Infant & Baby Sleep with Dr. Denise Gassner

Dr. Denise Gassner

Hello, everyone’s waving, nice to see you. I’m coming to you from the floor of my daughter’s room because working from home you have to make some concessions. I think everybody probably can appreciate what that is like right now. So that’s yeah, that’s my background that you’re seeing. Welcome.

I will just tell you a little bit about myself. And it’s really interesting, one of the first questions that I got that was asked was about, where do I start? There is information overload when it comes to baby sleep.

And holy moly, do I resonate with that so deeply. There is so much information out there, and I find even in the last five years. So my eldest is five and in the last five years, I feel like it’s just getting more and more and more in terms of lots of different sleep professionals, lots of different blogs, lots of different conversations, and rhetoric around baby sleep. It’s only increasing.

And so what I want to do in the first little part of this Live, is just let you get to know me a little bit, where I’m coming at when I’m talking about baby sleep. What I was confronted with when I became a mom and why I chose to, you know, kind of go into this information sharing world, because I think it’s so important for us to be able to have open dialogues about these kinds of topics.

So I want to give you a little bit of background first. My education, where I’m coming from so that you get an appreciation of why I found sleep to be both utterly perplexing and also incredibly fascinating. So I have been studying aspects of behavior for almost 20 years now. I teach at the University of British Columbia, I teach in areas of evolution and human cognition, behavioral ecology, primatology, so I have done quite a bit of research when comes to behavior.  I started out in neuroscience. So, you know, I have kind of that academic interest and passion for topics that are related to behavior. I went into motherhood with this idea that “Okay I am so excited to have my own children and be able to see how their behavior develops over time.” I know that the thing that kind of

hit me the hardest and the thing that was, as I mentioned, the most perplexing and the most surprising to me was sleep. It was not something that I had given much consideration to beyond the kind of scoffs and remarks that you get as an expecting mom. You know, get your sleep now because it’s gone after this. We tend to speak about it lightheartedly that way and almost joke that we’re going to lose out on sleep and that’s just the way that it is. But I found it incredibly challenging than when I was in it, not only to lose out on the sleep that I felt that I could potentially manage, at least for a short period of time, you know, we all kind of are prepared to sacrifice the things that we need when we have a new little baby at home, we want to be able to give them everything that we have. So I was ready for that, but it was more about the worry, the stress, and the concern around whether my baby was getting the sleep that they needed. The fact that it felt completely unnatural, that I thought, everybody sleeps every single day, this is something that with time, my babies will just kind of fall into. We’re going to be able to find our groove and our rhythm, that just was not the case.

It was not the case, it was so hard. I am a type-A personality, I wanted to have control. I didn’t have any control and I didn’t know how to approach it. It felt like the thing that was most difficult for me as a new mom. It gave me a lot of anxiety, it gave me a lot of stress, and I wanted to be able to manage it. I wanted to have some semblance of control over it, and I really had to admit to myself that I really didn’t. So I ended up going into this complete rabbit hole of research to try and understand baby sleep.

The thing that I want to communicate and the thing that I think is really, really important that we bring this dialogue, is that there are so many sources out there telling you how you can fix your baby’s sleep. I should do my air quotes a little bit closer together, “how you can fix your baby’s sleep.” So there are lots of tips and lots of tricks, and they’re coming from a really great place.

A lot of them, all of these tricks are coming from a source of what is typical, what is biologically normal in baby sleep. But so many of the sources out there didn’t explain to me why.

Why was this sleep thing happening in the first place?

And what I mean by that?

What the heck is an awake window?

Why are they the way they are at different points in development?

Why does a newborn only stay awake for 45 to 60 minutes, but an eight-month-old can stay up for two, three, and four hours?

Where is this coming from?

I wanted to understand that better.

Why do babies have to sleep multiple times during the day?

