Pediatric sleep expert Grace Koinange joins Janet this week to share her experience, knowledge, and a few secrets for helping babies and toddlers to sleep. Janet had the privilege of seeing Grace in action and was impressed by her ability to tune in to a baby’s most subtle cues and support his individual sleep rhythm. Grace and Janet discuss consistency, self-confidence, nurturing sleep from infancy, helping a toddler transition to a new sleeping arrangement, and trust in the child as an active participant in the sleep process.
Transcript of “A Holistic Approach to Baby and Toddler Sleep (with Grace Koinange)”
Hi, this is Janet Lansbury. Welcome to Unruffled. Today I have a great guest to share with you. Her name is Grace Koinange. She’s a pediatric sleep consultant and a lactation-trained newborn care specialist. Grace works privately as a concierge sleep coach. She prides herself in solving almost all newborn sleep challenges from infancy to two years. While I actually know many sleep consultants that I can recommend, I had the opportunity to meet Grace recently when we were working alongside each other. And I was so struck by her intuitiveness, her gentle, calm presence, and how she was able to read a baby’s gestures and signals. Also, her overall approach to sleep. Some of which was surprising to me. I’m learning a lot from her. I’m excited to share Grace and her knowledge with you.
Hi, Grace. Welcome to Unruffled.
Grace Koinange: Hi, Janet. I’m so glad to be here.
Janet Lansbury: Well, as you and I know, I happened to be in the situation where I got to work alongside you, and I was so impressed with your ability to understand babies and what they need and their cues, which I always had a difficult time with. You’re just a wealth of knowledge and intuition about everything to do with sleep and helping children develop the healthiest sleep possible. I would love to hear a little about your background in terms of this work and how you developed your expertise around sleep.
Grace Koinange: As a parent, nobody prepares you for what’s to come. I had no idea the things that I did not know. I am a trained doula and wanted so much to help my son who was struggling with sleep.
Janet Lansbury: What was going on with him? What was the problem for you?
Grace Koinange: There were a lot of sleep struggles. He was waking up at night every hour. He was breastfeeding. There was just a lot of me going back to put the pacifier in. And it just was quite destructive for both of us. As an adult, I could not function. And so I knew that there was information out there that I could get to be able to help him become a better sleeper. And also I needed to sleep because I felt like a zombie.
I braved myself enough to go to Google and search all the sleep techniques that were there. There was the cry it out. There was the extinction method. And just so many more that I kept finding myself getting confused about what to choose as a mom, because knowing my parenting style, I needed to choose something that was kind. I needed to choose is something that would help parents as a doula.
So I read sleep books. I took two sleep training courses. I researched and researched and through that research, I became curious enough to see if newborns could actually sleep or organize their sleep without much crying. And that was quite interesting for me. And this is how I discovered Magda Gerber. She founded Resources for Infant Educarers, and I loved everything about what she talked about. Competent, confident, curious, which is what I was. And I needed to incorporate this whole concept into sleep training. So I graduated and became a pediatric sleep consultant, and I incorporated some of RIE literature to help with my sleep science.
Janet Lansbury: You said something when we met that sounded very similar to what Magda always said. I think the way you said it was that sleep is actually about eating and play, even more than it’s about sleep. Magda Gerber used to say that sleep is about the entire day that a baby has and the rhythms of their day.
Grace Koinange: So yeah, the whole process taught me that there was no cutting-edge sleep science with training my son. Magda taught me that it is not about the baby waking up at 3:00 AM. It is truly about what happens the whole entire day from when the baby wakes up at 7:00 to when the baby goes to sleep at 7:00. It is the in-between because that’s what determines developmentally what the baby is doing. That was rich information for me to take. That was information that I wanted to use for my son, which I did.
At nine months, one of the things that was really important for me was, I never put my baby down. I never observed his play. He was working through a few struggles and I never thought that I could just watch him instead of pushing a toy to him. And so I helped him a lot in a lot of his play.
Magda taught me how to wait, just wait and see what happens. And I discovered that through sleep, that we have to wait for the infant to see what happens developmentally. So the secret for me was to just silently observe. That was the secret sauce of sleep training that I use right now and I also used for my son. It’s doing less, being present 100% on the floor with him, understanding that he’s going to work through that problem during play because that’s the same problem that’s going to develop at night.
Janet Lansbury: Were you observing that he was capable of doing more in regard to sleep than you thought?
Grace Koinange: Absolutely. The whole observation for me was that I realized that he was an excellent explorer. There was a consistency in how he played with his hands and what he was trying to do with his legs as a newborn. And I realized that allowing him to be on the floor and to experience his natural curiosity would help him do the same thing in bed.
Janet Lansbury: You realized that your son could be capable as an infant in terms of play if you just calmed yourself, right? And waited a little and you were still present. You didn’t distance yourself from him; you were still very much in it. I’m sure he felt your presence because children do. They’re so aware when they’re babies. So being able to see that helped you see that he’s maybe capable of more than you thought in terms of sleep. That you didn’t have to try to make sleep happen so much, which I think we all get stuck doing.
