Ep. 198: Healthy Baby Sleep Habits

On today’s episode, I’m talking with Lindsey of Sleep Little Lamb, a certified baby and toddler sleep consultant, all about how to create healthy baby sleep habits.  This is one of our most requested topics to dive into, and we can’t wait to share what we’ve learned from the experts!

We’re back with our 198th episode of the Fed+Fit Podcast! Remember to check back every Monday for a new episode and be sure to subscribe on iTunes!

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Episode 198 Links and Such

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Episode 198 Sponsors and Featured Partners

• Nutritional Therapy Association – The NTA trains and certifies Nutritional Therapy Practitioners and Consultants with a nutritional foundation that emphasizes the body’s innate intelligence and bio-individuality, because they know that a “one size fits all” approach to nutrition does not exist.  Head HERE to learn more about becoming a NTP/NTC through this incredible program!

Episode 198 transcription

Cassy Joy: Welcome back to another episode of the Fed and Fit podcast. I am your host, Cassy Joy Garcia. And I am really, really excited about today’s episode. It’s probably one of the most asked and avoided questions {laughs} that I have gotten on Fed and Fit since having a baby. Today, we are chatting with Lindsey McGonegal. We’re going to talk about the science of baby sleep. She is from Sleep Little Lamb. I cannot wait to introduce you to her.

So, to tell you a little bit about her. She’s a certified baby and toddler sleep consultant with a bachelors and graduate degree in psychology and a pastoral care to women. Decades of experience in child care and education. Plus two little girls of her very own who struggled with sleep. She knows first-hand the hardships of extreme sleep deprivation. I was there, in parenthood. With her personal and professional experience, plus passion for helping women. She has helped hundreds of families get the rest that they need to thrive and enjoy life again.

And I mean; that sounds like an extreme statement. But it is so true. After working; our family worked with Lindsey. Grayson was 11 months old when we finally decided we needed to do something. She was; and I’ll share a little bit about what we were doing in a second. But found Lindsey through a friend of a friend. And she came in, and really, I feel like I have a whole new lease on life. All of us do; all three of us do. Grayson is healthier and happier. And Austin and myself are rested for the first time in a year.

So, welcome to the show, Lindsey. So excited to talk today.

Lindsey McGonegal: Thank you so much. It’s so great to be here.

Cassy Joy: Oh, I am so excited. And I get to finally answer everyone’s questions by referring them to you. {laughs}

Lindsey, to share a little bit more. One of the reasons that I really, really appreciate and look up to her is; I think you understand the basis that there’s no one size fits all for babies, which I really appreciated. And you have really done the leg work of the research of staying on top of the latest literature. And she came over to our house, and walked us through this first night. We chose a gradual withdrawal method. I’m sure we’ll touch on some of that a little bit.

But one of the things I really appreciate was; because I’m sure you could see just the stress and the worry on me and in my eyes. And then, you explained the science as a geeky, scientist in many avenues. And I know a lot of our listeners are, as well. That is what spoke to my heart and put me at ease. Just understanding, developmentally, what’s best for baby.

So, anyway. I will promise not to take over the whole show. Can you share just a little bit about you, and what inspired you to become a sleep consultant?

Lindsey McGonegal: Yes, of course. Well, I’m a California girl, but transplanted to Texas a couple of years ago. At that time, I had a barely 2-year-old and a 6-month-old baby who was still up all night. And I just don’t handle sleep deprivation well at all. I mean, no one really does. But I was at my wits end within a few months. And she was still not sleeping through the night at 9, 10 months. Was up multiple times. And it was really taking its toll on me, and my marriage, and parenting my other daughter, and all of those things.

So we just had to figure that out. And we were able to figure it out with my first daughter. We struggled at first, but by 3 months, she was sleeping through the night and doing great. But this second kid, she is strong willed. She just came out that way, and she’s spirited, and I just could not figure out why she was still waking up so many times a night. She was so chunky. I had her on a good schedule. We were doing a lot of the basics right. So I was at a loss.

So out of sheer desperation, we hired our own sleep consultant. And that just really opened my eyes to how complicated the subject can actually be. It’s not just; check these few boxes and your kid will automatically sleep through the night. Which I’m sure a lot of your audience has experienced that. And then it’s just so life-changing to be able to give moms the tools to suddenly get everyone sleeping and feeling good again.

