This week I'm joined by Dr. Sujay Kansagra - you probably know him as That Sleep Doc, where he's built a following of 700K+ across social media. He's a professor at Duke and director of their Pediatric Neurology Sleep Medicine Program, he's authored five books (including My Child Won't Sleep), and he even invented a smart crib mattress along the way. His expertise spans sleep disorders across every age, from infants through adults, and he brought all of that knowledge into this conversation with total ease and zero judgment.

Here's what we got into:

• How to spot credible sleep info online- what to look for (and watch out for) in a space with no real regulation
• Late-pregnancy sleep struggles- what's actually going on (iron, sleep apnea, caffeine metabolism) and when to loop in your OBGYN
• The 0–6 week newborn phase- why it's normal for this stretch to feel like chaos, and the small routines that can help
• Safe sleep, realistically- what to do when your baby won't sleep anywhere but on you, and the safest way to handle those exhausted middle-of-the-night moments
• Sleep myths, rapid-fire- "sleep begets sleep," "never wake a sleeping baby," "wake windows," "nursing to sleep is a crutch," and what the actual sleep science says about each
• What "sleeping through the night" really means- (hint: there's no official definition, and the number you're picturing is made up)

If you've ever felt like everyone else has figured out sleep and you're just surviving - this one's your permission slip to relax the rules a little.

More from Dr. Sujay Kansagra:

Check out the Lullabee Smart Crib Mattress

Grab his book: My Child Won’t Sleep

Follow @ThatSleep Doc on Instagram, TikTok, FaceBook, & YouTube

Checkout Dr. Jade Wu

More from this episode:

Listen to episode 54: What I Wish I Knew About Baby Sleep Before they Were Born (from a mom of 4)

Helpful Timestamps:

• 00:00 Baby Sleep with That Sleep Doc
• 09:49 Pregnancy Sleep Troubleshooting
• 13:40 Zero to Six Weeks Normal
• 15:11 Early Routines and Tools
• 19:39 Safe Sleep Versus Reality
• 27:20 Sleep Begets Sleep
• 29:37 Wake a Sleeping Baby
• 31:40 Sleep Drive and Caffeine
• 33:19 Wake Windows and Cues
• 42:51 Define Sleeping Through the Night

About your host:

Lo Mansfield, MSN, RNC-OB, CLC is a registered nurse, mama of 4, and a birth, baby, and motherhood enthusiast. She is both the host of the Lo & Behold podcast and the founder of The Labor Mama.

For more education, support and “me too” from Lo, please visit her website and check out her online courses and digital guides for birth, breastfeeding, and postpartum/newborns. You can also follow @thelabormama and @loandbehold_thepodcast on Instagram and join her email list here.

For more pregnancy, birth, postpartum and motherhood conversation each week, be sure to subscribe to The Lo & Behold podcast on Apple Podcasts, Spotify, or wherever you prefer to listen!

A request: If this episode meant something to you, would you consider a 5 star rating and leaving us a review? Yes, we read them, and yes, they help keep L & B going! ♥️

Connect with Lo more on: INSTAGRAM | TIK TOK | PINTEREST | FACEBOOK

Disclaimer

Opinions shared by guests of this show are their own, and do not always reflect those of The Labor Mama platform. Additionally, the information you hear on this podcast or that you receive via any linked resources should not be considered medical advice. Please see our full disclaimer here.

Additionally, we may make a small commission from some of the links shared with you. Please know, this comes at no additional cost to you, supports our small biz, and is a way for us to share brands and products with you that we genuinely love.

Produced and Edited by Vaden Podcast Services

Mentioned in this episode:

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1

Speaker 3: By nature, we should normalize zero to six

weeks being a complete crap show when it comes to sleep.

2

When it comes to sleep and children's sleep and

parents' sleep, there's no one-size-fits-all really.

3

It's addressing that child's needs, that family's needs,

and take it all in totality and then addressing the issue.

4

Are you doing okay?

5

Is your baby doing okay?

6

Then I don't care.

7

Do your thing.

8

But you get to decide what a problem is or what, what problematic

sleep looks like because every family and every household is different

9

Speaker 4: Motherhood is all-consuming.

10

Having babies, nursing, feeling the fear of loving someone that much.

11

Then there's this baby on your chest, and boom, your entire life has changed.

12

Speaker 5: It's a privilege of being your child's safest space

and watching your heart walk around outside of your body.

13

Speaker 6: The truth is, I can be having the best time being a mom

one minute, and then the next, I'm questioning all my life choices.

14

Speaker 4: I'm Lo Mansfield, your host of the Lo and Behold podcast, mama of four

littles, former labor and postpartum RN, CLC, and your new best friend in the messy

middle space of all the choices you are making in pregnancy, birth, and motherhood.

15

If there is one thing I know after years of delivering babies at the bedside, and

then having, and now raising those four of my own, it is that there is no such

thing as a best way to do any of this, and we're leaning into that truth here.

16

With a mix of real life and what the textbook says, expert insights, and

practical applications, each week we're making our way towards stories that we

participate in, stories that we are honest about, and stories that are ours.

17

This is the Lo and Behold podcast.

18

Lo: What is up, my friends?

19

We are going back with a guest today to the world of baby sleep.

20

If you wanna hear more from me and my thoughts on it, I'll address this a little

bit in the podcast I actually gave you more personal mom thought anecdotal

stuff about sleep in episode 54, so feel free to listen to that one as well

as a great complement to the conversation I'm putting in front of you today.

21

I have Dr. Sujay Kansagra with me today.

22

a professor at Duke, and he's the director of Duke

University's Pediatric Neurology Sleep Medicine program.

23

Feels like such a mouthful to say.

24

He is excellent.

25

He is popularly known as That Sleep Doc on social media,

where he has over 700,000 followers across the platforms.

26

also the inventor of the Lullaby Smart Crib Mattress.

27

specializes in treating a variety of sleep disorders,

including sleep apnea, insomnia, narcolepsy, and parasomnias.

28

He works with adults and children, all the ages, all the spectrum,

so I think that's really special and really cool about him as well.

29

Dr. Kansagra is the author of numerous peer-reviewed research publications and five books,

including the book My Child Won't Sleep, which he qualifies as a high-yield, step-by-step

guide to fixing common sleep issues in children of all ages, infants through adolescence.

30

You guys are gonna love this.

31

He is so easy to talk to.

32

He feels so kind, and I think it's just a gift to hear

someone talk about sleep in such a stable, steady way

33

Dr. Sujay: Sujay, I am so glad to have you here.

34

You guys can hear me, I'm kind of laughing because

I was just clarifying, am I allowed-- what am I

35

Lo: allowed to call you?

36

So this is Sujay.

37

I'm gonna let you go ahead and introduce yourself more, let people know kind

of who you are and maybe how they might be familiar with you already if they

38

Dr. Sujay: are.

39

Yeah.

40

Yeah, thanks, Lo.

41

It's great to be here.

42

I'm Sujay Kansagra.

43

I'm a child neurologist and a sleep medicine doctor at

Duke, commonly known as That Sleep Doc on social media.

44

I live and breathe sleep and all of the various things that

sleep entails, and so glad to be here talking about it.

45

Lo: So one reason I brought you on, I would say, too, is bec-

and you just mentioned this when you introduced yourself a

little bit, is you are a sleep doctor, yes, but also this is…

46

And I-- you can see this on your profile, right?

47

So some people might be familiar with this, but

this is about, like, adult and baby sleep, right?

48

And so my brain lights up, I'm like, "Oh, baby

sleep." I have all these parents in my community.

49

That's the big thing.

50

But I also just like that there's maybe this more

holistic background of, like, sleep in general, right?

51

And this understanding- Yes … not just about the baby, but also about you, too.

