Kind and respectful approaches to sleep
Interview with Katie Cortés
I chat with Newborn Mothers educator Katie Cortés from Katie’s Babies, who teaches the module on sleep in our Postpartum Education and Care Professional training. Together we discuss the cultural expectations around infant sleep and how they are in tension with baby development. At the core of this conversation, we explore how sleep invites us to begin holding space for our child’s emotions, exploring ways to meet them whilst also respecting ourselves.
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About Katie
Katie teaches the module on sleep in our Postpartum Education and Care Professional training. Katie is a registered midwife and certified infant sleep consultant who believes in coaxing a love of sleep, through attachment, honesty, respect & fun. Katie balances the value of attachment parenting practices, breastfeeding, baby-wearing and co-sleeping, with mindful respect that each family has their own unique aims, challenges and priorities for a good night’s rest. Katie has supported countless families, guiding them through the various stages of achieving better sleep for their babies while gaining confidence in their own happy styles of parenting.
We explore the following questions:
How did you come to be interested in sleep? Why did you move from midwifery to sleep support?
What do we need to know about baby development and infant sleep? How does sleep actually help babies to grow?
A common misunderstanding is around the four-month sleep regression. What’s actually going on there?
How can we meet the needs of a parent and also meet the needs of a baby, without saying we have to completely sacrifice or compromise one for the other?
As a Newborn Mothers educator, what was the experience like of figuring out what professionals should know about sleep? What did you learn?
How have your learnings about sleep changed over the past few years?
Additional resources we spoke about:
Podcast - Episode 33 - Creating A Sleep Business - https://www.newbornmothers.com/blog/creating-a-sleep-business
Postpartum Education and Care Professional Training - https://www.newbornmothers.com/training
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Transcript
Julia Jones:
Hello and welcome to the Newborn Mothers Podcast. Today we have Katie Cortés on the podcast who is a midwife and a certified holistic infant sleep consultant, and also our sleep educator inside the Postpartum Education and Care Professional training.
Katie, I wanted to have you on today to have a little bit of a chat about cultural expectations around infant sleep and how they clash with baby development, maybe just clearing up some of the myths and misunderstandings. When I created this course and updated everything, I really wanted to include sleep because I feel like there's so much unhelpful information, even incorrect information out there that's so confusing and overwhelming for mums. I don't want our postpartum professionals to be adding to that confusion. Katie, one thing that you say that I love is you believe in coaxing a love of sleep, which I think is really beautiful. Welcome to the show.
Katie Cortés:
Thank you for having me. Always a pleasure to be here and I'll try not to waffle on for hours and hours, though I'd be happy to if you want me to.
How did you come to be interested in sleep? Why did you move from midwifery to sleep support? (01:18)
Julia Jones:
Yes. Katie, you and I go way back. We've known each other for many years and you've been teaching with me for coming up to a year now. We're running our third class together with you as the sleep educator. I guess let's start from the beginning. Tell me a little bit about how you came to be interested in sleep and why you moved from midwifery to sleep.
Katie Cortés:
It was an accident, really. I still don't know how I wound up in this job because when my children, my four children, when they were little, I would never have dreamed of hiring a sleep coach or going to sleep school or any of that nonsense. So it still baffles me how I wound up here, but there we are.
Look, to be frank, I was getting pretty... what's the word? Not overwhelmed, not burnt out, but just disillusioned with the midwifery profession, certainly within the context of hospital practice. I used to go to work and just constantly be on the hamster treadmill, filling in notes and doing all the clerical side of the job and not really spending a lot of time with mums and babies and that's where I got the real joy from my job. So I started to think about becoming my own boss, but I didn't know what on earth that could possibly look like.
Anyway, long story short, after a year off working and travelling with my family, I thought, yes, I need to start making a plan for how I can build a career that I feel pleasure in working at because I was losing that with midwifery. I think looking back now, what I wanted to become was a postpartum doula. But I mean, how many years ago is this? Seven, or eight years ago, it wasn't as well-known profession as it is now. To be honest, I didn't really know how to get clients in that field. I kind of accidentally stumbled across my first client who really needed help getting her toddler to sleep. She wanted regular help every few weeks and not being very good at the money side of it either, I thought, "Oh my goodness, this is going to cost you so much money. How about I help you get this toddler to sleep and then you won't need me every few weeks?" Gosh, not much of a business mind back then.
