How does development influence sleep habits?
Ask any new parent about their top struggles and most likely, sleep is in the top five! Contending with sleep regressions, sleep props, sleep crutches, sleep deprivation, sleep changes, sleep experts and philosophies in the infant and toddler years is enough to make even the most sane of us go mad.
On this episode of the Learn With Less podcast, Ayelet sits down with Dr. Sarah Mitchell of Helping Babies Sleep, a chiropractor and sleep consultant who brings a remarkably inclusive approach to an often divisive topic.
Ayelet and Sarah discuss Sarah’s personal journey into sleep consulting, a few of the truths and falsehoods about what a sleep consultant is (and isn’t!), common sleep changes that correlate with developmental leaps and growth periods in the first years of life, and a few tips and resources for families hoping to make informed decisions about what’s right for them.
Quick access to links in this episode:
The No-Cry Sleep Solution, by Elizabeth Pantley (affiliate link)
The Sleep Lady’s Good Night, Sleep Tight, by Kim West (affiliate link)
Learn With Less Podcast Episode, “The Permanence Of Objects”
The Wonder Weeks by Frans X. Plooij and Hetty van de Rijt (affiliate link)
Sarah’s Online Course, “Baby Sleep Training Step-By-Step”
Sarah’s free Facebook Group, “Ask The Sleep Expert”
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Sarah: Facebook / Instagram / Twitter
Text transcript of this episode
Ayelet: Welcome to episode 63 of the Learn With Less podcast. Today I am speaking with Dr. Sarah Mitchell, who is a sleep consultant, chiropractor and the owner of the website Helping Babies Sleep.
Sarah’s own experience with sleepless nights due to postpartum anxiety and a crying baby, left her searching for answers of her own, and she now works to empower tired, frazzled parents to get their children to sleep and helps by educating parents on age appropriate sleep needs and sleep options. Sarah, thank you for being here. Welcome to Learn With Less.
Sarah: Thank you for having me. I’m so excited to be part of your community and sharing some different perspectives and some educational information for your listeners.
Ayelet: Fantastic. That is what we aim to do in general at Learn With Less, so we’re very happy to have you be part of that, and today I’ve asked you to come onto the show to speak about the ways in which development can affect sleep changes in those early months and years. But first I want to hear a bit about you and what brought you to the kind of work that you’re doing today, and you know why you’re so passionate about it?
Sarah: Well, I’m so passionate about sleep just because I need a lot of it! I really need a lot of sleep. I need at least nine hours to feel good in the morning. And when I had a child like that just completely rocked my world. You know, I come from… chiropractors tend to be more holistic and natural. So that’s where I was coming from. I had a midwife for my birth and a doula and I planned on like babywearing and feeding on demand and all that great stuff for, you know, months and months to come.
And I was so confident I was going to be so great at all of this that I’d actually registered for a pilates class four weeks postpartum. Like, in advance of my birth. Like now I’m like, oh my God, I was so overconfident. And then things did not go as planned, which I’m sure many of our listeners today can relate to. Parenting is just, you know, you think you’re this organized Type-A, make-things-happen kind of gal and parenting hits in like all of your expectations of the window and you realize you have to reassess how you parent and how you are as a person and just, like, things in general.
Ayelet: Exactly. We’re so familiar with that. That idea of, you know, and we’ve had a guest on the Learn With Less podcast recently who said “I was the best parent before I had kids.”
Sarah: Exactly! That’s exactly what it was. So things went sideways from our birth. My son was 10 pounds, four ounces. I was undiagnosed gestational diabetes. Like I tested negative at the test that I actually had, and then he came out and got stuck at the shoulders, my doula was in tears at my birth, like that kind of goes to show you how, how things go and then, you know, that started us on a really bad sleeping path and my son would not sleep, and I was waking up every two hours to nurse him back to sleep, and the baby wearing just didn’t really work because it put so much pressure on the whole downtown area.
And then, you know, then there was the night that I heard him crying for me and I looked because we were co-sleeping kind of more out of desperation than really the natural parenting thing, but you know, you do what you gotta do. And I heard him crying, and I looked for him beside me, and he wasn’t there, and I was kind of groggy, and then I start frantically going through the sheets trying to find him, with my heart just racing.