Grace Koinange: Exactly. I think my sleep training as you said, it was very practical. It’s like, let’s see what happens during play because this will come up during the night. But at the moment, I would tell myself the story: he’s waking up at night, I am sleep deprived, I am struggling as a parent, and I need to create structure. Is he eating enough?
So there were a lot of questions that I would ask myself to try and adjust to what I’m looking at and thinking that my baby is doing. I became introspective and I started understanding that it is truly not in my power to understand that, but to observe, and then take notes. I would observe and take notes and see… what is he struggling with during play? And as a parent, I found myself helping. I would push a toy, not allowing him to make his own decisions.
I was engaging in his play, which meant that he was going to call for me at night so that I can also engage in his sleep. And so that was important for me to know that I should let him carry his burden as a newborn. And how do I do that respectively? Because I did not want to do the cry it out. I thought this would happen during play. And it was quite experimental and accidental, to be honest with you. It was trying to figure out: if he’s failing at this task, which is whatever he was doing at the moment, then he’s going to fail at the task of sleeping. And I was building expectations for myself and for him, which were not going to be achievable.
So because the cry it out was not attractive to me, I was going to be patient enough to do this with my child. And I was going to be patient enough to sort of understand: what is it that I need to gain for myself?
Most sleep books would tell me, they would say, wait three minutes or a few minutes if the baby wakes up, which is great. It’s a great concept when you think about it. We want them to develop a place where you’re not going in too quick to get the baby when the baby wakes up. But I thought to myself and I said: what if I could change this to waiting to three minutes before I could intervene in his play? What if I could wait a little bit before I could decide that he was doing something in my head that he wasn’t doing?
And so waiting for three minutes helped me understand that oh, he’s actually doing the work. He’s actually working on something. And so this was a sleep giver for me. It was looking at the solution and allowing the process to foster that helped me understand that setting goals and expectations really needed to happen during play so that he can transition to sleeping.
Janet Lansbury: And was there crying involved when you started to give him at nine months more opportunities to help himself to sleep?
Grace Koinange: There was some struggle. There was some crying. I was uncomfortable as a parent because I was like: okay, he’s uncomfortable. And so I really feel uncomfortable. But let’s wait another minute and see what happens. He would experience whatever he was experiencing. But what was really beautiful about this is like when I gave him the space to experience these natural changes, it helped him figure out for himself, and we were able to see that some things were really tricky, and if he was rolling over in bed, he would experience a hardship. He would cry. But if I waited a few minutes, he would figure it out or he would start playing more as he did during play.
This was huge for me to just watch him on camera. And if he was struggling with something and he would roll over and then he would start clapping his hands or he would start bringing his hands together or he would just sit down and play with a toy that I had put in the bed, which is what he did during play. So that made me pause. That allowed me to have an experience that was different than cry it out.
Janet Lansbury: Technology is very helpful in this instance, isn’t it, the new technology?
With my second we only had the sound monitors, but I didn’t even use that because I had gotten so confident in her ability to call for me versus talking to herself and all the other things that she did. And I told her quite early, “When you want me, you call “Mom!” like that.” And of course, she didn’t say “mom” when she was a baby, but she made a sound that was very similar to that. It blew me away. And so I was able to trust that she would let me know.
It is challenging as a parent, especially with your first to feel comfortable with any sound that’s less than contentment and happiness and giggling. It’s hard to hear because our mind goes to all the worse-case scenarios. They’re feeling abandoned if I don’t immediately pick them up and rescue them from this situation. They feel like I don’t care, that I don’t love them or all of those things. It is challenging.
Grace Koinange: It is very challenging. And I also think that we prioritize their needs in terms of what we think in our head. And so taking care of myself first and taking care of my body to understand… Let me just slow down a little bit and see and observe was really great. What I like about newborns and toddlers as well is that they’re actually organized in whatever disorganized world we think they’re in. We rush them developmentally into what we want them to do. But if we stop a little bit to see what they’re working through, we can follow the steps into how they transition from one place to another. I had transitioned my son from my room to the crib, and that was also another transition that he needed to face and go through. So just waiting and supporting him through that transition was important for him and also for me to sort of say: I need to hold onto my feelings. And I also need to know that he’s in a safe place.
Janet Lansbury: I think one of the reasons that people have such a strong negative response to the idea of a child crying, especially at bedtime… or having them be in their own room or sometimes even in their own bed… one of the issues is this idea that children will feel abandoned. The parent feels that this separation is very negative for their child and that their child feels abandoned. And one of the things that struck me about your approach and your knowledge is that you sort of reframed the issue of separation in a way that I had really never thought of in terms of going from breastfeeding straight to bed, or going from feeding straight to bed. That separation can be an issue, but it’s different than the way most of us think about it. Can you talk a little about that?
Grace Koinange: Absolutely. When you think about attachment and you think about how the baby bonds with us if you’re breastfeeding or feeding… Once they’re comfortable in that position, they tend to fall asleep. And then the next thing that happens after you feed, is you place your baby in the bed, and you walk away. And so you do not give them time to transition into understanding that you are leaving, right? And so they cry.