Anyway, we did that and I thought, "Oh, okay, so this wasn't so bad." Then suddenly I started to just get more clients and I thought, "Gee, I really need to get more education around this. I need more tools." Just having four children and being a midwife wasn't nearly enough.
Julia Jones:
Interestingly, you don't really learn a lot about sleep as a midwife though, do you?
Katie Cortés:
Well, no, not really. And not the useful stuff either. I mean, most of the stuff that we told mums was, no, you can't co-sleep, that kills babies. And you definitely don't do it in the hospital, it's not our policy and blah, blah, blah. But babies don't get that memo, do they? So they come out expecting to be nurtured as other baby mammals are, and we try and tell them it's different for them.
What do we need to know about baby development and infant sleep? How does sleep actually help babies to grow? (04:43)
Julia Jones:
So if anyone wants to go back and listen to a bit more of your starting out story, that's on episode 33 of the podcast. Fast forwarding a little bit to now, you've been working as a holistic sleep consultant for a few years. You've had dozens of families that you've worked with and supported, and now that you are helping us to teach some of this basic infant sleep information to our postpartum professionals, tell us a little bit about... Let's just go back to the basics. Tell us about baby development and infant sleep. How does sleep actually help babies to grow?
Katie Cortés:
Oh my goodness. How does sleep benefit all of us? Well, no, I could go on about this for hours and hours. Look, we all need good sleep, don't we? We all need good sleep for the most minute of cellular functions in our bodies, but not least for our mood, our general health and all of that great stuff. Now, there's often this misconception that if babies don't have X number of hours of sleep, their brains aren't going to develop properly. Well, that's just such dangerous information to be banded around. Unfortunately, I'm ashamed to say that unscrupulous quarters of the sleep industry love that particular piece of information.
Any research that's been done on there on the development of infant brains in regard to sleep have been done on older children. So toddlers, preschoolers, school-aged children, we're not talking about babies. So if you ever hear that applied to babies, you can just take it from me, you can ignore that piece of information. It's not relevant because babies sleep like babies for very good reason. As I talk about in the Newborn Mothers course, newborn babies in particular need to wake frequently throughout the night to re-oxygenate, to raise their blood pressure, to feed and raise blood glucose levels and all of that kind of good stuff. So babies are designed to wake up in the night. However, we're always going to get those babies who sleep well through the night. Some unicorn babies. I never had one. I don't know where we get these babies from, but they do exist.
Julia Jones:
You would be very rich if you could create unicorn babies, Katie.
Katie Cortés:
Absolutely. So we're not going to be waking up those babies unless they're very little or jaundiced or a few of those other reasons. So developmentally, little tiny babies are not adapted to sleeping the long stretches of sleep like adults are. This is often where I have to get quite clear on expectations with families when they come to me with sleep challenges and just look first at the developmental side of things and what their expectations are and are they realistic compared to where we're at developmentally. Did I answer that question all right? Was there more you wanted?
Julia Jones:
Yes. I think that's really interesting. Then I think the other interesting thing is what you've mentioned too, that a lot of advice that mums get like don't co-sleep or your baby has to sleep X number of hours or their brain won't develop properly. I mean, this is things that professionals are telling families all the time and it's not actually very helpful.
Katie Cortés:
No, no, definitely not. Because then parents feel like they're the only ones who aren't able to... So often I hear that parents feel like they're the only ones in the mother's group whose babies aren't sleeping through and it's just, they're doing a bad job. Now, of course, all these babies come to this world with different personalities, different needs, and different sensory needs. So what works for one baby may not work for another. Just because yours is the only baby that doesn't sleep through at the moment, it doesn't mean that they're not going to be sleeping through later on when all the others have decided they want to be awake in the night.
Julia Jones:
Yes.
Katie Cortés:
They all go through different things at different times.
Julia Jones:
There is also a bit of a culture of shaming parents if their babies don't sleep. Sometimes parents don't want to admit that their baby's not sleeping because it's seen as a personal failing as a parent. So I always think there's probably often a lot of people who just won't speak up about it.
Katie Cortés:
Yeah, absolutely. Or they won't speak up about other practices. So things like co-sleeping, feeding to sleep, all of that kind of stuff. And so they skirt around the issue. They don't want to be open about it, but then by not being open about it, people never share these tips with each other.