52

So-

53

Dr. Sujay: Yeah,

54

Lo: absolutely … do you feel like work leans more heavily in one direction, or

it really does all just come together and flows together and makes sense together?

55

Dr. Sujay: Yeah.

56

In, in my day job, it's I see only pediatric patients.

57

I follow some of my patients, uh, particularly my patients with

narcolepsy, I follow into their 20s and rarely into their 30s.

58

But our sleep medicine fellowship, which is a

one-year training program, is kind of cross-training.

59

It's all adult, pediatric, everything, and so we become very savvy

taking care of sleep issues and sleep disorders across the age spectrum.

60

Lo: Okay, perfect.

61

And then the other thing that I wanted you to get into

for me a little bit is this idea of credentialing.

62

Mm-hmm.

63

Because we were talking before we started that the sleep

world, and I'm talking a little bit more about this baby sleep

world now, or the toddler sleep world, is a little bit spicy.

64

And you hear conversations a lot about there

isn't any credentialing, there's no regulation.

65

Like, how do we really know if this person actually knows what they're talking about?

66

I don't care- Yeah … what their credentials are.

67

I'd rather have someone who wants to be a mother the way I'm a mother.

68

Like- Mm-hmm

69

how do you kind of address that with people, maybe online, certainly in

practice as well, for what they could look for if this matters to them,

or how they should- Sure … kind of think about that conversation?

70

Dr. Sujay: Yeah.

71

So this is a great question.

72

I will tell you that from a sleep medicine standpoint when it comes

to credentialing, you know, we, we have a pretty standardized kind

of training, and there's a board certification for sleep medicine.

73

So that's kind of what we do.

74

But getting to what you're addressing, which is there is a world of sleep professionals,

sleep consultants that don't necessarily go through any sort of accrediting body.

75

Now, it's fairly easy for me to essentially look at their profile,

look at the type of thing, content they're producing, and know whether

this is more of an evidence-based person in the sleep world versus

they're a little bit more fringe and maybe not so evidence-based.

76

so it's fairly easy for me to kind of tease that apart.

77

It may not be for those that are not familiar with the sleep medicine world.

78

So I always say, you know, be cautious.

79

Uh, the red flags for me are, "I've come up with this brand new

magical sleep solution that is only the Tsuji solution, regarding

behavioral interventions, and this is the only thing I use."

80

Because we know that when it comes to sleep and children's

sleep and parent sleep, there's no one-size-fits-all really.

81

It's addressing that child's needs, that family's needs,

and take it all in totality and then addressing the issue.

82

Now, the other thing that I will say in defense of sleep consultants,

because I know many now in the online world, and many of them are wonderful

advocates for science-based sleep and sleep safety and all that stuff- I will

say that even among sleep physicians, I can find folks that are a little

bit fringe and not really going along with true evidence-based medicine.

83

And so even in your most accredited kind of situations, you can

still find people that may have d- be kind of doing their own thing.

84

So that's that's kind of my, my broad take on it.

85

Lo: But did you answer my question?

86

You're supposed to tell me what are we supposed

to do- … and who are we supposed to look for?

87

Dr. Sujay: I don't know, Mo.

88

But I think- I don't, I don't know.

89

You know, I, I'd, I'd be cautious.

90

A- again, if they are touting, "I believe in evidence-based sleep

approaches, behavioral sleep approaches," you know, then I'm all about that.

91

You know, I know people, you know, personally like, you know,

Tracy Bronstein and Jane Havens that are, that are in the

sleep consulting space that are evidence-based practitioners.

92

And so maybe one day I'll just come up with my own little database to be

like, "I trust these people. These are the ones that you should go to."

93

Lo: Yeah.

94

Well, I think- Yeah … like so much of, you know, the labor and birth world that I'm

more in, lactation consulting, breastfeeding, stuff like that- it just always feels

like this fine line as a parent to walk between like if you're someone who says, "Yes,

I love the evidence-based stuff," or, "I want like evidence-based birth information,"

and then lining that up too with like the realities of the situation you're in.

95

Yeah.

96

Finding people who have that empathy for it without maybe sacrificing

a certain principle that you care about or that they care about.

97

I just think it's just like a complicated thing to do sometimes because

real life doesn't always follow the textbook- 100% … or evidence.

98

Yeah.

99

And so then I think that's why so many of us are

like, " But this doesn't make sense," and you said- Mm-hmm

100

you know, you being whomever, like you said

that this is what would happen in XYZ scenario.

101

So I think it gets just so tough definitely in with

baby, you know, particularly baby sleep as well.

102

Dr. Sujay: Yeah.

103

And I think when it comes to the evidence base, the literature that we

have when it comes to sleep disorders or labor and delivery, you know,

what we know, the, the principles that we think, are applicable to that

scenario form, I think, the, the kind of the scaffolding on which we build.

104

Because I guarantee every patient is in a situation that there's not any exact

right answer based on the evidence because of all of the factors that play a role.

105

So we use that, I think, as the foundation, and then we build off of it

and, you know, we just wanna make sure that we're not doing things against

what we know are, safe, predictable, effective solutions in the sleep world.

106

Lo: Right.

107

I know as a parent myself, I've had four kids, figured out how to get four kids

to sleep, figured out- Yeah … how to get my own sleep in the midst of all of it.

108

And there's a-- So I do not think I'm an expert except like an anecdotal

expert, like personal experience expert after trying- Yes … this a few times.

109

but I do think there… Yeah, I love that idea of like scaffolding and foundations.

110

I even, I released a solo podcast episode a while ago about

sleep, and it was like, "Hey, I'm not an expert, just a mom.

111

But I want to talk to you about-" Yeah … like foundational

things that have just been really valuable for me to float around."

112

I call them anchors.

113

Yeah.

114

And so I'm like, "These are anchors for us about sleep." Right?

115

And so in the days that go completely wonky or the times when the

routine has changed again or whatever, we just can like float around

these anchors and not get too far away from the things that I, this

is still me speaking personally, have, have come to believe is true.

116

So I feel when it comes to sleep, if parents can get to that place where

they feel really good about these, you know, these things that they can

hold onto or maybe there's some evidence-based medicine to support their

scaffolding and they're like, "I know I can anchor myself here even while

things are a little funky on this Monday, and then they're gonna be funky

again next Thursday through the weeken-" You know, because it changes so much.

117

I just think that idea is so helpful to have those, those anchors to float around.

118

Yeah.

119

And I want to get into some of those kind of like

anchors and narratives, et cetera- Let's, let's

120

Dr. Sujay: do it … with

121

Lo: you today too.

122

Dr. Sujay: I love it.

123

Yes.

124

Wonderful.

125

Lo: Okay.

126

I have one question about adult sleep since that you

are someone who can really speak to that really well.

127

Mm. If you have any sort of thoughts on… So someone actually dropped

this in my DMs a while ago saying, " Basically, I'm summarizing.

128

I'm getting like crap sleep end of pregnancy." Yeah.

129

"What am I, what do I do about that?"

130

Dr. Sujay: Yeah.

131

Is

132

Lo: there an answer that you have for someone who comes to you with that conversation?

133

Dr. Sujay: Yeah.

134

I- it's so tough because most of my difficulty sleeping conversations entail an

hour of like diving into all the different things that could be contributing.

135

I'll give you, I'll give you like the 10,000-foot view when it comes to late

stage pregnancy, which is one, is there any concern regarding restless leg?

136

Because your child, as they're growing, they're also sucking iron

out of you, and iron plays a big role in maintaining, that comfort

when it comes to that, you know, discomfort with, with restless legs.

137

So, could there be an issue with iron stores?

138

We know that obstructive sleep apnea symptoms can also start to,

to worsen over time, and so that's something to keep in mind.