So I just knew that I had found my passion. It was the perfect integration of my background, which was education and childcare and pastoral care to women, which, I love helping women thrive so that was a huge draw for me.

Cassy Joy: That’s beautiful. You are definitely gifted in this department. Because I feel like that’s exactly what I got. You were there; we had a template for Gray, and I bet the babies are the easier part of your life, and parents are probably more difficult {laughs}. Or at least in our house, that was probably the way it was.

Lindsey McGonegal: That can be true. {laughs}

Cassy Joy: I joked with my family. I was like; I realized I was the problem. {laughing} Ok, next question. All jokes aside. When a baby is born, I would love it. Can you outline to us what is a normal sleep behavior for a baby? And elaborate maybe a little bit on what’s going on hormonally, developmentally, and nutritionally that can affect sleep.

Lindsey McGonegal: Yes, for sure. Brand new babies, obviously, have really different sleep patterns than we do as adults. They will be just getting out of the womb where everything was warm, and super dark. They had loud, erratic white noise all the time, and they were hooked up to their feeding source 24/7. So they didn’t have to sleep and then wake up to eat and do all those things that once they come out, they have to do.

So, obviously in the beginning their sleep is very normal for it to be in very small chunks throughout the day. Probably won’t be hitting any long stretched of sleep from the beginning. And their sleep itself can actually be very unsettled. They actually spend a very large percentage of their time in REM sleep, which is the active dream sleep. So we do think, when brand new newborns will dream, and they move a lot in their sleep, and they’ll grunt and just be very unsettled.

They have mom’s melatonin in their system for the first few weeks, so that helps them be that sleep newborn for most babies. They’ll be pretty sleepy the first two to three weeks, but that wears off and they don’t start producing their own melatonin until closer to 6 to 8 weeks gestation, so if you have a preemie it will be even longer. And that in between time where they don’t have any melatonin, and their central nervous system is so undeveloped, they can just be really hard to settle and really hard to get into a deep sleep. So it can be a really tough time for parents around that three to six-week mark.

But as they get a little bit older, they’ll settle into a better rhythm. Their tummies get a little bigger. They can handle more food at once. So they can go longer between feeds. And then their own melatonin production starts to kick in a couple of months later. And that really helps them settle down at night, usually. But of course, there’s a lot more that goes into it besides that they just magically start getting melatonin and start sleeping. You need to have a lot of other things, like their sleep environment and a good schedule and things like that that will help them settle into really good night sleep eventually.

Cassy Joy: Oh my gosh, that sounds aspirational. {laughs} So when Gray was born, we had no idea what we were doing. And I just wanted to mother intuitively. I think that was my goal. And it worked fine. But we essentially just held her for the first three months for all of sleep and all of her naps. And then when she got too big to just hold, then I started side-lay nursing her. And during the day we were able to put her down eventually; around 6 months we put her in her crib to nap. And then at nighttime I just would side-lay nurse her to sleep.

But, because babies stir, which I learned after the fact, she was not waking up because she needed me, she was stirring because babies stir. And because mom was right there, I would just start nursing her. And so until 11 months, she was side-lay nursing every single hour, on the hour, all night long. And I was very tired.

And I thought; I didn’t know that I was unrecognizable, but my team {laughs} here at Fed and Fit, now that I’ve started resting more and coming back to life and working out and all of these things, they were like; wow. You’re back. {laughs}

Lindsey McGonegal: Yeah. You were one of those moms that handled sleep deprivation with an incredibly positive attitude, and I was like; man you’re handling this well. But at the same time, you probably don’t realize how sleep deprived you are.

Cassy Joy: I had no idea. I’m generally even; I usually am more even kilter, and I think that’s what went out the window with sleep for me. But all of that to elaborate; I would love to know, at what age. Because that was something that I really struggled with, and I just defaulted to; I’ll just hold her. I’ll just sleep with her. Because I didn’t know; at what age are babies really capable of sleeping through the night?

Lindsey McGonegal: Right. And that’s such a common question, and concern. And truly, there are a lot of different opinions about it. There’s kind of a biological standpoint of when are they physically capable of it, versus when should they. Every baby is so different, and I always do a very thorough analysis before confidently recommending that your baby is ready, specifically. But biologically and just physically; if you mean by sleep through the night, that’s 12 hours overnight with no feeds, which is usually what people mean. Then a good guideline is over 15 pounds, and established on solids with some protein, ideally. That’s a good rule of thumb. That usually happens around 6 months or maybe a little bit after. It might be a little bit later in breastfed babies.