And he had been safely stowed in the bassinet beside my bed! And I’d been so tired that I’d forgotten that I put him in, and I was like, okay, this is not working for us at that point. And so I used my academic training as a chiropractor… I read everything out there that was available on sleep and there’s very actual, very few scientific studies out there.
And I read just the different techniques in books and I put a plan into place for our family to get us sleeping more than two hours at a time and to stop using the boob as a soother because that’s what I had been doing. And by the time he was four months, he was 20 pounds. So, obviously, I had a lot of good, fatty milk, but I just kept, I didn’t know what else to do like I, that was what I had been ingrained with, just feed him. That’s what it was.
Ayelet: Right. And just to say out there, that is something that many of us do and there is nothing wrong with doing that. There is nothing wrong… like, Sarah, I know you and I know your philosophy and I think that it’s important that people understand that you are very much of the mind that… like clearly that’s what you wanted to do, but it just wasn’t working for you. And that’s okay.
Sarah: My policy is, whatever works for you works. That’s awesome. I’m just sharing my story about how I felt, how it didn’t work for me in the end, how I was hoping it would. And move from there! So I started getting into becoming a sleep consultant because of that experience, because by the time we could finally… when I took that back and he started getting the sleep and making the changes to have him happier, even though he was happy to begin with, but once he got more sleep, he was even happier.
So that’s how I kinda got into it and I, I really enjoy it because the people that reach out to me, you know, they had a journey, like I had! Something, they’re struggling with something and they want some insight. So it’s just the way… I really enjoy empowering parents, particularly moms who have been struggling.
Ayelet: I love that you pointed out how few scientific studies there are because, as we know, sleep tends to be one of these sort of highly divisive topics in early parenting. And I do think that new parents often come into parenthood like you did, and like I did certainly, with a particular philosophy or sort of expectation about what’s going on or what’s going to happen or how we’re going to deal with that sleep deprivation, which we know is coming… and then our own realities hit and maybe what we thought about ourselves or who our babies would be, you know, doesn’t always turn out to be the case.
And though some babies follow, I think what tends to be purported to be that sort of quote unquote typical sleep trajectory some don’t, and what we read about sleep is often based on theory instead of fact. And then personally, like in my own experience, I would, I’d try to, say, follow the advice of one of those sleep experts and then feel like a complete failure because my baby was say not interested and falling asleep on his own. And I was telling you, Sarah, before we started this interview that now that I have two little people, I realize how much of our own opinions are based on our own experiences, right?
And especially because my baby, my second baby was one of, I like to call them one of those “unicorn babies” who actually just wanted to be put down and be able to fall asleep on his own, which of course as I said, was completely the opposite of my first. I was like, oh my God, what? This does happen! It wasn’t me, right?
So taking that pressure off and then, you know, all that said, we have certain preconceived notions about also what hiring a sleep consultant means or even what a sleep consultant does. So I would love it if you could just sort of talk to us about some of those misconceptions that you face as a sleep consultant. And you know, feel free to sort of blow those myths out of the water for us.
Sarah: Ok. Well, the first one I get a lot is, “I don’t want to do CIO – cry it out.” And so, the first question I ask is, what does cry it out mean to you? Because to me, cry it out means extinction. It means to close the door and not return. And I do not subscribe to that train of thought. I really believe that we treat our children with respect, and if I was that child, I would want to be acknowledged and know that I’m heard. So I would say that mostly consultants, I’m not really sure, but we don’t do this whole cry it out thing.
Depending who you’re hiring, they may have a specific school of thought that they follow. So that’s a good question to answer. Do you have many techniques have you follow one technique? And most of us like what I do is I look at a person’s parenting history. The age of your child is so important because some techniques work better with smaller kids but they don’t work as well as older kids, and take all that into consideration. And then also what’s your timeline, like what’s your… Do you want to make changes fast and then get really consistent about your message about how sleep happens and make those changes really quickly.