Adults don’t sleep multiple times during the day, why do we move from multiple naps regularly throughout the day, by three, four years of age, being onto what we call monophasic sleep patterns?

So where you’re sleeping in one chunk of sleep at one point in time. And then how does the environment that is surrounding us, how does that influence sleep in babies?

Like, how are they responding to light and dark and sound and smell and touch and all of these other things?

All of these questions were really, really core to me for understanding baby sleep, and how sleep develops over the first weeks, months, and years of your child’s life. So I focus on sleep from zero to five years. I focus on specifically what is going on beneath the surface. I like to approach sleep [from] what I call from the inside out. So really understanding how sleep is developing inside a baby and then what they’re projecting on the outside because of that. Many of you will be familiar with the Wonder Weeks. You know, this is a source that allows us to understand

how our baby’s cognitive development is happening, it helps us to expect and appreciate. What is going on within their brains so that we can understand why they’re being clingy or fussy or anything like that a little bit better. And it’s just having that knowledge gives us some sense of comfort that it’s okay, this is normal and it’s going to pass.

I like to look at sleep in a very similar way, consider it kind of a Wonder Weeks of sleep, okay? So sleep develops across different stages as your child gets older. If we can look at it in these stages and understand that development, then we can better understand what our children are asking for when they can’t necessarily communicate it clearly to ourselves.

For that reason, [I’m almost done with my little spiel] I’m going to jump into a Q&A really quickly. I think it’s also really important that we don’t slap on blanket kind of prescripted or rigid approaches to baby sleep. It morphs and it changes as your child develops, so too should your response. Your response will morph and it will change.

I have done everything from walking out and letting my babies cry for a little bit of time, because I was at the end of my ropes and I was dealing with postpartum insomnia and postpartum anxiety, so I have definitely done that. I have also gotten into the crib and laid with my babies or laid on the floor holding their hands while they slept through the night. So I’ve done everything from in and between what all of the different recommendations are out there, and I never adhered to one kind of specific approach. So I don’t coin one approach that is my own.

What I really like to do when I talk to parents and when I work with parents I like to understand what’s going on in your environment, what’s going on in your situation, what’s your baby’s temperament like, what’s their personality like, what’s your bond like? All of these kinds of things and we really like to approach sleep from that perspective. There are lots of different ways that you can help your baby to establish the sleep rhythm. The sleep groove that will help them to get the most restorative and healthiest sleep that they can, which of course is going to end up in more sleep for you, most likely.

But the important thing here is that your baby is getting the sleep that they need when they need it. It’s one of the most foundational behaviors in our bodies, in our inner working system. It’s important for everything from cognitive development, learning, attention, emotional regulation, physical development, mental health, everything, sleep impacts every cell of your entire body, okay?

So there’s kind of my opening spiel as to why I do what I do. I am here visiting you from Oona. I am the infant and childhood sleep expert at Oona. I do have clinic hours that you can book and we can have one-on-one conversations about what’s going on in your specific situation. Then I’m also introducing a sleep workshop series. So the first one is coming up on Thursday, it is a Newborn Sleep Foundations. It is not a sleep training session, and neither are any of them, but the newborn especially, it is really about laying the groundwork.

Really understanding sleep from its core, understanding how newborn sleep is very different from our own and different from later parts in childhood development. How we can kind of establish that healthy sleep foundation for them, as well as understanding what is biologically normal within that stage.

So that’s the first one Newborn Sleep Foundations. And then the other ones that are upcoming are the Surviving Sleep Regressions, I’m sure I will talk about in this LIVE through questions that are coming up. The surviving sleep regressions and then also a managing toddler bedtime resistance.