So the thing that I discovered through sleep and through working with parents is that if you feed before, then give an infant an opportunity for play and then place them in the crib, you’ve built neurons in the brain where they understand, okay, this is a transition that happens. I will be feeding. And the next thing I will do is play, which is excitement. They don’t go from feeding to sleep immediately. Because that is when you have problems placing your baby in the crib and you can’t walk away.
The books don’t necessarily tell us the methods of how do I put my baby in the crib and let them fall asleep? We talk about self-soothing. We talk about not letting them fall asleep on you, but how do you do this? And the way you do this is by allowing that child to have the space to play before you can place them in the crib and walk away.
Janet Lansbury: So then you’re working towards the rhythm of: Your baby is sleeping, your baby wakes up, then soon after that you nurse or feed. And then they have some playtime after that before they are placed in their familiar, comfortable bed or entering into that bedtime routine, which you’re also a big fan of I know. That’s one of Magda Gerber’s basic recommendations: have a predictable routine and low stimulation.
Grace Koinange: Giving them an opportunity where there is not too much noise and there’s not too much intrusion allows that child to take five minutes to understand the environment, understand their body, understand exactly what you’re communicating to them. And so this becomes a process. It becomes a routine for both of you that the baby loves and enjoys.
And they discover that this is how I fall asleep. I do not fall asleep on a warm body and then transition to a crib. I fall asleep the same way every day. You walk into the room, close the curtains, change the baby’s diaper, get the baby comfortable in their pajamas or sleep sack. And then from there, you place the baby in the crib and you say goodbye.
There’s a process and it takes time. And the process doesn’t change at all even when they are a year old. It stays the same. And so if you give them that information, I call it the university of sleep. So we start gently as we grow. And as the baby grows with you, they understand that this is how life transitions from awakeness to sleep.
Janet Lansbury: And the other thing we commonly do or I certainly did in the beginning before discovering Magda’s work is the baby falls asleep with us and on our body or on the breast or whatever and then we place them in bed. Then they wake up in a place that they recognize, but they didn’t know how they got there. We don’t think maybe that it matters with a baby, but if you consider that they have actually higher awareness than we do as adults, it is something. It’s a thing. It’s a feeling of okay, I don’t really quite know what happens to me. I’m not a part of this so much. It’s a subtle thing, but …
Grace Koinange: It is. It is part of the process, and it’s also part of how the brain develops, understands, and consumes sleep.
I think parents, in the beginning, tend to think that sleep is always the number one thing. But the confusion of sleep and why your baby’s not sleeping is actually food and inconsistency on feeding routines and where we feed and how. Feeding at the same place, sleeping at the same place, and sleeping when they’re awake so that they can understand the environment.
I mean, it would be hard for me to wake up in the morning in somebody else’s bed. Waking up with the same invitation to begin another new event or another new day, because for babies, every time they wake up, it is a new experience for them. And so if they learn that this is how they wake up every day, they gain this knowledge. They are able to regulate their body. They’re able to understand that this is the process, which is really, really huge. Babies like to know. Babies like a really, really good plan. And they like the same plan. So it is really important that when we are caring for an infant or caring for a baby, that we give them this opportunity to learn that we are confident caretakers, and we will walk through the process the same way because this is easier for them to be able to learn and gain knowledge of how we care for them.
Janet Lansbury: Yes. And I mean, if we think about it, the world is so confusing and overwhelming to them. This new brand new world they’re born into. And it’d be like us going to a foreign country, maybe going to a different planet and not knowing anything. And we really want those parts of our day that we can hold onto and feel solid and depend on. It really helps to build confidence that hey, I can fall asleep. So creating that environment.
Grace Koinange: Yeah.
Janet Lansbury: What are some other things that get in the way as we’re trying to establish healthy sleep with our children?
Grace Koinange: I think the number one thing that gets in the way is the parent. It got in my way, sleep training my son. I love this slogan about the airlines when they say secure your own mask or your own oxygen mask before securing your child. If you’re taking care of a newborn, take care of your own body. Getting to understand that I will go get a snack or I will eat properly before I attend to my newborn. I will make sure that I’m in the right mindset. So giving yourself that minute before you walk in to be able to be present, 100% present with a newborn and you’re not doing other things is really, really important.
Also knowing as an adult, this is a really, really good time to activate your executive functions. I find most parents that I work with talk about how they were functioning adults before and now their baby’s here, and they feel helpless. And so activating your own executive functions to sort of plan ahead. If feeding is a struggle, I will maybe consult a lactation consultant.
I would also make sure that if I am struggling with feeding, sort of understanding, do I need to space the feeding so that baby is not feeding every hour? Maybe give an opportunity for a day to say, I’m going to feed every two hours and see what happens. Because feeding every two hours will help the baby sleep longer.
It will develop some sort of pattern for the baby so that you can be able to look through the data of your day and say, oh, this is where we are going, and this is what’s happening. I can build on this. That’s really important, to understand that we have the skills to do this and we can fix it.