139

Caffeine, if you are ingesting caffeine, the half-life of caffeine changes

drastically during pregnancy and the thought is it actually, it doubles,

meaning it takes longer for you to clear caffeine out of your system.

140

So we want to keep that in mind too.

141

If the same cup of coffee you were drinking before you

got pregnant now is potentially affecting you differently.

142

And then of course it's all the comfort things that and the discomfort

that comes along with pregnancy and the, and you know, the areas,

the ways that you can sleep and the ways that you can't sleep.

143

And so, and, and that's best handled, I think, through you and your

OBGYN regarding the most safe and comfortable positions for you.

144

But that was kind of the 10,000-foot view of

things to look for during late stages of pregnancy.

145

Lo: Yeah.

146

I mean, it makes perfect sense.

147

It makes me think, again, this like applies to birth as well, but how

there's always this-- There's, to some degree, pregnancy specifically

we're talking about, there's gonna be this level of discomfort, right?

148

But we don't have to ignore it, and so this- Yeah … includes sleep

as well, where it's like, "Sorry, you're just gonna sleep like crap

when you're pregnant, and you just have to deal with it," right?

149

Like- Mm-hmm … are there some things like those you just brought up that we

can talk about that we can use to address the discomfort or maybe address some

of these, you know, the restless leg or whatever else might be going on- Mm-hmm

150

so that maybe you're not gonna be 100%, but we can get you back to 85 or whatever.

151

And I think sometimes- Yeah … we get lost a little bit in… I

just think in pregnancy You can get that dismissive like, "Being

pregnant just kind of sucks, so you just have to deal with it." Yeah.

152

And so I think sleep is one of those areas where it's like, "No, no, no.

153

Speak up.

154

We could maybe address this a little bit and get you to a better place."

155

Dr. Sujay: And this gets to actually one of the problems

in sleep medicine, which is you may have a fantastic OBGYN.

156

They may not be as well-versed in sleep disorders.

157

You may have an outstanding sleep doctor, and they may not

be as comfortable handling challenges when you're pregnant.

158

So you mentioned at the start, do I have go-to people?

159

I love the information from Jade Wu, W-U, and she is what I would

consider an expert in the insomnia, and particularly for females,

you know, around pregnancy, around perimenopause, et cetera.

160

She's, she's fantastic.

161

So that's a resource, and I think she's written a

book as well, that you could potentially check out.

162

So…

163

Lo: Okay.

164

Great.

165

Thank

166

Dr. Sujay: you.

167

Yeah.

168

Lo: Yeah.

169

All right.

170

Let's get to some of this newborn stuff since- Sure … that's probably

what everyone's really, like, feening to hear your thoughts on.

171

So I kind of want to give you a, another like I just said,

"Oh, I'm eight months pregnant and I'm sleeping really badly."

172

Let's switch and say, " Hey, I'm eight months

pregnant." Maybe they find you on social media.

173

Maybe they're a friend in real life.

174

And they're saying, "I'm terrified about infant sleep because from what I can

see, it feels like it's impossible for anyone to do it well." We… Maybe this

is, like, another 10,000-foot back view, but how do you speak to someone like that

who approaches you with, with I think is a little bit of a valid fear or worry-

175

Dr. Sujay: Yeah

176

Lo: because of probably what they're seeing, taking in, seeing online.

177

And it is tough.

178

Like, let's not- Yes … pretend it's not tough.

179

Dr. Sujay: Yes.

180

Yes.

181

I see it in both directions.

182

I see some that are terrified and some that are watching

everybody's highlight reels on social media, and people are

backpacking, you know, in through Europe with their six-week-old.

183

And they're like, "Oh, this is gonna be a cakewalk." And I'm all about

normalizing what should be normalized regarding normal sleep patterns.

184

And so and then I like to bin it.

185

And so there are certain bins of, when it comes to age regarding sleep physiology,

and that also helps me give them actionable advice regarding things that can be done.

186

And so let's start at the very beginning, like zero to six weeks.

187

By nature, we should normalize zero to six weeks

being a complete crap show when it comes to sleep.

188

Right?

189

Interesting.

190

And many, and, and many other things unfortunately.

191

Like, this is like the perfect storm of like, gosh, you've just gone through a delivery.

192

You have just passed a human through your body.

193

You know, your body is recovering.

194

Hormones are changing.

195

A child is crying.

196

Your in-laws are giving you advice on what you should do.

197

This is like the perfect storm when it comes to like, you know-

198

Lo: Breastfeeding.

199

If

200

Dr. Sujay: you're breastfeeding.

201

Challenges of breastfeeding.

202

It's a lot.

203

Postpartum anxiety, postpartum depression.

204

I mean, the list The list goes on, right?

205

And then of course- Right … you throw sleep deprivation.

206

But I do want to normalize young infant sleep patterns.

207

So when you're zero to six weeks, you don't

really have much semblance of a circadian rhythm.

208

People always say, "Oh, they have their days and nights confused."

209

No, they don't.

210

They don't even know what day and night is right now.

211

They have no idea what's day and what's night.

212

And so you're gonna see roughly 50 to 60% of sleep

at night, and the other 40 to 50% during the daytime.

213

And child's gonna wake based on their hunger cues and,

they're gonna fall asleep based on their sleep drive.

214

And that's normal.

215

You know, that's, that's normal for infants.

216

They should be waking up frequently.

217

They should be eating frequently.

218

This is just a time where you have to kind of hang on.

219

Ask for help if help is available.

220

Use the tools that you have to hopefully make

sleep and your life daytime more, more bearable.

221

Talk to your OBGYN or your pediatrician or your family

medicine doctor if there are concerns about PPD and PPA.

222

It's a rough six weeks, you know?

223

And then but let's normalize it.

224

Let's get you set up for that knowing that, yeah, it's gonna be a challenge, and

things will get better, so there's reasons to stay optimistic as well, right?

225

Now, what can you do?

226

What are actionable things you can do?

227

I'd love to just, just touch on these.

228

One is it actually helps to have, I think, a nighttime

routine that maybe lasts 10, 20 minutes at nighttime.

229

Your baby is not gonna give two poopy diapers whether you go through the routine or not.

230

It's not really for them at this age.

231

It's mostly for you to have a time in your day where you can maybe get away.

232

If you have a partner, partner can be there with you.

233

Maybe you give the baby a bath every other day.

234

Maybe you have some time to just massa- give the baby a massage, read to them.

235

Just some time where you're away from all the chaos

and the mess and whatever else is going on, right?

236

So start doing that at some point at night, and that will translate into a

routine that hopefully sticks that will then benefit the baby when they get older.

237

If you are breastfeeding, and we of course encourage parents if they

are able to and willing to breastfeed, we want to make sure they

have every opportunity to be successful at that 'cause moms make

melatonin, and their breast milk is gonna have some melatonin in it.

238

If you are pumping, I recommend, and I wouldn't go crazy over this, but it's nice if

you could just put a little AM or PM on that stored milk and then give it to the child

at that time 'cause that might also help set some of that early body clock timing.

239

And then of course, as we mentioned, asking for help when you can get help.

240

Those are my- Yeah … kind of key actionable items at that stage.

241

Lo: It's gonna be my-

242

Dr. Sujay: And be, oh- My- Be- Go ahead.

243

Be optimistic.

244

Sorry.

245

I was gonna say be optimistic because things will get better.

246

I promise they will get better.

247

Yeah.

248

Yeah.

249

Lo: Yeah.

250

We do need to put that little pin in the conversation too of like it does get better.

251

And, and- Yeah … and I would say going back to that initial like, "I'm eight

months pregnant and I'm terrified," like- I, I wouldn't want someone to be terrified.