I have a three-year-old and I can tell you every two to three months we are revisiting toddler bedtime resistance. It just is how toddlers are, we get really creative in ways to help her to feel comfortable and stay put in bed when she needs to. So yeah, so that’s where I’m coming from. And I would love to hear your questions as they come. So I have some help on the backend with managing questions that are coming into the chat, so please feel free to write your questions out in the chat. I also have some questions on hand here that have come in previously. So I will bounce back and forth a little bit between them. So I will start off with one that I already have. So that you can kind of think about what questions you might have. I’d also love in the chat if you want to just introduce yourself. I’m going to go back to that first question that I was visiting about, you know, information overload on sleep and where do I start, what is a good approach for a newborn?

[Question] So totally information overload, I get it. So where do I start?

Newborns sleep so differently from you and I, their sleep system is very immature. I can tell you that, you know, our brains sleep in five distinct phases. You’ve probably heard about REM sleep and non-REM sleep, and non-REM sleep actually has different stages that are part of it. So our brains cycle in and out of these different stages, a newborn only sleeps in two. Already just from that information, the quality of their sleep is incredibly different. The other thing about newborn sleep that is different is that they’re not really that sensitive to the environment around them. They have spent the first nine months of development in a dark muffled sounded space, so they don’t have the responses yet to environmental cues. That they’re not going to be startled that easily by changes in sound, changes in light environment, changes in motion.

If you’ve moved them around and stuff, you might notice that a newborn generally sleeps quite easily. Also, their circadian rhythm is really immature, and so they also don’t really have that much of a rhythm. So that each day might seem very unique and very different from one another or from the last. So where do I start with a newborn?

You really, the biggest thing that you want to start with is establishing the difference between day and night. They need to get used to our 24-hour cycle, the sun, and the darkness that we experience day to day. I’m establishing a difference between what does 12 hours of night look like and what does 12 hours of day look like? Daytime obviously will have periods of waking in between sleeps. Newborns sleep short and they sleep often, but during the day they’ll have these periods of being awake. If they don’t, we want to actually encourage periods of being awake. Because we want the sleep drive to build up so that at night, they’re having the deeper, more restorative sleep that lasts longer durations, of course, there’s going to be feeds in between there, it’s not really realistic to expect a newborn to sleep all the way through the night.

Although those of you with two or three-month-olds might start to notice that you’re getting five or six-hour stretches out of them, that’s okay. But we don’t really expect a newborn to sleep through the night, they do need to feed regularly. So where to start establishing a difference between day and night, establishing a bit of sleep space. Spending a little bit of time, letting them know where that sleep space is even if it’s just for short durations before they’re with you and on the go, whatever that is. And yeah, and just starting to get into a little bit of a rhythm there.

[Question] So we’ve got a six-month-old and we really struggle with short naps.

Okay, this is probably one of the most common struggles that we see, short naps. And, oh my gosh, I called my son the King of the crap nap. That’s like, we didn’t see longer than 30 to 40-minute naps for so long.

So one of the things that I always recommend with a short nap is first of all if your baby is under six months, short naps are sometimes just the way that it is, okay? Especially if you’re trying to establish a sleep location, where they are sleeping, say in their crib for the majority of naps during the day. You’re establishing that sleep location and because daytime sleep is different from nighttime sleep, the naps may be shorter. So know that you might have some variation there.

By six months, we want to start to have a little bit more consolidation in the daytime sleep. We’re talking about around 60 minutes for a nap, which is two sleep cycles for daytime sleep. So my biggest recommendation for short naps, there’s a couple of things you need to look at.

Are they falling asleep at the beginning of the nap somewhat independently?

The biggest thing with baby sleep is that it’s a vulnerable space. It’s very vulnerable to be a baby and to be laying in a crib by yourself. If they fall asleep in your arms, on the breast, walking around and then you transfer them to the crib, when they later rouse from a single sleep cycle, which we all do [we all come up into later stages of sleep] they will wake up because they will recognize that something has drastically changed in their world instead of going back down into the next sleep cycle. So the number one thing is trying to get them to a point where they are feeling comfortable and confident falling asleep in the crib space. So that when they later wake up they are still in the space that they were previously in. And how I like to talk about it is, you know, if you fell asleep all cozy in your bed with your pillow and your blanket. Then later roused and your pillow and your blanket had been taken away from you, you are definitely going to wake up and be like, what just happened in my space instead of just your regular micro kind of arousal and then going right back to sleep.

