The 411 on Toddler Sleep: regressions, sleep training & the ideal bedtime routine (w/ Dr. Ari Brown)

25:44That's all the melatonin does. So if you're changing where you're going to be going to a daytime time zone and you want to get them adjusted, then it makes sense to do that. There are other certain situations, you know, kids with neurodiversity sometimes, you know, need melatonin, whatever. But for your average child, I would not recommend melatonin to help them fall asleep in routine situations. And why wouldn't you recommend the use of melatonin on a consistent basis with toddlers and children?

26:17Dr. Ari Brown:So some of it is melatonin is not regulated. And so you don't exactly know what you're getting. I'd be very cautious if you were looking for a melatonin supplement. I would go, I'd probably go someplace that sells it and backs their, you know, like we have a pharmacy here in town that really is very supportive of supplements, but very knowledgeable in supplements. And so it's their reputation and the products that they're selling. So, but I would not go buy any melatonin supplement online because you don't know what is in it. Sometimes it contains melatonin, sometimes it contains other ingredients.

26:55Sometimes it doesn't even contain much melatonin. So I worry about regulation with melatonin. But the deeper question is, are you creating something that your child needs to fall asleep, where in fact they probably are making plenty of melatonin on their own, and it's probably a behavioral sleep issue that you're dealing with, and not one because your child is not making enough melatonin? That makes a ton of sense. So we talked, you touched before on the ideal sleep schedule from baby through toddler, but what we didn't touch on was naps. And so what does the ideal napping timeline look like from baby through toddler?

27:42Great question. So naps for zero to three months are really all over the place and they eat and they take a nap and then they wake up and poop and go back to sleep, whatever. There's not a whole lot of schedule or routine in a zero to three month old with napping. Three months is really when they do start to have more awake time and more structured regular sleep patterns. And so a three-month-old is usually taking three or four naps a day, and they're usually pretty short, 30, 45 minutes. The afternoon nap is the one that will be longer. And as a child reaches like four months, they're usually down to three naps a day, two naps that are short, afternoon nap that's longer.

28:28Six-month-old is down to two naps a day, short morning nap, 30, 45 minutes. And then that afternoon nap really is a restorative nap. So it may be one to three hours. And they carry through two naps a day to at least a year. From 12 to 21 months, they'll drop a morning nap and they'll just have that afternoon nap. And that afternoon nap sticks around, hopefully, till they're three or four. About 25 % of four-year-olds are still taking a nap. Okay. It's amazing how much... How quickly you forget what you went through. And so I'm going back to Tate's nap schedule three months in and like that three to six months.

29:12And I completely forgot how we did it. Obviously today, I know that she's one nap a day, 12 to 1.30. And I remember the drop from two to one. But it is amazing how as a parent, like you quickly do forget these things. So it is an amazing refresher, especially now with baby number two. So I kind of want to re-punch back in on something, and you touched on it, and maybe that's all there is to it. But the biggest mistake that you see parents make around sleep?

29:50Dr. Ari Brown:Biggest mistake is they don't grow with their baby. And so they figure out what works and then they stick with it. But it's going to stop working because you don't have the same child. Every day is a new day. So you are not dealing with the same child. So don't treat your four-month-old like a newborn. Don't treat your two-year-old like a six-month-old. Like these things won't work anymore. And so you have to grow with your baby. The other mistake that parents make is that they have unrealistic expectations. and that's just baked into crowdsourcing and what they hear from other people. And so they think, oh, well, I can do this.

30:30I can get my child to sleep through the night. What is the secret? And truly, it is the holy grail of parenting. I'm not going to lie. I mean, everybody wants their child to sleep. But I think you need to be realistic that babies are not going to sleep for very long stretches for a while. They sleep a lot, but they don't sleep for very long stretches for the first few months of life. And then what you mentioned before is around a mistake you see parents make is they develop a crutch around the bedtime routine and how their child falls asleep, which then restricts how they soothe themselves in the middle of the night.