Or do you want to go really slow and change like how one thing at a time to work on, you know, work for, for a longer period of time. And that’s kind of in a nutshell and you know, when I’m working with someone, what we do is we work one to one and we share a google sheet so that you log your child’s activity and then I hop on and see how things are going, make suggestions for timing – timing is so important – and you know, what is reasonable.
So I think a lot of people when they start sleep training on their own, one of the reasons people fail is that they’re not sending the child up for success with reasonable expectations. So maybe they’re expecting like their three month old breastfed baby to sleep 12 hours at night. Where, in my world, I don’t think that’s reasonable, and I also think it could hurt your milk supply if you’re not keeping that night feed at that age. And so that’s not something that I would promote, but then you know, there are other people out there who will tell you, oh yeah, I had a three month old, and I breastfed and he slept 11 hours.
Ayelet: Exactly!
Sarah: I feel like I err on the conservative side of things.
Ayelet: Got it. Ok, interesting.
Sarah: Because, yeah. So that’s kind of what sleep consultants do. Look at your activity, look at your history, see where you may be going wrong and make suggestions for changes and guide you through that process.
Ayelet: It sounds like just the idea that you help educate families not only on what their choices are but what that implication is. And that for me, gosh, I mean that sounds like something I could have really used, especially in those early days because especially if you are making specific decisions about what you want for your baby and your own sleep needs or philosophies, you also… like when you’re in that early, early parenting days and months, you’re so sleep deprived to that like you can’t even imagine sleeping again. And the idea.
I remember feeling two times around that like even though I knew like, oh my God, this is going to be my life for the next 18 years. This is horrible, like, I can’t do this, right? And we know that things change and things shift and sleep also is affected by developmental changes and we’re going to hear much more about that in just a few minutes, but just to have someone like, like you Sarah, would been really useful to have some sort of guide to, to help families feel like, okay, this is what’s happening right now, here are some ways to shift that and you can do it this way or that way, and it totally just depends on your own priorities as a family.
Sarah: And on that note, like most consultants, most sleep training packages don’t start until four or six months. You know those first three months if you see someone that has a newborn package that’s not sleep training, that’s about, you know, learning to read your child’s cues more easily. So for example, I really confused hunger with – or, fatigue with hunger. So I kept feeding him when he was supposed to be napping kind of thing. So the newborn stuff, we teach you more of those things rather than like a cry it out sleep training option.
That’s not what’s happening in those newborn stages, you know? Okay. At 10 weeks when that whole witching period in the evening might start to be seen and that’s when you want to try and bump up your bedtime a little bit earlier and awake times, too. The most common parenting error is keeping our kids awake too long, and in the newborn stage is really more like, you know, just telling parents, like you’re in charge of deciding when nap time is.
So you don’t want to keep your child up too long because then it’s harder to fall asleep and stay asleep. That’s that whole sleep begets sleep idea, right? The four to six months period, that’s when you start getting into like, okay, what are your sleep crutches? What is, what’s that external thing that your child needs to help them relax into sleep that they need again, when they wake up like every three hours through the night, what is it, that’s your sleep crutch. How are we going to tackle that to start removing some of your child can then develop self soothing skills.
Those are skills that we all have that help us relax down into sleep at night and that’s really what sleep training is educating you on sleep needs and then how are we going to conquer the crutch? Basically, how are we going to take that away so that self soothing skills, can start to appear and then in my program too, we talk about like maintaining your milk supply through breastfeeding and how are we going to manage feeds depending on your child’s, your child’s age.
So sleep during doesn’t also necessarily mean getting rid of all those night feeds. So that’s a common misconception. Yeah. So I think when we go back to that misconception thing, is that what age of the child are we talking about? Right? Because really, most of them will be four months old. And are you breastfeeding or formula feeding, because that will affect your child’s ability to have certain length stretches at night and what sleep training techniques are we using? Because in my world, we’re not using close the door and not go back in – that’s not a technique. That’s just one action.
Ayelet: Interesting. And again, that is something that many people do and have done and that is absolutely fine to make a decision for your own family that you want to do.
