really good for them. First of all, it gets out any of that excess energy that they might still be holding on to at the end of the day. And, but also it’s really connected and it doesn’t have to be dad. It can be mom being silly or grandparents coming in and being silly or big sister or whoever it is just everybody together even having some silly time and to get out that excess energy and just really make sure that that sleep pressure starts to build up because. That you know if they’re not doing a lot of activity, then they’re already kind of at rest. So going to bed doesn’t feel like much of a change. So lots of connection at night is really important as well, and I don’t know who said it and I don’t know where I read it and I don’t know if it was Lindsay I’m not sure, but if. If somebody does hear this and tells realizes who it is, and please do say, but I read somewhere that for children and bedtime is saying goodbye. So it’s it is for them separation, you know, especially for families that don’t co sleep or room in together. And you know you’re putting your baby or your child to sleep and they’re saying goodbye to you for an unknown period of time and they’re expected to kind of be on their own and be Okay with that. Over time, yes, most children do become really independent sleepers and will go to sleep in their own bed in their own room in their own time. But for very young children it can be there is a little bit of anxiety about going to sleep and they might think well. What’s going happen when I close my eyes and what if you’re not here when I wake up and? And some of those thoughts are not conscious. The anxiety is very real, but the actual thoughts or the language to describe what they’re feeling doesn’t exist. Know, toddlers might not be able to say, I miss you or I’m scared that you’re not going to be here when I wake up, but that certainly might be what they’re feeling when you’re trying to put them to bed and they’re running after you and they’re climbing up their car or they’re. Messing around and crying or getting upset or whatever it is that they might be doing to, you know, extend that sleep time. What they’re looking for is connection. They’re looking for really solid attachment with with their parent or parents. So good sleep routine is good sleep hygiene as well. So predictable routine is really important. It doesn’t have to be the exact same thing at the exact same time every single day. When we talk about routine, we’re talking about doing things in the same or similar order. So we have tea, then we play, then we have a bath, then we play some more and do tea, then we go to bed, then we read some books, then we have cuddle and go to sleep. So it’s those things and it doesn’t have to be right, it’s 05:00, you need to do this. You know we don’t want it to be stressful it’s just going with the flow of life. You know some days are different if you’ve got all the kids who go to after school club and go to you know. Sports clubs or go visit friends or or other grandparents or whatever, and you’ve got all kinds of things going on. You might have one parent who works in the evenings. Everybody’s families are very different, so your routine isn’t doesn’t need to be really structured. Doesn’t need to be really like down to the second. They’re not panic if you’ve missed something out. Exactly and actually for lots of children. I’ll just mention this because I said about bath time. Bath time can be really stimulating for lots of children and if they have bath time too close to bed they’re like I’m awake and it can be really difficult to get them to sleep. If you’ve got a child that is very stimulated by the bath time change it, do it in the morning, do it earlier in the day do it just straight after tea, rather than close to bedtime you know we don’t have to follow anybody else’s routine we need to work what’s best for our family and for our children. Right? That covers a bit of a bit about sleep hygiene. Yeah. And I know when I’ve like, well, it’s been a while now, but when I’ve been away like Mediterranean countries and things, their children go to sleep totally different times to us. We have a very. Very pervasive idea that children should go to bed at 07:00 and I don’t know where it comes from I don’t know the history of this 07:00 bedtime but I don’t know many children that do go to sleep dead on seven and the variety of ages and times that the babies and children go to sleep is massive. So don’t don’t get hung up on having to get your baby to bed at seven and I think it goes partway along with that sleeping through the night that you know when’s your baby going to sleep through the night and I’m putting them down to bed at seven and I want them to wake up in the morning at seven and. You know we don’t actually have any clear guidance on what sleeping through the night means. And depending on which research is done, it can be anything from a four hour stretch to a six hour stretch or sleeping from midnight onwards. But actually, most parents when they say I want my child to sleep through the night is that they want the child to sleep when they want them to sleep. And that that varies wildly, you know most adults want to have evening time because we have very busy lives during the day we’re at work, we want to decompress, we want to relax. And we want to. We do want to spend time with our children, but afterwards we want to maybe spend time with a partner or we want to just rest and relax and have a little bit of time for ourselves. But yeah, like you say, in other countries, children are up till ten, eleven, twelve, 01:00 in the morning and then everybody just