Karen Faulkner – Nurture Parenting: Infant and Baby Sleep

Registered midwife, child and family nurse and registered baby sleep consultant, Karen Faulkner from Nurture Parenting joins me to chat about baby sleep, breastfeeding and formula, modern gadgets and whether they actually make your life easier and her holistic Nurture Sleep Program. This is a life-changing episode as we all know the importance of sleep. And a sleeping baby or child means sleeping parents and carers.


Nurture Sleep Program

Karen Faulkner’s website, Nurture Parenting

Dr Ron Ehrlich:

Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Now we’ve covered the subject of sleep before, but today we’re going to cover it from a slightly different perspective and I think if you were going to start good sleep habits, starting them from birth is a really good place to go. My guest today is Karen Faulkner. Karen is a registered midwife, a child and family nurse and registered baby sleep consultant. She’s published, she’s a pair as she’s parenting author, her proven holistic approach, and I can attest to this because she has consulted with my own family and my own grandchildren and had done that, made a huge difference to their lives and the lives of many of my grandchildren’s friends, young ones that is, and their parents as well. So if your baby’s not sleeping, can you imagine waking up after 11 hours of uninterrupted blissful sleep?

Dr Ron Ehrlich:

Well, I remember when my older daughter was born and that’s now 33 is ago. The pediatrician said to us, you’re the one thing you must do is in the first year of life, teach your child to sleep. Well, of course, we ignored that and it took us several years to recover from that lack of following, some very sound advice. And of course if you are not, if the baby is not sleeping and then the parents are not sleeping, then things can really start to go wrong. Not just emotionally within the family, but also health-wise. Sleep is as important to a newborn baby as it is to any of us at any age. And getting into a good sleep habit, a good sleep pattern, a good sleep routine is a really important part of building a foundation for a healthy life. So I hope you enjoy this conversation I had with Karen Faulkner. Welcome to the show, Karen.

Karen Faulkner:

Thank you, Ron. I’m, I’m very glad to be here. Thank you for inviting me.

Dr Ron Ehrlich:

Well, Karen, sleep is a very big topic, very important topic, one that we focus on a lot in this, podcast and there’s so much I want to talk with you about, but I wondered if you might share with our listener, your own journey, how you got to where you are at the moment. Yeah. To this point in time.

Karen Faulkner:

Yeah. And, I was, in Manchester at finished doing a psychology degree and I got told there was no jobs for psychologists in those days. This is like the 1990s and I was told I should go and do health visiting and go back to nursing. And at the time I had no idea what health system was all about, but I knew it was a bit of which are free a bit of nursing a bit of health needs and preventing health problems, but it also had a big component of behavioral psychology and a big component was helping people, parents with their children’s sleep. And we are also doing toddler behavior work as well. So we’re actually trained by psychologists how to do these interventions with families. And at the time my caseload was 350 families that I was responsible for. And in the very early weeks, from six to eight weeks, postnatal, the first six to eight weeks, we went to the homes, for an hour each week to teach parents how to teach their babies to self settle.

Karen Faulkner:

And so we worked on preventing sleep problems and I realised as soon as I got the skills, how much I could change people’s lives and I felt like I got gold in my hands and it felt really, you know, amazing and I became really, really addicted to doing this because you could just make the biggest, biggest health outcomes and England always used to say to families was are you put the baby down fully awake in the cot and just those few words every time we met a family meant we had very little sleep problems. And then fast forward to Australia 17 years ago and I was working in Melbourne for three years doing outreach work and again involved in doing sleep work, behavior work, sort of health promotion stuff as an enhanced home visiting nurse. And at that time I was, I was seeming to get really good results and colleagues would say “Karen, you’re amazing at this”.

Karen Faulkner:

I go, no, no, we are all trained. You can do this. They’re like, no, no, you have something ladylike are you Sure? And when you come from the North of England, you very grounded and my family is extremely grounded and so it’s like the tall poppy thing in Australia. You don’t big note yourself, you don’t say that he could do something, you just do your job and you carry on. And then I started working for the health service in Sydney. All my colleagues would go, you’re amazing, you’re amazing at this. And I was like, no, but you’re all trained, you can do this. No, no, you have something lady. And then my mom said the same thing. She goes, Karen, this is your gift in life and you have to share it. Moms are a bit spiritual and took me by surprise I was like, Oh what’s this? What does she know about me that I don’t know about myself? And I think she’s right, Ron. I do have a gift and when you have a gift it would be wrong, not to share it and not to take that path. And that’s how it came about basically.