And we do not have to fix 24 hours with a newborn. I say this to all parents. “Let’s fix 9:00 to 12:00, and then we can work on the other part.” So it doesn’t have to be a whole day. Because newborns also don’t have the same sort of organization during the day. But you will find that they will repeat what they do between 9:00 am and 12:00 pm. They’re going to repeat it tomorrow and the next day and the other day and the other day. So if that’s what you work on, then that’s your winning point.
The other thing is to follow through. If you’ve transitioned, let’s say you have a toddler or you have a child who is older and you’ve decided that this is the transition we are going to take, follow through. Follow through in whatever plan you have. And it doesn’t have to be follow-through for a week. Let’s do three days. Three days is enough for a transition to stick. I like to look at the results and see if they’re working or they’re not. So having some measurable accountability that helps you understand what you’re doing, which is what doulas do, and sleep consultants, right? This is what we do. We have a measure. “Let’s try this method and see if this works. And if this does not work, we ditch that and go to something else.”
The other thing is staying organized within your routine. You cannot do one thing today, and then tomorrow you skip it, right? If you’re going to do a sleep routine: bath, book, some sort of a song, and then you lay your baby down, the baby’s waiting for the song. So let the practice be the same routine over and over. It might be boring for us, but it is quite entertaining for the infant to say: I cannot wait for that book. I cannot wait for that song.
I also advised parents to read the same book over and over, just the same way you read it with enunciation, the way you get animated. It’s really, really exciting for an infant’s brain to stay organized within that play.
Janet Lansbury: Exciting. But it isn’t it also that it helps them to naturally wind themselves down.
Grace Koinange: Yeah.
Janet Lansbury: And prepare for separation because they know: okay, here’s this part. And then there’s this one more thing that happens. And then I go in my crib or I go on my bed and that’s when I go to sleep. And my parent is not going to be there while I’m sleeping. So yeah. It helps them to wind down if we have a gentle routine like that.
Grace Koinange: Yeah. And we also have routines. We don’t go straight to bed. Brush your teeth, you get in your pajamas. You check a text message or two, which keeps you up. These are routines that everybody follows. So it’s important to keep the same routine for children to wind down as well.
Janet Lansbury: And then for the whole day. Like you said, it’s not just about the wind-down routine. It’s their routine for the whole day.
Grace Koinange: Absolutely. Absolutely.
Janet Lansbury: I understand when parents say, “I don’t want to be on a routine all day.” It’s hard to keep that perspective that this is just for a short time and it’s going to actually serve you so much better in the end because you’re going to know, oh, I have this break between 1:00 and 2:30 in the afternoon where I usually… We can never count on it 100%, unfortunately, but… I’m going to have this break where I can do my thing. It’s such a benefit to us, and it doesn’t mean that you never break the routine, but you know that okay, well, I broke the routine, so now maybe I’m going to have a couple more difficult days, but we’ll get back to it.
Grace Koinange: Yeah. And it is truly just staying consistent with the nap times. Those are the ones that are important because if you’re putting your baby to sleep at 9:30 and 1:30 every day, trust me, there’s going to be at some point that child at 9:30 will start rubbing their eyes. Their body’s going to be ready, and you will just pick them up, scoop them up, do your routine, place them in bed. And they will sleep because then you’ve activated their circadian rhythm, which is a huge thing for sleep. And so exercising that and remaining flexible, remaining curious. I always say to parents “just let’s remain curious for a while. Let’s just explore.” When I have a parent who calls me and sleep is not happening and nap is disorganized and she’s waking up and it’s so fragmented. And I always say to the parents, “Let’s stay curious and see what’s going on. Let’s have a plan. Let’s make a plan for the morning. Let’s work on naps.”
And she will say, “I’m looking to sleep through the night.” And I say, “Let’s work on naps because it’s really, really important for you to work on the small wins, which is naps, other than working on the night.” So if you work on the naps and the naps develop in a way where you get to learn when you’re alert, and it’s not 3:00 AM in the morning when you’re exhausted and tired, you will get to understand your baby as well.
The routines really, really are important. Not necessarily reading a schedule and knowing, yes, this is going to hold me down and I don’t have a life and I have to stay home. But it’s being in a place where if I stick to this, the 9:00 or the 9:30 nap, I will be able to help my baby through the night. It is a win for the night if we stick to the routines and we prioritize their sleep. The fun will come later. You will have so much fun if you know my baby’s sleeping at this window and I can be able to take a shower at this window. Right? Just the simple things.
Janet Lansbury: Yeah. Simple things that we take for granted.
So now I want to ask you a couple of questions that represent common questions that I receive. So here’s one from somebody with an infant who is two and a half months old:
I’m writing to you for advice on sleeping. How do I set my child up for success? I have a bassinet next to our bed, but when I lay her down in it, she wakes immediately or only sleeps for 15 to 20 minutes. I try to rub her gently to help her get back to sleep or offer a pacifier. It sometimes works for a short while, but then she fusses too long or cries and I pick her up and hold her for some time, and put her back down. But neither of us gets to sleep much. I have her in a SleepSack with arms up for now. She seems to like that. Sometimes I take her out of that and lay her next to me in bed and we’re able to sleep for two to three hours at a time. Is this the right thing to do?