goes to sleep when they’re ready to sleep and children are just a little bit more ingratiated in adult life and adult times. So if you have a baby that or child that goes to bed at 09:00 and he’s absolutely fine with that and you’re absolutely fine with it, don’t worry about it. Nobody’s gonna knock on there is no sleep police coming around to make sure that the baby’s in bed at 07:00. So one of the questions that we’ve perhaps not gone into too much yet is is it okay to sleep with my baby in my bed? That’s the question. Yeah, so this is a big one, isn’t it? And we get this a lot when when we’re supporting, especially families with very young babies. Is it okay? Is not up to us to answer. That’s that is an entirely down to you as a preference as a parent. We can do is give you information about making sleep safer for you and your baby and making sure that your babies risks of anything happening when they’re asleep in your bed or as minimal as possible. So I think yes, we should go over what some of those what the safe sleep safer sleep kind of guidelines are because some people don’t know. So mainly we want to make sure that mom or mainly mom is sober and a non smoker and ideally both parents if both parents are in the bed should be sober and non smokers. Breastfed baby Baby should always be placed on their back to sleep, so we know that that back to sleep campaign reduced the number of SIDS dramatically from when we used to put babies down in a in a prone position on their tummies and thinking that that was the safest way to put them to sleep. Then research actually showed that that supine back laying position was safer and it reduced risk of SIDS hugely and very quickly. So we know that sleeping on their back is much safer. We want babies to be lightly dressed so not loads and loads of layers because your body heat is going to be keeping them warm. But we also don’t want them to be under the duvet. We need the baby to be separate from the duvet. So lots of parents who co sleep might tuck the duvet underneath that like through their legs so that it’s kind of tucked under. And there’s lots of really good. Onesies that you can get with like long sleeves that are kind of V necked that are great for just getting getting there getting a move out to feed. And keeping warm know certainly it’s something that people about in winter and maybe with the cost of living with not having their heating on as much and even just like a shrug or bolero type thing just sleeves on top of the vest and can keep you warm without you kind of struggling under the duvet. And we don’t want the bed to be too soft and a firmer surface is safer, but it doesn’t need to be really, really super firm. And We want to make sure that there’s nothing like wires or your phone charger or any gaps in the in the mattress or like if the beds placed up against the wall, it’s actually safer for it to be away from the wall. Now as scary as it is for your baby to fall off the bed, it’s probably safer for them to do that than it is for them to be kind of caught in a gap and unable to move. And we want to keep keep covers away from them and we want to do that for all sleep. And we want to make sure of course that everybody understands those implications. Those are ways of making it safer for you to sleep with your baby. And for breastfeeding parents, certainly you know we tend to make a C shape with our bodies, with the arm ups and the pillows are pushed away from the baby. Baby’s head kind of at breast height and mum’s legs are kind of up in a triangle sort of shape, so we kind of make a little cocoon around baby and lots of people have said, know my partner said I didn’t even move at all, I’m still in the exact same position when I woke up and my partner said the same thing. He’s like, I’ve seen you. You’ve watched you sleep all night. You didn’t move. You’re just in the same position and baby can just latch on and off and can support them to latch on and off quite quite simply and easily when they’re in that position. We do become very attuned to babies when we’re breastfeeding, breast sleeping. And we tend to wake up just as they do, Or even really infuriatingly just before they do, we think, oh, they’re still asleep. Can go back to sleep and get some more sleep and then they wake up. And it’s because our sleep cycles do kind of synchronise and certainly in those early days because of that reciprocal relationship with breastfeeding. Milk supply is meeting the baby’s demands. So we tend to just wake up at the time that they predictably have been. And so hopefully that makes it clear. If you are happy to have your baby in your bed and you are following those guidelines for making it as safe as possible. That’s entirely your decision as a parent and nobody can tell you. Yes or no, whether you should or shouldn’t be doing it. And we just want to make sure that everybody does it safely and quick note on that. If you are, if falling asleep by accident in bed with your babies is not, is obviously a risk. So if you do find that you are a breastfeeding mom and you think I’m feeling quite sleepy drowsy while I’m feeding baby. Get your bed set up in case you do fall asleep rather than trying to sit up, propping yourself and your baby up with loads of pillows or anything like that. It’s better to be in a safe sleep, safer sleep position than accidentally falling asleep. And the same goes for getting up and going on the sofa or sitting in a chair. We need to be really conscious that falling asleep on the sofa and in chairs is not not safe for anybody to fall asleep with a baby in those circumstances. Setting your bed up and following