31:11Dr. Ari Brown:Exactly. Exactly. And if you take it further than the baby period, I have a lot of families who have toddlers, toddlers starting at 12 months of life, who are still giving their child a bottle to fall asleep. And some of it is the parent and they love that, you know, it's cozy and they love it. But they also think, oh, my child needs to eat to be able to fall asleep, which they don't. They definitely don't need the calories and they don't need that sucking. They're toddlers. Grow with your child. You need to grow with your child. So again, every phase is different and you need to change with your child.

31:50Yeah, it's a consistent reminder of just how locked in we need to be as parents. Because you sit there and you develop to something that's working and you just want to keep it flowing through. But that isn't how it goes. A personal question to what you just said on the calories. I have noticed that sometimes at night, Tate gets so focused on her activities, that she really just won't eat and will refuse food. And so the only time that I will now give her a bottle before bed is when I'm with her most of the day, and it's clear to me that she's under-eaten. And is using my judgment in that case a good call, or no, I have to trust her and her behavior towards food.

32:48I'd say I do this twice a month.

32:52Dr. Ari Brown:Okay, well, you know, twice a month is not a big deal. I mean, it's fine. If you feel like you need to do it, you need to do it. So I'm not going to say that's the wrong answer. But I would push back and say to trust yourself and to trust her. and if she's hungry, she would have eaten. And toddlers, and we've talked about this before, you know, toddlers eat once every three days. They decide they're hungry once every three days or one really good meal in a day and they pick at the rest and they manage to grow. And so if she was really hungry, she would eat. And so I'm not worried that she's not gonna sleep at night because she didn't get her calories for the day.

33:32I know that she'll wake up the next morning and have a huge breakfast because she didn't eat the day before. That I know. But I would not be convinced that she's going to wake up. And I think that's the parent default is they're afraid because, again, you want to sleep. Like, what's the best way to make sure I'm going to get good sleep and she's going to get good sleep? I'm going to give her something. Yeah. The irony is I actually gave her a bottle last night and she was under five. And I don't think in the past two weeks she's been up before seven. So. And I was like, well, maybe I'm giving her the bottle and it's making her pee a lot more.

34:04And so her diaper is uncomfortable. and so she can't fall back asleep at 5 30 in the morning exactly and that's the other that's the

34:13Dr. Ari Brown:other reason which i will point out is do you what do you ever want your kid to be toilet trained don't give them a bottle before they go to bed that's the last thing you want to do but you're not there yet so but you figured that out good job i think we are close on that okay cool um she asked yeah she tried to go she tried to sit on the toilet uh this weekend it didn't work that's awesome yeah she's very curious about what we're doing so starting something new isn't just hard it's terrifying you guys so much work goes into the thing that you're not entirely sure will work out and it can be hard to make that leap of faith it also helps when you have a partner like shopify on your side to help shopify is the commerce platform behind millions of businesses around the world and 10 % of all e-commerce in the U.S.

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35:45And so I don't want to get too, too repetitive. I think one of the things we haven't touched on, and Dr. R, you keep saying sleep environment, but you haven't said crib. I think the crib versus the co-sleeping versus all that stuff would be really interesting. Because you keep saying sleep environment. My interest in co-sleeping is I think that there's a lot both good and bad that we can learn from other countries as it pertains to lifestyle, health and wellness. and co-sleeping is one of those things, that is done in countries where we do aspire, or we... Yeah, we respect and aspire a lot of their lifestyle decisions, a la the Nordics.

36:36And so it feels like co-sleeping here is something that is shamed and judged, and something that inherently, like, we didn't do. and I think that we were probably shamed or we didn't do it because of fear. Fear of making a mistake, fear of being judged, fear of not being fully up to speed on it. And so, yes, would love to hear about the ideal sleep environment. And does that to you mean crib? Does that mean co-sleeping or something in between?

37:08Dr. Ari Brown:I'm going to say something that is really important for all parents to hear. You can have a healthy, well-adjusted child no matter where they sleep. Okay? That's the reality. So if you want to have a family bed and everyone wants to have a family bed, that's the key, is everyone has to be on board. If you want to have a family bed, that's fine. It's not a problem. The issue in the U.S. and why, as a pediatrician, we recommend room sharing and not bed sharing for an infant 0 to 1 is that there is an increased risk of sudden unexplained infant death and sudden infant death syndrome. and the issues involve entrapment and suffocation.

