I help Mums with any questions they may have about:
- Weaning on to solid food
- Solids: milk ratio/balance
- Flexible routines tailored to baby’s personality and developmental stage
- Return to work
- Weaning from the breast or beginning to mixed feed (breast and formula milk)
- Dealing with separation anxiety and clingy phases
- Bedtime routines and night waking
- Gentle toddler behaviour management
Our society puts high expectations on how much babies will sleep which are not necessarily in line with what is actually natural for our species. It’s quite normal for toddlers and young children to need some reassurance at bed time, wake up once or twice a night to breastfeed, be comforted after a bad dream, to check that you are still there, to get a drink of water, find a lost teddy, go to the toilet, or have wet the bed and need changing or because they are restless during big developmental leaps. If they are teething or unwell then they may be up several more times. The gold standard of sleeping through the night 7pm to 7am is not always particularly realistic. It does happen, but for most parents of children 2-4 years old, they might get some nights like this and just as many nights where they are disturbed briefly several times.
What is not normal, but unfortunately all too common is a toddler or child waking 5, 6, 7 plus times per night and taking a long time to resettle. Parenting is not easy but humans are perfectly able to cope with disturbed sleep for the several years of raising young children, but being woken every hour or so for months or years on end can cause serious mental and physical ill health, not to mention being the cause of broken marriages, lost jobs and car accidents.
What are the causes of sleep problems in babies and children?
Sometimes children are waking frequently because there is an underlying cause such as undiagnosed food allergies, reflux and sleep apnoea or other medical conditions. Babies like this may also be fussy eaters and be waking because they are hungry, breastfeeding excessively, yet still being unsatisfied because by this stage breastfeeding alone is not meeting their calorific requirements. Nutrient deficiencies in fussy eaters also often cause further sleep disturbance and behavioural problems in the daytime.
These children were often high needs babies and poor sleepers right from the word go. Their parents have tried absolutely everything to get them to sleep and found that nothing helps apart from co-sleeping and breastfeeding an awful lot. Let me say there is nothing wrong with allowing your child to sleep in your bed for some years, provided you follow safe sleep guidelines; it is only a problem if you don’t want them there or keep chopping and changing. Babies are best being invited into your bed as a conscious parenting choice rather than out of desperation. In traditional societies where all children co-sleep and have unrestricted access to the breast, they often self wean and leave the parental bed without any fuss when they are ready – usually at around 3-4 years of age.
High needs babies will sometimes suddenly almost overnight, grow out of sleeping badly around 12-18 months either because they have reached sleep maturity or because they have grown out of reflux etc. More often, children who have been parented this way because they are ‘high needs’ will often not give up these behaviours easily without some nudging because they have become deeply ingrained habits. They have an innately sensitive temperament, therefore they cry often and easily as young babies. Young babies should be responded to promptly because they cannot yet regulate their own emotions. These babies genuinely need rapid responses from their parents before they become very distressed and take a long time to calm down.
By the time they are a bit older and need to develop their ability to wait a little, control their temper for short periods, (delayed gratification is one of the highest predictors of positive mental health, academic and social success in humans) their parents are also in the ‘habit’ of doing ‘whatever it takes’ to calm their crying child. These children are also more likely to be light sleepers and easily disturbed by parents moving around when co-sleeping. As children grow they become naturally more wakeful and things that used to work like breastfeeding them to sleep, eventually stop working as they outgrow it. An eight month old can easily be rendered milk drunk by a good feed when tired; soothing though breastfeeding is, a 20 month old who has just woken from a 3 hour sleep and had a trickle of milk is less likely fall straight back to sleep due to it’s sedative powers! Parents may not realise that over time they need to increase their child’s resilience and help foster their ability to self regulate. If toddlers are responded to as if they are newborns, then you are going to end up with a very demanding toddler. Children need age appropriate boundaries and if you don’t make them obvious then they will push and push to see how far they can take it.
Other times, sleep problems can be caused by a random series of events combining together to create the perfect storm. It could be that your baby was sleeping well and then they happened to go through an unsettling event such as moving house, at the same time as their separation anxiety peaked causing a sleep regression; they then had an illness which affected their sleep and also developed the ability to say ma-ma-ma-ma and da-da-da-da soon after. Of course you brought your unwell baby into your bed, of course you were worried that they would be scared in their new bedroom and of course when they had separation anxiety and they called for you by name for the first time – you responded instantly – as most good parents would! The problem then is how you get back to normal sleep once the storm has passed because by that time your child has developed a habit and developed firm expectations of how night-time should now be handled!
If we are lucky, sometimes excessive night waking has been caused by issues that are easier to fix such as inadequate calorie consumption, not drinking enough water, poor napping schedule, too much TV, not enough exercise or lack of bedtime and nap time routines and cues to wind down.
What options are there when choosing a sleep consultant?
In-home sleep consultants are very expensive and their high success rate is due to the fact that they literally do the sleep training for you until a new habit has been formed that you just have to continue with. The downside to this is sleep training often needs to be repeated whenever something changes. I do not offer that kind of service as I am Mum myself and my children need me at home most nights, plus the amounts I would have to charge for working overnight on a regular basis would make the cost prohibitive for most families. If you can afford it, this is a good option for many people though, and if you shop around you should be able to find someone whose values align with your own. Sleep training is not all about crying it out – there are more gentle options out there!