Sarah: Yes. And if you do that, you know, it works great for some people, I just think that if you’re going to pay someone to invest in coaching, that’s, you know, do other options before you have to resort to that!
Ayelet: Yeah. Well actually that’s a really important message, right? Like, if you want to hire a sleep consultant, you need more of that education like you said, and if you’re going to do cry it out, then maybe just do cry it out without having to spend the money. If that’s what you’re going to do!
Sarah: Right! Ha. The cry it out one is interesting, because I have used that, eventually. So, first of all, temperament, like you mentioned before, it plays such a big influence. So at least 50 percent of my clients are second or third time parents. They say, what I did with the first one just doesn’t work, or maybe it’s that their lives are busier and they don’t have the same amount of time to allocate to getting their child to sleep… Yeah, at least half are second or third time parents.
And, you know, there are kids, I have used that, after a couple of weeks. You know, mom’s presence, being there to offer reassurance and then we’re doing checks and that’s not helping either. And I think it’s time to close the door on this one even though I hate it. But you had given so much of your time at this point, offering physical and verbal reassurance.
You’ve been there, you’ve done that. Your presence just isn’t helping. This is more now about your child’s temperament than setting them up for success or delivering the same consistent message. You’ve done all that and so when they resort to that – which I really don’t like and it’s very rare. I might get like one or two of those an entire year.
Ayelet: Wow! Which speaks to your other methodologies, so that’s cool. How nice that doesn’t have to happen. And I think for people too, like, that can be really reassuring that there are so many other techniques that sort of the general parent doesn’t know, right? Because so many of those books are either the gentle attachment parenting approach, quote unquote or the hardcore cry it out, and there’s nothing in between. But it sounds like from the perspective of a sleep consultant, there are many things you can do in between.
Sarah: I think of the sleep training techniques as existing on a continuum, where you have the “No Cry Sleep Solution” by Elizabeth Pantley, and then you have like a “Sleep Lady Shuffle,” where you’re in the room offering physical and verbal reassurance, and then you move further away to, like, interval method where you’re going back into the room and checking, and then ultimately, there’s the close the door and don’t go back in. And you know, with the, with the average kid, this is a hard one – how do you know if your kid is average? The more gentle ones can work if you have the time and the patience to dedicate to it and delivering that same consistent message over and over again.
Ayelet: It’s hard, but it’s there. Okay, cool. Let’s take just a brief break to hear a word from our sponsors and then we’re going to hear a few tips and resources from Sarah about development and sleep and additional resources she recommends for families interested in more.
Ayelet: Okay, Sarah. So let’s hear about those ways that development and sleep are correlated. We know that sleep changes often occur around developmental leaps and growth periods and you know, as new skills are acquired and new milestones are met. So tell us a bit about these.
Sarah: Okay. So these are commonly referred to as “sleep regressions.” So whenever you hear someone talking about a sleep regression, know that it’s caused by some sort of change that’s happening in your child’s life, and the most common one and the one of the most shocking ones is that four month sleep regression. And that’s where you may have had a child who was sleeping a beautiful six hours stretch who is now waking up every three hours at night, because the night time sleep cycle is three hours. So, your child’s surfaces and then wakes up looking for you.
And the other symptom is that your naps become shorter – where they used to sleep longer, now they’re only sleeping 45 minutes, which is one daytime sleep cycle. And for four months, it can happen anywhere between like three and a half, four and a half months. The basic idea is that your child is dealing with object permanence, so he or she knows where you are now and that you’re not in front of her, you’re existing somewhere and where are you?
And if I cry, will you come back and see me? So yeah, the four month sleep regression is a big eye-opener and unfortunately in this country often coincides with when mothers are going back to work, which is really tough. Like if I, if I had one life mission or one superpower, it would be to give American women at least six months maternity leave so they can get their kids sleeping better and just kinda like get everything kind of under control a bit more than going back, you know, four months or earlier.
Ayelet: Which also is connected as it happens to object permanence.