all those rules as best as you can is going to reduce those risks as much as possible. That’s brilliant and I suppose as well we keep the babies with us all the time don’t we? Know that that’s but you know that’s it’s part of the safe sleep message but it’s part of that responsive message as well isn’t it? Yeah. Know occasionally when you’ve found houses and people will expect the baby to sleep in the same room as them during the night but then they will have put it in a different room during the day which you know it sometimes can be confused messages and you know. Yeah, so we want we want baby to sleep in the same room as an adult caregiver for at least six months. There’s some parts of the world that suggest as long as 12 and you know there’s good reason for that. And, but also, know, if they’re next to you, it’s much easier to respond to them. And you know, it’s much quicker. It’s quicker to settle them. If they’re in another room and they’re upset and there’s a delay with you getting to them, they might be even more frustrated and stressed when you get to them. So it might actually take longer to settle them. And if your baby falls asleep in your arms whilst you’re watching telly and having a takeaway or whatever, that’s absolutely fine. That sleep is just as good as if they were upstairs in a cot by themselves. Probably even, I don’t want to say better, but more convenient certainly and your baby is you know being responded to. If you’ve got a baby older than six months who will happily go to sleep in a cot in another room and you are happy to do that, then absolutely go for it. But for safer sleep reasons, we want to make sure that all sleepers with an adult caregiver for at least six months and some babies, you know, it’s better to do it a little bit longer. And you will you will know when you feel comfortable and you will know when you know if your baby responds really well to being put in another room and as long as it’s after six months then the risks for your baby are very low. Brilliant I’m gonna I’ll just move on to another question because I’ve realized we’ve been only time so our six months old waits crying often every forty five to sixty minutes when in her cot and will only settle if I brackets mum, pick her up. We end up safely co sleeping from about 11PM as it makes it easier to settle her and is the only way we get any sleep. Any advice on how we can help her to sleep for longer in her own cot? Hang on there’s a bit more. We have a short bedtime routine, dark bedroom environment, white noise, naps aren’t great during the day but we try to make sure we follow wake windows of around two hours, oh you’ve mentioned wake windows, and then she’ll sleep for around thirty minutes in her cot or longer if we’re on the move in the pram or car. Okay, so there’s quite a bit there to kind of unpick isn’t there? So this baby’s six months, did I hear that right around Okay, six months so loads going on for six month old babies probably being introduced to solid foods or they’re having, you know, a little bit of something to eat now. Probably on the move a little bit, certainly rolling, maybe definitely sitting aided at least if not unaided and certainly will be hopefully practicing those skills at least. Does a huge huge developments you know from a baby that just lies flat on their back to suddenly being able to sit up and hold their head. Know is that’s a huge amount of physical and mental development and then add in having food as well, which is just massively exciting and huge changes to the digestive system as well, which you know lots of scientists will refer to as the second brain. There’s lots and lots of stuff going on in your baby’s body and brain at six months that can affect sleep. So yes, we’ve talked about wake windows and I don’t want to kind of go rehash all of that. But what I would say to this mom is, are you following the wake windows or are you following your baby’s cues? So it might be that the nap times when you know baby’s not sleeping for as long as thirty minute naps. There might not be enough sleep pressure building up. We’re just thinking well they’ve been awake two hours so now it’s time to put them to sleep. Are they actually tired? Are they showing you those sleep cues? Are they ready to have a sleep? You know really looking at them rather than that two hours you know as we get older as well. Know two hours being awake might might not be long enough, they might need longer. For some babies, you know, yes, two hours might be absolutely more than enough and then they need to have a sleep and certainly that’s okay. But it might be that this baby wants to be awake for two and a half hours or two hours and fifteen minutes or two hours and forty five minutes. And that might actually change throughout the day or day to day even. And so that’s the first thing that I would sort of say, know, are we following wake windows or are we looking at baby? And I don’t mean that to sound sound rude or unkind. It is a question. It’s just something to consider and because babies routines do change things change over time babies needs change day to day with regard to things like. Sleep and food and that kind of thing you know they have different appetites and different amounts of activity. We have that average number of hours of sleep that they should get, but like we say some days it might be lower and some days it might be higher. And so it might be that if that thirty minute nap is is happening, but they’re not getting enough sleep pressure in between, and they only need a short nap. If they sleep longer, because they’re moving in a car or in a pram, you know