A common misunderstanding is around the four-month sleep regression. What’s actually going on there? (09:30)
Julia Jones:
Yes. Let's talk specifically about a common misunderstanding, I guess, or I guess a common sleep challenge, which is the four-month sleep regression. I know that's when a lot of parents seek out a sleep consultant. What's actually going on there?
Katie Cortés:
This is one of my favourite topics, and it's often the age that people bring sleep challenges to me, first of all. So they may have had a baby that's slept quite well in the first couple of months, and then around the four months, it can happen a little bit earlier. It can happen a little bit later. There's an actual change to the structure of the sleep cycle. And two new sleep phases arrive around this age, often in line with the development of or the achievement of more gross motor skills. So they're learning to roll, they're learning to reach, they're learning to grab. And so the changes in sleep cycles are actually really important for downloading all that information and the changes that need to happen in the brain in relation to these gross motor skills and some fine motor skills as well for some.
So sleep can seem disjointed. So these two new sleep phases that come are actually light sleep. So they may wake more easily, be awake for little stretches in the night, sound wide awake, and parents often then assume that it's their jobs to put them back to sleep. And also around four months, it seems common that parents are suddenly expecting a routine to emerge. They're starting to want to get their social lives back on track. So at this point, parents are thinking, "Right, we need a routine. I want some predictability," at a time of huge excitement for these babies. So all this amazing stuff is starting to occur to them. Light bulbs are flashing on all over the place in their tiny brains, and they're suddenly now looking at exploring other forms of sensory input.
For example, when we look at going to sleep, for instance, they may have been happily falling asleep on the breast up until four months, getting all their sensory experiences orally and for the hands and the skin and the face from mum's breasts and mum's clothes. But at this point, it's a really great time to invite other forms of sensory input too. So you might start to introduce a little toy of sorts at sleep time or a comforter at sleep time. Now, I will just put the disclaimer in here. We don't recommend comforters to be in with babies throughout the night at this age, but during the onset of sleep, this is often a time that I say, "Hey, how about we present this other opportunity to your baby?" And they may decide that they can actually start to develop a little bit more independence around going to sleep, find how they like to soothe themselves. And once they're asleep, of course we can move that item away.
But what commonly happens is the opposite where parents go, "Oh my gosh, this just feels like chaos. I need to reign it in. I need to gain control." So this is the time that they go, "No, no, no, this looks like chaos. I'm just going to rock you to sleep and feed you to sleep and pin your arms down and I'm going to avoid the advice to take you out of a swaddle. I'm just going to keep it all really controlled." And it often happens at a time as well where their stamina starts to develop. So that means they can be awake for longer periods between naps, but parents are still trying to get them down as frequently as they used to, or they're following the dreaded awake windows from some chart they've downloaded somewhere.
So then when the baby protests, because A) they're being put to bed probably sooner than they're actually feeling tired, and B) the windows are blacked out, they can't see anything. They've got their arms strapped down, they can't feel anything, they just want to play. They want to practice that rolling and they're being prevented from doing any of that because sleep has really taken center stage in terms of importance to parents - that of course babies get frustrated, they become furious. Some of them, I've seen it happen. The parents put the blinds down, they put the sleep suit on, they walk into the bedroom and the baby cracks it. So, so common. But then what gets the blame is, "Oh, I've missed the window. He's overtired. Look at him. He's so furious, he's overtired." And so they try even harder to get the baby to sleep. And so you see, it's like the opposite of everything the baby's saying. They’re saying, "I'm getting bigger, I need longer awake. Please give me that toy back, or please just open the blinds a little bit. I want to look at that tree outside while I go to sleep."
So it's my job when I come in then, is just to suggest, "Well, are you sure those tired signs that you recognized a month ago, are you sure they're still saying the same thing? Could your child be saying, 'Actually, I'm bored, or actually I want that toy back, or actually I'm not tired?'" Because those communications can mean so many more things when all these new areas of realization are opening up in their brains.
Julia Jones:
Yes. And what I really love about your approach, Katie, is you do have this kind of solid understanding of sleep, like what is sleep, what sleep needs different for parents and babies. But then you also just have very helpful ways to communicate with each other better and what could we try and what might work for this particular family, which I really love.
I think one of the key learnings of the module that we've put together on sleep for professionals is really that key teaching of a parent's sleep is at odds with infant sleep. Once you kind of realize that it's a huge weight off your shoulders to kind of go, "All right, it's normal for babies to wake up this often and it's normal for parents to want to sleep for a long time." And then as a professional, we have a really different perspective. How can we meet the needs of a parent and also how can we meet the needs of a baby, but without necessarily saying we have to completely sacrifice or compromise one for the other.