But there are a lot of babies that can start sleeping through the night a lot sooner than that. And I just read their signs, and make sure we’re doing it in line with what they’re really capable of. There’s plenty of 4-month-old’s that will sleep 12 hours with no feeds. But I just don’t push it until they get to a certain age and hit some milestones.

Cassy Joy: That makes a lot of sense. So speaking of these milestones, what are some changes you will see in sleep patterns as babies’ transition from newborn to that fourth trimester; which, if folks are unfamiliar the fourth trimester is essentially we argue that babies are not totally through gestation, I get, until their outside. They just get too big for mother’s to be able to deliver them. But their fourth trimester, externally.

So from newborn to fourth trimester to infant stages, what are some milestones, as you referred, that we could really start paying attention to?

Lindsey McGonegal: Right. That’s such a good question. You’re saying the fourth trimester, theoretically, but it’s also just practically true that it’s like they still need to be in the womb. They still need the darkness and the white noise and the swaddling to help them feel that security that they had. And they slowly come out of that. They slowly want to be able to move. They start making social contact at like 6 weeks when they start smiling. And that’s actually a milestone, because it tends to coincide with when melatonin production starts. So that can start settling their overnight sleep.

But, to get a little more science-y about it, as early as 6 months in utero, REM sleep is observed. So it’s possibly that even in your belly, the baby is already dreaming. And it’s a very active sleep. So they have a lot of involuntary movements. They may practice sucking motions. There’s a lot of brain activity. But then there’s the deeper sleep phases, which in the newborn phase is called quiet sleep. And they kind of just go in and out of the quiet sleep, and then REM sleep a lot. But they’ll get into a deep quiet sleep more often.

And then, as they get older, they get towards that 4-month regression. Which, anyone with a baby probably knows what that is and has Googled it obsessively, because it can really ruin a baby’s sleep if you happen to have a good sleeper at first. But it is a time where their sleep is maturing, so their sleep is going to become more adult-like. And their sleep cycles will actually become every 2 to 4 hours instead of every 4 to 6 hours. So they’ll wake up more frequently and they’ll go in and out of their sleep cycles at a lot faster rate. So that’s where you start seeing all of those wakeups. The hourly, the two-hourly wakeups, overnight. Because they’re just not used to getting themselves back to sleep, but their body is naturally going out of sleep over and over again throughout the night. So a lot of parents end up co-sleeping at that time, or just trying whatever they can to get through it.

And some baby’s will naturally get through it, but others won’t. And I’ll get parents calling with a 12-month-old being like; we’re still in the 4-month sleep regression! And they just never recovered. So that’s a really common problem that I see. They do get through it, and the good thing about the 4-month regression, which is really a progression, is that once they hit that point, they are more able to self-settle. And they’re reaching some really important milestones where they can understand, and learn, and where they’re a lot more receptive to giving them some independence to learn how to put themselves to sleep. So it’s a great time to start addressing the sleep issues that you’re having.

Cassy Joy: That’s so reassuring. It’s so nice. I even love “It’s a progression not necessarily a regression.” That’s just, in general, I think a great way to think about it.

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Cassy Joy: This is probably the million-dollar question, but it’s one that I think Austin and I have already asked you. We are not pregnant, nobody read into this.

Lindsey McGonegal: {laughs}

Cassy Joy: {laughs} But we do; we would love to keep growing our family. And when we do have another baby, what can we do as parents from the very beginning to help encourage healthy sleep habits?

Lindsey McGonegal: Yeah, that’s a great question, again. Obviously with newborns, and in my field the first thing I say is safe sleep environment. You want to make sure things are safe before you worry about anything else. Which, without going into all the details, a crib or bassinet as much as possible. Avoiding things like putting blankets in the crib, or sleeping on pillows, and sleeping in upright or slanted positions without supervision. So there are a lot of different things you can go into.