those things are quite soothing for lots of babies. Lots of babies love movement when they’re when they’re sleeping. And if you want to help them sleep for longer, if you feel that they do need longer than thirty minutes sleep, if you can put them in the primary, you can put them in the car and you want to do those things to help them sleep a bit longer, go for it. But that thirty minute nap might be exactly what they need. It might be restorative and it might just be that they’re sleeping a bit longer because of the motion and movement that’s just helping allow them to sleep. So there’s a few things there to unpack and the crying is normal. Babies waking up crying can sound a lot worse as they get older, they can sound quite distressed. Some of it could be just because they’re signalling, you know, are you still there? I need you help me and just help me go back to sleep. And sometimes they’re just frustrated that they’ve woken up, you know. I can hope in there. Most mornings I feel like that, you know, when I’ve got somebody crying my eyes open. And you know, it is it is normal for some babies to just think, oh my God, I’ve woken up what’s going on and be kind of a bit shocked that they’ve woken up. And you know, they sometimes just appear to kind of shock themselves awake and then are very, very upset. There’s lots and lots of reasons really that babies do wake up crying and it’s Okay that. Mom is the one to settle them with a cuddle. You want to have somebody else settle this baby, then habit stacking stacking is a great way to do that. So looking at maybe mom beginning the settling and then passing baby on to dad or partner to finish the settling or for even even Right, strip it right back down and just have that other person in the room at the time and as often as you possibly can. And you can introduce other sleep cues like patting, shushing, singing music. And consistently introduce those different cues so that when somebody else cares for baby or when you want to move away from doing one particular thing, you’ve got a whole bunch of other things that might help you baby go to sleep as well. The last thing that sometimes works for helping because I think she said that she wanted David to sleep a bit longer in the cot. Yeah, I was just gonna prompt you with that. Yeah, this is the one. Yeah, sometimes it is just down to, you know, the cot is not as comfy as you cuddling me and I don’t want to be in it. Sometimes it’s a temperature fluctuation. You know, we know that you lay down and you feel really, really hot and then you’ve been laid there for ages and suddenly you’re really cold and you need a blanket. It may be that because they’ve been, you know, laid there settled for a while that their temperatures dropped a little bit, in which case they might need a blanket popping over them. You know, maybe just before they would normally wake up from that thirty minutes, but actually one of the techniques that might work is something that’s called seated settling and it looks a bit funny and it’s it’s a bit difficult to describe, but I’ll do my best. So it’s kind of you put the baby down on the bottom so they sat in the cart and you still be cuddling them and holding them and shushing them. And then as they start to fall asleep, you would just gently lower their body down onto their back in the cart. So you just keep keep hold of them, hold them close and just really gently place them on their back as she falls asleep. And sometimes you just need to do that. Again, there’s never a super instant fix with sleep. Lots of these things take time to change. But actually lots of them change just by themselves without you doing anything. So you could try seated settling or you could also try a floor bed as an option where you lay with baby rather than putting them in the cart and lay with them on a mattress next to the cart. And lay just yourself next to the cot until they’re used to you being close and with them and then they might increase the amount of time that they sleep and you can start moving out of the room as they increase the time that they sleep in the cot. So there’s a couple of things that you can try, but ultimately I think at six months and there is so much going on developmentally with babies that any change that you kind of try to put in place now might not stick. And you can certainly start introducing things like habit stacking and try a floor bed and try and see to settling but don’t be surprised if something changes again in a couple of months when babies go through that next really big developmental phase. And also just to reassure this mom as well, everything that you’re describing is perfectly normal and it probably feels quite intense when you put your baby down for a nap and you think right, I’m gonna go and get some stuff done. And then they wake up after half an hour and you’ve barely done anything. And, you know, I’ve had this conversation with somebody recently, even with my own health visitor, you know if if you need to get things done, you can do those things while your baby is awake. You don’t need to use nap time to do activities. It’s okay for your baby to see you cleaning to see you running errands or to see you simply just sitting down and having tea and having your own dinner or. You know, doing your makeup or whatever it is that you need to do It’s okay for you to do that in the time that your baby’s awake and for you to rest at the time that your baby’s resting. Even if you don’t sleep in, it’s just literally laying down next to them or sitting in the sofa and taking some deep breaths. That’s absolutely fine. I think sometimes we feel under a