So that’s the number one thing with a crap nap, which is making sure that they’re falling asleep independently. If they are falling asleep independently, if you have managed to get to that point and your baby is pretty confident and happy to go to sleep at the beginning of the nap, then I would say it is okay to help them extend it, okay? So if they’ve only had a 30-minute nap, you can help to extend that nap. That looks like a lot of different things. I have a blog post that’s called Crap Nap Chronicles on my website, which if you don’t know, is www.theresamonsterinmycloset.com.  My blog has information on crap naps, and it gives a couple of different ways that you can help to extend the nap. Everything from a little jostle before they wake up to help them kind of link into the next sleep cycle without fully waking to picking them up and helping them to go back to sleep to get another sleep cycle. Their body eventually will learn to connect those sleep cycles together but that can take time.

And then the other thing just to keep in mind, is making sure that you have kind of age-appropriate sleep rhythms going on because if you don’t they might be overtired and as soon as they’re overtired, you’re almost sure to get a crap nap in. So really looking at wake windows. So for a six-month-old, we’re talking two hours is kind of your upper limit to an awake window, especially early in the day.

[Question} Eight and a half months old is still night waking for breastfeeding, [We are] co-sleeping, okay, and would like to move her to a crib.

Yeah, this is another thing. A lot of people will ask me about the co-sleeping relationship and whether that’s something that is conducive to good sleep. And the answer is, of course. Of course, it’s conducive to good sleep if it’s working for everybody. If it’s okay that your baby is in the bed with you, and I do have to mention within the confines of the recommendations for safe sleep, so this is really important is to make sure that you are having a sleep relationship that is safe. If that is the case and your baby is waking and perhaps nursing back to sleep and that is not that disruptive to you, then there’s no reason that you have to change that environment.

There are lots of studies that have shown that parents get better sleep in the co-sleeping relationship, though there are also studies that suggest that babies, especially, later on, toddlers and preschoolers actually get a little bit more of disrupted sleep in the co-sleeping relationships.

So just things to consider here. If you do want to move to a crib, I recommend doing it really, really gradually. The very first thing to do is just work at bedtime. Work at bedtime and see if you can get your eight-and-a-half-month-old comfortable with falling asleep on the crib surface.

Even if they wake up an hour or two hours later, that’s okay.  We’re talking small exposures for a period of time, okay? So getting them comfortable with falling asleep on that surface, and that might look like trying to replicate as much as possible how you get them to fall asleep in the bed with you. Which might be getting your body right down in there with them, laying up next to them, rubbing their belly, potentially even breastfeeding a little bit. Getting them to a point where they feel comfortable on that surface, and then just gradually bringing yourself away from that. If they can fall asleep there, that’s the first exposure, then we can start to move that through into later periods of the night, as they start to feel more comfortable with that environment. Again, consistency in the environment is what is going to help to keep them sleeping longer. So if they fall asleep in that crib, they’re going to be less aroused if they wake up later and they’re still in that crib.

[Question] Another daytime nap. What’s the best method to follow? Naps at the same time every day or following wake windows?

Excellent, excellent question. So it’s really interesting. This is one of those blanket things that I find is sometimes communicated or miscommunicated, and it can be really hard to know the difference.

So the answer is actually, it depends on how old your baby is. So the circadian system, the circadian system, just for like a little refresher, all of us kind of have some vague conception of what the circadian system is. But it is that thing that controls the rhythms of our body at the same times each day. So you probably notice for yourself, you generally get tired around the same time and you generally wake up around the same time each day. I know all of you moms out there are laughing at me being, like, “I’ve been up all night long, what does that even mean?”.