Dr Ron Ehrlich:

Well, well I can vouch for the fact Karen through personal experience through my own daughter and her family. You definitely have a gift. And this, issue of putting, of getting children to sleep. You know, one of the things that I think the best piece of advice I’ve ever received from a healthcare professional was when my daughter, who is now 33 years old, when she was just about to be born, the pediatrician said the thing you have to do in the first year of life is teach your child to sleep. And, and, and that is about routine and it’s about a whole lot of other things. And, and we just totally ignored that of course. Cause how do you teach someone to sleep? And, but you said something there and we want to get into a little bit of that, but you said something. Are you putting your baby awake in their cot? And, and there in lies the first really big thing, isn’t it? Cause it’s so easy. It’s so gorgeous for these little babies to fall asleep on us.

Karen Faulkner:

It is, it, she’s so easy, Ron. And it is something that has to be taught. It doesn’t happen by chance. No matter what people think. You know, if you know it’s going to change, it’s going to improve, it’s going to happen. But unless you actually actively put them down, fully awake in the court before four months, then you most likely end up with a sleep problem.

Dr Ron Ehrlich:

Hmm, gosh, that’s a pearl. But listen, let’s go. Let’s, cause there’s more of these I’m sure, but what, what is realistic? Good sleep for babies and toddlers. What’s, what’s that?

Karen Faulkner:

So realistic, good sleep. It’s being able to self-settle is being able to put yourself to sleep. That’s, that is basically the foundations of good sleep because once you can do that, then you can resettle and then you can eventually sleep through the night. So sleeping through the night doesn’t really happen till between four and six months. It depends on the baby, but then it’s also dependent on diet and having a really good balanced diet with the right balance of nutrients. So there’s lots of things that have an impact on sleep. Dark bedrooms for example, which we struggle with in Australia. Having a cool bedroom, having the right sleep clothes for cool climates. Not being overheated for summer. All those things have an impact.

Dr Ron Ehrlich:

Mmm Hmm. And, and what, what, okay, so what are some of the problems that you do? See why, why, why do we see these problems? Cause if they’re not addressing those issues I guess, but what are some of those problems that you’re being called in to help with?

Karen Faulkner:

Yeah, so I’m seeing babies that might be, that’d be waking up 10 times at night time, 10 months of age, having 10 breastfeeds in the bed with mommy and daddy. Because in the early weeks and the early months, midwives and nurses are saying to the parents, feed them to sleep. It won’t cause any problems. And under four months it is unlikely to cause a problem. After four months it does. Your mouth has more nerve and, and touch receptors and the rest of your body and you know, feeding to sleep. It’s like the dummy, it’s a soothing thing. I mean it feels nice to the baby, but it’s not sustainable for them sleeping through the night and for teaching good sleep habits. And so I think we’ve gone a long way with the breastfeeding stats, the breastfeeding rates. But that’s come at the detriment of sleep, unfortunately. You know saying to moms, feed them to sleep and then suddenly you’ve got this baby who’s very addicted to feeding to sleep. To try and take that away is extremely hard. Whereas if we took the English approach and did the prevention of put them down fully awake when they’re very young as often as possible and try not to feed to sleep, then we’d have far less sleep problems over here. But that message is just not getting through. We don’t work on prevention yet in Australia, unfortunately.

Dr Ron Ehrlich:

Hmm. I mean it’s changed. The advice has given has changed over the years. I mean it’s changed over the last 50 or 60 years. How, how, what are the been the big changes?

Karen Faulkner:

I’d say it’s, it’s the SIDS information about putting babies on their backs to sleep and that again created a lot more sleep problems because when babies are on their backs, they’re actually more stressed when they’re on their tummies, there much less stressed. We’re almost seeing more reflux because of the back sleeping. Because when you’re on your back your gut, doesn’t quite work the same. And so those are things that have a big impact on sleep. Also all the gadgets that we use nowadays, and with the social media, these lovely bedrooms, there’s lovely nurseries but they’re often not conducive for sleep. So all these things have had a big impact Ron. It’s, you know, it’s the back to sleep campaign. It is promoting breastfeeding and feeding to sleep. It is social media. It’s a combination.

