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Baby Sleep Consultant – Comprehensive Guide to Baby + Toddler Naps

SO, HOW MANY NAPS DOES MY CHILD NEED? HOW LONG SHOULD THEY BE SLEEPING DURING THE DAY? 

As you might imagine, this completely depends on their age – so let’s take a look.

Newborns (0-4m) – Our tiniest wee humans need between 3 and 5 naps, and ideally should be spending 6 to 6 hours of their daytime asleep.

4-12 months – In this period, there’s a big change in the number of naps, with children transitioning from 4 naps, down to 3, and then to 2 (this final drop happens, on average, between 6-8 months). During this time, a child’s total time spent day sleeping will reduce to somewhere between 2.5 – 3.5 hours. This means that parents need to increase awake times dramatically to ensure their wee ones are tired enough to sleep well at naptime. Key to survival here is understanding how long your child can (and should!) manage to stay awake in one stretch.

The other thing to note during this time is that Dr Wisler says that ‘motion naps’ – those taken in the front pack, stroller, or car – become less restorative. For this reason, we recommend that at least one nap a day is done at home, or at least in a stationary space, like a cot.

12 – 24 months – During this time a child’s daytime sleep needs reduce to 1.5 – 2.5 hours. From here, until a child turns three, things become way more variable. Most children move from 2 naps to just 1 between the 15-18 month mark, and the majority of children (but not all!) drop this final nap before they turn 3. All children are different, however children who don’t nap well – either because they’re catnapping or aren’t having the right sort of daytime sleep for their age and stage – may start to find their night sleeps are impacted. If you suspect your child’s naps are interfering with their night sleeping, don’t be afraid to talk to your child’s preschool and make some changes.

CONSOLIDATING THE CAT-NAPPING

Catnapping typically emerges around the 8-18 week mark and, far from your child’s sleep being broken, it’s a completely normal developmental stage that occurs as their biological sleep cycles emerge. However, the research points to the fact that as babies get older, shorter naps are not as restorative as longer stretches, so it is important to help your child resettle and consolidate their catnaps.

SETTLING: WHEN NIGHT AND DAY ARE AS DIFFERENT AS, WELL… NIGHT AND DAY

We’re often asked about why babies are so much easier to settle and resettle at night-time, while daytime naps remain a battle. There’s a scientific reason for this. Our baby’s physiological drive to sleep is felt more acutely at night-time (as is ours, in theory!) Daytime sleep is important, but their body won’t be hanging out for it in the same way.

When it comes to settling techniques, newborns often respond well to hands-on settling techniques, while older children find these methods frustrating (especially at nap-times!) and need time and space to settle.

To us, sleep is sleep, so apart from the bath, do everything else in the same way that you would for their night sleep for each of their naps. The same conditions will indicate to them that it’s time to sleep.

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Breaking the feeding through the night association

Breaking the feeding to sleep association

Your baby is born neurologically very immature, they don’t know the difference between night and day, and thus round the clock feeding and napping without any decent blocks of night sleep is pretty normal and to be expected. It’s easy to start feeding to sleep, and almost to be expected.

As your newborn moves through those early months, their circadian rhythm develops, they know the difference between night and day, and lots of babies start to sleep 6-8 hours in a row around three to four months old.

This feels like bliss compared to the broken night sleep of a newborn, and as parents we breathe a sigh of relief, this is a sleeping pattern we can cope with!

But what to do when suddenly between 4-6 months your baby reverts back to waking every 2 hours overnight!

This is such a common situation and almost predictable, especially in those babies who are still cat napping in this 4-6 month period.

Your baby’s night sleep becomes more organized by 4 months old, they move from awake to REM sleep, then into Light non – REM sleep, and further into Deep non REM sleep back to awake, every 2-4 hours.

Often your baby will drift from Deep sleep, into REM, have a brief awakening you are not aware of and go back to sleep. Or they will move from that Deep sleep, all the way to full awake and possibly cry out for you here.

If your baby relies on feeding to get from that awake phase back to sleep, then every time their sleep cycle phase enters that awake period they will cry out for you to feed them back to sleep. Thus – a feed to sleep association.

This could be as frequently as every 2-4 hours throughout the night, often more frequently after midnight.

As these nighttime cycles emerge around 4-6 months old we can be caught off guard and think our babies are going through a short-term growth spurt, so quickly fall into the habit of feeding back to sleep as frequently as every 2 hours.

Days turn into weeks, and we realise perhaps this wasn’t a growth spurt, or what started out as a growth spurt is now a habit.

Reverse cycling is when a baby is taking in more calories overnight, than they are throughout the day. The symptoms we see of this are babies not interested in feeding throughout the day, appearing fussy or distracted at the breast or bottle, or simply refusing feeds.

Ideally, we are working towards a feeding balance where most calories are consumed throughout the day, and less so at night. This helps support the bodies circadian rhythm and work towards better more restorative night sleep by babies first birthday.

If you have found yourself stuck in the situation where you are feeding to sleep every 2 hours overnight, then understanding that its normal for your baby to wake frequently overnight is important.

The goal is not to somehow change their naturally occurring sleep cycles and phases, but to encourage your baby to get from that awake phase, back to their sleeping phases without a feed from Mum.

Knowing your baby is reverse cycling with these 2 hourly feeds helps us to know that we can’t drop all these night feeds at once.

When we plan to tackle 2 hourly feeding to sleep overnight, we need to make changes gradually and give your baby a chance to increase their calories and feeding throughout the day in order to successfully change their night sleep feeding patterns.

I have the most success by aiming for 4 hourly feeds for the first few nights, when trying to change a feed to sleep association. This gives baby enough time to increase their day feeds, and 4 hours overnight is not an unrealistic time to go between feeds as long as your baby is thriving and gaining weight.

In between these 4 hourly feeds your baby will go through phases of REM sleep, non REM sleep, and awake. When they reach the awake phase, they will be looking for that feed to get back to sleep, this is because the feed has become a sleep association for your baby. It is here where the change occurs.

If you are stuck with a feed to sleep association, we need to teach your baby to fall asleep independently. This can be done gently by sitting by your child and soothing them with your voice, try shushing or singing. If they are upset, pick them up and soothe them with a cuddle, maybe pat their back. Be patient as they will probably be rooting looking for that feed to get back to sleep.