252

My hope would be in- Yeah … a conversation like that, I'm

sure yours as well, is like, "Hey, let's actually talk through

some of these normals. Let's just set expectations better."

253

Yeah.

254

Because I think a lot of times then it's that, the, the

expectation is not met, and then that's when someone's showing

up online being like, "Ugh, I'm gonna terrify everybody." Mm-hmm.

255

And really a lot of times it's just the expectation was wrong at the start.

256

Yes.

257

And then that's getting, that's trickling out to other

people via however someone's choosing to share it.

258

Yes.

259

And so do you talk about- My mom brain was just listening to those three,

or I guess you said four things at the end of, of ways to kind of have some

rhythms and routines even though it's gonna be chaos, and that's normal.

260

Mm-hmm.

261

I'm just trying to picture, like, what bedtime looks like, quote-unquote bedtime, right?

262

And having these routines, but then also recognizing for me, I'm

sitting here going, "But newborns don't have a bedtime." That's right.

263

Like, they do whatever the heck they want, right?

264

That's right.

265

So it's like this arbitrary… For me, that's how it was.

266

You can tell me if you disagree.

267

Mm-hmm.

268

It was like they're not gonna go to bed at 7:00 PM, like

this whole seven to seven thing when they're three weeks old.

269

Now, maybe at 9:00 or whatever time feels good to you, you're gonna

start doing your wind down with them, but then know that, like,

they're still gonna do their thing after that bedtime, you know?

270

And so I just ha- I feel like, again, in so many of these sleep

conversations, like I've already said, I don't feel like an expert.

271

I feel so much like a mom and I'm like, "Oh,

that's true," and also it's really wild and crazy.

272

Like it's just-

273

Dr. Sujay: Uh,

274

Lo: I- … all this stuff that you mentioned.

275

Dr. Sujay: I feel plenty of, plenty of reason to prepare but not be scared.

276

I agree with you.

277

I think having those expectations are important.

278

I often see questions in parenting forums where they're like, "My child

is five weeks and I, they, I can't get them on a schedule," to which

I'm just like, " You know, who told you they were gonna have one?"

279

You know, they're, they're… It's normal to not be scheduled.

280

You can't spoil your baby.

281

You can't really put them on this wake window schedule that early.

282

This is a time where, again, you just kind of hang on.

283

You do your best, you can to just enjoy this really

small new baby without worrying too much about routines.

284

Reading, kind of reading your baby's cues, right?

285

Baby's hungry, all right, we're gonna feed them.

286

The baby seems sleepy, we're gonna rock them to sleep and do whatever we, we need to do.

287

You're not gonna spoil your child at this age, and you're

not gonna really get them in a schedule at this age.

288

Let's set that expectation for everybody.

289

Lo: Right.

290

And as hard as it is, I mean, I'll just throw in this,

I'd go back and I would, I would do it again tomorrow.

291

I mean, it's such a sweet, exhausting thing.

292

but it's just… Yeah, I think it's just so, so worth it.

293

Not that maybe you probably don't need to hear that and you already know that.

294

But yeah- Yeah

295

I think the sleep thing- Yeah … those early weeks are wild, but man, they are quick-

296

Dr. Sujay: Yes

297

…

Lo: in the grand scheme of things, and then you're, you're missing

it, and you'd go back for a night where you're holding them.

298

I don't know.

299

I would.

300

Maybe some people are like, "Absolutely not, Lo. You're crazy." I would.

301

Dr. Sujay: There's probably something evolutionarily protective about

being so sleep deprived that you forget how miserable things were.

302

There has to be.

303

And then you're like, "I'll do it again because I forgot how

terrible it wa- Yeah … you know, not terrible, but how, how hard

304

Lo: it was.

305

Also something evolutionarily protective of the

ring of fire or whatever those labor things are.

306

Yes.

307

And then you're like- Absolutely … "I'll do that again.

308

Sure.

309

That sounds great." Yeah.

310

So.

311

Dr. Sujay: Yeah.

312

Lo: Yeah.

313

That's

314

Dr. Sujay: wild.

315

Lo: Okay, Let's segue then.

316

You mentioned some things that are kind of perfect

for this next question that I do want to ask.

317

I know you're- You're big or firm on, you know,

like safe sleep surfaces and safe sleep practices

318

Dr. Sujay: Yes.

319

Lo: So how do you address that, with the kind of reality of like, "Oh, they only want

to sleep on me," or, "I'm really strugg- they won't sleep in this bassinet next to me."

320

Dr. Sujay: Yeah.

321

Lo: Those first weeks are wild, like you said, and we're snuggling and holding

and just- Mm … getting them to sleep when they can and when they will.

322

Yes.

323

So how do we do that?

324

Because the reality is that these babies don't want, many of them-

325

Dr. Sujay: Yeah

326

…

Lo: don't want to sleep by themselves these first weeks and- Yes

327

give us a three-hour chunk in their bassinet.

328

Dr. Sujay: Yes.

329

Well, I will tell you that i- ideal scenario for those that do not intend

to bed share is doing what you have to do to get them to fall asleep, and

then having them practice, you know, staying asleep in their bassinet,

knowing that they are going to wake up after maybe an hour or two.

330

Their sleep cycles are short.

331

They're going to get hungry relatively quickly.

332

but when they are asleep and when you're asleep,

ideally having them in their safest sleep scenario.

333

Now, there will be a lot of people I'm sure that are listening to you that are

also big proponents of bed sharing, and I will say that there are some things

that those that are hardcore safe sleep surface folks and those that are I'm

going to try to safely bed share folks, there are some things that everybody can

agree on, and I think it's important to share those things, which is the most

dangerous thing that you can do, or the most dangerous things that you can do,

are sofa share or recliner share with your child when you're both sleeping, right?

334

That, th- those are notoriously multiple orders of magnitude higher when

it comes to, to risk than the other kind of safe sleep scenarios, right?

335

So we're not going to do that.

336

We're, if we're going to share a bed space, we're

definitely not going to be drinking alcohol or smoking.

337

We know that those are also huge risk factors.

338

We're not going to have a, an old bed, you know, an old

mattress because that can also predispose to, to challenges.

339

So, and I think everybody can agree on that.

340

Now, to the mother or to the parents that want to practice safe sleep scenarios and are

like, "But my kid is not sleeping," I will completely agree that there are other risks

that can occur to both the child and the parent when everybody's sleep deprived, you know.

341

And, and I hear that.

342

You know, we, we talk just about safe sleep when it comes to

SID and SUID, but there is a whole, there are a whole other s-

ramifications you have to think about when it comes to parental sleep.

343

And my approach here is ideally still trying to have them spend their time on

a safe sleep surface, and do what you have to do to get them to fall asleep.

344

So whether that's holding, rocking, nursing, pacifier, whatever it

takes, you get them to fall asleep, and then transfer them into a safe

sleep surface, if that's the direction that you are choosing to go.

345

Now- I'm happy to talk about Lullaby because this is the exact scenario where I feel

like even myself, you know, when we had kids, my kid drop-kicked me in the face.

346

I knew all the techniques when it comes to sleep,

and we were just struggling those first few months.

347

But there's nothing that necessarily helps children sleep in their safe sleep

space because by nature it's supposed to be boring and firm and not with anything

else in it, and on their backs, all of which make sleep more challenging.

348

So, so my, my goal here is to give people options, as many options as possible, whether

it be sleep education, whether it be, you know, Lullaby or a smart crib mattress.

349

What- whatever I can do to help make that more possible,

more likely to happen, both sleep and safe sleep surface.

350

Lo: Yeah.

351

I appreciate everything you just said because I feel like you

addressed something that Is not addressed, let's say, at the bedside.

352

Like when we're discharging these parents to home,

and we're going through all the things, right?

