#343 | Rest Assured: Your Instincts are Right About Your Baby's Sleep with Louise Herbert

I'm Cynthia Overgard, birth educator, advocate for informed consent, and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Show. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello. It's lovely to be here. I'm Louise. I am the mum behind mother, nourish, nurture on Instagram and obviously online, but that's really kind of a secondary thing. So first and foremost, I'm a pediatric sleep and development specialist. I have a long history in terms of perinatal infant mental health, infant feeding, so it's kind of all of the puzzle pieces that make up thriving and health in those early years. And I decided to bring my kind of clinical practice online during covid, because that was just what everybody was doing right. Telehealth became a thing. And I wondered, Is this going to reach the moms that need it? Because there was this kind of big epidemic, even more so of kind of loneliness postpartum people really, really feeling like, oh my goodness, I'm completely the only one I'm on my own. Is anyone else feeling this way? So I figured, let's pop it onto Instagram and just kind of reach out and make a few connections and see if any other mamas out there are feeling this way. Maybe I could help. Just give some advice, some guidance, some support, and it just blew up. It turns out there were a lot of moms out there who really, really, really did need a sense of community, and it's just kind of snowballed since then, and it's been amazing. I now train professionals in this stuff, because the infant sleep world especially is not an it's not a regulated field, which is just horrific for parents, because, you know, it's it's so crucial in these early years. And what we're seeing is lots of families being given quite dangerous advice or just wrong advice. So I'm trying to offset that. We have an accredited training program for professionals, which is going amazingly well, and obviously I support families. That's the crux of it, obviously, as a professional, but as a mom too, I have, I have two not so babyish babies anymore. So yeah, so that's kind of my background, where I'm from, and why I'm here, really, because I know, if ever anyone learns what I do, you know, just like in a playground or just wherever you just hear this word sleep, and you'll what's the first question? Oh, okay, how do I make my baby sleep? Oh, my goodness, my baby never sleeps. My baby hates sleep. My baby won't sleep through the night. Everybody else seems to so I think this is the kind of conversation that a lot of us are already having on repeat. So it's just nice to offset some of the the misinformation out there with some of the facts, some of the science, and that's also, I have a book coming out soon, and that's literally the heart of the book. So the book is kind of everything I just said, all rolled into however many pages of information, facts, of course, but also lots and lots of support in there. So just to have a mum pick it up and feel like she's understood, heard, and has some practical strategies, is kind of the intention behind that. So that's called Rest Assured, which I know we talked about the kind of the title of this episode. So, yeah, it's it all blends in. That's a great name.