Sleep consultants that you visit outside the home for advice can be very successful for parents who have the emotional & physical strength left to do some sleep training and have an average baby who has just got into some bad habits. They have a lower success rate overall compared to in home help because they give largely standardised advice but every baby, every parent and every family dynamic is different. Their advice is only as good as your ability to implement it. If you are depressed and chronically sleep deprived, following what sounds like quite a simple system on paper, can be very hard to stick with in real life. If on top of that, what you’re being told to do is some kind of strict, formal sleep training and this goes against your personal parenting philosophy, then your chances of bringing about lasting change in your child are low. If you are worried that you are going to damage your child in some way then you are not likely to follow through on the advice when the going gets tough.
What is your approach?
I never pretend to have all the answers or offer some miracle solution that’s going to get your child sleeping through the night. I don’t stand in judgement over parents, I know how easily things can go from being okay to being nightmarish and that once you are exhausted yourself you lack the cognitive skills to think your way out of the problem.
When I first set up the business I imagined that women would book my services during pregnancy and I would visit them from birth to six weeks, hence the word postnatal in the business title. This does happen, and when it does, it is the ideal way to do things. It’s so much easier to get off to a good start with the right advice and nip problems in the bud before they snowball. I usually continue to visit or advise Mums well into their baby’s first year so that they can approach each developmental stage with confidence, but much less frequently than in the early days.
Many clients contact me for the first time when their baby is much older and the real problems with sleep and ensuing maternal exhaustion have set in so over time, I’ve branched out into helping Mums of older babies and toddlers. It’s not unusual for me to begin visiting for purposes of helping with a newborn in the family, but also be able to help out with the sleeping patterns or behaviour of the toddler in the family too.
My approach is a bit like doing some detective work. I ask a LOT of questions and try to look for all the underlying reasons which may have started the problem and what behaviours as a family you are unwittingly doing to maintain the problem. If there are underlying issues then I know whom to refer to get a proper diagnosis. I look at the bedtime routine, how they are responded to at night, what and how much your child is eating and drinking, how much screen time they are having, if they are under or over stimulated, if they are getting enough fresh air and exercise and how daytime naps are going.
Parents often know exactly what caused the problem, what they think they should do to fix it, but are literally too bone tired to enact their plan and their resolve is low. They also often have to accept worse sleep and changing their patterns in the daytime in the short term to see medium term improvements and maintain them for the long term. Even if we know that if we fall asleep now we will be up again in 40-60 minutes, the drive to sleep NOW becomes overwhelming and overrides our best intentions and knowledge that we would get to sleep longer if we stay awake now and do things differently. Scientists call this ‘sleep pressure’ and it is the brain’s way of protecting itself because staying awake for too long will eventually kill us; that’s why sleep deprivation is used as a form of torture!
Mums have sometimes become depressed by the time they contact me. Sleep deprivation can be a major factor in triggering depression and/or anxiety and even if it wasn’t a trigger, lack of sleep over time will worsen your mental health or at least make recovery trickier. They have often given up by the time I see them, having had little help from their GP or CYH nurse as all they get is standard advice: they have to learn to self settle and they need to eat more solids. Or maybe their baby has ‘failed’ sleep school and they have lost all hope that things will ever change.
Mums also feel really emotional due to tiredness, can have low self-esteem and be plagued doubts about their abilities as a parent. Parenting is the most important and most difficult job in the world and we are doing it at a time when we have less support than ever and we also have more conflicting sources of information and opinions available to us at the touch of a button. A little bit of information can be a dangerous thing, not just in your own hands, but also in the hands of every keyboard warrior in parenting chat rooms.
I see you and your baby as a unit and take a holistic approach which encompasses unpacking your emotions and thought processes that contributed to the problem; this may go as far back as this birth experience or even your own childhood – for example the Mum who did not have a responsive mother herself may overcompensate and over respond when her baby is actually overstimulated and needs time to wind down by crying in her arms. You also come as a family unit and where you have a partner you may not agree on how best to respond to your child’s night-time waking which can add further confusion for your baby and stress for you.
I will help you to scientifically question your faulty thought processes but still respect your opinions and parenting philosophy even if it’s different to my own. For example, your thought may be: ‘If my two year old cries at night I have to stop the crying or they will be damaged for life.’ I will challenge this kind of anxiety based decision making - young babies who are left to cry unattended can have their stress levels set high for life, but a toddler having a tantrum because his routine is changing needs the opportunity to be held through his distress and or be allowed to express his rage safely while you remain nearby, calm and accepting of all his emotions including the negative ones. If you are frightened of his big emotions, how can you help him to master them? This emotional self regulation begins now, not when he is an 8 year old in a playground fight or when he is a teenager putting his fist through a wall because he’s grounded. Hence we often see behaviour problems in the daytime in children who are poor sleepers, partly because they are too tired to behave well or eat properly and partly because they haven’t been given appropriate boundaries. Their parents are also too tired to parent at their best during the daytime.When you are existing in a state of chronic sleep deprivation and bone aching fatigue, it feels like you are walking through treacle all day every day, every task takes twice as long because your thought processes and energy levels are so low.
Please have a look through my blog articles to get more of a sense of my parenting philosophy and don’t be afraid to call me for no obligation chat about your baby. Even if you don’t think my approach is right for you, I have many useful contacts in parenting services in our area.