Dr Ron Ehrlich:

Hmm. Let’s go to that back sleeping because, you know, I talk a lot about sleep within my practice and, and I actually identify stomach sleeping as a problem structurally for head, neck, jaw, lower back, muscles and airway. And yet SIDS alerted us to the problem. So side sleeping is what I always encourage people to do is that what is a good position for children?

Karen Faulkner:

Babies actually like to sleep on their sides or on their tummy’s, it’s actually their preferred position once they learn to roll, it reduces stress dramatically. So when I worked in NICU, in the special care baby unit, and then after intensive care, all those babies were always on their tummy’s to sleep because it stopped them dropping their heart rate, dropping their oxygen saturation, and it just keeps their heart rate and breathing and everything constant. Whereas the back sleeping, it reduces the risk of seeds. But structurally I don’t see a problem really because, under two, we’re not using pillows. See with pillows, it wouldn’t be good structurally for your jaw and your headaches.

Dr Ron Ehrlich:

Hmm. So where has that left us now with SIDS and, and, and the, and the advice they’d still talking about back sleeping.

Karen Faulkner:

It is. And interestingly, I trained as a midwife over 30 years ago when babies were always on their tummy’s to sleep and I saw far fewer sleep problems in those days than what I see nowadays. And so we’ve decreased the risk of SIDS, but increased the risk of sleep problems.

Dr Ron Ehrlich:

But I mean, if you had a choice of SIDS or sleep problems, you’d probably choose the sleep problems. What do you, what do you see as having happened with SIDS, this, this epidemic that it almost seemed like at one point, where did that come from? Was it just sleep position?

Karen Faulkner:

The thought that babies, when they go on to their tummy’s that they go into a deep sleep or unable to wake themselves. Do you think that this is where this, this sort of came from? We’re now thinking there’s a defect in the back of the brain and the cerebellum in these babies and they’re doing some research over at Westmead and they’re looking at checking out the protein levels in these babies and they’re even talking about doing MRIs to check the babies that are at risk of this, which I’m not sure that many parents have actually agreed to that. That’s where we’re currently at with the SIDS stuff, but yes we have decreased the risk dramatically. So, you know, there have been positive benefits from back sleeping.

Dr Ron Ehrlich:

Mmm Hmm. Yeah. Yeah. Well position, an interesting one. Breastfeeding. You mentioned breastfeeding and it has so many positives, but of course, when a child, and you mentioned the problem of allowing the child particularly over the age of four months to fall asleep on the breast, which again is one of those, I guess for a mother, just a wonderful thing and it’s beautiful, but, but you would say not a good thing after four months to do that.

Karen Faulkner:

It’s looking at nutritive sucking versus non-nutritive sucking. Just identifying that when the baby starts on nutritive to think about taking them off before they go into a deep sleep. But that would be all it needed to do wrong to stop that from happening. And you know, no one again, it’s okay to feed, to sleep. It’s just all the time it can become a problem. You got a baby with a very strong personality that just gets easily addicted to it, which you can understand that.

Dr Ron Ehrlich:

Hmm, Hmm Hmm. What about, you know, the positives of breastfeeding is one thing, but when a child suffers from Colic, it certainly undermines the confidence in breastfeeding ability. What do you say to a mother who’s having, who’s breastfeeding ticking that box? But the child has Colic.

Karen Faulkner:

Yup. So I would look at spacing in the feeds out because if the feeds are too close together then you’re likely to get a lactose load, which increases Colic because the first three months the baby’s body doesn’t produce enough of the enzyme lactase to digest all the lactose. It is a normal thing and it will pass. And we used to call it three-month Colic because at three months miraculously, the enzyme, lactase increases production and so just go away. But it is hard and those first few months, particularly in the evenings, can be very challenging. There’s a lot of things that you can do. Baby massage is very effective in reducing Colic as well as Reflux, bathing the baby in the evening, cluster feeding in the evening can be really helpful as well.