I read that you should put your baby to sleep in the crib for naps and nighttime, but she sleeps so much and is only awake for short times. That would be a very long time spent in a crib. I also want to be sure she is getting quality sleep because sometimes she doesn’t sleep so well being held and then is overtired and struggles to fall asleep. I just want to be sure I’m doing the best possible thing because sleep and having the ability to fall asleep, stay asleep, and have good quality sleep is so important. And that is something I’ve always struggled with myself.
Grace Koinange: That is a loaded question. I love it. So as you are reading, as I get to understand what’s happening with the baby, I actually know what the struggle is. And the struggle is actually not sleep. The struggle is food. If you’re not feeding the right amount to the right weight, then the baby struggles and wakes up. And you find that you have to replace a pacifier. And this is a big deal for parents. If your baby is full and they are able to settle themselves down, then they do not require extra support from us. They do not require a pacifier. They do not require any rocking or any interference. They can be able to settle their body down.
Assuming that this baby has not eaten enough and so will not be able to fall asleep, what I would say to this parent is let’s look at the food math. Let’s look at how much the baby is feeding depending on the nap times and how the baby is feeding in a 24 hour period. We should feed our babies at the right weight. So for instance, if your baby is 12 pounds, they need to have 24 ounces of milk in a 24 hour period. And then you break that down into different feeds. And that really helps babies, whether it’s to settle down or to sleep through different feeds so that you can, if you’re breastfeeding, you can be able to replenish and make milk, or you can be able to rest. So this is a feeding question and not necessarily a sleep question.
Janet Lansbury: Sorry, so you said 24 ounces because it’s a 12-pound baby. So it’s double, but it’s in ounces.
Grace Koinange: Yes. Double the weight.
Janet Lansbury: I don’t have to give 24 pounds.
Grace Koinange: Yeah, don’t give 24 pounds of food. It’s 24 ounces of milk, whether it’s formula or breast milk. And that begs the question: If I’m breastfeeding, how do I know how much my baby is having? And this is a simple thing that you can do. If you have access to a scale, a baby scale, that would be great. 48 hours is enough for you to know how much your baby is having in a 24 hour period, because then you have two days to compare. I would weigh after every feeding for two days and, every feed, I will write it down so that I can know how much they’re having. If you don’t have access to a baby scale and you have access to your scale in the bathroom, just weigh yourself first, then step on that scale and weigh the baby. And this is going to be just a lot of math of you just subtracting. But I will tell you this, doing the food math gives you perspective in understanding: why is this baby not settling? It’s because they’re not having enough, but nobody tells us what is enough. Enough is just double the weight. Make sure they’re having double their weight. And the baby will be able to settle.
When you read that question, my brain triggers food, food, food. I would not even touch sleep because sleep is going to be a byproduct of whatever we do, which is as we feed the baby and they’re little enough, they will be able to settle back to sleep because they know how to put themselves to sleep.
Janet Lansbury: That’s amazing that you got that from this note. I would’ve been much more confused. And then how about another question, which is very common about transitioning a toddler. Let’s say like a two or three-year-old, maybe younger, maybe a little older, from bed-sharing or co-sleeping to sleeping in their own bed in their own room, and the child is resisting and doesn’t want to do this. How would you approach that?
Grace Koinange: So the first thing is making a plan, making sure that as a parent, if this is what you’re going to do, a plan that would comfortably allow the child to understand the decision that you’re making. Because it’s hard for a child to emotionally disengage from not sleeping in the same bed with you. It does become an emotional task for the toddler. So letting them understand: “We are going to have a separate bed for you. We have decided this is what the bed looks like, and it’s a toddler bed.” And you show them the pictures and you get them involved. “We are going to paint your room and we have two colors that you can choose from. I know you like pink, or you like purple, you like blue or green.” And so the child becomes part of the process. That’s the first thing that you do.
The second thing that you do is pick the day. If I am going to approach my two-year-old or my four-year-old, who is going to be sleeping alone, or my six-year-old and sometimes an eight-year-old, I would approach them in terms of telling them, “This is happening in four days.” Make it as tangible as possible for them to understand the timing because children don’t understand next week, or in two weeks, we are thinking about this. So just make it as short as possible. It’s going to happen in four days because you’ve been working on it as a parent, and then mark your calendar.
And I like to bring this conversation up before dinner happens. Your child is asking you so many questions, and they’re impatient about the food. This is a good time to bring up a conversation about, “Hey, we are thinking about your room. I know we’ve talked about this. Today is day two, day three or whatever.” And point to the calendar. So they get engaged. So when they’re eating, they can ask more questions. And when they sit down at the table, you give an opportunity to sort of think about this before bedtime. So if there’s a position for them to think of something else as you’re walking to bed, or as you’re doing your bedtime routine in your bedroom, you can say, “And tomorrow or on Thursday, we’re going to start transitioning into your bed. And the sleeping routine will be the same. We’re going to do bath. We’re going to read a book. So this is all going to remain the same. The only difference is you will have your own big bed.”