Just think of your natural rhythms. We do have a circadian system. We also tend to get hungry at around the same time as each day, we tend to have the same burst of energy at around the same times each day. So you might notice that that’s your circadian system taking over. Babies, that is very immature, okay? It’s there, it starts to establish, we start to get a bit of a rhythm, we start to get a little bit of consistency, but that system does not take over until about nine or 10 months of age.

So my answer to that question is if your baby is younger than nine months? Wake windows. Wake windows. Wake windows. Wake windows.

Why? Okay, wake windows are the other sleep system. So there are two sleep systems that regulate your baby’s sleep. The first is the circadian system and the other one is the sleep drive.

What is the sleep drive? Well, if you think of a balloon, when you wake up the balloon is completely deflated, okay? As you are awake, the balloon fills with air. What is this filling? Well, it’s your brain filling with information and all of the byproducts that come along with it. So your brain fills up as you’re awake because you’re taking in all of this information until the pressure is so strong on the edges of that balloon that it needs to deflate again before it can start to fill again.

Okay, and so we need to almost reset the stage. An adult’s balloon is very large. We can stay awake for 16, 17 hours of our balloon filling up because not so much as new in our world and our brains have already experienced a lot of things. So we can stay up for a really long time and then we go to sleep, and our balloon deflates. A baby’s balloon is very, very small and it only gets just ever so slightly gradually bigger as they get older. So the wake window of a newborn is about 45 to 60 minutes, okay? So that balloon is 45 to 60 minutes, and then it needs to deflate, and then it fills, and then it needs to deflate again. A balloon of a six-month-old, as I mentioned is about two hours. So it takes two hours for it to fill before it needs to deflate again. In the first nine months, that matters almost exclusively, okay?

So you paying attention to wake windows is what is going to allow that that pressure doesn’t build up so much in your baby’s brain that they get overtired and irritable and start to lose it as we’ve all experienced. Once they hit nine to 10 months the circadian system takes over and it’s much more important that they are sleeping at around the same time each day. They are more resilient to that balloon and there’s more give, it’s a more flexible balloon, and so they don’t need to have as rigid of a wake window at that point in time. Ideally, what we want is that those two systems actually align, that the balloon fills and deflates at the same times each day. But that takes nine to 10 months to develop, okay?

[Question] At what age can you expect longer consolidated sleep at night and what can you do to help?

So this is a tricky question. It kind of depends.

So some babies will start sleeping long periods, as I mentioned already, you’ll notice that around three months often. Parents start being like, oh, my baby slept five, six hours at night, this feels so great. And then the four-month sleep regression hits, and bam, they’re up every hour to 90 minutes again. So you might get, it might wax and wane a little bit, how long your baby sleeps at night. I’m a very big advocate for continuing breastfeeding if you are breastfeeding or just feeding in general through the night, even though the first year. That can look like a 5:00 AM feed from 10 months on just doing one feed to help them get through and extend into the morning. So our expectations of how long a baby will sleep at night, that’s pliable, there’s a lot of variation there.

One thing that I can say is that you want to try and strive for wakings that coincide with needed feeds. So if the wakings are occurring in-between what you intuitively know is not a feed time, you know, they’re waking up every 90 minutes.  They’re not feeding every 90 minutes during the day so they’re very unlikely needing a feed 90 minutes after they got one at night. So we want to try and get to a point where they are only waking up when a feed is actually required and then settling back down to sleep quite quickly. So one of the things that you can do to help is look at how frequently is my baby feeding during the day?