I just want to ask you before we get started, you said sometimes dangerous advice is given. And I'm so curious to know what would be dangerous advice when it comes to sleep strategies. So a lot, I would honestly say 90% of the stuff you will find online is dangerous and carries risks that are not discussed. So when parents are being given this stuff, this advice is guidance. I do not believe they're consenting to the full guidance they are trying out, because I don't believe that they are given the full risk profile. So any intervention has risks, right? So if we are trying to manipulate or we're trying to change biology, you know, how humans sleep, we have to look at the whole picture, and we have to say, Okay, well, if we do this, what is going to be the likely consequence, or the likely outcome? And a lot of the kind of what I would call mainstream, but I do think it's becoming less mainstream as you know, more information and science comes out there, but a lot of the information that we just see kind of top of google or top of blogs or it circulates online, on social platforms, is we need to change the behavior of the child, so that's changed the behavior of how they're sleeping. And we're told that we can teach this, we can train this, we can control this. And we're told that we do this by limiting how we respond, or limiting, literally, whether we respond to the baby or the toddler that's in front of us, and we're told that this is great, because we can then shape their sleep, and the outcome is they'll sleep more. And of course, that's what everybody wants, right? Okay, so if we dig into that, what we find is actually you cannot train or teach sleep. It's not a skill to be taught. It's a homeostatic process or function in the human body, much like breathing, digestion, our heartbeat. So we are not teaching or training our babies to breathe. We are just taking it for granted that their bodies know how to do that. And when we look even deeper, that's on a neurological point there. So the very front of our brains, that's our our. Logic and our reasoning that's not really mature until we're pretty much 30. It's literally three decades in the making for that to be really robust and really good in terms of our reasoning. So our teeny weeny babies are infants. They come into this world. They are totally dependent on us, and they are not driven by this frontal part of their brain. They are driven by the back part. And I call this the lizard brain, because it's the part of the brain that's always been, always will be, and it's just there ticking on no matter what, and it's literally what keeps our heart beating. So we're not logically telling our bodies beat now, heart beat now, beat now. Beat now, because that's all we would ever do. We're taking it for granted that this part of our brain has that covered sleep falls into the same category. So when we are tired, we take it for granted that we will sleep. The problem, and I'm using inverted commas, there is that there is a disconnect between us as adults and what we think babies should be sleeping, and truly the biology of infant sleep. How babies sleep? Why do they wake? Is there a reason that they wake? The answer is yes, they wake because it keeps them safe, because if babies fall into too deep asleep, they are at a much increased risk of sibs, so by rousing at the end of each sleep cycle and to actually kind of get a little bit of external support, because, of course, they're so new, so they are really dependent on us and our bodies and our skin and our breath, etc, for keeping them physiologically safe, not just emotionally, but also literally, physiologically safe. So they rouse Okay, their breathing kind of stabilizes. Their temperature control is good. Maybe they have a cuddle with Mama, a little bit of milk, because they only have tiny tummies. And then what do they do? They sink back to the next sleep cycle for baby. That's just kept them really safe, that little wake up that's been amazing, that's kept them safe. For mom, it can feel really draining because you're like, Oh man, you know, I have to be up at seven in the morning. I have an alarm set. I'm watching the clock tick by. This is the third wake up of the night, and you start to go down this kind of rabbit hole of wondering, Okay, do I have to fix this? Is this a problem to fix? And in most cases, it's not. But when we try to fix it, and coming back to that kind of what's the risk profile? When we try to shape behavior and we limit how we respond, or whether we respond at all, or we leave them crying alone, etc, what that does is it raises stress levels for babies, so we see their stress profile actually increase. It also raises stress for moms and dads as well. We know this for a fact, which also for the dynamic isn't good, and just for the parent, you know, that's not fun. And what we see is the stress rises in babies, and it kind of peaks. So depending on the level of this, it can kind of peak. And what we see is a state of disassociation. So when we see that sleep after sleep training that's not healthy, wonderful, you know, sleep that was really needed and gone into in a really, really safe, nurtured way, that is disassociation, because the baby is preserving their energy reserves, because they realized, hold on, no one's coming. If I keep crying, I'm going to wear myself out. I don't know when I'm going to be responded to next, so I need to just shut down. What's non essential. So they shut down and they self Preserve. So that's the risk profile that we're seeing, and it's something that we're not really told about. You know, as parents, because no one really understands. The majority of people don't understand the science of how and why babies sleep the way they do.

I just want to say two things quick. I want to go back to what you said about the frequent route arousal of the baby for feeding, or proximity, closeness. We do have research out there that shows that babies who co sleep and breastfeed are the safest and most protected against SIDS, and you just explained exactly why that is. So I want to make sure that everybody caught that, because a lot of people say, Well, how can that be? You know, this is sleeping in the bed is the thing that is supposed to increase the risk of SIDS, and it's actually the opposite. When babies sleep close to their mothers and they're breastfeeding, they're waking more frequently. They're avoiding that deep, deep, deep state of sleep. They have the higher arousal, and that is protective. The second thing is about this comment about it being, you know, harmful to sleep trained babies, and the disassociation that happens, is that long lasting, or is that just happening in those first three to seven days that you're technically training your baby, and then they have learned to sleep, and now they're sleeping healthy and well, and all is great. Are you saying that they aren't actually learned to sleep, it is like an ongoing rewiring of the brain to disassociate from these arousals.