Once they are calmer in your arms you can put them back down and continue to use your voice and gentle touch to help them as they go back to sleep. If they get upset again, repeat and pick baby up again. This might happen several times, be very patient and calm with your baby.

Remember they are used to being fed back to sleep, so this change is not easy for them. It is your job to support them and not get frustrated with them.

After 2-3 days of doing this you should notice baby is settling much faster without a feed, and everyone is getting more sleep. You will need to gradually reduce how much assistance you provide over the coming days. Less touch, less voice, and fewer pick ups.

This will gradually support your baby to learn to put themselves back to sleep without your help.

Continue with this sequence until baby falls back to sleep, it shouldn’t take more than 45 minutes on average for the first night, and it will become quicker and quicker as the days move on.

Gently changing a feed to sleep association overnight can take 1-3 weeks to fully successful, and letting your baby grizzle or cry might take 7-10 days to fully change babies sleep association.

Both will work, the best option is simply the one which you feel most comfortable with, and which doesn’t compromise your parenting style.

Once you have managed to get your baby down to 4 hourly feeds throughout the night, they will be taking bigger longer feeds through the day, and if your baby is showing signs they are not hungry in the morning you can work on dropping down to one feed.

I would only recommend this if your baby is gaining good amounts of weight, is not hungry at 7am, and your naps are going well. You can use the same settling method you used to change your babies feed to sleep association, to drop one of those night feeds.

  • Short naps throughout the day
  • Over tiredness
  • Late bed times
  • Short distracted day time feeds
  • Lack of positive sleep associations

THINGS YOU CAN DO TO SUPPORT BABY’S NIGHT SLEEP

  • Encourage at least 1 long nap throughout the day
  • More frequent naps if they are short (45 minutes)
  • Early bed times
  • Remove distractions and encourage full feeds
  • Introduce positive sleep association such as white noise, sleeping bags, swaddles and sleep rituals
  • Try our online sleep program with our sleeping through the night plans and FREE email support!
    Click HERE.
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Navigating the six-month minefield

Navigating the six-month minefield

It’s no surprise to me that the most common age that we start working with babies is when they hit the six month mark. There’s so much going on at six months old that can affect a little one’s sleep.

As a baby’s sleep cycle matures, they’ve likely started catnapping. You might be starting to introduce solids and move around their milk feeds, and there is (in some cases) the arrival of those first few teeth.

Some mums and dads may have been holding onto the belief that six months is somehow a magical age when the challenging sleep deprivation of having a newborn in the house will resolve. Unfortunately, this simply isn’t the case! Others may fall prey to one (or many) of the misconceptions about this age and stage… So, let’s take a look at the hurdles you might expect to encounter around the six month mark, and some advice to get you through them.

A DIFFERENT AGE CALLS FOR DIFFERENT TECHNIQUES

One of the initial sources of frustration for parents as their children reach the six month mark is that the techniques that had worked to get your newborn to sleep – whether rocking, patting, swaddling, or similar – stop working. Put simply, children outgrow them, and they start fighting your efforts.

Often, this is their way of telling you that they’re ready to self-settle. By this I don’t mean just put them down and walk away; that’s not necessarily going to work either. But it does tend to mean that you can start backing off a bit and supporting them to find sleep themselves, as opposed to relying on you getting them there.

ADEQUATE AWAKE WINDOWS

I’ve mentioned that six months is a time of vast changes – there’s been a lot of progression to get to this point. Your child will have moved from 45 minute windows of time spent awake as a newborn, to 2.5 hours in a stretch by six months old, or at least nearing that sort of window. If your child hasn’t progressed and lengthened their awake times along those lines, they might now not be having enough time awake in a stretch, which can mean they won’t sleep well during the day.

FIGHTING THE THIRD NAP AND THE NEED TO CONSOLIDATE

Speaking of day sleep, most six month olds are still having three naps a day (the majority are ready to drop to two around seven or eight months of age). However, by six months old, it’s likely that your littlie will be starting to fight their third day sleep. At this age, this nap is often an assisted one – in the pram while you’re out for a walk, or in the car. It’s a short (sometimes just 10-15 minute) power nap to help them make it until bedtime, because if they go to bed overtired, they’ll wake more overnight.

I tend to find that children will refuse or drop their third nap when they are ready, whether they are doing a long lunchtime sleep or not. That’s why it’s so important to cure catnapping and help them to consolidate their sleep. Bedtime is a long way away for a child who sleeps just 45 minutes, as opposed to a couple of hours, at lunchtime. Similarly, helping them to consolidate their sleep overnight has a flow-on effect to longer, more consolidated naps too. By this age, your child is biologically able to do anywhere between a four to eight hour stretch of sleep overnight.

DROPPING THE DREAM FEED

Just because your child is biologically capable, doesn’t mean they will suddenly start sleeping all night. If you’ve been doing a ‘dream feed’ until this point, now is the time to drop it. By six months, you (and your baby) are better served by feeding them when, or if, they wake up hungry. As they are now going into a deeper sleep, the dream feed starts to disturb their consolidated stretches, which can contribute to more subsequent wake-ups overnight.

Further to that, feeding triggers both hormonal responses and the digestive process, which makes the baby wake up further. Overall, we know as adults that eating doesn’t encourage sleep, so forcing a feed into them here starts having the counter-effect to what you may be intending.

LOTS TO THINK ABOUT WITH SOLIDS

So often we hear from parents who were holding firmly to the belief that once they start solids their child will sleep through the night. These parents go all in with the introduction of solids – sometimes too quickly – which can cause a milk/solids imbalance. It’s common when we start working with people to drop one of the solid meals in the short-term, enabling us to increase their daytime milk feeds again while we decrease their overnight milk feeds.

The other thing that happens at ‘starting solids’ time is that your baby has to start producing different enzymes. Their gut microbes change and they just feel different as they start digesting actual food – all of which can affect their sleep. This is part of the reason that professionals recommend starting by introducing a solids meal at lunchtime, so that if it creates a disruption it is to their lunchtime nap, not their night sleep, which is – ultimately – more important.

Another consideration with the introduction of solids, and how they interact with sleep, comes down to timing. While you’re giving a milk feed first in those early days, some parents space the solids out so long after milk that it becomes very close to the next nap. It can also put them off their next milk feed. It’s a delicate balance but the scenario you want to avoid is going back to having as many frequent feedings (across milk and solids) as what they were having in the newborn days.