Dr Ron Ehrlich:

What, explain cluster feeding.

Karen Faulkner:

Cluster feeding is where you feed every, every hour just to help calm them. At the end of the day, you know, your breast milk supply is often less than what it is in the morning. And so by cluster feeding, your making sure your baby’s really full and we just need to be careful during the rest of the day that we’re spacing our feeds to help with this lactose load that we don’t, you know, cause access Colic by feeding too often. But a lot of babies really benefit from cluster feeding in the evening in the first three months.

Dr Ron Ehrlich:

But beyond that, I mean, where children are, I’m still feeling this. I mean, it’s amazing to me. I’ve done a few podcasts with some pediatricians who tell me that it’s not unusual for young children to be prescribed protein pump inhibitors like Nexium, and that just, I mean, the implications of that for an adult is bad enough longterm use. But for a child, I mean, should we be, I mean, people, what mothers are eating may be a problem there too.

Karen Faulkner:

Oh, totally. And that’s the first thing that we should be looking at. You know, there’s a big instance between reflux and cow’s milk protein intolerance or allergy. I see lots of these babies. I actually have this issue myself Ron, so it’s something that’s very close to home with me that we need to look at diet because if we’re not looking at diet, then again, we’re moving into the treatment model of health, not prevention. So it’s looking at is there a family history of asthma, eczema, hay fever. Is there a history of autoimmune disease in the family particularly from the Mum’s side? Is there a history of reflux in the family? Were there any babies with reflux? And also is there a history of food intolerances or allergies in the family as well. If this is on both sides of the family, then the incidence is quite high. If it’s just on the mum’s side then. Then yes, you’ve got a fair incidence. But just from the dad’s side, it’s less of a risk. So we need to look at diet and, and look at, certainly, if we’ve got all those risk factors and the baby’s poo if we’ve got mucusy poo or we’ve got blood in the poo, that it’s good to do an elimination diet with the mum’s diet and take out cows milk protein for two to four weeks and that often will sort the problem out and then reduce the risk or need for the all these medications.

Dr Ron Ehrlich:

Hmm. And, and when people are having trouble breastfeeding, I mean, you know, even with the best of intentions, not everybody is successful there. What are some good alternatives? What do you see as, what do you recommend as some good alternatives?

Karen Faulkner:

Yeah, so with, with that, with breastfeeding issues, I think it’s good to take advice of a lactation consultant, first of all, to see exactly what is going on there. But then obviously you’ve got infant formula so that that is an alternative to breastfeeding. And then looking at the outcomes for babies that are breastfed versus infant formula, stats are actually really interesting. The IQ point is only one different at the age of seven. When you’re looking at allergies and overall health of kids breastfed versus formula, there’s not that big a difference.

Dr Ron Ehrlich:

Hmm. Interesting. What about you did mention their lactation consultant cause there’s that in-between bit, you’re having trouble breastfeeding, but what do you do about it? What are some of the problems? Why are people, why, why do some women have trouble with breastfeeding? What are some common reasons?

Karen Faulkner:

I think you know, in, in the first 24 hours, particularly the first hour to six hours of birth, if the baby does not latch well, that can be indicative of a future problem. So it’s getting those babies to do skin to skin after birth and certainly getting them to feed fairly quickly after birth. It’s looking at, you know, obviously that the palate is well. Some babies have a high palate some have tongue-tie. I think it’s, you know, it’s educating the midwives, to recognize these things and it’s quite easy to do it, you know, to snipe a tongue tie and get that sorted out. We need to be trained to recognize. It’s just something about it. So you know, it can be the mechanical issues, it’s getting that supply going as well. But I think it’s increasing the staffing levels in the hospitals on the postnatal ward. So it’s getting that help. But it’s, it’s education, the nurses and midwives to make sure that that help is good help as well.