So usually [obviously] newborns feed kind of every two hours. This is why if your baby is waking up every two hours and they’re a newborn, they probably are hungry and they need a feed. But a five-month-old usually can go about three to four hours between feeds. So if they’re going three to four hours between feeds during the day, then try to keep that rhythm during the night. A little bit of that kind of interval feeding time. This is not holding off on the feeds. You’re giving the feeds, but you’re just spreading them out and making sure that they’re nice, full, healthy feeds that they’re getting.  If they’re waking up in between that, try other soothing methods to be able to help them go back to sleep. Perhaps a partner going in and helping or it’s yourself and using kind of some soothing techniques that you can use that you might’ve used at bedtime to help them fall asleep without the feed to reassure them that it’s okay, that you’re still there and that it’s time to go back to sleep. But it’s not quite time for a feed yet.

If all unravels and falls apart and they absolutely won’t go back to sleep and you’ve been trying for half an hour, you’ve still got a feed to fall back on if you haven’t given it right upfront. So one of the things that I always like to recommend is, like, keep that feed in your back pocket. Use it if you need it, but maybe don’t have it as the first thing that you offer if you know that they can go longer periods in between feeds.

[Question] Why does my baby sleep at night in the crib but during the day can’t?

 That’s a great question. Babies treat day and night sleep differently, okay? Day sleep is more challenging. 90% of the time, usually, babies master night’s sleep first. This is because of a lot of things, but the environment around is really telling them that it’s time to settle and go to sleep. The whole energy of the environment shifts at night, and so they can have deeper periods of sleep. Their sleep cycles are also longer at night so they can really stay down, they’re not rousing as frequently and so it’s easier to maintain sleep. Except for in the early morning hours, which is always the other issue that comes up.

So crappy naps and early morning wakings, it’s kind of because of the same thing, where babies are spending more time in later stages of sleep and having a harder time kind of falling into deep. With naps, I always recommend starting kind of slowly, start with the first nap of the day. The drive to sleep for the first nap of the day is the strongest, and so when you’re trying to establish crib naps, start with just that one. Don’t worry about the other naps. Go for a walk, take them in the stroller, whatever it is that they require in order to get a nice juicy napping. Do that for the remainder of the naps, but start with just the first nap of the day. Make sure you’ve hit a good wake window that they’re going to be ready to fall asleep. Try and help them fall asleep independently, which I know is a completely contradictory statement, but help them fall asleep independently in their cribs space. Then if needed, if they do fall asleep independently then help them to extend that nap if it falls short.

In the crib space for the first nap of the day, once they’ve kind of mastered that, if they can get to about an hour of sleep in the crib for the first nap, then you can move on to the second nap. Try and do it then. Often that last nap of the day, especially in young babies, so I’m talking four or five months old even six-month-olds, that cat nap that’s thrown in as, like, a last nap before bedtime, it can be nearly impossible to get that to happen in the crib. If your baby is really resisting it, they need that little reboot, just wear them, go for a little walk, get half an hour out of them so that you can get to bedtime.

By eight months, generally, we see babies on a two-nap schedule, and that’s kind of when you want both naps to be occurring in the crib for those. So that can kind of be a goal.

5:00 AM wake-ups. So this is kind of the same type of scenario. What happens with the 5:00 AM wake up. Talking about the different stages of sleep again, we spend the majority of our time in deep, non-REM sleep in the first third of the night [that was a lot of things to say]. Essentially, in the first third of the night, we’re sleeping really deeply. We do cycle into the other stages, but not as frequently. So the predominant amount of time that we’re spending, it’s down in deep sleep. This is why it tends to be very, very settled sleep.

So that’s what we see in the first part of the night. At the last part of the night, we are actually spending much more time in active REM sleep, which we come out of and have these little micro awakenings following each cycle. Plus, we’ve spent the whole night sleeping and so our sleep drive has worn off, that balloon has deflated. So the actual drive to stay asleep is way less from 5:00 AM onwards, essentially.

So what to do about this early morning wake up because usually baby still needs to be sleeping. And we, at least, I, I always wanted to avoid the early to bed, early to rise type of scenario. My husband commuted and he wouldn’t get home until 6:30. So I just did not want to put my babies to bed before 7:00. I did everything in my power to keep them in bed in the early morning hours. So what to do about it, first thing, a 5:00 AM feed. If that works to settle your baby back down and get another hour, hour, and a half out of them, do the feed.