TRICKY TIMES AROUND TEETHING

I swear that if everything that parents attribute to teething was happening as a result of teething, all of their children would have 200 teeth! Jokes aside though, teething can cause pain and discomfort – however it’s unlikely to completely disrupt sleep if you have established good night-time sleeps and your child has some ability to settle.

It’s common, however, for parents to feel confused about whether teething is causing their child’s distress or wake ups. A couple of little tests that I like to employ:

  • Are they happy during the day and then just upset during the night? If this is the case, it’s probably not teething. Tooth growing is not a strictly nocturnal activity. If the issues arise at bedtime, it’s more likely a sleep issue.
  • Offer pain relief one evening, and see how they are in 20 minutes. Painkillers take 20 minutes to kick in and effectively dull pain, so if they are quietly settled to sleep in that window, it could very well have been pain disrupting them. If they are still upset and worked up beyond that point, it isn’t purely a pain problem.

Despite – or perhaps because of – all the myriad of things that are going on at this age, six months old is the best possible age to start proactively working on supporting your baby to sleep. They’re not crawling, pulling up to standing, or walking yet. They’re not hungry, as you’ve well established breast and/or bottle feeding by then. They’re no longer in their newborn stage. Unfortunately, past that ‘sweet spot’ of six month olds, sleep training gets exponentially harder. Even the most age-appropriate measures tend to meet more and more resistance – so start now and you’ll be setting your child – and yourself – up for great sleep.

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The official word on sleeping through the night

The official word on sleeping through the night

I would hazard a guess that most parents have lost track of how many times they’ve been asked if their child is sleeping through the night. It’s considered the holy grail of sleep, and it’s plain to see why.

But first, confusion abounds as to what actually constitutes sleeping through the night; everyone seems to have a different definition. We define sleeping through the night as a child going to bed between 6-7pm and getting up between 6-7am, with zero to one feeds or resettles in between.

That’s right – sleeping through the night doesn’t always mean you just walk out of their room at bedtime and don’t hear from them until the morning. Every child ‘wakes’ at some stage throughout the night as their sleep cycles emerge and, in many cases, it’s still age-appropriate to have a feed in a 12 hour period.

However, they’re not sleeping through the night if they wake excessively (every 1-2 hours) and need your help to settle back to sleep each time. These frequent wakings start to interfere with the quality deep sleep most beneficial to the brain. It is in this sleep state that the brain rests, moves things to long term memory, and forms new synapses; key reasons we should be helping our children work towards healthy sleep hygiene.

BENEFITS OF SLEEPING THROUGH THE NIGHT

Alongside the brain benefits above, why is it so important that we help our children to sleep through the night? Firstly, there’s the obvious fact that, as parents, we then get enough sleep to function the next day. This benefit shouldn’t be downplayed. I meet lots of parents who feel guilty about wanting their baby to sleep through because they’re not coping; this is a legitimate reason. You matter – as does your health and wellbeing, which depend on sufficient quality sleep.

However, there are also significant benefits to your baby of sleeping through the night when they are ready to do so. For starters, they wake up happy and well-rested and are more content throughout the day.

When children (or any of us) wake up tired, we’re starting the day on the back foot, which can quickly spiral into overtiredness. The other, related benefit is that good solid night-time sleep means your baby will nap better throughout the day, so the cycle continues to combat overtiredness.

The other major benefit of a baby starting to sleep through the night is that they’re making important moves towards the age-appropriate structure of their sleep. As newborns, a baby’s sleep occurs about 50% during the day and 50% at night; there’s very little distinction in those early days. However, by three years old, your child will be relying almost solely on the quality of their night sleep and not depending on day-time naps to get them through. Getting to this point is a process.

SO, WHAT ARE THE AGE-APPROPRIATE STEPS ALONG THE WAY?

Newborn (0-3m) – At this age, it is common to wake during the night for feeds. Depending on the newborn journey that you and your baby have had, this may happen multiple times. That’s not to say that there aren’t things you can do at this stage to lay the foundation for better sleep; it just means that it’s entirely normal to wake during the night at this point.

3-6 months – During this time, most babies start to consolidate their night sleep. According to the research, they do this in the earlier part of the night first – which is good, as this is the most restorative. While some babies will start to sleep through at this stage, lot of others will still be working to consolidate sleep cycles. Regardless, it’s a reasonable goal to have at this age. Whether your baby is breastfed or formula fed and when they’re starting solids will have an impact on how soon they can go through the night and how many night feeds they need.

6-9 months – By this stage, every baby has started solids and, if they haven’t already, can cut down to just one feed overnight. If you are happy with what you’re doing and it’s working for you, then stick with it – but if you want to change things, this is something you can aim for. At this stage, the ability to sleep through becomes at least as much about learning the skills around settling as nutritional intake. The ability that your child has to link their sleep cycles becomes vital.

9-12 months – At this stage parents can be fairly sure that they can drop all night feeds, as long as there are no health or growth concerns. The ability your child has established to settle here is important, as is their nutritional intake. It’s vital to make sure that children get the right quantities of carbohydrates, protein, and fats throughout the day to avoid a hypoglycaemic dip that causes them to wake hungry. Children also rely on their daily intake of iron as their body’s stores deplete at this stage. Unlike with adults, where we equate low iron to tiredness, in children low iron causes them to wake frequently – so making sure they’re getting enough is a factor in whether they sleep well.

CONSOLIDATING NIGHT SLEEPS

Starting from around the four month mark, your baby goes through biological changes and we see their sleep cycles emerging. Waking more often here is normal. Unfortunately, parents often get stuck using survival techniques, thinking that it’s just a phase and that their child’s sleep will sort itself out.

In reality, this is a permanent progression or change in your child’s physiology. They’re not just going to grow out of it – instead, to work through it, they need to develop the ability to resettle themselves when they’re not hungry. So how can you consolidate night-time sleeps and deal with the changes in your child’s sleep cycles?