353

And we're addressing sleep and, hey, put them in, you know, the ABCs

of safe sleep, and we go through the kind of rote American pediatrics,

you know, alone on their back in their crib or bassinet, whatever.

354

You know, and, and we don't get into the nuance of what I feel like you just addressed,

which is, hey, if you're falling asleep with your baby, Like, don't sit up in a

chair, in a couch and think that's better than them sleeping in your bed, right?

355

I think even in the AAP statement, correct me if I'm wrong, they address this

like, if you're falling asleep, because we recognize that parents sometimes

fall asleep with newborn babies, like it's safer to fall asleep in a bed.

356

Now, they're not saying that bed sharing is safer.

357

The ABCs still apply.

358

That's the safest thing.

359

But like that knowledge of, hey guys, don't fall asleep in the

rocker because you're trying not to fall asleep in the bed with them.

360

And, and I just think back to my first and my husband and I, we were on the

couch with the baby taking shifts, you know, every single night, at least

for the first couple of weeks, I would say, trying to figure it out together.

361

And both of us were constantly falling asleep with this swaddled baby on a couch.

362

Like, it freaks me out when I think back, like how quickly she could

have tumbled out of our arms, been smushed between us and the couch.

363

Yes.

364

Just little things like that where it's like, we thought we were

doing, I'm going to say the right thing because our goal was safe ABCs.

365

I know I keep going back to the acronym, but you know, alone- Yeah.

366

Yeah … in her bassinet.

367

Dr. Sujay: Yeah.

368

Lo: And we were actually doing something that was inherently more dangerous

than if she ha- were to fall asleep with me while I was, you know, in

the bed following those rules, kind of you just mentioned like safe- Yes

369

sleep seventy type things.

370

Yes.

371

And no-- But it's no one ever told us.

372

No one ever said, "Hey, assuming," let's say, air quotes, "you want to do

all the right things when it comes to sleep, let's also check in on what

happens if you were to fall asleep, because it's very possible," you know?

373

Mm-hmm.

374

Yes.

375

And so I appreciate that you addressed that, and I appreciate that the

AAP has that in there, not because they're trying to make it confusing

and condone different things, but simply to say, hey, reality is you're

really tired and people fall asleep with these little babies all the time.

376

Yes.

377

So let's address how to do that in the safest way possible, you know,

until you get back to whatever your goals are or whatever that might be.

378

So- Yeah.

379

Yeah … mostly I'm grateful you said that, and I'm grateful

that people are saying that now because it feels very do it

this way or co-sleep and have them in your bed all the time.

380

And I'm like, what about the parents who want to do it this way but also fall asleep and

then are, are trying to Not freak out, but also like, "I don't like how this is feeling.

381

Like, how do I do this as well as we can-

382

Dr. Sujay: Yes

383

…

Lo: when I'm really tired and they're 12 days old?" You know, whatever.

384

Dr. Sujay: The wor- the worst thing we can do is make that blanket statement

to say there should be absolutely no bed sharing, and then somebody,

assumes that recliner sharing or sofa sharing is not bed sharing, right?

385

So, uh, yeah, I mean, it's, it's, I think it happens all the time.

386

So we definitely have to make, that pitch, you know?

387

Sofa sharing, recliner sharing is about the, the- Yeah … the,

the most unsafe thing, so you have to be very careful.

388

Yeah.

389

Lo: So, so important.

390

So hear that- Yes … you guys.

391

That beautiful rocker glider you bought for your nursery, it's not

a safe place for them to fall as- you two to fall asleep together.

392

That's right.

393

Don't do it.

394

Dr. Sujay: That's right.

395

That's right.

396

Now, if they're doing a contact nap- And I know how easy

397

Lo: it is

398

…

Dr. Sujay: and you, and you're awake- Yeah … no problem, right?

399

I mean, but-

400

Lo: It's the best

401

…

Dr. Sujay: but geez, you know, it's so, you fall

asleep so quickly as a sleep-deprived parent.

402

You think you're wide awake- Yeah … one minute and the next minute you're out.

403

So just please be careful.

404

Speaker: Hey friend, quick pause for just a second.

405

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406

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407

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408

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409

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410

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411

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412

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413

Okay, let's get you back to the episode

414

Lo: Yeah.

415

Yeah.

416

Okay.

417

I want to get into, you kind of mentioned one of these when

you were talking about the melatonin in the breast milk.

418

Some sleep kind of- Narratives, ideas, I don't want to call them all

myths, but just some stuff out there, and then get your thoughts, on them.

419

So we can, you can treat it- Mm-hmm … a little rapid fiery.

420

I have like five or six.

421

I'd just love to hear what you, your response is to these.

422

the first one, what are your thoughts on the, narrative idea that sleep begets sleep?

423

Dr. Sujay: Yeah.

424

So, I will tell you that, in my mind, it's good sleep

habits beget good sleep habits beget good sleep.

425

Let's put it that way, right?

426

So there's, there's nothing that we know physiologically that says just because

you sleep beautifully this night, you're gonna end up sleeping more the next night.

427

Otherwise, some of us great sleepers will just turn into constant

like hibernating creatures because we'll be sleeping all the time.

428

So I would say that the good sleep habits you put in place will hopefully

help you get the amount of sleep that you need, and then you will

continue to do that day in and day out because of those good sleep habits.

429

Now for infants particularly, their 24-hour sleep need is their 24-hour sleep need,

and it's usually on average around 14 hours, but the range is actually very wide.

430

Like it, like frighteningly wide when the children are really young.

431

And so for them, they're probably gonna get their full sleep need one way

or the other, you know, regardless of what you kind of do or try, try to

do when they're really young because again, that sleep drive is so high.

432

So y- we don't really have a lot of like truly sleep deprived young infants.

433

Like they, they will get their sleep one way or the other.

434

Lo: Right.

435

Okay, you just mentioned something within that which is that idea of needs in 24 hours.

436

Yes.

437

Will you speak to that a little bit more?

438

Because I love- Yeah … that parents think more like, okay, they need

about this in a day versus this nap has to be X, Y, Z or whatever.

439

Dr. Sujay: Yeah.

440

I will tell you that trying to schedule naps is just an exercise in like,

you know, frustration and, you're gonna end up pulling your hair out.

441

At the end of the day, children are gonna nap however the heck they want to nap.

442

You can set them up for success best you can.

443

But I really encourage you to think about it in a 24-hour window, which is

yes, are they getting what I think is their, their quote unquote sleep need.

444

It's genetically determined really.

445

If both parents tend to be short sleepers, I have a lot of patients where both

f- both parents are physicians, and they're naturally both really short sleepers.

446

and then what, what happens in that scenario?

447

Well, the child is a short sleeper, and they end up in my clinic saying,

"My kid's only sleeping eight hours a night or nine hours a night."

448

And I'm like, "Oh, well, you're probably a short sleeper too." And you know, so, uh

449

Lo: This is, this is your fault.

450

This is

451

Dr. Sujay: your genetics.

452

This is like this is sleep karma coming back.

453

The, the, the misery you gave your parents is now

coming back to- Your mother, yeah … get you.

454

You know, that's right.

455

So, no, but, but I, I like to think about in, in a 24-hour period

because that also helps set you up for success because you're like, "Oh,

my kid's a wonderful napper and he's taking six hours worth of naps.

456

Why is he only sleeping nine hours a night?" And I'm like, "Well, let's

think about it in a 24-hour period, not of a nap and a nighttime."

457

Lo: Okay, so that's what I wanted you to get to as well because that

brings me to this next one is this idea of never wake a sleeping baby.

458

What are your thoughts on that?

459

Dr. Sujay: Yeah, it depends on your goals, right?

460

So it depends, it goes 100% on your goals.