How can we meet the needs of a parent and also meet the needs of a baby, without saying we have to completely sacrifice or compromise one for the other? (06:12)
Katie Cortés:
Yeah. Yeah, that's a great question. So I think what it boils down to is community and support. It's really hard for one person to manage this on their own. So, one of the first things that I say to many parents that come to me, especially if they consider that they're in a sleep crisis, is to figure out, all right, well, can we take shifts?
What we know from studies is that mums and dads, I believe as well, do much better, emotionally speaking, certainly in the context of postnatal depression, they do much, much better with at least a four-hour stretch of sleep, uninterrupted stretch of sleep. So I don't mean that's enough for them to sleep throughout the entire night, but a stretch somewhere in the night that is around four hours, they do much, much better emotionally.
Whereas a lot of parents may take it in turns, if the baby doesn't need a feed, the partner might get up and rock them back to sleep or soothe them somehow and let mum carry on sleeping. And so they take it in turns. But I often say, look, it's much better if you can actually take a shift. If mum's breastfeeding, then maybe partner can bring the baby to mum in her sleep space, be there to help facilitate the feed, and then take the baby back, settle, change the nappy, all of that kind of thing.
So yeah, it's acknowledging the adult sleep needs while also acknowledging where we're at with the baby's sleep needs and just reassuring them that even if we do nothing, even if we change nothing about the way the baby sleeps, the chances are they are just going to get much, much better with their sleep as time goes by. So this is not something we have to engineer. There is no magic window of opportunity for making sure you've got a good sleeper. This is where I just say, that if you can just foster a love of sleep and some happy vibes around sleep and not feel too resentful about sleep, then that's probably the best ingredient to get anybody started.
As a Newborn Mothers educator, what was the experience like of figuring out what professionals should know about sleep? What did you learn? (18:20)
Julia Jones:
Yes, I love it. I have one more question to throw at you, Katie. How was your experience of teaching professionals? Because usually you work with mums and families directly. During this process of trying to figure out what is it that professionals should know about sleep, how was that experience for you? What did you learn?
Katie Cortés:
The merging really, because they're a merging of the two ideas because I think a lot of the people I was talking to had been mums previously, are mums obviously. So a lot of them were thinking about it from their own personal journey and going, "Ah, I wish I'd known you when we had our babies. That makes so much sense." I think it also lets professionals off the hook a little bit in terms of you don't have to be telling parents what to do, it's just reassuring them and having the faith yourself that this baby knows what they're doing. You don't have to engineer anything as long as people are lying down as much as they possibly can be.
The points that we go into in the course are things like, look, let's learn to co-sleep safely or at least sleep on adjacent sleep surfaces. Let everybody stay lying down because why are we sitting up in chairs holding babies while they sleep and nodding off ourselves? Because we've been told that's the safer thing to do when science tells us it's 18 times more dangerous than co-sleeping with a healthy full-term baby.
Julia Jones:
Yes. I think the safe sleep lesson was a really interesting one to write, and I agree with you about our students' responses to the module, and in fact, this is true from everything we teach. There's so much myths and misinformation and also just gaps in our knowledge around almost everything to do with postpartum that it is often like a huge learning journey and healing experience for our students personally as well. So they do this course thinking, "Great, at the end of it, I'll get a qualification and I'll start a new career." And that is true, but they also realize, "Wow, I've got a new perspective on life and I've forgiven myself for a lot of the mistakes I made, and I've understood better why people gave me this bad advice and I've forgiven them and I've got..." There's so many personal learnings that come out of that process too.
Katie Cortés:
Yeah, that's a really good point. Forgiving yourself and forgiving the advice that you were given because my first baby came along 16 years ago and they didn't know half of what they know now in terms of things like attachment development and all of that kind of stuff. It was still very much ‘Save our sleep’ and oh... What was the other one? Gina Ford and all of those, which was just like, do this, this, and this, and you'll have a good sleeping baby. And if you can't do this, this, and this, well, you are weak, which is just appalling advice now when you look back.
Julia Jones:
Yes and true throughout the ages. I know that we've talked about this a lot, but we could have an entire history and culture of sleep module as well, because it really helps to understand, ‘Oh, I had a baby in this year, and that's the book that was the bestseller at the time, but it's actually got the very similar founding principles as a book that was written a hundred years ago that's not based on any science or research at all.’ You know?