Sarah: Yes, exactly. Nine months. Teething is another thing that causes sleep regressions. Often what will happen is your child’s… like all humans waking in the night, right? You and I, we wake up, change positions, check the clock, and children do something similar, but if they get all kinds of help falling asleep at night, they will require that same kind of help throughout the night. Once your child has some self soothing skills where they sleep in a certain position or suck on their thumb or rub their head in the mattress so they can roll over themselves back to sleep.
When you are teething, your child’s surfaces and is then distracted by the discomfort in their gums, which prevents them from falling back asleep. In sleep regressions. You may see more night waking and you may also see early morning wake ups, so like those 5:00 wake ups, where again, your child surfaces from a sleep cycle and then is distracted by that new motor skill that she’s learning, wondering where you are now because she knows that you come and go, or your teeth.
And so that’s basically in a nutshell, you know, how sleep regressions happen and there’s a bunch right? Nine months, 12 months and they all vary it a little bit because our children develop at… you know, we get the guidelines, but really, my child didn’t walk at the same stage as yours did, and yours didn’t get teeth at the same age as mine did, so they’re going to vary teething, walking, your first year molars at 12 months… and then in the toddler years, wow!
You know, there’s so much going on that you can’t really see. You know, at 15 months, like there’s more of like, I want power. I’m testing out my opinions on the world, language bursts at 22 months. Eighteen months is a really tough time as well… I hate saying all this because it just sounds like, oh my God, it never ends!
Ayelet: There’s so much – right!
Sarah: There’s just so much. And really, sleep from my perspective, like two and a half years is kind of when kids will consistently sleep solidly through the night, up until that you’ll have weeks that are awesome and then something will happen. It’s never, it’s kind of like a moving target, the whole sleep thing and obviously you can help by understanding what’s going on, but also having, you know, a child who has really strong self soothing skills so that they don’t need you to help them back to sleep every single night or every early morning.
Ayelet: Can you just tell us briefly what the difference in the kinds of suggestions that you give for a young infant who’s going say through a sleep regression, that you would give to a family that’s dealing with something like that, versus a toddler at say 18 months. Who’s going through sleep regression due to things like motor skills and other cognitive and communication skills?
Sarah: Right. So the first question I’ll ask is, does your child, you know, so you’re, you’re going through a blip. Where things aren’t going as well as they previously had been going. The question to ask yourself is, can my child put himself to sleep independently at bedtime, so can I put them down in the crib calm but awake and walk out? If so, then your child has the skill to do so in the night, and so what’s bugging him? What’s new that’s preventing that from happening?
Again, this is a different question. If you say, no, I, you know I rock to sleep or I nurse to sleep, well, then you need to provide that again in the middle of the night. You can’t just leave that person because she has no idea how to put herself back to sleep. So then the question is with these regressions is, one, does your child have – is she or he or she sleep trained and that becomes the root of your issue, really.
Ayelet: And for that, meaning, for you – what that means is?
Sarah: Being able to be put down in the crib from calm but awake as Mom walks out and he or she babbles and coos, rolls over, and puts himself to sleep. But if that’s not the case, then we have a bigger kind of issue. And how do we help kids, let’s suppose that your child has great self soothing skills. How do we help kids, then, through these regressions? What works is always offer more reassurance. We’ve been heard.
I love using that sportscaster voice even when they’re little, right? This is what’s happening. I can tell you’re feeling this way and I… and empathy. Lots of empathy. I know that’s so frustrating. And, oh, I know, you don’t want to be awake right now. You’re so tired – and offering more reassurance. You know, and a two-year old is much more strong willed than like a six month old and a two year old knows that there’s a tv out there or an ipad or what not. So I distinctly remember the first time we hit one of those two year old sleep regressions watching Dora the Explorer at 3:00 AM because we had no idea why our child was so upset. Yeah!
I’m like, what’s going on? I have no idea what’s going on! So one of my first things is, you know, keep your boundaries. So, you keep your child in the room at night, you could always offer more physical and verbal reassurance. But don’t leave the room. That’s my first one. And then if we’re talking about like a smaller baby, you know, you want to be offering that much more reassurance, comfort and what not, and again, what’s bugging him, what’s the root of this issue? And maybe at six months, it’s teeth are coming through and teeth are tricky because the pain really comes before they pierce through. You can’t see it. It’s like hindsight diagnosis.