Dr Ron Ehrlich:

It’s interesting, isn’t it Karen? Cause, that help would have traditionally come from our village. You know, we will have, we will have lived and been surrounded by all generations and watched as we grew up, how our mothers and aunties and uncles and all that, we just don’t have that anymore. Hence, YOU

Karen Faulkner:

And the irony is I actually come from a little village in, in, in the Lake District where we knew everybody in our village. And I was actually a home birth. And, and this is one of the reasons why I became a midwife was because I had this idol called nurse Brackin who was my midwife at my home birth. And she was the district nurse. She was the nit nurse, she was the midwife. She was a school nurse and everything, right. If we don’t see this, we don’t know how to do it. I come from a very big family. My dad’s one of nine siblings. And so I’ve got 21 cousins and so around me, all I saw was babies and children. And so I think I’ve sort of learned about parenting as to how I grew up, how I started my village. But most parents in Sydney don’t tend to have a village. In Melbourne, it’s not as bad. There are very extended family communities over there. But over here I’d say at least half to two-thirds do not have a village. And how do you do this without a village? It’s, it’s a real struggle for them.

Dr Ron Ehrlich:

Mmm Hmm. Of course. One way of compensating for the villagers use lots of tools, lots of little gadgets that, that substitute for that village. What is it? Sleep sheep, rocking cot, fancy baby monitors. I mean, we’ve done programs on the EMF output of these. I can’t imagine that. What, what, what do you think a lot of this is? Clever marketing or ?

Karen Faulkner:

Yeah, it’s clever marketing. It’s playing to their fears and I think they’ve lost that. They’re sort of like with all this stuff, that just so that the trusted the trusting machines, they’re trusting things rather than trusting their own instincts. They just don’t trust their own instincts at all. They’re doubting themselves. They’re lacking in confidence. A lot of parents nowadays because if you don’t have a village, how do you have that confidence? How do you have that parenting confidence?

Dr Ron Ehrlich:

Yeah. Well, well, I know you have, a Nurture Sleep Program and I wonder if you might share with our listener some of those tips, you know, to leave our listen with, you know, that program.

Karen Faulkner:

Yup. So I set up this online Nurture Sleep Program. I was like writing it about 18 months ago. I just finished writing the toddler and child version of it now. I quickly realized that there needs to be, more of me and thought, how do I make more of me? Right. I need to translate what I do into video, into the written word. And luckily I’m actually a natural writer and, and so I’ve just played to my strengths and I brought something out that can be used all over the world. There is like this is teaching parents exactly what I teach in the home when I do a consultation and this has taken me 30 years to learn. It didn’t happen overnight. I think when things arrive over a long time then there’s actually more satisfaction. But it’s actually giving parents that courage, that confidence, the knowledge and it’s replacing the bullish that’s gone.

Dr Ron Ehrlich:

Yes. Well, you know, Karen, one of the things that I was particularly attracted to, what you do is this word holistic, which I’ve been using in my practice for over 35 years. But your approach is particularly holistic. You go into foods, routine, environment, development, sleep methods. Could you just give our listeners a little taste of some of those things like food?

Karen Faulkner:

Sleep is like a jigsaw. So this is how I describe it. And you’ve got to get the pieces in the right order to get it to work properly. And so if you don’t look at it holistically, you’re not going to get very good results no matter how good the sleep training. So we have to run up the right sleep training method for the right age, for the right gender, and for the baby’s temperament. For example, a baby with a very strong personality will react differently to the same method as one that’s got a very meek and mild personality. So it’s how you which method you choose, how you implement it, and also how consistent you are with that as well. And then when we look at food, food is, is ultra important to get kids sleeping really well for growth and development, for brain development.

Karen Faulkner:

So looking at the balance of nutrition, when you’re looking at a pie chart, you’re looking at 100%, 50% of that pie chart should be good fats up to the age of two in every meal. So we’re talking things like butter, olive oil, cheese, coconut oil, coconut cream. We’re talking things like animal fats. We’re talking nut butters, peanut butter, almond butter, etc, avocado. Nut butters has got us about three times as many calories as avocados. So we’re looking at those good fats to help with brain growth. But what the good fats do as well is to make the body more alkaline they reduce the risk of allergy massively. Whereas when you’ve got a low-fat diet, you’ve got a high allergy risk and it’s just fascinating to look up where we are currently with diet, with children and babies that parents had been sold the low-fat diet of the 90s and the noughties and the thing that’s what they should be doing with their babies now.