So if we look at how the brain is wired and what happens so when a baby is born, the brain is not wired yet, right? It's still growing. They're born kind of early compared to our closest animal relatives, so we have this period of extra gestation, so that means to continually gestate outside of the room. And that's why teeny ones need our skin to skin. They need proximity. They need milk on demand. They're just like, literally, these little dependent, beautiful blobs. So what happens is, all of this stuff is feeding the brain development. And it's wiring the brain. So what I mean by that is there are neurons in the brain, that's the brain cells, and then we have these little kind of call them highways in between, called synapses. And it's these that are the pathways that are firing, firing, firing. We're talking millions, millions of seconds, firing, firing. Now when we fire these up, have you heard of the term? If you use it or lose it. So this goes with brain development really well, because these synapses, these highways that get used a lot, they're the ones that get really robust. They get really protected. So when we go through these phases where we actually shed some of these away during life, the ones that we use the most stick around. And that's kind of like a very basic, very basic explanation of kind of human behavior patterns and personality traits and these kind of things. And what we find is the children who are nurtured get very used to being nurtured, expect nurture, and it becomes their just their norm. Right now, if you are to literally on repeat, kind of ignore, avoid, limit responsiveness, the nurture pathways are not going to be as robust, and the pathways that go into kind of self preservation are going to be stronger, because that's the ones that are being used. Now, of course, this is all a spectrum, right? But what I would say is, if you've sleep trained, that's not like, Oh, that's it. You know, there's no turning back. No, no, no. I talk a lot, and I work with so many families who are kind of repairing after sleep training. So what would repair look like? Well, it would look like lots of responsiveness, and it would look like lots of closeness, proximity, eye contact, skin to skin, all that good stuff that we know feeds and fuels that really healthy brain. And in terms of kind of what I also see, so there's also a bit of a there's a bit of misinformation there about what sleep training does in terms of how it works. We assume that if we sleep train, we're going to get a sleeper. It's not really the case. So in my clinical practice, the majority of families that I support who are coming to me, they've reached the point where they need support, right? So they are literally like I'm tired, I'm waking constantly. I just can't do it anymore. They've reached that point. Most of them have already sleep trained at some point in the path. Some of them on repeat, some of them for extended durations of time. So there are some families that have sleep train for weeks on end because it isn't working, or there's some that have to sleep train or re Sleep Train after every single development leap, every single cold, every single vacation. So anything that changes, they're having to redo that behavior shift, and they're having to retrain. And they're told this is normal, this is what we do. But they don't like it, and it feels icky and it raises stress. And so they're reaching out and this, they're thinking, hold on, there has to be a different way here. There has to be something that we're kind of missing in terms of joining the dots together, and that's where sleep biology comes into play, right? Because when we understand how and why babies sleep, we can support it safely, we can avoid all of that stress that's unnecessary, and we can actually work with the biology that we know exists, as opposed to ignoring it or literally just having no awareness that it's there in the first place.

So can we talk about what the biology says is sort of in the normal range? Because, yeah, as I'm sure you know, some moms, their babies are waking up every hour, all night long, for nights on end, and that can't be good for the baby or the mother. So is there, is that normal for that baby and that should just be supported? Or can you give us some parameters, if there are any at all?