38:04And there are people who are at higher risk, which are people who are under the influence of drugs, people who are under the influence of alcohol, people who are on certain medications that make them tired, babies that are born prematurely, babies that are born under five pounds, they are at higher risk. But one of the risks is being exhausted as a parent and accidentally rolling over on a kid or having bed sheets and comforters or pillows that are risk factors for these deaths. And every new parent is exhausted. And so as a pediatrician, I'm going to say it's just not worth that risk for a zero to one year old.

38:48And that's why those recommendations are there. So people push back and they're like, well, it doesn't promote breastfeeding, you can breastfeed successfully room sharing, you can have that baby right next to you, right next to you, but in their own sleep space. And so that's the reason why the recommendations are there. Once you have a toddler, if you guys want to all share a bit, I don't care, everyone can climb on board. But I do want to talk about the everyone needs to be on board with this, Because what I frequently see in my practice when people say we have a family bed is the reality is the mom and the child or children are in one bed and the dad is in the guest bedroom or somewhere else.

39:33And that is just because they're exhausted and they want to sleep and they are not on board with that. So that's why I think you guys need to approach this as a family and make decisions together. But it's true. Other cultures have family beds. This is not something that is frowned upon in the U.S. I think it's a choice that people make, and it's just our lifestyles. But you can do whatever you want to do. Again, you can have a healthy, well-adjusted child. When I hear that, and obviously removing the drugs and the intoxication, because that isn't applicable for us, The just the small chance of being overtired and creating a bad scenario on the back end of that is is just enough that it's like, why?

40:27Like, that's just how it all lands personally for me. The other comment I want to make about having a safe sleep space for an infant is a lot of families will default to having the baby sleeping on them and they're in a recliner or they're on the couch. and on a certain level that's even more dangerous than co-sleeping in a bed because as much as you want to stay awake the reality is at some point exhaustion kicks in and you have a risk of this baby falling off of you off of the couch or off of the recliner so it's really important especially in those early days where you can't seem to find a way to get your baby to fall asleep do it safely.

41:15Dr. Ari Brown:If you're going to have the baby on you, use a baby Bjorn or an Ergo Baby for at least the baby is secure on you. So if you do doze off, they're not rolling and getting injured. And so, you know, continuing on the theme of safety, when is the right time and the safe to transition from a crib to a bed. And I think what's top of mind for us is, like, Tate does, when she wakes up, she does this thing. She does, like, the flop where she puts her arms over the crib and calls for us to get her. And it feels like she's very close to being able to flip over. And so, like, this is very top of mind for us right now.

42:05Yes.

42:07Dr. Ari Brown:This is such a popular question is when's the right time to transition a child out of their crib? Sometimes kids figure out how to climb out. And if they've made, you know, crib jumping an Olympic sport, it's clearly time to move your child out of a crib. Sometimes they get displaced by a baby behind them who needs the crib. I personally tell people, if your child is happy in their crib, which most kids are, they like their... It's kind of like a kid cave, you know? Mm-hmm. If they are happy in there, if they are not trying to get out, try to keep them in the crib as long as humanly possible. Like age three, I would aim for, because it's a safe sleep space and they can't leave.

42:52So, key.

42:53Dr. Ari Brown:Now... Interesting. Yes, as long as possible. And a lot of parents will transition earlier. Unknown reasons why if they're not being displaced and the kid isn't trying to climb out. I personally wouldn't. It's up to you, whatever you want to do. But the key point I want to make is that once you do transition them, I personally tell people to just transition to a twin mattress on the floor, not a toddler bed where they're elevated, because the safety rails are really not that helpful. and you don't want your child to get stuck or to roll out of bed. Rather, they roll on a mattress a few inches onto the floor.