So make it as exciting as possible because it is part of the process. And when you make children part of this process, they become sold in so easily in the choices that they make.
Now, the biggest challenge is you can plan, you can paint, the bed is ready and everything works, and then the day comes, the child is obviously going with the plan and then falls asleep, but then wakes up and walks to your room and keeps walking back and forth. And so this is the big one. This is when we decide if we are two parents, who is going to do the work? Children at 3:00 AM are great negotiators. This is a point where you have your script and the script can go something like, “I am going to walk you back to your room. I will tuck you into bed. I will walk out of the room and I will say goodnight. And I love you.” You know, just however you talk to your child.
If it was my child, I would say, “Hey, Devon, I’m going to walk you back into the room. I’m going to tuck the bedsheets. I’ll give you your stuffy. I’ll kiss you on your forehead. And I will say goodnight, and I will see you tomorrow.”
Right? So that’s the process, but it’s the same thing over and over. So in case they’re talking over you and saying, “But I want to come and sleep back in your room. And I want to do X, Y, Z,” you’re listening kindly, but you’re responding back with the same answer. Whatever script you have, it has to be the same tagline all along as you’re doing it. And as you’re walking out of the room, don’t linger. Parents tend to linger because it’s an emotional place where you feel like: Oh, maybe this wasn’t the right thing. Or maybe they’re not happy. Or maybe X, Y, Z. If you’ve made a decision, this is a decision you’ve made because you want to care for your own body or because you’ve not been sleeping well and they haven’t been sleeping well, then this is the right decision.
And once you’re in it, let’s work through this struggle. It’s been gentle. It’s been kind. And not having a timetable for this, not being angry that the process is taking too long. You’re going to have three bad nights, for sure. If you have a toddler, you’re going to have three bad nights where you walk back and forth.
And also as you make your plan, let’s expand the plan. “So I’ve walked them into their room and I’ve said, goodnight, and I’ve said all this, the tagline you’ve given me. Then what do I do?”
So the next thing is planning to say, “I’m going to stay here until you fall asleep. Tomorrow, I’m going to be halfway through the room until you fall asleep. The next day I’m going to be outside the door.” So giving them the exact information of where you’re going to be and what you’re going to do within this time.
The other thing I also talked about is having just that one parent. One child will ask where is the other parent. And they might just be calling their name or just asking for them or screaming for their name. And you will remain calm and say so-and-so, maybe, “Dad is not available right now. Dad is sleeping because it’s at night and I am going to sleep and you’re going to sleep.” And helping them through that process.
And if they are not moving or they are not doing what you want them to do, just pick them up gently and say, “I am going to help you through this process and I’m going to take you back to your room, and I will pull the covers.” Whatever the script is, just repeat that script as you’re helping them through there.
Children understand the process. They really do. The people who don’t understand the process are the adults. Because the child will say, “Oh, I am thirsty.” And then you walk to the room to get the water. And they’re like: oh, okay. I can definitely ask something else. “Oh, I am this. And I am this.” So you are running, getting stuff for the child. And the child is also building information and saying, this is not an adult who is firm on the decisions they made.
So just being firm and understanding that I will just keep saying the same thing, repeating the same script, but also preparing yourself. If you know your child is thirsty, bring a bottle of water. If you know your child sleeps with the stuffy, you bring that stuffy. Don’t bring noisy toys. Don’t bring trucks and things that are going to be destructive. Bring soft things that will not be destructive towards you and their sleep. And so, again, repeating the process helps and knowing that this is short-term for long gains. Don’t give up. Just stick to the process.
Janet Lansbury: I love that. There are so many great messages there about the child being an active participant and having ownership of the changes that we want to happen, as they want to have ownership even from birth, in their life as much as possible. Communicating with them honestly.
And then also I loved what you brought up about something we all feel as parents that… it’s separation again, but it’s our separation hiccup, not even our child’s so much. It’s us having those doubts seep in because we want to separate in this wonderful, loving, easy way. We don’t want to feel all our doubts coming in about, oh, my child doesn’t feel loved enough, or they can’t do this, or all those things. And understanding that we’re going to be inclined to have a little separation issue with a change like this.
I also loved what you said about the negotiating, because when they say, “Now I need another thing.” Again, being prepared in advance like: “Here’s the water. How many hugs should we put into the routine?” Because when they ask for another hug then we can at least feel a little more confident saying: “I can’t wait until the morning, I’m going to give you another hug. And that will be a wonderful time for me.”
But not getting engaged in the negotiation. For me, I had to see it as I’m really not helping my child there at all. It may feel nicer to me, but I’m actually not being as nice to my child to prolong this and make them feel my doubt and have to make it okay for me, have to make me feel better about this.
So yeah, it’s a lot of reframing of ideas.
Grace Koinange: Absolutely. And it reduces confidence they can see. And so at 3:00 AM, knowing I am confident and this is what’s going to happen. I won’t waver, and it’s through love and support. And I think children, once we are consistent with the message and we are confident about what we are saying and what we are doing, they feel supported. They feel loved. They feel like you got this.