So there's no official parameters, but there are kind of healthy guidelines that we can work with. What you just talked about, there is what I would call hourly waking, and it can be a red flag for something that is a problem. But when I say that, that's not a sleep problem. So the sleep is, you know, it's, it's the kind of the outpouring of, hey, hey, hey, look deeper. Look deeper. So when we dig in the problems that that might be related to, would be, sorry, things like low iron stores. So low iron can do that, things like oral ties and restrictions. Can do that. You know, we've got breathing difficulties, we've got allergies, we've got sickness, we've got intolerances. If you think about adults, if we weren't sleeping very well, we probably think to ourselves, hmm, I wonder why. And we probably look at the overall picture, we wouldn't just think, oh, I have a sleep problem. I diagnose myself with a sleep problem. We would actually look at the root cause. And that's exactly, exactly what the sleep problem is, is inviting us to do it, saying, hey, there might be a problem here. Let's look into it. Now. Some babies, yes, if they're waking hourly, let's say you look into it, and maybe they've got oral tension, or maybe they've got allergies on their tummy is literally really sore overnight when they're drinking their milk or whatever it is. Well, that's wonderful that they've kind of shown us that so that we can address the problem right now. Other babies, yes, they do wake very frequently, and maybe they're completely, literally, completely healthy. They're thriving. Everything's going great. And it's this point where families say, oh, goodness, why? Why me? You know, I felt this non sleeping human. So there's a few things here. One of them is, we're all different in terms of our temperaments, so in terms of our sensitivity, in terms of how we relate to the world, etc. And some babies are simply born more sensitive than others. So what that means is, when they are naturally rousing, and all of us rouse as humans, at the end of our sleep cycles, and a baby's sleep cycle is really short compared to an adult sleep cycle, so when they're rousing, if they're quite sensitive, they're going to be more likely to a notice, if anything is a mess, a miss and B, let us know about it. So if you have a really chilled out baby, so chill, they're the type of baby that will sleep anywhere, sleep through any noise. They're just so chill. They sleep for long stretches. We have a more sensitive child. They are going to wake up if someone sneezes three blocks away, they're going to wake up if you know they're going to notice any sound, any movement, any change in their body, maybe they're a tiny bit hungry, and it feels very alarming, so they're going to let us know really loud and clear about it. So if you think about what we're doing in sleep cycle, when we're waking at the end of our sleep cycles, we're doing something. We're checking it's all about safety. All of this comes down to, are we safe in our bodies and our environments as humans? So we're sleeping in little, tiny chunks. As adults, we do this too. They're slightly longer chunks, but they're still chunks. And if you think about years and years and years ago, we'd have been in some kind of a camp or a shelter, what would have we been checking for? Is the fire still burning? Is there a predator coming over the hill? Am I hungry? Thirsty? Is am I in pain? Am I safe? They're just checking. As adults, we still do this. We're not looking for predators so much, but we are thinking, Am I thirsty? Etc. So if there is a need we need to meet. We're going to wake up properly and we're going to meet it. So let's say we rouse at the end of our sleep cycles and We're thirsty on one of those cycles. Well maybe we go to the kitchen, pour ourselves a glass of water, have a drink, go back to bed. There's a chance we'll remember it in the morning. We don't always, but there's a chance we'll think, oh yeah, I woke up last night. I got myself a drink. Okay? For babies, when they come to the end of their shorter sleep cycle, they're doing their check, and it's an internal, external check. Internally. Am I hungry? Am I in any pain? Am I thirsty? Am I too hot? Externally? Well, they can't think about predators because they don't have this section of their brain developed yet they're fully in the lizard brain because they're still so dependent. So they're externally checking, and they're saying, Is my person near me? Is my mama there? Is my daughter there, etc. If that person is close, that's the big tick they need for that external safety. And this is why we often see babies sleep for longer stretches in arms or while co sleeping versus in the crib. It's not because they hate the crib. It's because when they're checking and they're doing their external check, they don't get that instant tick that says, Oh, my person's here. Of course, my environment is safe because my mama is right here. So instead, they're like, Oh, I better call her Hey, hey. And of course, for us, we're coming in from across the hall, from the other room, and we're like, oh, man, just been working from my sleep. And it just, it kind of just feels like a lot, but when we're actually looking at what the rousing is doing, it's an internal, external check. So how do we support it when we meet the needs ahead of time. So we really think logically about you know, let's make sure that they're not hungry and thirsty and cold. So let's make their environment so wonderful and supportive of sleep. Let's make sure that it's not really loud and really cold in that whatever it is, equally, the external check is really the thing that's developmental, and this is where sensitivity comes into play. Because some babies, they don't care as much, like they love you so much, but they're just chilled. They're okay. And other babies, it's literally, if you walk, you know, one meter away from them, they're like, come back, Mama, come back. And it's those babies that often will wake a little bit more frequently. They'll notice the change. They'll call out a little bit more just in terms of the temperament. That doesn't necessarily mean there's a sleep problem, and it doesn't necessarily mean there's an underlying problem. What it means is, you've got a more sensitive child.

Sorry to interrupt you, Louise, this is just to clarify. This is a nervous system thing in the baby, correct? That matures over time. Because people think that if their baby is waking this frequently, or I have a Velcro baby that I can't put down, that maybe that their baby isn't as good as what people say as as another baby who can be independent is already showing at, you know, six weeks of age, that they can be alone and they're independent and they're they're good on their own. But this has nothing to do with being a good baby or not a good baby, or anything that the parent is doing or have done. It is literally the nervous system in the body that they are born in and the sensitivity to the world around them.

It's genetic. It's purely genetic in terms of that temperament tree. So we are born with it, and you'll probably, you know, maybe, if you're listening to this, you can probably relate. Some people do relate and feel I am quite sensitive. I do notice those tags on my clothing, or I don't like tight socks, you know, I feel very overwhelmed in busy spaces. That's, that's genetic, that's your body, that's nobody's taught you to do that, and that's very, very it's not a problem either. Just to put that very clearly, it's not a problem. The world needs highly sensitive people and less sensitive people. It needs all of us, right? So when you have a more highly sensitive baby, it's very easy to go down that slippery slope of thinking, okay, there's a problem. I need to fix this. What's wrong? And actually that sensitivity, as you you know, as you say, it's developmental in terms of, as that baby grows, you'll see really wonderful traits that are associated with sensitivity, so things like, you know, empathy, understanding, and deep and rich in a world of creativity, all this beautiful stuff that we love. But, you know, it kind of comes with this, this other side of things, which is, yeah, they do notice, and maybe they're gonna put their hand up a bit more and say, Hey, I need you quicker.