But after that, you can start to try to lay them down drowsy, but not fully asleep. And this might look really gradual. It might start out that they’re 95% asleep, but just a little bit awake before you put them down. And then you get it down to 80% of sleep. And you just work really gradually. It might take a few weeks. But eventually, you’re putting them down awake, and they’re actually putting themselves to sleep. And they’re definitely kids who, if they’re given the opportunity at a newborn stage to do that, they’ll hit the 4-month regression and just kind of sail right through because they’re already putting themselves to sleep.

So that’s a really good way to do it. But of course, also healthy sleep habits have a lot to do with their sleep environment. Which I know we might talk about. But just helping things to be conducive to their sleep. Dark and quiet and all of those things make a big difference.

Cassy Joy: Ok, wonderful. Well, let’s run right into that question then. What are some environmental concerns that we can really control?

Lindsey McGonegal: Yeah. Well, once their melatonin production starts, that dark room does become really important, even for naptime. So you’ll want to put your 6-8-week-old in a dark room for naps. And even start trying for early bedtime because their melatonin will start producing in the early evening, so that’s when an earlier bedtime becomes more achievable. But that’s why the darkness.

And then white noise is super helpful and important for 99% of newborns. Because they’re just all coming right out of your womb, which was very noisy but in a white noise type of way. Not distinct noises, just kind of a vacuum cleaner or a shower. What we put on for them, and it calms them down.

And there are just some basic things; like I don’t recommend using those light up toys in the crib. Or mobiles that play music. You can use them as part of your routine before you put them to sleep. But once they’re ready to sleep, turn it all off, let it be dark with the white noise. And then just safety again is kind of the big concern with newborns because of the SIDS risk.

Cassy Joy: Makes perfect sense. Ok, this is so helpful. The next thing; and this is probably, of all of the wonderful information that I have ever personally consumed and really held in high regard from you. I that think your advice on crying was really helpful. Could you elaborate a little bit on the science of crying, and how that can relate to sleep?

Lindsey McGonegal: Yes. On a very basic level, crying is just how a baby communicates. They don’t have any other way to do that from the beginning. So learning their cries; their tired cries, their hungry cries, they’re in pain. It’s all really important, because I think for a lot of especially new moms but any mom, you hear crying and you automatically get stressed. And you assume that your baby is really stressed because they’re screaming.

And it may or may not be the case that they actually have a really high cortisol spike or whatever your sensing. So we react really emotionally, and we fear there’s a lot of distress going on. But there’s some really good research now, and there’s actually this whole American Academy of Pediatrics research that was just put out where they compiled all of the research on childhood and even infant stress and they categorized it into three different categories. There’s basically a positive stress response, which is brief and mild to moderate in severity. And it’s something like getting their immunizations or their first day of daycare. Not nothing, but it’s a little bit stressful for them. And it’s where there’s an adult that can buffer the stress by providing a loving and supportive environment. They promote growth, and these provide important opportunities for the baby to observe and learn and practice healthy and adaptive responses to these kinds of negative experiences.

So, there’s one study in particular; I might have even told you about it when we were doing our first night with Grayson. But there was one where they took one-week-old infants; so way younger than any baby that I would try sleep training with. But one-week-old infants. They put them all through a routine physical check, where it included a little foot prick with a pin, like they do to get the little blood sample. And the first day all the babies cry, and they scream when they get pricked. And then they register their cortisol levels. And their cortisol does spike; not a crazy amount, but it does spike. And the second day they did the exact same exam with the same babies, same situation. Screamed and cried again for a foot prick, but there was no spike in cortisol. At all. They just; and the third day they cried less and there was no spike of cortisol.

So the researchers concluded the babies are clearly learning; even though there are tears involved, their stress level doesn’t necessarily correlate with the level of crying. And they take that to mean that the babies have learned something from the day before and through that adverse experience that they went through. And of course, these babies are being loved on throughout the day by their parents, and there’s a lot of support going on.

The other two stress responses are a toxic stress response, an intolerable stress response. And without going into all the details; the toxic stress response is caused by a strong, frequent, and prolonged activation of the body’s stress response system in the absence of the buffering protection, the support of an adult relationship. So that’s straight from their research.

So a lot of people think sleep training is a toxic stress response, but the research is really clear that it falls easily in the positive stress response category. Where there’s learning going on. Where it’s potentially a negative experience that is turned positive because of the growth and development and because of your loving, supportive environment. So I think just explaining that to parents. Helping them understand that there are these different research categories that support this. That there’s actually some good that comes from some of the struggle that they go through.