I usually find that that starts to wane around 10 months, where that feed stops working, it stops putting them back to sleep. What to do next, the next thing would be to just help settle them. This can be anything from lying next to them, bringing them into a nursing chair and holding them and settling with them, anything to keep the environment dim, dark, under stimulating, you want to treat it like it’s still nighttime. So you don’t want to be lively, energetic, awake, turn a light on, anything like that, ’cause all of those are environmental cues telling your baby. Reinforcing to your baby, “it’s time to wake up, it’s time to wake up’.

So instead we want to keep things boring, dim under stimulating, and then just help them in any way that they can. Again, we’re trying to train their circadian system that that’s not time to wake up yet and that often takes a little bit of effort on our parts to get to that point. So, yeah, so that’s what I would recommend there.

[Question] Do I work with lactation consultants and looking to night ween 14 months?

I, myself worked with a lactation consultant with my daughter, ’cause I had some breastfeeding challenges and I just have to say feeding comes first, feeding always comes first. If you are struggling with feeding and you are struggling with anything to do with latched digestion, anything like that, feeding comes first before sleep, okay?

So try as much as possible, I know it’s kinda hard to say this but, like, try not to stress about the sleep aspects until you have the feeding kind of under control and a bit of a rhythm going with that. That will, it will trump all for sure.

At 14 months, you can certainly move to night wean. And this is, you know, physiologically, your baby doesn’t need the calories anymore. And they’re probably waking up because their body is telling them that they’re hungry because they’re used to getting that feed through the night.

Just like I told you, we tend to get hungry at the same time every day. That’s because we give ourselves those calories at the same times every day, and our circadian system tells us. “Oh, it’s that time, it’s time to go eat”.  So it’s the same thing at night time if your baby has been feeding for long periods.

So how to drop feeds. I like to drop feeds gradually when you feel that your baby is ready for that. A great way to do that is similar to what you would do with a time change, approach it in 15-minute intervals. So if you’re finding that your baby always wakes up at 3:00 AM for a feed and 5:00 AM for a feed, and you’re like, “Okay, I don’t think they need both of those feeds.”

Well, let’s try and get it where we can merge them together, instead of holding off on one or anything like that, let’s merge them.

How do you merge them?

Well, if they wake up at 3:00 AM, can you hold them off for 15 minutes? Just 15 minutes, soothe them in other ways, be there, reassure them, perhaps send your partner in because mum, if you have milk, your baby is going to want the milk. So if your partner can do it, send them into, to just kind of settle baby without that feed for 15 minutes.

Do that for three or four nights, so you’re aiming for 3:15 and then give the feed. Full feed, back to sleep, no problem, 5:00 AM, another feed, no big deal. Three to four nights later, try and get to 3:30 instead, okay? So you’re doing another 15-minute interval, holding them off from having that feed, then three 30 comes along. You don’t even question it, you pick them up, give them that feed and they can go back to sleep.

What is going to happen is that their body system is going to dysregulate the feed being associated with, like, the three o’clock, for example, and often they just end up sleeping right through it. But otherwise, it will creep closer to the five o’clock feed, where the five o’clock feed will drop off because it’ll be so close to say four before they get the feed that then they don’t need the five o’clock one. So you’ll notice that one of them drops and they end up merging together, and then you don’t have to not give them.

Another option that is always kind of talked about is monitoring how long they’re feeding or how much they’re taking in and just slowly weaning that back. That’s really tough because if you, say you’ve been feeding and it’s been a 10-minute feed and then you’re like, okay, tonight I’m only gonna allow you to feed for seven minutes, and then the next night I’m only gonna allow you to feed for five minutes, weaning them back on how much they’re taking in. When that seven minutes is up, you have nothing left. If they’re not asleep and you can’t soothe them back to sleep, you don’t have anything left in your skillset to be able to help out. If you’ve waited 15 minutes, you have the feed to fall back on. Again, I said this earlier, keep the feed in your back pocket and pull it out when it’s most needed. That can really, really help.