Janet Lansbury: Right.
Grace Koinange: So when we waver back and forth, it becomes confusing. And they’re like, are we communicating this? Or are you saying this? It’s like having a relationship with a couple arguing about, “I hear you say this, but you’re doing this.” Right?
Then the child is really telling you, “You’re not saying what you’re doing.”
So staying confident within what you decided to do. And that’s why… Take time to think about the process. Take time to think about what we want to do. Children love anybody who can exude confidence because they are confident humans. They are true to themselves. They know what they need, and they need an adult who is unwavering and makes them feel safe and who makes them feel like you got it. I don’t need to worry about it. I don’t need to worry about my bedtime because you have it.
Janet Lansbury: Right. Because if we’re wavering, how are they supposed to approach this challenge, whatever it is, with confidence? We’re shaking their confidence, in other words. But yeah, I’ve spent a lot of time telling myself all these things, whenever I had to do anything that my children might have not totally signed on to. So this is all wonderful.
Thank you so much. You’re such a gift. You really know this topic inside and out, and I really appreciate you sharing so much of your wisdom with us.
Grace Koinange: Thank you so much, Janet.
Janet Lansbury: Thank you. And I’ll be posting Grace’s contact information and her website for anyone who would like to contact her about consulting. I’ll have all that information here in the notes on this podcast and also in the transcript. So thank you so much again.
Grace Koinange: Thank you.
You can learn more about Grace’s consulting work and contact her HERE.
Also, please check out some of the other podcasts on my website, janetlansbury.com. There are many of them, and they’re all indexed by subject and category so you should be able to find whatever topic you might be interested in. Both of my books are available in paperback at Amazon: No Bad Kids, Toddler Discipline Without Shame and Elevating Child Care, A Guide To Respectful Parenting. You can get them in eBook at Amazon, Apple, Google Play, or barnesandnoble.com, and in audio at Audible.com. Actually, you can get a free audio copy of either book at Audible by following the link in the liner notes of this podcast.
Thank you so much for listening and for all your kind support. We can do this.
TLDR: Calculating required breastmilk volume by weight in infants older than 1month is NOT evidence based – response from a doctor
I love your work and your perspective – I was fortunate to read your book – Elevating child care – when I was pregnant and I have had such an amazing journey delighting in my daughter since she was born because of your advice. She is skilled in independent play (and so many other things) because you taught me to be an interested observer and I enjoyed hearing your talk with Grace Koinange – how true that sleep is about what happens through the day.
I wanted to address the advice Grace gave in your podcast regarding calculating breastmilk intake by weight – I am a doctor and in my medical opinion the advice she gave is not evidence based. Formula intake is generally calculated by weight because cow’s milk formula and other breastmilk-substitutes are metabolised differently than breastmilk. Research has shown that breastmilk intake varies between babies but is relatively stable regardless of weight in an individual baby from age 1 month to 6 months (generally between 750-900ml / ~25-30oz in 24hrs) and then after 6 months decreases with the introduction of solid foods. This is important as telling women otherwise may lead to:
-loss of confidence in their supply (and often related loss of confidence in themselves),
-anxiety related to normal fluctuations in weight and/or inaccurate scales (scales need to be accurate to 2g in order to make use of the weigh pre and post feeds Grace described),
-adding pumping and bottled breastmilk top ups and or formula top ups which can add to parents’ workload; can make it harder for babies to self regulate their milk intake; and can lead to bottle preference and unplanned early cessation of breastfeeding.
The parent’s question that you asked Grace I wouldn’t confidently answer without more information but besides being hungry the mother did say her baby sleeps a lot and it did sound like the baby could have had low sleep pressure at night and was being put to sleep when they weren’t tired enough and so contact naps could be maintained but as soon as the baby was put down that low sleep pressure led to them easily waking. Each baby has unique sleep needs and some just don’t need as much sleep over a 24hr period as others, if baby isn’t sleeping well at night they may be spending too much time napping during the day.
Please see this link to an article discussing normal milk intake patterns in babies if you are interested. https://dhss.delaware.gov/dhss/dph/chs/files/resmohrbachermagicnumber2011.pdf
Agree 100%. Thank you for posting!
This was also very strange to me – and contradictory to advice given on another podcast to ‘trust’ that children know their nutrition needs.
Also my baby spent her life at the breast till around 4 months and gained weight like nobody’s business, was unhappy doing anything else and slept and napped terribly (unless next to or on me). I’m pretty sure each infant’s calorific needs (and mother’s breast milk composition) will vary as we all vary!
I think the advice in this podcast largely ignores (some) infants’ needs for near-physical proximity to a care giver and the fact that breast milk adapts itself to a baby’s needs. I can tell you now, I would have been extremely triggered as a mum overwhelmed by near-constant breastfeeding to be told maybe my baby’s sleep issues were around her not getting enough!