461

I don't like waking up kids, but if, if your child is napping at

5:00 PM and your goal is for them to go down at 6:30 and they're

like an older infant, that you're setting yourself up for issues.

462

So I say either yes, you can consider waking them up if you need.

463

If there is a structure that you're trying to abide by that's worked for you, that's fine.

464

You're not gonna, you're not gonna hurt them.

465

They might be a little bit cranky when you wake them up, but

you can gently wake them up to get that sleep drive built up.

466

Or you can compensate for that larger nap by pushing bedtime a little bit

later with that whole framework that we talked about of the 24-hour sleep.

467

And so don't expect your child to have a really low sleep drive and

then magically then sleep through the night because they've only had

like an hour, hour and a half wake window and they're six months of age.

468

It's just not gonna work.

469

So it depends on your goals.

470

Yeah.

471

Lo: Right.

472

That's why I want, I wanted to bring that together 'cause I think that 24 hour,

like needs in 24 hours is a really valuable part of the conversation, and also this

idea of, hey, you mentioned like if your baby takes a six-hour nap, well guess what?

473

They're not gonna go to bed at 7:00 PM anymore.

474

And I think that sometimes we do think, "Well, it's bedtime, right? And I'm doing the

routine." And it's like, well, but they're gonna… If you, if they were to truly go to

bed right now, you're trying to make them sleep 20 hours today in this 24-hour period- Yes

475

they're not gonna do it, right?

476

Yeah, yeah.

477

And so I think, I think that sometimes gets a little lost in the weeds sometimes,

'cause we just think- Yes … they took a great nap, sleep begets sleep.

478

Well, it's like- Yeah … well maybe they took a very long nap.

479

If you're fine with that- Mm-hmm … great, but then you need to adjust on the

other end because of the, you know, kind of it's, again, going back to that

their sleep need in one day, well, we're pushing, we're pushing that limit.

480

That's fine.

481

Yes.

482

But, like, you have to adjust somewhere for that.

483

And I think sometimes parents aren't getting

that or they're not putting that all together.

484

It's more just like they take, they should take

two naps a day and we go to bed around 7:00.

485

Mm-hmm.

486

But there is a lot of like flexibility and nuance in that-

487

Dr. Sujay: Yes

488

Lo: that we have to be, yeah, addressing or else we're gonna

end up frustrated like, like, like you're talking about.

489

Dr. Sujay: And, and there's very useful sleep physiology that I'll nerd

out for a second if you don't mind, just because I think it helps- Yes,

please … drive this point home which is there, there are two main processes

that modulate how we feel throughout the day when it comes to wake and sleep.

490

One is the circadian rhythm.

491

That's naturally just hanging out in the background, 24-hour period.

492

Regardless of what we do, it's giving us awake signals and sleepy signals.

493

That's kind of operating on its own.

494

But the other one is called a homeostatic sleep drive, which is essentially

the longer we're awake, the sleepier our brain feels, and that's modulated

by a variety of chemicals that build up in our brain, but the main one

is adenosine from the breakdown of ATP which is our energy molecule.

495

And we have receptors in our brain that bind onto that adenosine and our brain can tell

I've been awake for six hours, I've been awake for 10 hours, I've been awake for 12 hours.

496

That's your sleep drive.

497

That's why you can't really stay awake for, you know, two, three straight days.

498

Your brain is gonna force you to go to sleep or start

taking micro-sleeps because that sleep drive is so high.

499

So for children we have to think about that.

500

Is their sleep drive building up enough during wakefulness?

501

Are we adding enough sleep drive during wakefulness to help promote deeper,

longer sleep at night if they're at the age where we can try to promote that?

502

Lo: Yeah.

503

Perfect.

504

You can always geek out with me.

505

I love all that kind of stuff.

506

Love

507

Dr. Sujay: it.

508

Yes.

509

I love, I love, I love geeky stuff.

510

Oh, and by the way, what blocks adenosine receptors?

511

Caffeine.

512

Caffeine is what- Mm … it's a temporary trick, displacing

adenosine, and so you don't feel as sleepy as your brain really is.

513

But it doesn't get rid of the adenosine.

514

It's still there.

515

So when your caffeine leaves your system, you kind

of hit that wall because adenosine is hanging out.

516

Yeah.

517

Your brain always knows.

518

There's no tricking your brain.

519

So then you

520

Lo: drink another cup of coffee, right?

521

But you have a

522

Dr. Sujay: cup of coffee and then you have disrupted- Trickin' your

523

Lo: body.

524

Dr. Sujay: And then you have disrupted sleep the entire night.

525

You wake up feeling miserable.

526

Right.

527

And guess what?

528

You grab more coffee.

529

It's a great cycle for Starbucks.

530

Terrible for your brain.

531

Not for us.

532

But great for Starbucks.

533

Lo: Okay.

534

Good to know.

535

Um, Okay, so you just mentioned wakefulness.

536

You said the term wake windows a couple times.

537

Yes.

538

So another kind of big thing out there.

539

Well, I would say just the topic of wake windows, but really I've also heard

there's no science behind wake windows, so just don't even worry about them.

540

I've heard that a little bit.

541

I love wake windows, I'll just tell you that.

542

Yeah … but what are your kind of thoughts on that or if people are coming to you with-

543

Dr. Sujay: Wake windows-

544

Lo: ideas about that?

545

Dr. Sujay: I, I like, I like them in concept because it actually gets down to

what we know of sleep physiology, which is, yes, your sleep drive does build up.

546

And so I love having a rough kind of ballpark estimate of

this is the typical range for wake windows at this age.

547

Again, it gives you the foundation on which to then build off of.

548

But it oftentimes if people are saying this is the exact wake window, I say, "Well,

we don't know what the child's sleep needs truly are. We don't know what number

of naps they're taking," because that'll vary depending on the child and the age.

549

So we have to take all that into account.

550

But the concept of wake windows is still steeped in the known physiology of

the homeostatic sleep drive, which is sleep builds the longer you're awake.

551

So that's why I like wake windows for, for that reason.

552

But I, I don't like to be prescriptive about it

because the variation of sleep range is so wide.

553

But I love for families to think about that.

554

Just be like, "Gosh, is this wake window too short?" And that's usually the issue.

555

It's, it's usually too short when they're trying

to promote better sleep as the infants get older.

556

Lo: Right.

557

It makes me think of the whole, I'm gonna say cliche, but my mother-in-law did

this as well, but the whole like, "They're not tired. Look how awake they are."

But it trickles into… I think wake windows really trickle into sleep cues, right?

558

Yeah.

559

And if I were to tell a friend or even students in my own courses and

we're talking about sleep, it would be, I'd care less about you watching

the clock as much as you watching them and how they're cuing you, right?

560

Yeah.

561

Yeah.

562

And so wake windows I love, and maybe you're like, okay, they're usually up about

an hour, you know, this week of their life because I feel like they change so much.

563

Yes.

564

But also I'd rather you be looking for the cues anyway and understanding

what those are and how those are indicating, hey, sleep is approaching.

565

Sleep is encroaching.

566

Like they're- Now what do you- … looking like they're ready.

567

Dr. Sujay: Are you proposing we actually take the child into account here, Lo?

568

This is crazy.

569

This is crazy talk.

570

Yeah, no, 100%.

571

Because the other thing about wake windows is that by nature

they should be different depending on the time of the day.

572

Oftentimes they're much shorter earlier because of- Right … our circadian rhythm.

573

And so yeah, wake windows can be all over the place.

574

But you're, you're right on the money here.

575

Like if you can read your child and they're starting to get a little bit of that

glazed look or they get a little bit of that redness in their face or a little bit of

that, you know, yawn and you're like, "Yeah, I can, I can see them getting, getting

tired now," go with it, you know, regardless of what the wake window's telling you.