Cassy Joy: Oh, that’s so reassuring. And I think the thing that really pushed me over the edge; because we chatted quite a bit before we really decided to jump in and go for it with sleep training. Which, like I said, we opted for a gradual withdrawal method. But Gray was, we did the gradual withdrawal method. And for folks who don’t know, there’s a spectrum. I’m stealing Lindsey’s spill.

Lindsey McGonegal: Go for it.

Cassy Joy: This is from her. But there’s essentially a very wide spectrum of sleep training styles. And you have everything from very gradual withdrawal, which essentially what we did is we lay Gray down, and then we had an air mattress right next to her. And every night, we would just move the mattress away just a little bit further every day. And we would just be right there with her. And that’s on a very gentle end of the spectrum. And then you go all the way to what most people think of as sleep training, is pure cry it out. That’s where I think a lot of people’s minds go. But it doesn’t always necessarily mean that.

The idea for us was to get our baby sleeping independently in her crib. And the thing that really pushed me; and then of course, there are many variations like you described to us in between those two. And that was really helpful, having somebody hold my hand how to navigate the options, depending on Gray’s personality, and how she’s reading us, and her desires to sleep and all of these different things. What she found stressful.

And what I thought was the most compelling was the importance of sleep before midnight, I think, when you started talking about that for developmental purposes. The reason why she really needed to have uninterrupted sleep before that kind of midnight hour; that first part of the night, is what I thought; ok. This is the best thing for her. Because her with me, waking up every hour, is just interrupting these really crucial hours. So it was just so helpful.

Is there anything; what would you say if someone is listening and they’re thinking; gosh, I don’t know if this is for me. I don’t know if I should work with a sleep consultant. Do you have any pearls that you would want this person to consider if this is the right way to move forward?

Lindsey McGonegal: Yeah, absolutely. I tell mom’s, I just say; if you feel stuck, and if you’ve tried a lot of different things but aren’t seeing any changes, or the changes that you really need to feel good again. If you’re seeing any deterioration in your marriage or your relationships because of sleep deprivation. If you’re feeling depressed at all yourself. I mean, depression is way more closely related to negative child outcomes than very brief sleep training.

There is actually no negative outcome for children that are sleep trained in this very brief amount of time. But for kids that grow up with moms that are depressed; or even just for babies who are having a mom who is struggling with depression. I’m not saying that sleep cures, but it is a very important part of your recovery. So that’s a huge reason to do it.

My rule of thumb basically is if it’s been going on for two weeks or longer, and if your relationships, or you, or your baby appears to be suffering from sleep deprivation. Like crankiness and falling asleep in random places. A lot of babies even will delay developmental milestones because they’re just so sleep deprived. So if you’re seeing anything like that, and you feel stuck or you’re just not sure how to move forward, it’s definitely a good idea to get some help.

Cassy Joy: That’s wonderful. Can you tell everybody how they can find you?

Lindsey McGonegal: Yes. I’m on Instagram and Facebook at Sleep Little Lamb. And also SleepLittleLamb.com.

Cassy Joy: Yes! And she’s wonderful. I mean, I have the extreme fortune of living in the same city as Lindsey, {laughs} so we hired her. She came to the house and literally held my hand through that first night. Austin needed way less hand holding than I did. {laughs} But she’s got incredible information online. Definitely go check her out on Instagram at Sleep Little Lamb. She’s got some really wonderful information that she puts out.

And for anybody needing a resource, I think it’s a really, really solid one, and I stand by it.

Lindsey, thank you so much for coming on the show today.

Lindsey McGonegal: You’re so welcome. And I’ll just mention that if you do go to my website, there’s a free nap cheat sheet for the first year, so it will tell you how many naps per age that your kid should be having. How many feeds, daytime and nighttime, so it’s a really helpful resource for moms.

Cassy Joy: Oh, that is helpful. I’m going to go download it and put it on my refrigerator. It sounds great, because I’ve probably got more questions. {laughing}

Thank you so much. Thanks everybody for listening. If you enjoyed this chat, there may be more Lindsey at some point on Fed and Fit. So stay tuned for that. Thanks everybody, we will have a full transcript over at www.FedandFit.com. As always, we’ll be back again next week.