43:29Dr. Ari Brown:And the other important point is once they are free of the crib, that doesn't mean they get free reign of the house. So their room becomes their crib. It's a safe sleep space that they can't leave. So I'd put up a safety gate in the doorway, or you can put like a little monkey lock on it. But unless you trust your toddler to roam around your house in the middle, without you watching them, I would not allow them free reign. Yeah, that's exactly our concern, is that while she... And to be clear, she hasn't shown the inclination to try and crib jump yet, but she leans over it. And when I watch how she climbs over other things, I kind of think she could do it if she wanted to.

44:18But that is exactly my concern, is that she also knows how to open her door. She's gotten decently good at navigating gates. And so, but she still doesn't understand, like... She can't be obviously trusted in the house and still doesn't understand stairs very well. So that's our big concern. Did we really hit the nail on the head on what an ideal bedtime routine is. I know we talked about the importance of it, but did we say this is what you should do and this is what you shouldn't do? I feel like we did for almost the younger than six months, but maybe at Tate's age, what the ideal bedtime routine looks like could be interesting.

45:09Okay. Yeah, I'd love to hear that.

45:10Dr. Ari Brown:Sure. So toddlers are usually sleeping 11 to 13 hours a day. They usually have one nap in the afternoon. You want them to be awake maybe three to four hours before bedtime. And bedtime, I would say general rule, will be seven to eight o 'clock at night. If you know that bedtime is going to be seven or eight o 'clock, then push back what you need to do to get to that point. Do not make this a long, extended routine. I like your six-minute routine. That's awesome. It's short. It's sweet. It's consistent. You know, get into your pajamas, read books, sing songs, chill out, go to sleep. Make sure that you're brushing their teeth before they go to bed.

45:57Dr. Ari Brown:And again, if you want to give them some water, that's fine. But if you've already brushed their teeth, they should not be having any type of milk before they go to bed. And then follow through. And I will tell you the typical toddler tactics is they'll ask for one more thing. So one more book, one more sip of water, one more hug. Every toddler does that. And they're just trying to drag it out. So be consistent. We're not going to do one more whatever. And keep it simple. Keep it consistent. And say goodnight and have them fall asleep on their own. Okay. Amazing. Um,

46:37so one thing that, that you did not mention there and unsurprisingly so is, is screens. And so would love to talk about the impact that screens have on sleep.

46:52Dr. Ari Brown:Screens are not good for any of us. So I would highly recommend that the screens have a bedtime and the screens go to bed, maybe in the kitchen to recharge but i would not involve screen time as a wind down tool because number one it doesn't calm your brain number two that blue light interferes with the melatonin being released and as we all know as parents when you take the screen away it actually causes frustration and anger and not calming so i would not involve screens at least 30 minutes before bed And if we're talking a young toddler like Tate, hopefully screens are not really part of your daily routine anyway.

47:38Yes, they are not, but still very topical. Yes. And what about how diet and daily activities impact sleep?

47:50Dr. Ari Brown:Yeah, so physical activity actually helps you produce melatonin and it actually helps you get into deeper sleep. So highly recommend for kids and adults to be physically active on a regular basis because it actually helps you sleep better. Very nice. So I guess to bring it all together here, why don't we kind of play a bit of a game, probably not a fun game, and we'll call it Common Sleep Issue versus Talk to Your Doctor. and we'll talk through different things that kids can experience and whether that is common or whether you think they should bring it to their pediatrician. Sounds like a fun, nerdy pediatrician game.

48:33Dr. Ari Brown:I'm in. Love it. Loud snoring. Talk to your doctor. Wow. I did not expect that. Frequent nighttime awakenings. If you can't solve the problem, talk to your doctor. Excessive movement. Depends. Might need to talk to your doctor. Waking up tired after an adequate night's sleep. Oh, very important, because there's sleep quantity and there's sleep quality. So just because your kid is sleeping 10 hours a night does not mean they're getting good sleep. And so... Yes, talk to your doctor. Okay. Difficulty focusing. Talk to your doctor. And that's a really important point because a lot of kids who get evaluated for attention issues, we discover that they're not getting good sleep, which turns out to make you not very focused during the day.

49:34Okay.