576

Just, yeah.

577

Yeah.

578

Go with it.

579

Lo: It makes me think of my husband, God bless him, but sleep's never

been the thing he's like the best and most supportive in or whatever.

580

Mm-hmm.

581

And he's always like, "Okay, what time do they need to go to

sleep?" You know, if I were to leave them and go do whatever.

582

Yeah.

583

And I'm like, "Well, around noon-ish," but you know, like if her eyebrows get red.

584

My kids, some of them they had like the red eyebrow thing.

585

Yeah.

586

You know, whatever.

587

They each had different cues too, and they- Mm-hmm … the cues would show up at

different… Like yawning for some of them was an early cue versus a late cue.

588

Mm-hmm.

589

You know, there's all this stuff that w- you know, we figured out over time.

590

Mostly I- Yeah … figured out over time.

591

And, and so I felt like it so often, and he probably like so many people

want that a little bit more prescriptive because it just feels easier.

592

Like, oh, they go- Yeah … down around noon.

593

Yeah.

594

But there really is a lot more that, that goes into it, and I think

that's where the, yeah, watch your baby sounds very rote, right?

595

Like blah, blah, blah.

596

But really watch your baby and get to know your baby

and they're gonna tell you so much more than the clock.

597

Dr. Sujay: Yeah.

598

Yeah.

599

And I agree, and it gets easier the older they get because I feel

like they do get more predictable, the patterns get more predictable.

600

And so there is a time where you might be able to be a little bit more

prescriptive and be like, yeah, they always go to sleep at this time and they…

601

Because they've shown you that pattern.

602

But especially early on it can be, it can be very hard.

603

And I will also have a caveat here to those that

whose children don't give them any, any cues.

604

'Cause my, my first went from like wide open to like fully

asleep in like the matter of like a second when he was nursing.

605

I was asking my wife, "What's coming out of there? Is this whiskey?" Like there

was no cues whatsoever, and he'd go from content and awake to completely out cold.

606

And so that can happen too, and that can be a little bit more challenging.

607

But then you get into, again, patterns where you're like, okay, this is what's working.

608

This is the timeframe that's working and we're gonna stick with that pattern.

609

Lo: That makes me think back to where I talked about anchors, right?

610

And just having those things, you're like, "I got some patterns."

611

Dr. Sujay: Yes.

612

Lo: I'm sure you probably are, like, anti that schedule vocabulary as

I am as a parent too, but, like, definitely it's patterns, rhythms,

routines where you just float around them and know, like, we're

613

around these things and recognize that we're getting

close to something, that we can be watching for something.

614

Yeah, just love- Sure … the idea of floating around these rhythms or

the scaffolding, you know- Yeah … to use your vocabulary from earlier.

615

Dr. Sujay: Yeah.

616

Lo: Okay, one more.

617

Okay, kind of two more, but I feel like I know

what you're going to say, so I'll ask you this one.

618

You can be quick if you want.

619

Mm-hmm.

620

Nursing to sleep is a crutch.

621

What do you say

622

Dr. Sujay: to that?

623

N- I would say no.

624

I mean, particularly early on, you know, you can do anything that you want,

you know, to help a child fall asleep because they often need that closeness.

625

They need that comfort.

626

As children are getting older, a lot of it depends on what pattern that you're developing.

627

So if it's a child that's waking up three times at night and

they're truly just using mom as a pacifier, you know, or they'll…

Mom's like, they're not, they're not actually getting a full feed.

628

They're, they maybe latch for 30 seconds and they're out again.

629

Then you could say, well, this is turning into a little bit more of

a habit than a caloric intake and a nutrition, you know, a behavior.

630

So it all really depends on the, on the patterns.

631

you know, the, the goal long term, again, is if sleep is a problem for you after

a certain age, which is typically around four to six months, if the sleep patterns

are problematic for your family, then we look at the pattern of what's going

on, how the child is falling asleep, and determine if things need to be changed.

632

If it's not a problem for you, for example, you nurse your child to sleep, they're

six months old, they wake up twice, they want to feed, you nurse them back to

sleep quickly, you fall asleep quickly, and you all wake up in the morning fine.

633

If it's not a problem for you, nothing needs to be fixed, right?

634

So in that case it's, who, who cares if somebody calls it a sleep crutch.

635

Are you doing okay?

636

Is your baby doing okay?

637

Then I don't care.

638

Do your thing.

639

You know, do your thing.

640

But you get to decide what, what a problem is or what, what problematic

sleep looks like because every family and every household is different.

641

Lo: I wish we could just stop the episode right

there, 'cause that's such a good place to end.

642

But I have one more question.

643

Mm-hmm.

644

But

645

Lo: I love that- Editing, you nursed my kiddos to sleep at night, but

I didn't nurse them to sleep for naps, and we figured out what we liked.

646

And so it was like, I'm gonna nurse them when I feel like it, and I'm gonna,

you know, figure out, try how, try not to nurse them when I feel like.

647

And this happened later, like you're saying.

648

Those first weeks, like just feed the baby and they fall asleep- Yes … and whatever.

649

But it, it just always bugged me when everyone's like, "Nursing to sleep's

like a crutch," or, "You should avoid it." I'm like, are you kidding me?

650

I do it sometimes when I want to, and we figured out and this is what works for us.

651

Yes.

652

And so that's what I really liked about what you just said too is,

if something's not a problem for your family, you do not have to

change a single thing, and I think that that is, you know, the idea.

653

Let's end it right there, ' cause that's what I would want people to hear.

654

If someone else is, wants their six-month-old to sleep through the night, great.

655

They can pursue that- Mm-hmm … if that's what

they need and that's what their family needs.

656

If you don't or you aren't and you're fine with

it, you do not have to change a single thing.

657

And I think that that gets lost sometimes in this sleep

conversation because you think their baby's doing this, mine is not.

658

Mm-hmm.

659

What should I do about it?

660

But if you're happy and you're good and your family's okay

with how things look, then keep doing what you're doing.

661

Don't change something that- Absolutely … isn't, I guess I'll say broken.

662

Not that babies are broken, but-

663

Dr. Sujay: Yes

664

…

Lo: why are we messing with something when we're

okay with it just because our neighbor- Yes

665

is doing it differently?

666

It, I mean-

667

Dr. Sujay: That's right.

668

That's right.

669

And also on the flip side, I always like to say because it's working for your

neighbor and it's not a, it's not a problem for them, doesn't mean that you

should feel like it's not a problem for you if it is a problem for you, right?

670

So they may be able to fall asleep quickly.

671

You may have insomnia.

672

You may be driving around a lot during the day, and

you'd prefer a more consolidated night of sleep.

673

So, you know, you should not feel, feel guilt over needing to

change something if the solutions are safe and effective, which

there are n- numerous, you know, solutions in, in, in that realm.

674

So on either side of the coin, I feel like no judgment, you know?

675

Judgment free, you know?

676

You need, you need that help, there are things

that can be done that are effective and safe.

677

And if you don't, that's wonderful.

678

Nobody should tell you you have a problem.

679

Lo: It's interesting to think that we need to do parenting in community, right?

680

We need each other, but there's also this aspect of some of these things we

need to be doing almost in a silo as well, just in that thought of, like,

other people don't get to decide what makes sense for you and your family.

681

So it's like- Mm … you get to choose those things, and then we lean on

each other as we pursue whatever is feels right for us and our families.

682

It's this weird dance of, like, I'm not gonna

look around and let you tell me how to do this.

683

But I am gonna look around when I need you, and I am- Mm … in the midst of something.

684

It's kind of this funky- a little in between.