lot of pressure to get our babies to sleep so that we can get a million things done. And I appreciate that lots of families do have lots of very busy lives and lots of things to do. But it is okay sometimes if we just let let things go. Do the bare minimum. And if sometimes all you’ve done is is just look after your baby and everybody’s happy at the end of the day that that is more than enough. Brilliant. Have we got time for another question? We do absolutely go for it. How can I gently reduce the number of night feeds? This is with a 15 old baby. Right okay 15 olds are brilliant. I like this age. It’s definitely a good time to start reducing feeds if if your baby’s responsive to that. Night weaning completely is often a bit easier from a bit older, so 18 ish. But there are a few things that you can do to kind of start that process that babies might be a bit more responsive to. If you do, if your long term plan is to cut out feeds completely, you’ve already kind of made a bit of a start on that. But don’t panic if your baby is not totally into these changes straight away that again 15 is a huge lot of brain stuff going on busy busy baby time so. There’s a couple of things that I would suggest which first of all is reducing the amount of time that baby feeds. So rather than you know if they’re if they’re working through the night and feeding for twenty minutes and you’re getting really frustrated, then try and match them a little bit sooner and see how they respond to that. That usually helps. That’s the main thing that I would suggest for a baby this age. Could could pick one feed out of all of the night feeds and cut that one out completely and lots and lots of conversation with your child about what’s happening, you know we’re not going to have milk when you wake up next time. Just gonna have cuddles. There’s lots of really great weaning books as well. Now there was one when I tried to night me my little boy, but now there’s like, there’s at least five. There’s lots of really good picture books that you can sit and read with a toddler that show children being nightly that show them stopping having milk at night. And that can really help as well. So reducing the amount of time that you spend feeding and even saying to baby you can only feed for one minute. They don’t need to know they’re not. They don’t know what a minute is. You can make that up. Know if it’s ten minutes, but you say one minute doesn’t matter. Whatever you’re comfortable with and then reducing that time each feed so that you know eventually they might not even bother to have that feed because it was only thirty seconds long anyway. Not interested. And then again, the other option is picking one feed and normally the easiest ones to keep other sleep. The feed to sleep. That’s usually the last to go in families that I support who breastfeed long term. The feed to sleep is usually the last one to be to be caught, and there’s a good reason for that. It’s an excellent way to get your baby to sleep. And also the first one in the morning feed so that the kind of feeds that punctuate the night are the the ones that are usually the last to go. So it may be that you keep keeping feeding to sleep, but the one after we’re going to cut that one out and we’re going to try and go through to the next night, the middle of the night feed. We’re going to cut that one out and try and do the morning feed off. If they feed twice or three times through the night, you might pick the one in the middle. But be consistent. Pick that one and stick to it. Barry might be really frustrated, but it’s really hard when you’re used to being a breastfeeding parent that you might just think every time that baby gets upset, we’re just gonna breastfeed them. And there’s nothing wrong with that. Absolutely nothing wrong with that. When you’re trying to stop feeding them, we’re looking at introducing other cues. So habit stacking can work really well here as well. But when we’re cutting out that one feed, we just need to be really consistent and still be really responsive. Yes, you’re really sad. I know you really want milk. I’m really sorry we’re not having milk now. Can have a cuddle, you can have a drink of water, and you can have another story. We can you know whatever. You can fill in the blank and and you know as long as you’re being really responsive to your baby, you still meeting the need. Some children really will absolutely not agree with you cutting that feed out and you will know as a parent whether it’s the right time or not. If your baby is really, really resistant to it, it might be worth just stopping. Carry on as normal for another couple of weeks and then try again and see how that goes. The difference is that you’re now swapping breastfeeding for something else that’s responsive. And as long as you’re really responsive, you’re still meeting the needs of your child. If they’re thirsty, will have a drink of water. I suppose as well, some babies might think, oh, I love 10 stories. So you might find that then you’re like, oh, I’m just gonna go back to the feeding. Yes, exactly. You know, the amount of parents who’ve said, I need tonight wean for my sanity, I can’t cope with this baby feeding all night. And then you know we’ve gone through these these gentle ideas of night meeting and had some you know put some plans in place and then they’ve suddenly gone. They’re still waking up. But I can’t they don’t want to feed anymore. And I don’t know what to do. So be really, really, really sure first of all that it’s what you want to do. Lots of people think they need tonight wean for all kinds of reasons. If it’s, an If external factor and