Louise, I have a question for you. This is very interesting to hear about the biology, and I'm guessing, so just help me, set me straight on whether I'm envisioning this wrong. But I'm guessing, when you start to work with a new client, one of the first things you're interested in, in addition to educating them on the normalcy of the biology, which is definitely an important part of your work. You're probably assessing their environment, and you're probably checking that out and determining whether those conditions are really well aligned for a good night's sleep. My question is, if the environment is good and the baby is waking up, and whether it's a more sensitive baby or not. What does it take to incite you to decide that the parents do need to change their behavior? Like, is there ever a family you work with where the baby wakes up during the night and you won't say, oh, that's just biology or something in their external environment or internal that needs to be different. When do you say to the parents, okay, there is something you can do, yeah? Oh, pretty much every time. Like an example of that, because, yeah, I'm coming up with nothing. I'm just thinking back, yeah, that was all sounds normal.

That's exactly what we kind of that's one of the issues with the messaging around sleep as well, because we almost fall into two categories, like, well, sleep train, so it's high intervention, and we do all the things, or absolutely nothing, and we just wait it out, so it's quiet out, or wait it out. I'm here to say there's a there's a middle, there's a middle that we can be safe and healthy and really supportive for everyone in the family, not just baby, not just mama, etc. So we're really kind of looking at that dyad as a team and saying, Okay, what do we do? So there's a million things, honestly, and it very much depends on circumstances, but this is my work. This is literally the crux of it. So in terms of what would I suggest? Well, I would look at sleep drives. So we are driven to sleep by two sleep drives. One is a circadian rhythm, so that means that we're awake in the day and asleep at night. And we want that to be lovely and supported and robust. And the other is sleep pressure, and that's just a really fancy way of saying, How tired are we. So I would really build these sleep drives up so tiny babies, they don't have a mature circadian rhythm yet. There are things we can do to support that in the early days. Breastfeeding is one. So if you're already breastfeeding, you can kind of take a lot of comfort in the fact that every time you're feeding your baby, especially at night, you are programming their body with your body, because your nighttime milk, for instance, includes higher levels of melatonin. So we're looking at, literally, biology is gifting us this amazing more melatonin. I mean, that's incredible. It's just amazing. So the other thing is, well, you know, lots of families don't press for you, okay. Well, what do they do? Well, light, light is the key in terms of circadian rhythms. So can you get your baby outside, or just by a window on a front porch for a few minutes? You know, 10 minutes towards sunrise will be ideal. Towards sunset would be ideal. If you can't that's okay. Just get outside in the daytime, get that sunshine on their skin safely. And that, again, it programs their biology to tell them you're not a bat, you're a human. You need to be awake in the day and asleep overnight. So we're really supporting circadian rhythm there. And the other thing, in terms of supporting the sleep drives, so the tiredness drive, the sleep pressure. This is a really, really big one, and this is the one I come to probably the most often. It's lots and lots of people think babies should sleep for longer than they actually need to sleep for. So we have kind of a bit of an epidemic of under tiredness in families and babies, not in mums. So what we end up with is an under tired baby and an over tired mama. And what that here is because we're trying to facilitate sleep at every chance, and we're trying to have long, long, long stretches overnight and long, long, long naps, and keeping on that, holding on to those naps for long, long, long into babyhood and into toddlerhood. What we often see is if we tweak routines, we tweak rhythms, and we actually. Maybe reduce, remove a nap. If we later the bedtime, if we just kind of look at the structure of the day, it can make a huge difference. And if the day structure is already great and the baby is still relatively under tired, well, what increases tiredness? Stimulation. What's the best kind of stimulation, safe and healthy, natural stimulation. Get that baby to touch the petals, touch grass, touch rocks, listen to music, have a social experience in mom's arms, go for a walk to the playground. All these things when babies are learning, they are built for those synapses to connect, for that brain to mature, and that happens via lived experience. So the more we facilitate lived experience out in the world. Obviously, with the safe proximity of mama, a baby can do two things, rest in the comfort of mom's arms and in that proximity and that safe keeping, but also really just experience the world. You know, the wind on their skin, the rain on their skin, the changes of the clouds, the sun, the bird song outside, all of this stuff is going to tie them out. And it's that, you know, I'm sure, like, I think my grandma used to say to me, oh, take them outside. They'll sleep great tonight. She wasn't wrong. But now we know the biology of why. Because we are building sleep pressure with the more just natural, safe stimulation experiences we have. And we can do this with movement. Long muscle movement is key. So you have a toddler, get them to sweep up, have them push things. Have them pull things, you know, have them engage in meaningful ways with the world that they live and exist within, and they will sleep better that night.