SOME OF THE THINGS THAT CAN HELP

  • Trying out new strategies in the evening – You may feel that you need to address night wakings and daytime naps, and you will, eventually. However, starting with working on night-time sleep is easier. In the evening, we have a stronger physiological drive to sleep and our hormones encourage this, so new strategies are more successfully adopted at night-time and sleep issues at night resolve quickly with consistency.
  • Make sure you’re not reverse cycling – Reverse cycling occurs when your baby is consuming more calories overnight than during the day. We explore more about it here, but suffice to say you’re in for more night-time wakings until you can remedy this.
  • Make sure they’re rested before bedtime – This might seem counter-productive and we’re not suggesting pre-dinner naps (unless they’re still newborns!) but make sure that your child has their age-appropriate awake time before bedtime. Putting them to bed overtired can make it harder to go to sleep and stay asleep; their little bodies produce adrenaline, which makes for a more fragmented sleep.
  • Keep the environment conducive – The basics of sleep hygiene apply here. Make sure the room is not too hot or too cold, that it’s dark enough, and that it’s quiet and free from distractions. White noise can help to drown out other household or neighbourhood noise.
  • Stop and listen before responding – A study found that waiting just three minutes before you go into your child’s room upon them waking is the single biggest determinant of whether they will be sleeping through by 12 months. Waiting before responding gives your child a chance to go back to sleep themselves (and sometimes they might surprise you!)
  • Teach them to resettle independently – As you’re starting to do with waiting before responding, teaching them to resettle themselves when they wake often involves backing off a bit and moving past strategies like rocking or holding them to get them to sleep.

Even once your child seemingly masters the art of sleeping, remember they are not a robot. There are always likely to be minor regressions along the way. Some babies, when they learn a new skill – like crawling or walking – have a minor sleep setback, as they’d rather be practicing their new skill.

What’s important for parents to remember is that your child hasn’t forgotten how to sleep; they just need you to be consistent. Stick to the normal routine and they will go back to sleeping through when they are ready.

Lastly, give yourself a break from the perception that your child is broken if they are waking up every hour overnight. No child is sleeping 12 hours straight – and the ‘unicorn’ ones that seemingly are have simply learnt the ability to go back to sleep independently. Your baby can too. Good luck!

References

Sleeping Through the Night: A Developmental Perspective
Thomas F. Anders, Leslie F. Halpern, Jenny Hua
Pediatrics Oct 1992, 90 (4) 554-560;
Burnham, M. M., Goodlin-Jones, B. L., Gaylor, E. E., & Anders, T. F. (2002). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: a longitudinal intervention study. Journal of child psychology and psychiatry, and allied disciplines, 43(6), 713–725.

Sleeping Through the Night: The Consolidation of Self-regulated Sleep Across the First Year of Life
Jacqueline M. T. Henderson, Karyn G. France, Joseph L. Owens, Neville M.Blampied
Pediatrics Nov 2010, 126 (5) e1081-e1087; DOI: 10.1542/peds.2010-0976
Help Me Make It Through the Night: Behavirol Entrainment Breast-Fed Infants’ Sleep Patterns
Teresa Pinilla, Leann L. Birch
Pediatrics Feb 1993, 91 (2) 436-444;

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From tranquility to turmoil

From tranquility to turmoil

For Amy’s first few months, sleeping had mostly been a breeze. An easy going and good sleeper, one feed would keep her asleep for up to 8 hours.

However, that all changed when Amy hit five and a half months old. All of a sudden, the great systems Amy’s Mum, Cara, had in place simply stopped working and Amy’s sleep deteriorated quickly. She began to take up to an hour to settle each evening and was waking up multiple times overnight for a feed. Night times rapidly became stressful and exhausting.

According to Cara, a month of these draining evening and overnight routines quickly started to take their toll and things felt like they were reaching a “breaking point”. Tired and unable to see an end in sight, Cara knew she was going to need some help to support Amy to improve her sleeping patterns.

Making a plan

Cara’s friend recommended she talk to baby sleep consultant, Daniela, who had helped her when she experienced something similar. Feeling at the end of her rope, Cara sent Daniela an email and with lots of information about Amy and the sleeping challenges they were having. Because Amy and her family didn’t live centrally, Cara and Daniela decided on a phone consultation and booked a first call a few days later.

“We were on that initial call for over an hour, working through where we were at and developing a new plan to move us forward,” Cara recalls. “I already had a sleep schedule that I had sort of been working to, so we talked through that together and Daniela suggested some adjustments to try based on where Amy was at and what she was doing at that point.”

Together, they decided that the ‘spaced soothing’ technique would be best for Amy’s temperament. Amy was quite an alert baby and would have found an ‘in room’ approach overstimulating, so they went with a method that gave her some space to learn to settle on her own without Mum and Dad’s help. The plan was for Cara to leave the room after putting Amy down, returning at set intervals if Amy was upset to give her a reassuring pat or stroke. To minimise disruptions, they also devised to keep the room completely dark and use white noise throughout the night.

Getting worse before it gets better

The first night of the new programme was a challenge; Amy was overtired from not getting her usual amount of sleep during the day so didn’t settle very easily. “She was really fighting it,” Cara recalls. “I was expecting the experience to be tough, but it was really emotionally tiring that first night. And it was looking like a tough road ahead. I’m thankful for Daniela’s support, as that really helped us to persevere.”

And with that persevering spirit and some reassurance and additional advice from Daniela, the next day went remarkably better; Amy was asleep within 20 minutes and, after a few more days, was falling asleep within just three minutes! Not only that, Amy was waking and needing a feed only twice overnight, which her family were happy with for her age. According to Cara, “it’s been smooth sailing ever since.”

Relaxed and confident

Now, the whole family is relaxed; night times in their household are more peaceful and everyone is getting a lot more sleep! Amy’s parents are also feeling a lot more confident and happy supporting Amy to get to sleep. “We even went away for the weekend recently, which would have been really difficult before we worked with Daniela,” Cara adds.

Cara appreciated Daniela’s understanding of her family’s situation, and willingness to provide personally tailored advice. “Nothing felt generic, and the sleep guides were easily adaptable to suit and work for Amy – and for us!” Cara explains. “Daniela understood that no one approach would work for every baby, and gave us some flexibility to find out what worked for us, as well as how to cope when things didn’t go to schedule every day.”

“The other thing that was hugely valuable throughout this process was Daniela’s direct and clear advice, which gave me confidence and reassurance.” Cara says. “In our follow up calls, we worked through suggestions and discussed any needed tweaks. Daniela’s constant support was really appreciated!”