All so interesting to read and I’m sure letting our kiddos play with less adult input and help can aid sleep. However, sleep training is associated with lowering mama’s milk supply and often seen as the end of a plentiful milk supply. Sleep looks very different for the formula fed baby vs the breastfed baby at the breast (vs pumping and feeding by bottle). The reason for this is that the less a baby feeds at the breast the less milk mama makes. A baby sleeping through the night ie 7-7 for example with no pumping will result in mama making less and less milk and within a few days her supply will reduce and before long she will have to supplement and then it generally results in the end of the breastfeeding journey.
I do feel it’s important for mother’s to know that a newborn feeding every hour (sometimes it feels almost continuous) is quite normal. Human beings are a ‘contact species’ which means a newborn’s heart rate, breathing, body temperature etc is regulated by the adult. This is why they fall asleep peacefully at the breast – isn’t that perfect!! Let’s embrace that rather than fighting it.
Another important fact is that because the storage capacity of each woman’s breast is different and the size of each baby’s stomach is different the number of times and the length of a feed varies widely. The best way to accept this and ensure a plentiful milk supply is to throw away the clock and read baby’s cues! Afterall, clocks are modern inventions and babies thrived well before the advent of any technology 🙂
Re quantities of milk, each baby differs in how much milk they want and need at each feed and that amount is completely different from feed to feed and depending on breast or formula. These are completely different substances with virtually nothing in common. In addition, breast milk can be fattier or more watery from feed to feed so that will mean that only baby will know when they need more or less and they need to be listened to! Also, if it’s hot weather, a baby will often drink more from the breast. Trying to decide for the baby how much they need takes away their agency – they know exactly how much to eat and how often to suckle in order to maintain perfect health – we must honor that. We do not know best and nor does the clock! Letting a baby fall asleep at the breast ensures adequate milk intake and adequate stimulation of the breast to make just the right amount of milk.
Breastsleeping, as described and researched by Dr James McKenna, is the ideal and species appropriate way to feed our young. We sleep and they sleep and feed throughout the night. The benefits of breastfeeding for mother and baby are dependent on frequency and duration. For mother infant couples with no risk factors such as smoking, obesity, substance abuse etc breastsleeping is the most protective way to sleep with our young.
Please also note that babies most often die alone. This is why sleeping in the same room as your baby is recommended for the first year of life. In addition, the use of formula is associated with a higher risk of SIDS. So, the last thing we want to do by sleep training is cut short a breastfeeding journey.
Mothering can be so simple, just be with baby and put them to the breast often. Let them sleep where ever and when ever they feel happiest whether in your arms, on your breast or in a stroller. It doesn’t matter as long as they have access to comfort and the breast whenever they need it. It is a need.
And lastly, doesn’t anyone else wonder how it feels to a child to see his parents cuddled up together while he/she has to sleep alone? Shouldn’t we lead by example and have Mama and Papa in separate rooms. If we expect a child to sleep alone we can at least start by showing them how it’s done? I think that’s only fair. If that doesn’t appeal just cuddle up together in a family sized bed!
I am a huge fan of yours. Listening to your podcasts has helped me with my (now) 4 children! I am also a physician (for adults) and felt very strongly about writing you after listening to this podcast. I was so surprised to hear what Grace Koinange had to say about the 2.5month old breast fed baby who wakes up after 20 minutes after placed in a crib. Her response implies – wrongly so – that (breastfed) babies have short naps because they are hungry. Furthermore, the calculation of how much breastmilk a baby should take (double the weight in pounds) was also completely wrong. For decades, mothers have been told that they are not giving their baby enough breastmilk! Please do not add to this misinformation and potentially destroy an already very delicate relationship! I would suggest deleting this segment from your podcast. It is confusing and adds to what is already mountains of misinformation about breastfeeding . I would also suggest perhaps having a true breastfeeding expert/well-practiced lactation consultant comment about infant sleep and breastfeeding if at all possible. Per kellymom.com, breastfed babies can take 19-30 oz breastmilk /24 hours. It is my understanding that this amount does not necessarily increase over time. https://kellymom.com/bf/pumpingmoms/pumping/milkcalc/
Also note that at 2.5 months, babies still have the moro reflex. This baby’s arms are out, so perhaps suggesting a swaddle that allows the baby’s arms to be up but that also suppresses the moro reflex might be helpful.
Whilst I’m a big fan, I was also quite disappointed with this episode, and felt that it runs counter to the Janet Lansbury philosophy of trusting in your baby.
I highly recommend having a look at Dr Pamela Douglas’ work at Milk and Moon Babies http://milkndmoonbabies.com/ The program is completely evidence based, up to date and is very much about supporting parents in nurturing their bubs based on their individual needs, values and goals. Perhaps Pamela would be a great guest to have on the show, to counter many of the breastfeeding and sleep myths that abound in this space.
I love the podcast and listen regularly from the UK but went to specifically to check Grace’s qualifications and background because I was very surprised by a lot of what she was saying and recommending in terms of infant sleep. Didn’t seem to fit with a neurobiological understanding of infant sleep and wasn’t back up by any strong theory or research other than personal experience and other sleep training approaches. Overall disappointed that there was not more questions asked or critique of some of this information, particularly the advice in regards to nutrition which is noted above in the other comments.