Karen Faulkner:

And babies need the opposite to what our adults and needing. So we need to give lots of these really good fats to help their brain growth and development and help them sleep really well. We also need to have a good balance of carbohydrates and when we are looking at carbs, low glycemic index carbs in particular. The diet should be about 40% which leaves 10% for protein and the rest I call the fruits and vegetables. So fruits and vegetables are good for health, but they don’t help sleep per se that much. So what we’re looking at diet, what would be a good diet for a baby of six to 12 months would be something like either porridge or Weet-Bix made with full cream cow’s milk, add some cream to that or some coconut oil and some peanut butter, some finger foods, whole meal toast or rye toast with butter on or peanut butter or almond butter.

Karen Faulkner:

Then we move to lunch, something like chicken sweet potato and some of the veg like zucchini for example, and add some melted butter and grated cheese to that. And then I’d be looking at some dessert, a no sugar dessert. Something like a chia pudding with banana, organic cacao, coconut milk, dates, Medjool dates in particular. And then I put some vanilla bean paste. And three of those ingredients promote sleep. So organic cacao, bananas and chia, are really amazing for promoting sleeping babies after six months. And then for dinner, something very similar, but I’d be looking at finger foods as well as purees. When you allow a child to self-feed and you eat with them, which lots of people are not doing that, the child will eat up to 25% more food, which will sustain them through the night.

Karen Faulkner:

Absolutely. Most people are not giving that balance Ron. So it is, you know, diet is, is, is a massive issue. I’m really fortunate that my grandparents were farmers and so my childhood was very much what I’m talking about. It was nose to tail eating. We sourced all our own produce. I never had anything that wasn’t organic till I was 18. Never had takeaway until I was 18. How many people can say that nowadays? Everything was grown by my dad or my granddad and literally we, you know, we sourced all our own produce. So we knew where it came from and that knowledge has been lost. And I was, I learned to cook at the age of five, which how many kids nowadays do that? Not very many. So you can probably see how I’ve ended up with looking at this holistic jigsaw of nutrition.

Karen Faulkner:

Next, we have to look at development. We need to make sure that babies are doing enough tummy time in the early weeks because tummy time is the activity that is going to help with the gross motor skills long term and that’s the thing that has a big impact on learning. Children that don’t do all fours crawling have issues with learning often because the two hemispheres of their brain don’t crossover. This is activity starts with tummy time with very young babies at two weeks as we need to maximize that to get the outcome at about six to 10 months of crawling and all fours crawling in particular. So that’s three of the things I’ve covered. Next, we’re looking at the environment when your topic a really pitch-black room. Once you’ve got a really dark bedroom that triggers melatonin and that’s the thing that helps you get to sleep. It’s the hormone that helps you get to sleep and stay asleep. When you’ve got a pitch-black room, they get to sleep 300% quicker, which is much easier than trying to battle with a bedroom where it’s really way too bright. So that really helps you day naps and it helps your night’s sleep. And then it’s looking at getting these kids self-settling, doing good day naps because that reduces the cortisol, which helps them sleep better at night as well. But making sure they’re dressed in the right clothing, particularly for winter. I’ve had lots of babies this winter being been cold and hungry, which is really a bit sad to think about. But we’ve gotten so risk-averse with thinking that we’re overheating babies is that we are underdressing them. So as long as you use natural fibres like cotton, bamboo, merino wool, you can’t overheat a baby. It’s not possible because the heat will just go, it will dissipate. And I think it’s having that knowledge that’s basically a jigsaw or that you’re looking at Ron. That’s holistic.

Dr Ron Ehrlich:

Mmm. And, and the part of the village of course is giving everybody their own room. The opposite of that rather is giving everybody their own room. Sharing rooms is a, is a, is an important part of development, isn’t it? I mean, I shared a room with my brother until I was 10 he was 13 we’re still talking 60 years or so later. What do you think?

Karen Faulkner:

Many parents… We’re actually starting to get their kids to share bedrooms. It’s really interesting that we are actually seeing a trend coming back to that because it’s teaching good values about sharing about, you know, those are life skills, negotiation skills when you share a bedroom with somebody else, but it’s actually a really healthy thing is to share a bedroom, you know, to sleep alone to me seems a little bit unusual, a bit strange. And babies, they actually get into the pattern partner breathing with their parents and that’s why we recommend rooming in the first six to 12 months. So it just lots of benefits to sharing a room.