Cara knows too that Daniela is never far away should they need help in the future – like when they soon plan to drop that second nightly feed!

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COLIC – sorting the myths and misconceptions, while learning to cope

First, however, I need to make some distinctions. The first thing to understand is that babies cry; it’s normal and the way they tell us they’re hungry, tired, and the rest.

The other important factor to understand about colic is that it’s not reflux. Reflux causes babies to cry from pain, but this is not the same thing. In fact, only 0.5% of babies who have colic also have reflux; most of the time it’s just reflux. A hard distinction to make, but an important one because reflux is far more treatable.

Possible causes of colic

There’s no specific test for colic; often it’s a diagnosis of omission, when there’s nothing else that can be done to stop a baby crying. And as I mentioned, a definitive cause for colic is unknown. However, research has found that there is no correlation between colic and what a baby is fed (breastmilk or formula), a baby’s gestational age at birth, or socioeconomic status.

The current list of possible causes acknowledged by the medical community includes:

  • Alterations in microflora which result in an unbalanced gastrointestinal microbiome. This is basically the scientific way of saying that the bacteria in their gut is out of whack.
  • Cows’ milk protein allergy or intolerance
  • Lactose intolerance
  • Gastro immaturity (an underdeveloped gastrointestinal system)
  • Inflammation in the gastrointestinal system
  • An increase in serotonin secretions, the majority of which comes from our gut
  • Increased intestinal permeability
  • Poor feeding techniques, i.e. not getting a very good latch
  • Maternal smoking
  • Under or overstimulation, i.e. too much different visual input, swapping parents constantly etc.

Sorting through the solutions

There’s no shortage of anecdotal solutions, or so-called cures for colic out there, so it can be tricky to know what to try. For example, there has been no evidence of pain relief working for colic, even though it appears the child is in pain. Here we’ve compiled the complete list of evidence-based (i.e. not prone to bias) solutions for parents who are struggling with a colicky child.

  1. Removing possible allergens from the baby’s milk

This step can consist of a mum removing possible allergens from her diet while breastfeeding, or switching to a hydrolysed formula if they are formula-fed. Different from a lactose-free formula, a hydrolysed option has the cow’s milk protein broken up, which hides the protein so that it can’t trigger a reaction, while being easier to digest.

Every time you feed an allergenic food, the gut environment gets upset and falls out of balance, triggering inflammation. When you get rid of that allergen, it takes some time for the inflammation to die down and then balance to restore; this can take around 3 weeks, so this approach requires some patience.

1.The pros of probiotics

Research has found a particular strain – Lactobacillus reuteri DSM17938 – of probiotic that has been proven to result in a 50% reduction in crying time in infants suffering from colic. Not all probiotics are created equally, so the important thing to note is that it absolutely has to be this specific strain.

Probiotics in real life: I saw the power of this probiotic with a client and her 4 week old who was failing to thrive. We introduced the probiotic and switched the (already being formula fed) baby to a hydrolysed formula and had a 70% reduction in crying plus the baby gained 400g in a week!

2.Reducing parental stress

Far from being a parent-blaming scenario in the slightest, research shows that parental stress is one of the reasons babies cry. Them crying then stresses us further and a vicious cycle is created.

Evidence shows that parental reassurance and encouragement – taking the time to explain the causes of colic (or the fact that it can have no cause!) and supporting parents with settling strategies – can reduce symptoms in babies by 50%.

This is a large part of the reason we feel so passionate about empowering parents and giving them confidence. When parents feel inadequacy and anger, it’s more challenging to bond with their babies, which increases risk factors later in life. Not only that, but colic has been found to be a risk factor for child abuse, so as a society we have a responsibility to empower and support parents, especially those with a colicky child.

3.The five S’s for settling – and the right balance of stimulation

We often talk about the five S’s, which research have linked to less crying. Swaddling, side or stomach holds, ssshhhing, swinging or rocking, and sucking (either on a breast or pacifier) are proven, practical ways to settle an infant.

I mentioned before about the right amount of stimulation, which is vital because to calm a crying baby, we have to trigger their sympathetic nervous system. The five S’s work with a group of reflexes that are vestibular, auditory and tactile, which when combined provide the right balance of stimulation.

The final thing to note is that a child who has had colic is likely to have a different temperament by the time they are six months old than those who haven’t. For starters, in their colicky early months it’s likely been impossible to establish natural sleep habits or get into any 3 hourly routine, so it’s normal that most of these children require some sort of sleep training later on.

However, the other significant difference tends to be that they’re OK with crying; short bursts of crying during sleep training is nothing compared to the stints they used to do. There’s the thought that their stress responses have adapted too, and they may have a higher adaptive level before cortisol kicks in.

It’s also been hypothesised that colicky babies respond differently to those without it; they don’t have the same response to skin on skin and require different soothing strategies. The important thing to remember if you do embark on any sleep training is that the approach has to suit your individual child and respect their temperament.

Emma Purdue

Emma is the owner and founder of Baby Sleep Consultant, she is a certified infant and child sleep consultant, Happiest Baby on the block educator, has a Bachelor of Science, and Diploma in Education. Emma is a mother to 3 children, and loves writing when she isn’t working with tired clients and cheering on her team helping thousands of mums just like you.

Our newborn online sleep program covers all the strategies we know help to reduce colic symptoms.

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Stories from actual Mum’s who have experienced colic

“My baby has colic/reflux. I think it was more the reflux getting to him than the colic side of things though, but it was hard, so hard. I couldn’t put him down even for a moment.

He had to sleep being held upright or on his tummy on someone. I got hundreds of hours of baby cuddles though ? and we have bonded so well with my really gentle approach and accepting this is what he’s like and what he needs.” ~ Kristen

“We were put in the colic category for so long, and I was so angry that they weren’t helping any more as I knew my little on had something going on (she had reflux also), and it turns out she had an intersussection (telescoping bowel) which then got stuck and she ended up going from just a “colic” baby to a baby vomiting non stop, and pooing red.

I think with this experience of colic, I find that the babies guts are so sensitive, but often mums get lumped into the colic category so that we can call it something but not given any resources to help.

We found a small heat pack warmed to just over cold, placed over her tummy over the blankets helped her. Similar to how we have heat pack on period cramps!