This is so interesting because we live in a society now where people are very afraid to take their babies out. They're very afraid to bring them around people. They're very afraid of germs. So they're keeping their babies, their young babies, home. And they're not because of that. They're not getting natural daylight exposure, which has helped building to build the sleep pressure, and they're not getting that brain stimulation of seeing the world and the people and the sights and the sounds and all that extra stimuli. They're staying home where the stimuli is a lot less and the light exposure is really not healthy for their melatonin. So that's interesting, because it's a very different society that we live in now, whereas, you know, back in the day when mothers were carrying their babies outside and they were just lived outside, probably sleep was never really much of an issue.

It wasn't. Yeah, this is the thing. So one of the core pieces that I teach about in my practitioner certification and also my book, kind of kicks off in this way as well, is I take you way back. So it's the anthropology of human sleep. I take you way back to what were we like 1000s of years ago? Because it is it is really significant, because the human brain hasn't changed. Our circumstances have massively, but our brains and our biology hasn't changed. So what we end up with is a bit of a disconnect. You know, what we're built for and what we live within, and it's my job to marry those two. It's my job to bring them together so that we can exist in a healthy way in the society we exist within, you know, here we are. You know, we live in shelters now. We go out to work. We have bills to pay. We have, you know, less of a supportive village around us. There's a lot here that we have to support families with, and it would be a huge disservice if I just said, here's the biology, go swim. And also, if we said, let's not look at the biology, because it's too hard. So we really have to go into that sweet spot where we say, what's actually biologically healthy and normal, and how do we make that work in the world that we actually exist within, so that the whole family can thrive as a unit?

So of course, we got a ton of questions from our community for you, and there's so much that we want to ask you. But for the sake of time, I do want to make sure one thing that we address before we get into the quickies, is, is there are we talking this whole time about like very young babies, zero to 12 weeks, and then after, are we talking zero to 12 months? Are we just talking in general, like any age baby?

So when I talk about infancy, I talk not to three, because that's the neurological infancy duration. When I talk about baby sleep, I'm talking zero to one, and toddler sleep is one to three. So but everything I'm talking about in terms of brain development, proximity, seeking, nurture, etc, it's the It spans the whole way. But just to give some reassurance, if you're listening to this and you're like, Ah, I can't wake up straight for three years, it gets better. So with the maturity and the development of that brain, and with all of that lovely synapse connection and all of that kind of leaning into nurture, it gets steadily, steadily better. It's not linear. It does this along the way, but your baby's sleep cycles are simply going to lengthen over time. You know, their naps are going to reduce in terms of how often they need to take a nap. All of this stuff naturally will happen regardless of what you do. So things will improve. But there's so many ways we can improve them that actually makes sense.

Okay? So let's hear what the community has to say here. Yeah. Well, the first question, I think we can all already answer, but I'll throw it out there anyway, is it really more dangerous to co sleep? And it sounds like the answer is the exact opposite.

No, it's not more dangerous, so long as you're doing it safely. So we need to have safe co sleeping, that's the key. But then it's super protective because of that proximity and safe co sleeping would include a flat surface, nothing on the surface, like lots of cushions, pillows, etc. We want it to be firm. We want it to be free from Fall risks or entrapment risks.

How can we get the sleep we need without crying it out? How do you break a nurse to sleep habit?