Dr Ron Ehrlich:

Hmm. So have the baby in there for the first six to 12 months. Yeah. Makes sense, doesn’t it? I mean it’s a challenge to a relationship, but a wonderful challenge

Karen Faulkner:

To throw a baby out before six months it just seems to me you’re a little bit strange. And you know, I often get asked when should my baby leaves the bedroom? Well, I’m actually not going to tell you what, when, what is, because that’s a very personal thing. Certainly, for the first six to 12 months, they should stay with you.

Dr Ron Ehrlich:

Hmm. And how should we respond to, you know, we’ve, we’ve fed the baby but we haven’t let it sleep on the breast. It’s used to self-settling. Although this may be the problem when we put the baby down and it starts to cry. How should we respond to that?

Karen Faulkner:

Yeah. So I want to explore crying Ron, because most people get stuck is with the crying. We mustn’t let babies cry alone cause that creates abandonment and that is just toxic. But babies need to cry. And nowadays people are very risk-averse with letting babies cry. And if you don’t let a baby cry, then they’re actually absorbing and holding all their stress. It’s like those when we’ve had a bad day we need to get it out and we’re actually stopping this from happening and this is where all this sleep associations come from because cause we want to keep them quiet because our partner’s going to work. We’re worried about the neighbors in the next-door apartment, worried about other siblings, about waking those. But if we teach this really young, there’s hardly any crying. We teach them at six weeks you might get a minute of crying. If you teach self-settling at two to three months of age you get 20 minutes of crying if he teaches it 4 months you get 40 minutes of crying. It teaches at six to 12 months, you get one to four hours.

Dr Ron Ehrlich:

Oh my God.

Karen Faulkner:

Yeah, looking at the trajectory of that chart. I would do that when they are really young.

Dr Ron Ehrlich:

Okay. But I mean I think you’ve made it.

Karen Faulkner:

Yeah, it’s about managing their stress. It’s managing their emotions, it’s helping them. When I sleep train or teach self-settling, then I’m listening to the baby’s cry and that tells me what to do. So when babies are becoming really stressed, we pick them up. We do little cuddles, we put our hand on their chest and we keep on doing this until we hear big pauses. When you hear the pauses in the crying, it means they’re actually not stressed or likely to go to sleep. Now all the children past six months, cuddles might actually work against you because they might have a lot of alert behaviour. We stay by the cot, we help them. So most of my methods involve staying in the room with the baby to help them, not pick them up. Not with all the kids. I try not to do too many cuddles because it doesn’t help cause it teaches them. If I shout, I get a cuddle. So they just keep on shouting for longer. So it’s about, you know, doing a cuddle to take the edge off the crying on night one but by night two to try and do no cuddles. And each week you move your chair or put away towards the door till hopefully by week four you’re out the room. But you know, with all the babies there is a lot of crying to keep. You haven’t taught this when they’re young. Night one, it’s hard not to the same, slightly better, not three or four gets worse before it gets better. With toddlers, it’s night five and then by week to 10 days. And this is based in behavioural psychology and it’s learned, it’s imprinted and it’s unlikely to come undone. Things can derail with development in the future. And that’s important to know about that sleep is like a continuum is like a roller coaster of life. You know, you think you’ve got it nailed. And then the next thing is some developmental leap will come along, some new developmental skill will come along. But as long as those foundations are there, you can’t derail that easily. It’s impossible. And that’s why I’m a big believer of teaching this early.

Dr Ron Ehrlich:

Mm Hmm. Because I guess, you know, we’ve made it compelling, you have made a compelling argument for getting in early in teaching good skills. But the reality is that people’s children aren’t sleeping well. I mean, I had a patient in who, you know, three, four years old and they’d not had they themselves and the child had not ever had more than two hours sleep in that entire four years of life.

Karen Faulkner:

Yup.