But tissue salts were amazing too.” ~ Rachel

” My baby had colic and it was horrible we didn’t know what was wrong with him. We didn’t find anything that worked as far as quiet bath, feeding, walking, driving etc.

In the end the only thing that helped was colic calm the natural remedy. It was a life saver!

We were so desperate for something to help him/us.” ~ Gems

” My baby cried a lot in the first 3 months of her life.

One day for over 5 hours straight and I honestly thought I wasn’t going to survive motherhood.

I used to sit on the couch and cry and think I was a failure.

My husband and I tried everything to help her, and even put her on reflux medication as I was sure something was wrong.

Nothing worked and we were constantly housebound as we couldn’t go for outings in the condition she was. Around 13 weeks, she just grew out of it! I wish I knew that crying was normal and that it does eventually end.” ~ Abby

Our online sleep program comes with free email support to guarantee your success.

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References

Vandenplas Y, Abkari A, Bellaiche M, et al. : Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants From Birth to 12 Months of Age. J Pediatr Gastroenterol Nutr. 2015;61(5):531–7.

Bellaiche M, Oozeer R, Gerardi-Temporel G, et al. : Multiple functional gastrointestinal disorders are frequent in formula-fed infants and decrease their quality of life. Acta Paediatr. 2018;107(7):1276–82.

Wessel MA, Cobb JC, Jackson EB, et al. : Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954;14(5):421–35.

Benninga MA, Faure C, Hyman PE, et al. : Childhood Functional Gastrointestinal Disorders: Neonate/Toddler. Gastroenterology. 2016;150(6):1443–1455.e2, pii: S0016-

Johnson JD, Cocker K, Chang E: Infantile Colic: Recognition and Treatment. Am Fam Physician. 2015;92(7):577–82.

Wolke D, Bilgin A, Samara M: Systematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants. J Pediatr. 2017;185:55–61.e4. 10.1016/

Savino F, Castagno E, Bretto R, et al. : A prospective 10-year study on children who had severe infantile colic. Acta Paediatr Suppl. 2005;94(449):129–32.

Gelfand AA: Episodic syndromes of childhood associated with migraine. Curr Opin Neurol. 2018;31(3):281–5.

Shamir R, St James-Roberts I, Di Lorenzo C, et al. : Infant crying, colic, and gastrointestinal discomfort in early childhood: a review of the evidence and most plausible mechanisms. J Pediatr Gastroenterol Nutr. 2013;57

Nation ML, Dunne EM, Joseph SJ, et al. : Impact of Lactobacillus reuteri colonization on gut microbiota, inflammation, and crying time in infant colic. Sci Rep. 2017;7(1):

Pärtty A, Kalliomäki M, Salminen S, et al. : Infantile Colic Is Associated With Low-grade Systemic Inflammation. J Pediatr Gastroenterol Nutr. 2017;64(5):691–5.

Eutamène H, Garcia-Rodenas CL, Yvon S, et al. : Luminal contents from the gut of colicky infants induce visceral hypersensitivity in mice. Neurogastroenterol Motil. 2017;29(4):e12994.

de Weerth C, Fuentes S, de Vos WM: Crying in infants: on the possible role of intestinal microbiota in the development of colic. Gut Microbes. 2013;4(5):416–21.

Pärtty A, Kalliomäki M, Endo A, et al. : Compositional development of Bifidobacterium and Lactobacillus microbiota is linked with crying and fussing in early infancy. PLoS One. 2012;7(3):e32495

Savino F, Cordisco L, Tarasco V, et al. : Molecular identification of coliform bacteria from colicky breastfed infants. Acta Paediatr. 2009;98(10):1582–8.

Originally published here

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A little night owl makes the switch

REACHING OUT FOR HELP

The decision to do something to help change their sleep situation wasn’t made easily.

Annette had tried several things, including the idea of starting the day earlier to try to bring everything back, but nothing had worked yet.

Annette’s parenting style could best be described as ‘going with the flow’ and the thought of a routine scared her. “I didn’t think I could stick to one, as I really liked to just go with the flow, but I had got to the point where I knew that something had to change.

Luckily my husband was supportive too!”

When Annette reached out to Baby Sleep Consultant she was put in touch with Becky.

“I definitely thought I would need an in-home visit, as I had tried putting Kaleb in his cot and it was a nightmare; he would scream and I didn’t want to do that.”

However, an initial phone call with Becky set Annette’s mind at ease that perhaps they could tackle it that way.

“As I was explaining to Becky what was happening, she could pre-empt what else was occurring – she totally got it!” Annette recalls.

“We agreed on a gentle approach, which definitely suited me better and Becky assured me she would create a plan that gave approximate times for things. I asked her lots of questions related to Carly too, and it was definitely worth it to get a plan for how to fit the two – at different ages and stages – together in a way that worked.”

SLEEP STRATEGIES FOR A NOCTURNAL WEE FELLOW

Despite waking at 9am, Kaleb had still been (quite willingly) going down for a two hour lunch nap at midday. Becky’s first suggestion was to delay that until closer to 2pm and stretch his morning awake time to be a bit longer. The pair also agreed on an 8pm bedtime (and 8am ideal wake time) so planned the rest of the routine from there.

“The later lunchtime nap took a while for him to get used to, but he was OK with it,” Annette confides.

“The other daytime change was dropping some bottles. He really loves milk, so was probably having too much by that stage, so we’ve stuck with one only when he’s going down for a nap and at bedtime. He’s eating more as a result; his appetite has emerged!”

Lastly, there was the matter of getting Kaleb to sleep in his cot. Annette started with the cot side down and his cot attached to the side of her bed.

“The idea was that I would gradually each time get a bit further away from him,” Annette explains.

“As he got happier going to bed, we could eventually put the side back up and then we got to the point where I could even leave the room and pop back in to check on him – that was huge!”

EVENINGS RECLAIMED

Soon Kaleb was not only settling earlier, but was sleeping through solidly.

“That 8pm bedtime has made such a big difference!” Annette admits.

“Even for my relationship, because I hadn’t really had any time with my husband. He still sometimes comments that he misses having him up with us in the evening, but it’s nice to spend some time just the two of us. I feel as though I have some sanity back because I get some time to myself. I have more energy during the day too; I’ve even started exercising, which I couldn’t have done when I wasn’t getting enough sleep!”

COMMITMENT AND CONFIDENCE

Once Annette had committed to sleep training, she went all in.