Katie Cortés:
That's right. With the industrial revolution, women were in the workforce more so therefore babies had to behave in a far more convenient way, and that involved sleeping through the night so mums could go to work and be more productive and blah, blah. So yeah, it was a tough gig for babies, I think, from that point onwards.
Julia Jones:
Yes. And at the same time, families were becoming more nuclear and moving away from extended families and had less of that community support that we know is so essential to be able to get those four-hour blocks of sleep.
Katie Cortés:
Yeah. I mean, it's a luxury for some parents to have two invested parents there to help, but that's woefully insufficient, isn't it? And from your perspective and all you know on anthropology and all of that kind of stuff, it's like two people... You're joking, aren't you? Two people, one baby. How do they do that? What did you say? Is it 14 on average? 14 adults from anthropological research?
Julia Jones:
Yes. Anthropological research shows that in many cultures it's between eight and 14 adult carers a day that would look after a baby.
Katie Cortés:
Oh, imagine.
Julia Jones:
Yeah. Yeah.
Katie Cortés:
Blissful. Yeah. Mum could just lie around all day just looking after herself, couldn't she? And being looked after.
Julia Jones:
Yeah. Or she could even just go to the toilet and have a cup of tea.
Katie Cortés:
Yeah, no. Yeah. And sleep and all those wonderful things.
How have your learnings about sleep changed over the past few years? (23:45)
Julia Jones:
Yes, yes. Katie, I think I've come to the end of my questions, but I just wondered if you have anything else that you want to add and anything else about your learnings about sleep over the past few years and how your perspectives changed as a midwife and that sort of thing?
Katie Cortés:
Okay. My practice as a sleep coach has certainly changed over the last seven years. I think you probably had a lot to do with that as well, getting me back in touch with my original postpartum roots as a midwife. I've just found myself going off, on faster and faster, really down the trajectory of attachment-focused development... What am I trying to say? Developmental aspects of sleep and just finding really kind and respectful ways of improving sleep for everybody rather than just getting to that point where parents are so desperate that the only thing they've got up their sleeve is to shut the door and walk away. I think once we start going down that route of ignoring our children's cries for help, if we get a little bit too conditioned to do that, who knows what we're turning our backs on as they go through childhood and adolescence.
So this is a really good time to start listening to our babies. Even if they just say they want boobs for comfort, well, there's nothing wrong with that. But if mum's a little bit fed up of that, well, maybe we can help them find what else they might like to get comfort from rather than just saying, "Hey, sort it out, kid. I'll be back in the morning," kind of thing.
Julia Jones:
Yeah, I love that because a lot of it is just getting to mums earlier with more support in many ways that would prevent many of these things actually becoming such a huge problem before it becomes a crisis.
Katie Cortés:
I mean, one of the topics that I've come up against a lot of times with families is talking about it's never too early, it's never too young to learn to start helping or to start coaching your child with their emotions and holding space for those emotions, whatever they may be. And we don't always have the answers, do we? How many times have you held one of your babies? They're screaming their head off and you go, "I don't know. I don't know. What do you want? What do you want? I've fed you, I've changed you. I've burped you. I don't know how to make this better." And that's okay to say that to babies, but in a way that's not panicky or just, oh, you just let it all out. I know. Let's work this out together. Rather than, "Oh gosh, I'm doing something badly wrong because my child's crying and this is damaging them."
Having an upset in the arms of a loving carer is never going to be damaging. It's totally okay for us to go, "Wow, I really can't work this out, but I'm here with you. I'm listening, and I'm trying the hardest to work it out." And really that's all kids need from us, whatever age, big or small.
Julia Jones:
Yes. I love it. That's exactly what I was going to say is you said it's never too early to start…
Katie Cortés:
Yeah. Those skills you are going to need for many years to come for little people or big people. Yeah.
Julia Jones:
Oh, well, beautiful to chat, Katie. Thank you so much. And if people want to get to know you better, they will pop your website in the link. And also, if people want to study the Postpartum Education and Care Professional training that you have helped us to create the sleep module for, they can join us there. So we'll pop all that information underneath the recording and thank you so much.
Katie Cortés:
My pleasure. Thanks for having me.
Julia Jones:
No worries. Bye.