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50:05I think Skims must have read my mind because here's the thing. I recently decided to replace a bunch of my underwear and bras. And I wanted to invest in new cotton pieces. And boom, there it was in front of my eyes. They made it. And they made it really well. So you guys get in on the goods because there's nothing better than good bra and underwear, especially with summer coming up. Shop everyday cotton and all of my favorite bras and underwear at skims.com. After you place your order, be sure to let them know we sent you. Select podcast in the survey and be sure to select our show in the drop down menu that follows.

50:36Night terrors.

50:39Dr. Ari Brown:Talk to your doctor. Scary, most of the time benign. And yeah, can we just talk a little bit about night terrors? How common are they? What are the drivers of them? I oddly, vividly remember that I've had two night terrors in my life. One was at a very young age, and one was when I was at camp in the infirmary. And like, I remember both of them. okay let's talk about the different

51:15Dr. Ari Brown:they're traumatizing i'm sorry that was so traumatic for you but i also have something to share with you if you remember them they weren't a night terror so let's talk about what the definition is of a night terror so a night terror is a parasomnia it's like sleep sleep talking and sleepwalking so there's no recall of it the next day and it happens pretty exclusively to kids like 18 months to three years of age so your summer camp experience was definitely not a night terror sorry it's a bad dream

51:53Dr. Ari Brown:and nightmares yes night terrors no so the thing that's so kooky about night terrors is the kid will wake up like after their first or second sleep cycle so it's usually every night like an hour and a half or three hours into sleep and it's like clockwork and the kid wakes up they're not really awake but they stir and they're possessed like they've you know they've seen a ghost and the parent goes in and the kid is like screaming and looking elsewhere not making eye contact not connected at all and so it's super freaky as a parent to see that happen but they're actually not awake. And if you wake them up, then they're like, what's going on?

52:41Dr. Ari Brown:Like they don't process that that was actually happening. And so scary to the parent and freaky to the kid if you actually wake them up. But the reason why that happens frequently is because the child is overtired. And so one solution is to have an earlier bedtime, and that often will break that. The other solution is to actually go in and like gently wake the child up like 30 minutes before that time that happens every night and it breaks the sleep cycle and then they go into their next sleep cycle. But I will point out that every once in a while it's because the kid has low iron levels and so we do check ferritins on kids who have frequent night tears to make sure that they don't need an iron supplement interesting very interesting and so um that list that general list funny enough was put together by jules excellent job thank you when when you put it together i almost like re like went into chat gpt and was like i feel like she's just gonna say these are all normal So great list.

53:48Thank you. Great list. What other sleep issues that parents should not brush off beyond what we just talked about?

54:00Dr. Ari Brown:Well, what we talked about are the symptoms. Yeah. And what I think is important is to connect the dots to what those symptoms can mean. So somebody who is snoring loudly, a child who sounds like grandpa, that's not good. It's probably because their tonsils are huge. They may be so huge that they're actually kissing. And the adenoid, which is tissue behind the nose, can also be enlarged. And so the child is snoring because they're actually trying to get air through these gonzo-sized tonsils. And some kids will have sleep disorder breathing where they're constantly thrashing around, super restless at night because they're moving to breathe.

54:44Dr. Ari Brown:And the kids who are actually snoring and pause, that's actually obstructive sleep apnea. And both of those end up being causes of poor quality of sleep because they never get into deep sleep. And hundreds of times a night, they're having these little partial wakenings to breathe. They also can have drops in their oxygen levels. So it's actually really important to get that checked out because, again, sleep is really important because so many things happen when your child is asleep. We want them to have good quality of sleep for health and behavioral reasons. Super interesting. What are some sleep things that parents come to you with that are normal?

55:30a lot of it is the behavioral stuff that we've talked about is my child can't fall asleep at night and that's because they're protesting and they have FOMO and they don't want the party to end um or they're waking up in the middle of the night um they start coming into you know if you don't restrict access and the crib is no longer in the picture you know these kids keep coming making a beeline into the parent's bedroom every night often. So a lot of them are behavioral things and less medical situations that need to be addressed. A super hot topic amongst all parents and our friends included is sleep training and cry it out.