“I pretty much stayed at home for the two weeks of doing the plan, so that I could see it through. I think both consistency and the timings of everything were what made it work.”

For Annette though, the real value came in confidence.

“Having some sort of routine, and appropriate timings, meant that I felt more confident putting the kids down and I knew where they were at. I had a better guess whether they were hungry; I could tell what their cry might be telling me. I also learnt a lot about different children’s temperaments. I can leave my daughter to cry for a few minutes more easily than I can with my son, because they’re so different.”

“We’ve found a good mix of what works for me, and for each of them – and Becky helped me to get there. She was supportive and never judgmental as she tailored something that would work for me. It was definitely money well spent.”

— TESTIMONIAL:

“Thanks for everything you have done. I had sat and watched your page for a year with my son who was a bad sleeper, but with two kids now I finally took the plunge.

My son stayed up till 12pm every night with us and was a nightmare if I tried to put him down early. He feared his cot like crazy and had been co-sleeping with us for a year and a half.

I was tired and getting frustrated at night. I had tried so many options and feared routine, but Becky was able to tailor a sleeping programme that fitted me and my family and the routine – or rather timing options – has allowed me to know what is upsetting my children and what they need. I find my son’s nutrition intake has also increased.

Now when we have setbacks I have the tools to try and get him back on track. I finally have time to myself.

It took at least a week of consistency but has made a huge difference! He responded way better than I imagined to the small changes and the gentle approach made me comfortable too, which allowed me to be consistent and commit.

Thanks for everything.”

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Our Baby Sleep Program helps tired parents TO DEVELOP HEALTHY SLEEP HABITS BY FOCUSING ON NAPS, SETTLING AND NIGHT SLEEP.

  • Empowered: Feel empowered as a Mum as you learn to understand your growing baby’s needs and cues.
  • Simple effective settling: Gentle, proven self settling, evidence based techniques.
    Content happy baby and parents: Better sleep creates content babies & happy parents.
  • Freedom: Predictable routines and longer nights creates freedom. Solve your sleep problems for more freedom.
  • Work with your babies circadian rhythm: Work with your babies biological clock for faster easier results.
  • Awesome naps & nights: You’ll create consistent naps and nights with our support.

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0-3 months

3-8 months

9-18 months

18 months – 4 years

My baby has reflux can you help?

When your baby has reflux, feeds can be difficult and your baby can be in a lot of pain both during and after feeds. This pain can cause feeding aversions and failure to thrive. This is why true GERD (Gastroesophageal reflux disease) needs to be treated by a doctor. Once your baby’s doctor is satisfied your baby is feeding well, and you have the right medication or formula then we can start a sleep plan and you will be successful.

My baby has colic will this help?

Colic is defined as 3 or more hours of crying per day in infants. Crying subsides in the second second trimester. If you are still experiencing colic symptoms speak to your baby’s doctor about whether this could be reflux, an allergy, or over tiredness. We can help you work on better sleep with this program at the same time as your doctor investigates the pain and crying.

What if the program isn’t working?

We have a dedicated help line to ensure your success. Just email our team via the details in your program and a certified, experienced and friendly sleep consultant is ready to stare you in the right direction to ensure your success!

My baby was born early, can you help?

Sleep is neurological so we always work off your babies neurological age, that is their corrected age. When you look at our sleep programs purchase the program that your babies corrected age fits into.

What if I have questions or need more help?

Our sleep programs come with private email support. You don’t have to post in any public forums or groups, just email the exclusive helpline that our team of certified sleep consultants look after and we’ll answer all your questions and help you on your way.

Can this program help with my babies night sleep?

Yes, all our online sleep programs contain night sleep plans. We will teach you how to move from multiple night feeds to 2 or 1 or none (depending on what is age appropriate and appropriate for your baby.) Don’t worry we will show you to figure this out too. If your baby is unsettled at night but not feeding, our plans will help you with consolidate night sleep and self settling when age appropriate.

My baby is cat napping can you help?

Cat napping is a very normal physiological stage that your baby goes through. At this stage (3-8 months old), cat napping can start to be a long term issue and compound into over tiredness and affect night sleep and your babies happiness. Good news, this is a great age to work on re-settling, self settling and better longer naps!

I have 3 children, can this work with my family?

I totally understand how busy life is with 2, 3 or more children! Even if you need a flexible schedule we can still work on settling regular naps (some on the go!), and better evenings and night. Flick our consultants any specific questions about your family’s schedule of activities and we can help you work out what is possible nap wise.

I don’t want a fixed routine, can you still help?

Yes. A fixed routine is one option, regular naps and regular awake times is another. Both are valid and you are welcome to do what works for your family. We understand you are all different and what works best for one family won’t be best for another.

I’m formula feeding, can you still help?

Yes we have specific advice for formula feeding parents, and we support your decision to feed any way you choose. We even have a special video series on formula feeding and everything you need to know. Just ask our consultants about this extra if you need it.

I’m exclusively breastfeeding, can I follow your plans?

Yes! While breastfeeding babies need to feed frequently they still need quality sleep day and night. We have specific advice for breastfeeding mums and an exclusive discount on Julia Daleys breastfeeding course if you need extra help.

I’m bed sharing, can your program help me stop?

Yes. We often fall into bed sharing, we call this reactive bed sharing. Or we have simply changed our mind, and moving on from bed sharing we need some support. Our programs and consults will guide you through gentle sleep methods, which are more appropriate for most bed sharing babies who are moving towards independent sleep in the cot.

I’m feeding to sleep, can you help me stop?

Yes. Feeding to sleep is a common sleep association and one that works well for lots of newborns. Often we need to move on from feeding to sleep when it starts to cause short naps, or prolonged settling or frequent night wake ups as baby looks for their association to go back to sleep over and over again at night. We can teach you how to teach your baby to self settle and move on from feeding to sleep when the time is right.

I’m rocking to sleep, is their a solution?

Yes. These are common sleep associations, we refer to this as assisting to sleep. Let us show you ways you can develop independent sleep and settling strategies with our online sleep program, or one on one consult.

Is this program based on Cry It Out?

No. Cry it out is the common name for a sleep training method where you put baby down and don’t respond or check until they are fast asleep. There is no CIO involved in this program as we feel this should be only done under proper supervision. Instead we have included all our very gentle approaches and more mainstream techniques for you to choose from.