Dr Ron Ehrlich:

I kind of mentioned that. Yes,

Karen Faulkner:

Yep, I come across those cases all the time. I have a child it was my worst case in 2017 and he is called Sonny. He is actually on my blogs and he’d been diagnosed with Autism and ADHD in which he neither. He was just tired and he got sent to Royal North Shore for an MRI and the nurse at the MRI listen to their story and these parents were just like broken. This kid was on sedation, which I think is slightly outrageous. It was on the melatonin and Clonidine and they were talking about putting them onto chloral hydrate, which as we know we give to psychiatric patients or kids for procedures. I was shocked. I thought I’d never see this in my career but I did. And so the nurse handed my name over on a piece of paper to the parents and said, if anybody can help this, it’s Karen, you need to get Karen.

Karen Faulkner:

And so I went down to Jervis Bay for three nights, stay down just in Defense Force. So the ADF paid for me to go down to sort their child’s sleep out. And you know what? He’s now sleeping through the night. He’s an amazing little sleeper and he does not have a sleep problem. The parents, they were actually giving him six to eight bottles of milk, 200 mls in the middle of the night. And my first thought was why hasn’t the sleep doctor thought of this? I thought that’s the first thing that I take away because when you’re having so much milk, you’re not eating any food. And he wasn’t and he wasn’t speaking because he was so tired.

Dr Ron Ehrlich:

We did a, we did a program with the respiratory pediatrician who once said to me that 50%, I think he said 48% of ADHD children that are diagnosed have an undiagnosed sleep-disordered breathing problem or sleep problem.

Karen Faulkner:

Yup.

Dr Ron Ehrlich:

And, and you’ve just named, was it Sonny?

Karen Faulkner:

No, this was Sonny.

Dr Ron Ehrlich:

Oh, Sonny. Well you just mentioned Sonny and that is a prime example of an, and that’s a statistic which we’re seeing one in 10 kids now have ADHD diagnosed one in 63 I think have autism. When you wonder how many have actually not had a good night’s sleep.

Karen Faulkner:

That’s right. I think a lot, Ron. I’ve had a few with diagnoses of autism that don’t have it and they’ve sorted their sleep out. So, you know, it horrifies me that we’re giving diagnosis and we’re giving pills out to kids that are, you know, sometimes tired.

Dr Ron Ehrlich:

Mmm Hmm. And now listen, we’re coming. You’ve given us so much here, Karen. So many things. And of course, we’re going to have links to your website in that wonderful online program. You mentioned that. Just finally taking a step back from your role as a nurse and it and a sleep consultant and all the things that you’ve done, cause we’re all on this health journey together in life. What do you think the biggest challenges for people on their health journey through life in our modern world?

Karen Faulkner:

I think it’s, it’s sifting through all the noise on the internet and there is a lot of noise and Mr Google and all the rest of it and it’s trusting their instincts as parents. But I think, you know, there needs to be more support in the home in the early weeks. There needs to be better information given to parents and from a respected source. I’d like to see the health service do more, you know, visiting in the early weeks, rather than the opposite which is happening. But, that is something that I’m working on Ron.

Dr Ron Ehrlich:

Ah, you are and I’m glad that we can actually get that message out. Karen, thank you so much for joining us today and sharing your knowledge on such an important issue because if the kids sleep well, the parents sleep well in the family. So thank you so much.

Karen Faulkner:

It’s a pleasure. Thank you so much Ron. I really appreciate it.

Dr Ron Ehrlich:

Well there it is and some great tips, great tips. Well obviously for parents, but with young children, but it’s a reminder about routine, routine, routine, and getting sleep hygiene in good shape. So, I’ll have links. We’ll have links to Nurture Parenting, which is Karen’s website, her holistic approach, which as I said, we can attest to. I think she’s fabulous and I think her experience, well, it’s well worth it. You know, in years gone by in, throughout our human history, of course, our, our tribe would have taught us all the sleep routines that we needed to know, but as we have lived in, in this modern world, we can be very isolated. And so having someone come into consult can be life-altering and, and I actually believe life-saving. So I hope you enjoyed that look. Don’t forget to leave a review on iTunes, get in there and give us a review. We need all the help we can get to get this message and so many more messages we convey a cry out to a broader audience. So, until next time, this is Dr Ron Ehrlich. Be well.

This podcast provides general information and discussion about medicine, health and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.

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