Okay, that's two questions. So the first question is, we support those sleep drives. We support environment. We support babies sense of safety, internal, external. So we work with their biology. We work to support their environment, and we also support the mummy and baby dyad, or the caregiver baby dyad, because what we do know for a fact is that emotional availability at sleep times actually has a direct consequence on the how good baby sleeps at night. So we want for that kind of wind down into bed to be really beautiful and nurturing and connected, etcetera. And we need to support mum for that to even be possible, right? Because it's so hard to kind of turn on this Mary Poppins when we're tired and we've had a long day. So we need to support their all parties. And then that second question, how do we break the nurse to sleep association? So number one, you don't have to. So if you're asking that because someone's told you you have to, you don't have to. You can nurse to sleep and have a beautiful, healthy night's sleep. That's possible. I see it all the time. I did it with my own babies. It's all great, very healthy. If you want to, maybe you have a version you're just fed up, whatever. Totally fine. That was me with my second baby after a while. Totally totally fine. So we can break the association by this is going to be much longer than a quick fire. So maybe we can come back to this another day. But the key is to remove the milk without removing baby's sense of comfort. So that's the key. And I talk to families about this all the time, it's like one of my backbone things. So we want to ensure that baby's sense of falling asleep isn't just substituted away or changed dramatically, so that they can still feel soothed, etc.

Would that be, maybe, where the father comes in to support, not always okay? That can, that can help for some babies and for some families. You know, that can help to have an extra caregiver there. But no, we do not have to have anyone else there, and we can very much wean that association with sleep in the gentlest of ways. I would tend to give it some time. I always recommend to try to give it about four weeks start to finish. So if you're planning to stop that association into the in the future, just maybe plan ahead. But yeah, it's step by step, and it can be super, super gentle, awesome. How long should I co sleep? I currently have three little ones in our bed, or as long as you want to, they're not going to be in your bed when they're 30. There is no expiration.

When is independent sleep? Biologically normal, and how do we make sure kids get there?

What's independent sleep? Because, you know, as adults, often we all sleep just next to someone else's adults often will have a podcast in while we're going to sleep or whatever, you know, maybe have a warm drink. Where does dependency? Where do we break that line and define dependency? If you mean supporting baby all the way to sleep, as opposed to putting in them in their beds and saying the night, then that's very much dependent on the child's temperament, very much on their association with sleep. What I do see clinically over and over again are the babies who wake a lot and need a lot of nurture at sleep times typically become the older toddlers and preschoolers who are excellent at getting themselves to sleep. Why? Because sleep is a truly safe space to go into a safe, safe state, to enter sorry and they like sleep. They don't have any association where sleep is stressful or lonely, it's really lovely. So you know, hopefully, if you're holding a little baby right now and they're asleep in your arms, and you're like, oh, man, I should have set them down already, that will come, and what you're doing now is actually paving the way for their independence in the not too distant future.

I'm so happy to hear that. I think that was exactly what happened with my two children, and I always felt like I kind of did it wrong. I feel like, for the first because they were waking up again. I'm not exaggerating when I say, like, five, six times a night, still at one year old, and it was shortly after one year old that I just started to change that. Like, had my husband get them for a few nights, and like, just shifted it without anything dramatic. But I sometimes feel like all this time from hearing other sleep experts, I kind of feel like I missed my boat. I should have done something at four months. At six months, I just made myself running ragged. And now I did always tell people, then they slept perfectly from then on, like always. Now I feel so happy to hear that, because it never occurred to me that the. Absence of anxiety around sleep, because I do regret the times I sometimes let them cry I waited. I, you know, I was at my wit's end sometimes. And there were times I remember with each of them one night trying to let them cry longer, and my heart breaks even remembering the instance with each of them on each of those nights, I have one memory of each of them really making them wait for me and cry. And I feel so bad when I think about it, but I also heard you say, like, they heal from that. There's no deep damage done. I heard you say, like we can, we can restore them after episodes like that. I just feel a little bit better about everything hearing this, and I do feel good knowing that the women listening who are going through it right now can take heart that they're likely to have children who really do sleep very well through their childhoods, because a lot of children don't.

Children just need to feel safe falling asleep. That's the key all humans, actually, we need to feel safe. We don't sleep. If we don't feel safe, not really, not in a healthy way, we will kind of have short bouts. You know, when we're very stressed, you might get you might wake more and it's harder to fall asleep. That's because your body is keeping you awake, because it senses threat. We want to reduce and remove any sense of threat for babies and children at bedtimes, that's the key very quickly for me. Then what do you have anything to say to the parents whose children are 3456, and the mother father lies down in the dark with them until the child falls asleep, and then, of course, the parent falls asleep, gets knocked, has to crawl out of the cave and go back and try to enjoy a little, you know, awake time before bed. Is that one of those that that sounds like you would say, that's absolutely fine. Is that creating a bad habit? Or what would you say? It's natural?