Ayelet: Right, I mean in the first year of life, especially with my first, we just thought that he was constantly teething. Even when… like oh! Teething.
Sarah: Oh yeah. I’m not sure if I really answered your question there!
Ayelet: Yeah, I think, you know, it’s all about just sort of figuring out how to balance that and what the differences are in different times. So that’s definitely helpful.
Sarah: And while I think, like, sleep training isn’t for everyone, I feel like for myself and my clients, is so helpful because that helps you. My child definitely knows how to put herself to sleep, and so when things start to blip now you’re like, oh, something’s going on. Something’s different! What’s bothering her? Whereas if you’re already waking up a few times every night to help your child back to sleep, it might not even look different and it’s really hard to tease out what the nuances are.
Ayelet: That’s a, that’s a really good point. Okay, well that’s super helpful Sarah, and I hope that you can share with us a few of your favorite resources for families who’d like to learn more. You know, we’d love to hear about things that you can recommend that might help parents feel like they can make informed decisions and learn more about infant and toddler sleep.
Sarah: Absolutely. Well, I have a whole bunch of posts on my own blog. I’ve written about every single milestone, and different sleep training techniques and what’s reasonable, in my opinion, for breastfed babies versus formula fed babies for night feeding, that type of thing. For newborns. I love the app, the Dunstan Baby Language. Have you heard of that one?
Ayelet: Yeah.
Sarah: That Australian opera singer who has deciphered that different cries have different meaning, and I think that is such a great tool for the zero to three month old to help you meet your child’s true needs rather than masking them with rocking or something else. It’s just a great educational tool, so I love that app.
Ayelet: Yeah, it’s a nice way to just sort of get, I guess you could say get in touch with the different kinds of sounds and things that your baby is doing. And I think, I mean, certainly within reason. I think especially in those first three months, we’re all so vulnerable and we all feel so intensely about like, I’m doing it right or I’m doing it wrong and I need to do it better and I think that app I love because it’s super useful in that way, but like anything, take these things with a grain of salt because when we follow something whole heartedly and then obsess over it, which we tend to do, especially when we’re sleep deprived, like, then it’s no longer helpful. So it’s one great resource. Yeah.
Sarah: Yeah! Tools in your toolbox. You take a little from each piece, and you figure out what works for you. So that’s one great tool. And then I really like the Wonder Weeks, right, the book or the app that tells you about the different leaps and when they can happen. And that one I like to take with a grain of salt, because basically, with each leap, it’s like, your child will be fussy, and you may have to offer more reassurance, and it’s like – yeah, ok! So like every other week you have to do that.
Ayelet: But it’s a framework!
Sarah: Yeah – framework. Great word. If anyone is interested in learning more about sleep training approaches, I have created an online course that’s online, on your own time, it’s two and a half hours of video with a course book to go with it, and then the option of joining my small private facebook group where you can ask follow-up questions because I find that something like you read all these books, you still have ongoing questions that you could you ask about that, so I’ve created a community to have people who’ve gone through the same thing as you and I am in there as well, answering questions, so that can be helpful.
Ayelet: And where can we find that, Sarah? We’ll link to all these things in the show notes as well of the podcast, but tell us right now, as well.
Sarah: Thank you. It’s www.babysleeptrainingstepbystep.com
Ayelet: And then your website is www.helpingbabiessleep.com
Sarah: Yeah, and you can get to the course through on my website as well. And then if you just have like really general questions about sleep and you don’t need sleep training, maybe you’ve done it already on your own successfully and you just have some questions about the leaps and the transitions, I host an online free facebook group called Ask the Sleep Expert with Dr. Sarah Mitchell and you can access it through my page helping babies sleep. You can join there as well. Thanks so much for having me.
Ayelet: Yeah, thank you so much and thanks to all of the participants of the Learn With Less® Curriculum who are here listening live. We are going to continue the discussion and open up for a Q and A session with Sarah and with all you guys in just a minute. I see we have a few little comments and questions already and for everyone listening from home or on the go, thanks so much for joining us and we are going to see you next time.