56:17And so we'd love to hear what are the big issues you see with this methodology And on the flip side, do you think it works?

56:27Dr. Ari Brown:Yeah, this is a great question. And I think when people delve into any sleep space online, they see, you know, CIO and cried out and I don't want to do this. And I don't think that people really understand that there's protesting and then there's cried out. and your kid is going to protest. There will be many battlefronts as a parent where your child is not going to like what you're saying because you're establishing a boundary and drawing a line, and you're making that line for them because you're trying to make healthy choices for them. And sleep sometimes ends up in that category because you know your child needs a good night's sleep.

57:18Dr. Ari Brown:And guess what? You do too because you're a better parent if you are well-rested. So for everybody's sake, I think it's important to draw a line and say, this is our line. We're going to have bedtime at this hour and we're going to structure it so that you're not overtired when I put you to bed and you're going to be prepared for sleep and you're not going to do the toddler, you know, tactics to draw out bedtime any longer. And so unfortunately, your child may protest and you have to be willing to accept that if you draw that line. So I think that's the important message I want parents to hear is it's okay to draw a healthy boundary for something important like sleep.

58:01And if you draw that boundary and you're consistent about it, you can bypass a lot of the protests because your child will know they're still not going to get what they want even if they protest about it. So that's the thing is if they see there's wiggle room, they're going to keep negotiating and they're going to keep protesting. If there is no wiggle room, this is what we're doing. We're doing this every night. We do this every day at nap time. You can bypass a lot of that. Now, cried out gets a bad rap because there are some sleep training methods, which honestly were from the 1980s. This is when it started sleep training methods where you would go in at increasing intervals and let your child cry and not do anything.

58:46Just walk in and make sure they're okay and then leave the room. And then they cry louder and then you wait a longer period of time.

58:53Dr. Ari Brown:I will say that that was done in 1980 when we didn't have video monitors. And the point of going in at increasing intervals was to make sure your kid didn't get their leg caught in a crib rail. That was the point really for the parent to know the child was okay, but not to actually comfort the child. We've evolved since then. And the important point that I want parents to hear about all of these sleep methods is that we all firmly believe that establishing the healthy routine is what allows you to not have to train your child. You're creating a healthy routine. You're not having to break bad habits.

59:38If you're breaking bad habits, there are going to be protests and then you have to decide how you're going to deal with it. At our house, we've all been obsessed with the same meal almost every day. And that's the thing. We are all obsessed with Goodles, Mac and Cheese. You guys, it's the ultimate comfort food, but it's packed with protein and I'm breastfeeding. So protein is the name of the game. And also I can't have dairy anymore and they have a dairy free option and goodles just dropped a new flavor of microwavable cups called twist my parm that's right you guys microwavable cups so if you've got a toddler's like i'm hungry right now boom you pop it in the microwave you microwave it and it is ready to serve every serving of goodles mac and cheese has protein fiber with prebiotics and vitamins and minerals from real plant sources most goodles products are low glycemic index giving you steady energy instead of a carb crash.

1:00:31They're also Clean Label Purity Award certified, meaning Goodles has been tested for over 400 contaminants and meets the highest standard. There's truly something for everyone. So many amazing flavors, plus vegan and gluten-free options. Trust me, you need to upgrade your mac and cheese to Goodles. I know you'll love it, and I know your kids will too. Plus, find the new Twist My Parm cups online at Goodles.com. And you can pick from so many of their products online or at the stores nationwide at Target and Walmart, plus many other grocery stores and retailers. I like to use a Band-Aid analogy for how you approach change.

1:01:07So some of us rip the Band-Aid off. Some of us peel the Band-Aid off slowly. Some people just wait for the Band-Aid to fall off in the shower. So you have to decide which type of Band-Aid person you are. Are you willing to rip the Band-Aid off? Well, you're going to have one really long night to get your child to adapt to a new routine. They will, but it's pretty unpleasant, but it's real brief. If you're more of the, I'm going to wait for the Band-Aid to fall off in the shower, you don't have any discomfort with that other than the fact it's going to take a really long time to see change. So you as the parent are in charge of changing a disrupted sleep routine.