Yeah, for the child, that's completely fine, and that will just stop in time for the parent, it might not be fine. So a lot, a lot of families come to me and say, I just need my evenings back. I just can't lie in a dark room anymore. I am losing my mind. That's totally understandable, right? So again, we live in the real world, you know, and we have to work in terms of the circumstances that we're in, and there's lots we can do here. So again, it's all about in ensuring safety and comfort. There's methods that I talk about a lot, which is bridging. So bridging is ensuring there's kind of like, think of it like an imaginary core between you and your child. And there's lots of practical play strategies that I support families with in those years, particularly so that later childhood and preschool years and early childhood. Children are amazing at play, so we can really work with play and narration and storytelling to change their expectations and to change what they do each night. So we can use lots and lots of kind of background, holistic support measures to reset expectations around bedtime. And then we can use lots of direct bridging strategies to ensure that they're not feeling like they've just been kind of left and to make sure that they're feeling still just as safe with Mama just down the hall as they would with Mama right next to them. And when you're working with that age of child as well. Yes, they don't have fully mature cognition in terms of their logic. They do have a little bit more in terms of their understanding of time and cause effect, etc, the older they get. So there's lots we can do to work with them. So work with their biology, so that everyone in the family can have the evening that they so desire. And this occurs for like, if you wanted to have an evening away, or if some another caregiver is settling your child at maybe at daycare, at nap time, at bedtime. There's so much we can do to increase the flexibility without increasing the stress levels.

One last one, how do you move on from always contact sleeping? I love the benefits, but I really need my space in sleep.

That one is such a big one. Sarah, again, I talk about this a lot like a broken record with this, again, it's comfort and flexibility. I do actually have, at least have a guide on this. This is in the book. It's everywhere. But the key is, instead of just kind of subbing yourself out, what we want to do is build in interchangeable comforts that we can apply within, for instance, a crib or an independent sleep space, so that baby doesn't feel the direct change, because change, for a child, particularly a baby, is going to just raise an alarm bell in their system. That's not necessarily a bad thing, but it is going to mean that they're going to kind of cling tighter to you, because any change, they need us to show them that this change is safe. It's like when you introduce a new food and you give it to them in their own plate, they're often like, Nope, don't want that. But if you're eating a new food and they happen to be on your hip, there's every chance they're going to be grabbing your spoon and they want to try it. Why is that? Because they're watching mama do it, and they're trusting if mama thinks it's safe, it's safe for me. So what we want to ensure is again safety and comfort, and then we can build in the flexibility.

So Louise is, do you think that there is at any point a place where a parent needs to put their baby in a separate room and leave them alone? To cry. Is that ever normal? Is that ever recommended? Is it always okay for the baby to do exactly what they're doing if the parent is okay with it, and we only need to make changes if it's really a struggle for the parent or the family, and then we are going to utilize these sort of supportive, safe, comforting approaches to help make the transition.

So I would say it's always okay to set your baby down somewhere safe and to take a few moments to gather yourself, even when you need to. It doesn't make you a bad mom. It makes you human. It means that you're doing a very hard job. It's a hard job raising human beings, right? And we need to give ourselves lots of love and lots of grace. If you need a breather, you take a breather. It's okay that your child is crying while you're looking after yourself. That's always okay. The key is when you then return to your child, we repair we pick them up. We say, I know it was so hard without mama here. I missed you too. Mama. Just needed a few seconds. I'm here now, and you hold them close, you look in their eyes. You have skin to skin, and the world is right again in terms of kind of building in this idea of, you know, is it ever okay to kind of just follow the child's lead indefinitely? For some families, that's their perfect approach. They don't even think about it. That's just what they do. Other families that would be horrific. It would be so stressful, and they would hate the idea of it. So it's about just getting really attuned to what you need in your family unit. And we're all different, and you have to honor your own family you know your needs and your expectations. So if it's working for you, I always say this, if it works for you, it's working right, it's all good. Don't let someone else's message tell you that you're doing it wrong. And if it's not working for you in any way, and maybe you're just thinking, Oh, I just like a little bit extra sleep, or maybe I just like a bit more flexibility, and I'd like them to sleep in their crib just sometimes, and I'd like to be able to support sleep, sometimes with milk and sometimes without milk. If you just fancy a little bit of flexibility or nuance, or you really are just like, yeah, I need to some support here. Then, yes, there's so much we can do that are safe and biologically effective interventions that you know don't come with the the risk profile, and that actually work with your baby's body to make sleep just a safe, wonderful state, just to.

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