Is this based on Science or Art?

Both! As a scientist I (Emma) have spent over 8 years researching the science of sleep. I have educated and certified over 500 consultants around the world as sleep consultants, and have worked with thousands of clients. I love the scientific explanations of why we see the sleep patterns we see, and this science helps us to shape plans and solutions that we know will work. But there’s an element of art to getting a baby to sleep, understanding the right combination of things that will work best, and this is where your instinct comes in.

Emma Purdue

Emma is the owner and founder of Baby Sleep Consultant, she is a certified infant and child sleep consultant, Happiest Baby on the block educator, has a Bachelor of Science, and Diploma in Education. Emma is a mother to 3 children, and loves writing when she isn’t working with tired clients and cheering on her team helping thousands of mums just like you.

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Teething and Sleep – what does the science have to say?

ACCORDING TO THE SCIENCE…

Many of you will know about my science background… When things are in doubt I dive into the research, so let’s take a look at what the science says about teething.

My first finding was that none of the symptoms of teething are scientifically proven.

Most studies found a flat-out “no” to the question of a significantly raised temperature, although one reported a rise in body temperature only on the day the tooth actually erupts and cuts through. Even then, temperature variations topped out at a barely perceptible 0.39°C.

But what about the rest?

The diarrhoea and nappy rash that seems to occur when a tooth is on its way?

Popular opinion here is that an increase in saliva leads to more acidic stools, but the science for this just doesn’t stack up. For starters, the pH level of our stomachs is already 1.5-3.5, which is incredibly acidic.

Our saliva, on the other hand, has a pH of 6.2-7.6, which means it’s basically neutral or slightly on the alkaline side. If we could consume enough saliva to influence our stools, it would make it more alkaline.

Even if it did become acidic, something that could burn the bottom would also be burning the skin off their mouths. Diarrhoea is more likely the result of a virus (rotovirus or ecoli) or – less commonly – lactose intolerance. The saliva-acid idea we must chalk up to a physiologically impossible myth.

Some of the other symptoms may have a bit more of a basis; the redness in the cheeks, increased irritability, increased salivation (drooling), and gingival irritation (a sore mouth) have been found in the minority of cases.

However, what came across constantly was that teething is a natural physiological process that usually occurs without problems. Another study I came across found that of 50 babies that were hospitalised for “teething symptoms”, 48 were found to have another organic cause for their illness.

This is not to say that our babies don’t experience discomfort when they are cutting a new tooth. However, the symptoms are usually very mild and therefore any disturbance to their sleep is also very mild. If your child is experiencing major sleep issues, it’s likely to be something else.

The other way that it’s easy to tell is looking to their temperament during the day. I maintain that teeth growing is not a strictly nocturnal activity, so if they are distressed in the evening due to a tooth, they will be during the day too.

SO WHAT MIGHT ACTUALLY BE THE STORY?

The appearance of teeth tends to follow a fairly normal pattern: incisors, canines, then molars. Studies that did cite any symptoms found these to be worse for the first teeth our babies get.

The period of teething also coincides with a reduction in immune function and a switch for our babies from passive to active immunity. Basically, this means that they’re losing the antibodies they’ve had from their mum (through pregnancy and potentially breastfeeding) and are now having to make antibodies themselves.

This lowered immune function comes at a time when they’re starting to put their hands in their mouths much more, and while their gums are erupting and raw. It follows then that this is a time of increased infections, from upper respiratory to middle ear and urinary tract.

ADDITIONALLY

…increased saliva could correlate to our little one’s salivary glands kicking in, as happens when they need amylase and further enzymes for the introduction of solids.

So, not only are your baby’s first teeth the most likely to cause a problem, they are also the ones that grow when our children are younger, with less of their immune system developed and while their bodies are undergoing a huge number of other changes.

BUT, WHAT ABOUT THE ISSUES SURROUNDING SLEEP?

Teeth generally start to emerge between 6-8 months, which we know is a time of huge changes not only for our babies’ bodies, but also for their brains and development. I’ve looked at the causes of sleep issues at this age before – including learning to roll, learning to resettle, transitioning down to two naps from three, and being ready to be un-swaddled.

All these things are likely to spark sleep issues; however, they are all things that are completely resolvable.

Perhaps there is a night that your little love is cutting a tooth and needs an extra cuddle; these small blips are natural. However, to avoid the slippery (and all too easy) slope of habitual wake-ups, we need to be confident the next day to stick to good sleep habits.

Sleep disturbances (from teething or otherwise) can quickly lead to overtiredness, which can really keep you stuck.

SO WHAT DOES WORK FOR TEETHING?

The results here say that numbing creams, like bonjela and the like, don’t work as our babies produce too much saliva for them to be effective. Similarly, Pamol is not usually recommended. In fact, any pharmacological treatment should be monitored carefully.

So, what can you do? The only two treatments found to be effective in easing symptoms were an ice-cold flannel or toy to chew on, or the simply-can’t-beat-it comfort of ‘cuddle therapy’.

Anecdotally I believe that the way that some other treatments appear to work is because they are often administered with a cuddle too; it is likely the latter that made the difference.

A WORD OF WARNING: WE’RE OFTEN MISSING SOME OTHER IMPORTANT CUES

As well as setting the record straight more generally about what can, and can’t, be attributed to teething, there’s another important reason for writing this post.

As one article I came across attested “the suboptimal management of the common patterns [that we attribute to teething] are causing us to miss serious illnesses.”

The science states that any teething symptoms are minor and relate to discomfort rather than physical illness, so if your baby is unwell, it’s likely that they’re actually unwell. That may well require an altogether different treatment.

If your baby has a fever or diarrhoea (which can be particularly dangerous in infants and lead to dehydration), seek medical advice.

Similarly, if they have little or no appetite for days, or become really irritable day after day, see your doctor – there could be something else going on that they are unable to communicate. And, if it is a sleep issue in and of itself, reach out and we’d be happy to help.

Emma Purdue

Emma is the owner and founder of Baby Sleep Consultant, she is a certified infant and child sleep consultant, Happiest Baby on the block educator, has a Bachelor of Science, and Diploma in Education. Emma is a mother to 3 children, and loves writing when she isn’t working with tired clients and cheering on her team helping thousands of mums just like you.