you’re not 100% about it, then it might not be the right time to do it. If you absolutely have had enough and you really want to get on with it, go for it. You might find that it’s easier when your baby is a bit older and you might need to go really, really slowly. And so that’s why the sort of timed feeds works a bit better. Again, it doesn’t mess. You don’t need to get up and have a stopwatch. You can just you know, think about actually I’ve had enough of this now and unwatched them and see how they respond. And just you know, be really calm really consistent acknowledge the feeling acknowledge that they’re not going to like I’m really sorry I know you’re upset. Love you let’s have a cuddle we’ll go back to sleep let’s cuddle up and go back to sleep, or you know, whatever it is, and that you feel is appropriate to be responsive to them. Over time they’ll they’ll get the message, but it is tough, because it is what they’ve got used to, And it is it is gentle even if they are upset that’s the you know lots of people, so it doesn’t feel gentle because they’re crying crying with you. Is very different to being left alone to cry and be left alone to do those feelings And so holding them and cuddling them and comforting them in other ways is just as responsive as breastfeeding. Hopefully sometimes we all get upset, don’t we? And it’s about how how I suppose that’s dealt with, isn’t it? More than you know the actual feeling. Yeah, absolutely. Yeah, you know, as adults we probably wouldn’t want someone to be like, you know, do really, know, say, let’s have something to eat like you if you’re really upset, you know? Yeah. Might be, you know, lots of people comfort eating is absolutely a thing, but it might not be the thing that I want at the time that I’m full of tears, it might be the thing that I go to afterwards when I’ve had a bit of comfort from somebody when I’ve had a conversation and had a cuddle with somebody or just you know, got them tears out and then gone I’m gonna have a donut now because I deserve it. Don’t feel very nice or I feel better now. Had a cry. I’m gonna go celebrate with donut. I like donuts if you didn’t realize. But you know, it’s really hard when you are a dental parent when you really focused on being attached and responsive to your child that when you’re trying to change something, you know that behavior modification and looking at, you know, putting something in place that isn’t breastfeeding and it can feel really huge. The other thing to be mindful of when we stop breastfeeding at night or when we reduce breastfeeding at night is to be mindful of whether we do feel engorged or we have any any issues with with soreness. Know if you wake up and you’ve managed to drop a couple of feeds through the night, you might feel engorged in the morning even at 15. Do be really mindful of listening to your body and respecting if you do need to hand express or if you do need to pump or feed your baby in the morning to empty the breasts properly, then you know listen to it. Hand expressing is usually the best way if you are trying not to feed. Just enough to reduce that engorgement and then you’re not in pain and not risking anything like mastitis. But take it really slowly. Night weaning can when it’s done at the right time, if your child’s ready for it and you’re ready for it, it can be done very quickly. It’s usually two or three really difficult nights and then things start to improve. But certainly at 15, you will come up against probably some resistance. But it will get easier. And again, if it’s not the right time and your baby is really, really frustrated, save it, Wait another couple of weeks. You don’t need to wait forever. You can just give it up for a week or two and then try again. Babies develop very rapidly, we’ve always got the opportunity to try again later. Brilliant. Okay. That’s great. I’m I’m just I’m just gonna say if I know we’ve gone a little bit over time, but if anybody does have any questions that I’ve not answered, because I know we’ve posted about the event in quite a few different places, there might be some questions that have come through that I’ve not seen. If anybody does desperately want some support and I haven’t answered your question, then please do comment on the event, comment on the video, comment on wherever you see this. And I’ll do my best to go around and make sure that everybody’s got a response so that nobody’s kind of left left hanging. And I hope that’s okay and I’m really sorry if we didn’t get around to answering your question. Yeah, thank you so much for having me. Thanks Charlotte and I have popped in HCRG the Care Group websites and Safe Sleep information site as well into the chat box. Thanks that’s been great. I’ve learnt loads. Yeah there’s some fab information on the website so that’s langsyoungpeoplefamilyservice.co.uk. There’s safer sleep, breastfeeding, there’s information about Latchhead and Anja and how we can serve and support families in Lancashire. I think your group’s on there as well Charlotte. Yay! Yes, my breastfeeding group. Please do come along even if you’ve just got questions about sleep. We’re more than happy to come and just give you that peer support that one to one mum time. Sometimes that’s all you need isn’t it somewhere just to plonk your baby around some toys and just be around other parents who get it. You know we we are a breastfeeding group but we welcome all parents. We’re more than happy to have anybody who has breastfed or hasn’t breastfed. We are ultimately a community group so everybody is welcome. Thank you. Thank you. Thank you very much for having me. Okay. Goodbye. Goodbye.