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[Question] How to eliminate false starts in the first two hours of nighttime sleep for a four-month-old?

Four-month-olds are learning how to sleep. They are relearning how to sleep. They are now sleeping in more stages than what they did as a newborn. Those stages that are new to them

are the really light stages of kinda, like, nodding off like you would do as you’re watching Netflix before going to bed. So it can be really hard for them to get deep. So what’s happening in these false starts. Is that they’re getting, they might be getting down into stage two a little bit, and rather than getting right down, they’re actually startling and browsing again and coming back up.

So what to do is really just help them to figure out how to fall asleep independently. So if they went down and it’s only been 45 minutes and they wake up and then you offer a feed again and that puts them back to sleep. Then you put them down and then they wake up another 45 minutes and then you’re like, “Ah, do I give them a feed again?” And that puts them back down, you know the cycle, they are just continuing to wake up to go, “Whoa, My environment is totally different. I fell asleep at the breast, why am I now in my crib?

So really, really helping to focus on, can I help you to fall asleep in your crib, in your sleep space? And a coined phrase that I always like to say is, as much as you possibly can bring yourself to them rather than bringing them to you. If they are in their crib and they’re upset

and they are, you know, fussing and all of that, as soon as you do this and you pick them up to settle them and you bounce, the reinforcement that you’re sending is, “You’re right. The crib sucks, I’m way better.” And you bounce them around  and then they settle and they’re like, “Okay, yeah, this is exactly what I needed.” And then you lay them back down again and they’re like, “No, I hate this. I don’t wanna do this.”

We haven’t reinforced that the crib is a good space.  So what we wanna do is if we can bring ourselves to them, comfort them, wrap our hands around them, get down nice and close to them, it is going to reinforce to them that you believe that that space is the safe space for them. Sleep is very vulnerable, and we want them to feel safe. Safe, secure, comfortable. So as much as we can we want to help them learn how to fall asleep on that surface. So that would be the number one thing.

Then with a four-month-old, just stick to it as consistently as you possibly can. They’re learning, and there will be a lot of false starts in that month. It’s usually, you know, four to five months, there will be a lot of false starts. It will feel like a lot of work and it will feel like on days you’ve taken three steps back. Trying to stay consistent, trying to power through, and trying to help them understand that this is okay. This is the space that you fall asleep in and this is how it occurs. That is going to help to get them through and it doesn’t mean that you have to walk away and close the door.

So I think that’s a really great place to end this. I just wanna throw it out there, I love to give lots of tips and tricks, yes. Lots of people do that though. I like a lot of discussions around framing, reframing sleep, discussions about sleep, and understanding sleep development.

So if you want to follow along with that, you can find me @sleep.monster on Instagram, if you’re not already following me, @sleep.monster. And if you wanna check out my website as well, it’s at www.theresamonsterinmycloset.com.

I have clinic hours at Oona on Wednesdays and Fridays. We are launching the Sleep Workshop Series as I mentioned, starting this Thursday with Newborn Sleep Foundations. There are still spots left if you would like to sign up. Next week we have the Surviving Sleep Regressions. Then February 10th, we have Managing Toddler Bedtime Resistance.

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So check those out, you can find those on the Oona website under their postnatal classes. So if you’re navigating around, I also have a link to the Newborn Sleep Foundations workshop in my bio, on my Instagram. I’m on Oona right now head over to @sleep.monster for that. But I think they might actually have it on there too. Check us out, thank you so much for tuning in today, and if you have more questions, send them my way. I would love to help you out in finding your sleep grove and support you through your journey.

Thanks so much for being here.

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