685

Yeah

686

Dr. Sujay: I, it's so tough because even the folks that are, I think, very, like,

research-based and like to look at data, we are always biased a bit by our own

experiences when it comes to things like, for example, sleep training or the things

that we've heard online, you know, regarding what should or should not be done.

687

And no matter what parenting forum you post a

question on for opinions, you're gonna get the range.

688

And I feel like oftentimes you're left with more questions than answers.

689

And I like to say there are, like, a million right ways to do

it, 'cause we're always on this endless odyssey of what's the one

right solution that's gonna make everything perfect for my life?

690

And the answer is there's probably a million different ways to

do it and end up with a thriving, healthy, happy child, right?

691

And I think parents need to know that.

692

Like, there is usually no one right solution as long as

you are keeping your child fed and, sheltered and safe.

693

Lo: Yeah.

694

Yeah.

695

All right.

696

Again, wanna end there, but just kidding, I wanna ask

you one more thing 'cause I think it comes up a lot.

697

Yeah.

698

Yeah.

699

Okay.

700

Sleeping through the night, how is it actually defined or qualified?

701

Is it- There is- … truly 12 hours?

702

Dr. Sujay: There is zero definition of sleeping through the night.

703

Thank you.

704

Sleeping through the night is whatever-

Exactly … helps, helps you be happy with what you got.

705

And it's funny 'cause when I look at…

706

I've looked into this research to be like, well, how have,

how have studies tried to define a good stretch of sleep?

707

And it all, it ranges.

708

You know, some people say a, a six-hour timeframe in which- That's

nice to hear … a parent does, does not have to re- respond.

709

It can be an eight-hour timeframe in, at any point in the night.

710

It can be an eight-hour timeframe defined by a

711

It's all over the map.

712

You know, if your kid is connecting some sleep cycles and everybody's

getting good restorative sleep, then, you know, then your kid's sleeping

through the night, you know, and you can define that however you'd like.

713

Yeah.

714

Lo: Yeah.

715

I just think it gets tossed around so much, like, "Let me help you

and your child sleep through the night." I'm like, " What do you mean?

716

Where did that come from?" 12 hours?

717

That's BS.

718

Someone made that up.

719

Yeah.

720

And now we all talk about it.

721

Like- Yeah … I just think… But it is so prevalent, right?

722

This idea- Yes

723

of 7:00 to 7:00 or whatever.

724

Yes.

725

And so sometimes we're like, we are chasing a goalpost that doesn't even exist.

726

That's right.

727

Not even real.

728

Dr. Sujay: That's right.

729

That's right.

730

And, you know, the reality is, like, no human being sleeps

through the night in, in, when it comes to sleep physiology.

731

You know, I've read thousands of sleep studies.

732

Not a single person has slept 100% of the night.

733

That's normal.

734

You know?

735

We should be waking up, especially after we go through a sleep cycle, and that's

why children tend to wake up a bit more, 'cause their sleep cycles are shorter.

736

But that's healthy.

737

That's protective.

738

You want to shift around.

739

You don't want to sleep on your arm the entire night, and then you

don't have any blood flowing to your fingers for eight hours at night.

740

You know, we want to have those awakenings.

741

So normal, protective.

742

Lo: Well, I feel like I could talk to you all day about sleep,

but I will officially stop and not ask any more questions.

743

This is great, thank you.

744

I just think it's such, yeah, just an area of angst

as we kind of wait and then once we're in it as well.

745

And I don't know that it has to be.

746

I think it is tough, but it doesn't have to feel so, like, divisive, make us feel so

unsure about the choices we're making or what we're doing, and I think I hate that.

747

I hate that a lot of parents just end up feeling so kind of out of control in it.

748

Just wonder if, yeah- Less spicy mode … wonder if more of that normal expectation can-

749

Dr. Sujay: Yes

750

…

Lo: can help us change that.

751

Dr. Sujay: Let's make it less spicy, to use the word that you used.

752

Yeah.

753

Little less spicy.

754

Turn down the volume just a little bit.

755

Yeah.

756

Lo: I'll take it.

757

I love it.

758

Okay, one question I love asking at the end.

759

Well, kind of two.

760

One, tell us where we can find you.

761

I know you kind of mentioned it when you intro'd

yourself, but where they can find you on social or online.

762

Yes.

763

Where they can find this kind of smart sleep mattress that

you have as well, 'cause I know that is- Yeah … part of what

you do and what you've been working on the last couple years.

764

Dr. Sujay: Yeah.

765

Lo: And then after you do that, I'll ask the last question.

766

Dr. Sujay: Sure.

767

ThatSleepDoc is my handle on just about every social

media platform: Instagram, TikTok, Facebook, YouTube.

768

And, Lullaby.

769

Lullaby is the name of our smart crib mattress we invented out of Duke, and we hope it's

gonna make, hopefully, parenting a little bit easier for those that choose to use it.

770

It's another option- Yeah … out there to keep your kid

in a safe sleep space and help them with their sleep.

771

Lo: Remind me, is it standard sized mattress, bassinet?

772

Dr. Sujay: 100%.

773

It looks like an- Like this is just a

774

Lo: mattress, right?

775

A crib- It's just

776

Dr. Sujay: a mattress

777

…

Lo: like a crib mattress.

778

Dr. Sujay: That's right.

779

It's, a lot of regulation in the US about s- the sizes- Yeah

780

of crib mattresses, and so they're all very standardized.

781

So it's a standard crib mattress.

782

It's meant to replace your crib mattress.

783

Yeah.

784

Lo: Okay.

785

Okay.

786

Sounds good.

787

And then last question, just for fun, what is something in

your life right now that's just bringing a ton of joy to you?

788

Dr. Sujay: My, my kids have gotten, older.

789

So I have two boys.

790

They're 10 and 12.

791

And, they are great sleepers.

792

But what brings me joy is that sometimes we can break with the sleep routines, you know.

793

So if my kid is like, "Hey, can you stick around for a little bit longer, or scratch

my back for a little bit," or, "I need a little extra time at night," I feel like

our routines and everything have gotten so robust that we can break these, you know,

these AKA like strict routines and do whatever we want and still have great sleep.

794

And so, so I, I love being able to do that.

795

Yeah.

796

Lo: It is really one of the sweetest places to get to with your kids.

797

And I think that it can happen earlier too, where you're like, "You know

what? If we push this nap today or we skip it, we're gonna be okay." Yes.

798

"We'll get them to sleep tonight. We can go to Disneyland."

799

You know, whatever.

800

I just- Life happens … I can, I remember that period with all the

kids where you're like, "Okay, we're okay." Like, we're gonna still

have some moments, but we can do this today or we can do this this

week and, and it's gonna be totally fine, and that feels so good.

801

Yeah.

802

Dr. Sujay: Life is important.

803

Life happens.

804

You know, sometimes we have to make space for life.

805

Lo: Yeah.

806

That's right.

807

Dr. Sujay: Yeah.

808

Lo: Well, thank you so much for making space for me today.

809

Look at that.

810

Of course.

811

Great segue- Same … to the ending.

812

Really.

813

This is a great conversation, and yeah, I'm

excited to turn down the spice in the sleep world.

814

Dr. Sujay: I love it.

815

I hope

816

Lo: this does.

817

Dr. Sujay: Thanks for having me on.

818

I appreciate it.

819

Speaker 2: Thank you so much for listening to the Lo and Behold podcast.

820

I hope there was something for you in today's episode that

made you think, made you laugh, or made you feel seen.

821

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mentioned in this episode, please head over to loandbeholdpodcast.com.

822

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823

And if you haven't heard it yet today, you're doing a really good job.

824

A little reminder for you before you go, opinions shared by guests of this show are

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825

Additionally, the information you hear on this podcast or that you

receive via any linked resources should not be considered medical advice.

826

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