1:01:49If you have one of those, you're in charge of changing it. You can create change. Your child is very adaptable and very resilient. And I know that they can change. You have to be the one to be willing to change. How you change is up to you and which type of band-aid person you are. And it really lands because so much of how we personally went through Tate's sleep schedule was off a feel. And I think our mindset coming into it was very different than the reality of what happened. And I think coming into it, both of us were very pro cry it out sleep training. And we very much felt, and we tried the 5-10-15 method.

1:02:35But I think we very much just felt like we can develop a routine with her and then can pretty clearly identify like what is, you know, kind of natural. What was the word you use? Like fighting, resistance. Protest. Protest. What's just like a subtle protest versus what's a real cry for help. And we wanted to avoid those, you know, severe cry for helps, but we're very comfortable with subtle protesting and, you know, got to a place that worked for us. So. And in like the world of pediatrics, like cry it out isn't like a thing. It's just that's a marketing sleep industry thing. Right. Or is it something that you talk about with your with your patients?

1:03:35Dr. Ari Brown:Yeah, I talk about different approaches to sleep, and I always try to emphasize being ahead versus being behind. So I talk about this at the two-month wall check is this is what your baby's doing now. You're going to have a new kid, three to four months of age. Let's establish these healthy routines where your baby's falling asleep on their own. Give them five minutes to see what they do. You won't know how they're going to do if they can fall asleep if you don't give them five minutes. And every week, you can give them 10 minutes, 15. You can give them an extra five minutes because at some point between four and six months, they should be able to fall asleep on their own if you give them that opportunity.

1:04:18Now, is your baby going to cry after five minutes? Maybe, and then you can go in. But again, you're giving them a few minutes. That's not what I would define as crying it out.

1:04:28Dr. Ari Brown:there are the breaking the sleep cycles that you have created there there can be a method where you let your child go and that's what you have to decide is that right for you are you going to just let your child go and wait until they fall asleep on their own are you going to go in I personally think giving them a few minutes is fine and if you're consistent about it they will figure it out, but I don't think you need to wait two hours of crying to, you know, and that, that would be kind of a classic cry it out technique. That doesn't mean it doesn't work. And that doesn't mean that your child is going to be harmed by that.

1:05:08And I think it's important to point that out is, um, the people who are anti-cry it out will say there's data to support

1:05:16Dr. Ari Brown:that this is harming children. It's not, but it's also not for everybody. And so you have to decide you know, how much are you willing to give your child the time to figure it out? And that's where the band-aid analogy comes in. But it doesn't mean that it would be unhealthy to do that. Yeah. Do you want to add, like, those that attach, what is it? Like, that it affects attachment style or, like, things like that. I feel like that was always interesting. So the study that people who are very anti-cry it out like to discuss is one on children with neurodevelopmental diagnoses. This is not in neurotypical kids and your average kid.

1:06:04And that's where this attachment question mark came up. The data does not support that this is going to create a problem with attachment with your child. And these are very quick interventions. This is not months long of doing this. This is a quick reset and ways to approach it. Again, different approaches feel right for different parents, but what you choose is not going to be harmful to your child. You have different options. It just depends on how you feel. But I would not be afraid of giving your child an opportunity to figure out how to self-regulate however that works and you feel comfortable with.

1:06:47Yeah, and this is one of those things that I'm very surprised at how intuitive it felt in the line between giving them the few minutes versus like actual distress and going in there and needing to readjust something.

1:07:00Dr. Ari Brown:Right. So, and I know that's probably a scary thing to hear if you're expecting a child, because I very much have a brain where like, I love processes and, all right, we'll do A and then B and then C, and if C doesn't work, you go this direction. And this is one of those that, yeah, I really, like, both Alex and I were just completely on the same page in terms of how to do it and what we didn't want for our child, which it just didn't feel right for us to have in there crying for very, very long periods of time. You just brought up something I do want to talk about because it relates to kind of planning, as you're describing.

1:07:48Dr. Ari Brown:Okay, so I have my toddler 4-in-1 sleep plan, which is cleverly named sleep because you're so exhausted it's hard to remember anything else. S is set up a routine. Routine is king. And make it short and sweet. L, less, is more. Less intervention means more sleep. E is empower the child. We want the child to know how to self-regulate because self-regulation is a key life skill for sleeping the rest of your life. The other E is early to bed. Don't wait for your child to be overtired. It's harder to fall asleep. It's harder to get into good deep sleep. So early to bed actually means late to rise.

1:08:44Kids sleep longer when they go to bed earlier. And then P, which is so important, is plan together. I don't know how many parents. One is doing one game plan, one's doing the other. You guys need to be aligned and decide together. And don't decide at 3 a.m. what you're gonna do, because that's when you're gonna do whatever the shortest path is to get back to sleep. I feel so lucky that we tripped and fell into doing all of those methodologies. Because they're amazing and they make so much sense. And I'm proud to say that we took the sleep approach with Tate. Wow. Hope it works the second time.

1:09:32Am I allowed to say that? Yeah. Why not? Yes. It's literally... Yeah. Good job. I love it. What a great acronym. Okay, amazing. So assuming nothing else, I have one last question. Go for it. One of the most common things that we go to when Tate is having a bad night's sleep is we say we think she's teething. This is both consensus of Alex, myself, and our neighbors. So two-part question. What is the best way to deal with teething toddlers and babies through sleep? Or is this a crutch that we've made up that isn't actually happening?

1:10:16Dr. Ari Brown:Teething gets blamed on everything and it's responsible for just about nothing. I wish Alex heard this. Should I say it again? Yes. Oh my goodness. We'll call her in. Yes. So it's a night or two as the tooth is breaking through. The only exception is the molars. There are one-year molars that usually come in around 12 to 18 months and two-year molars that come in around two to sometimes up to age three. Molars, there's four of them. They do hurt and it takes a while for them to break through, but everything else is like a night or two. So if this is weeks or months, this is not teething. And if it's really a rare night where you have a child who usually is sleeping and there's no other good reason, and if you want to do a dose of ibuprofen for a kid over six months of age.

1:11:08I'd probably do a dose of ibuprofen, one. I wouldn't do it every night, and I wouldn't do it for weeks or months. And if your child has a fever or diarrhea or snotty nose, it's probably not teething. It's definitely not teething if they have a fever. And you should check in with your doctor if you don't know why they're up every night. Yeah, no. And sorry, I should have clarified. This is like a twice a month type situation. But I do think we reference it quite often. And so that is very helpful.

1:11:40Dr. Ari Brown:Every parent thinks it's teething. It's rarely teething. Okay. Very good to know. All right. Well, I think that is everything. Except... I do want to say one more thing. Oh, please. And that is that Teller411 is coming out next month. And you guys are officially blurbers. So thank you. Of course. Thank you for being a blurber. We're excited. Of course, we are so proud to support you and proud that the new edition is coming out. So Toddler411 available everywhere that you can buy a book. Amazon is my personal go-to place to buy books. And anything else to note? That's it. Expecting 411 is coming out in August.

1:12:30Dr. Ari Brown:But yep, baby and toddler. Toddler, you can pre-order now. Baby is out. Okay, fantastic. Please plug your socials, as Alex would normally say. You can find me everywhere at Ari Brown MD. And thank you so much for your time, and thank you for listening. Yay. You did it! Yay! Thanks for listening to another episode of Two Parents in a Podcast powered by Just Media House. If you enjoyed the show, don't forget to like, subscribe, comment, rate, and review. Stay connected on Instagram, TikTok, YouTube, and Facebook at Two Parents and a Pod. Welcome to our home. Sorry it's so messy. New episodes Mondays and Thursdays.

1:13:14Spring just slid into your DMs. Grab that boho look for that rooftop dinner, those sandals that can keep up with you, and hang some string lights to give your patio a glow up. Springs Calling. Ross. Work your magic.