The article below was published in and of interest in improving infant sleep for long term health benefits and in particular reducing the rates of childhood obesity.
Sleep works long-term to prevent child obesityPublished Monday 3rd September 2018 in United Independent New Zealand News
When it comes to obesity prevention, sleep is not usually something that springs to mind, but a University of Otago research team has found we should not underestimate its importance.
Professor Rachael Taylor, Director of the Edgar Diabetes and Obesity Research Centre and co-leader of the team, says one in three New Zealand children is overweight or obese by the time they start school.
Treating obesity once established is challenging, however, in a study published in The American Journal of Clinical Nutrition, and funded by the Health Research Council of New Zealand, researchers found a sleep intervention in infancy reduced the risk of obesity for participants later in childhood.
“Sleep is a very important behaviour that we need to consider. In terms of maintaining a healthy weight, sleep usually isn’t the first behaviour that comes to mind – for parents or health practitioners – yet the research is actually very clear,” she says.
“The relationship between not getting enough sleep and being at higher risk of obesity is actually stronger than the evidence base for nutrition or activity, where the findings are often more mixed.”
The researchers studied more than 800 babies, dividing their mothers into four groups, three of which received intervention in addition to the standard Well Child/Tamariki Ora care: sleep; promotion of breastfeeding, healthy eating and physical activity; and a combination of both.
For the sleep intervention, while pregnant, mothers and their partners were invited to a group discussion based on what to expect, sleep-wise, with their baby in the first few months and how to prevent sleep problems.
When the infants were about three weeks old they were visited at home to see how sleep was going. The researchers talked to parents about assisting their child with sleep by learning to recognise signals from the baby that they were tired, and then encouraging baby to settle themselves to sleep.
If a sleep problem developed, expert support was immediately available until infants were two years old. About a quarter of parents took up this support.
For the nutrition and activity intervention, mothers had access to a lactation consultant at least two times during the first few months of feeding, researchers visited them to discuss how to eat healthily as a family, and Sport Otago ran group sessions for parents and babies about being physically active as a family.
Researchers found the brief sleep intervention reduced the risk of obesity years later, while no benefit was observed with the nutrition and activity intervention.
“For those children who received the sleep intervention we found that at two years of age they had about half the risk of obesity compared with children who had not received the sleep intervention,” Professor Taylor says.
“But more importantly, these benefits were still apparent at five years of age, despite no intervention having had occurred for three years.
“As any parent knows, getting enough good quality sleep keeps a child happy, behaving well and enjoying life. However, it also helps them do well at school, their diets are better, and they tend to be more active – all factors that help us be healthy.”
Professor Barry Taylor, Dean of the Dunedin School of Medicine and study co-lead, describes the results as “amazing” and the long-term benefits, despite no ongoing contact, as “almost unheard of” for obesity interventions.
He also runs a special clinic for very overweight children and says it is important for children to have a regular sleep routine. Children should go to bed at a time that gives them enough sleep so that they are not tired the next day, and screen-time should be avoided for at least 30 minutes before going to bed, as well as in bed.
Health Research Council Chief Executive Professor Kathryn McPherson says the study findings are of real interest and have a very practical application.
“It can seem, and be, difficult for children to go to sleep without external aids but, this programme shows that even very young infants can learn to do so relatively quickly – and that combined with a few other strategies, it works not just for better sleep but for better health.”
The research team believes a more intensive or extended sleep intervention may have larger or longer-lasting effects and further study is planned.
At Caroline's Angels, we are very interested in the long term health benefits of sleep for babies and children. As health professionals we want to support parents and other health professionals to improve a baby's sleep while supporting their mental health for a lifetime of benefits, not just immediate relief for the parents and babies. It is important that we offer parents acceptable choices to addressing their child's sleep so that this is implemented with both more ease and support that parents have experienced in the past.
At Caroline's Angels we implement our Dynamic Sleep Connection™ infant sleep model. This is based on a set of underpinning principles for healthy sleep that a parent applies to their own unique child. This has been likened to the complete opposite of controlled crying methods. That by nurturing and supporting a child while offering change to sleep and settling is beneficial and the child is able to learn how to settle more independently. When the foundations of healthy sleep are addressed, the side effect is improved sleep.
Our aim is for a baby and parent to delight in achievement, gain confidence and feel supported, safe and explore change for positive progress." - Caroline McMahon
Caroline and Caroline
We assist so many tired, exhausted and frustrated parents. With a wakeful child (or two! ), getting through each day can be tough. But there is another cost that is not so closely looked at, talked about or understood. Breastfeeding.
Parents and health practitioners understand that breast milk is best for babies. While we understand that not every mother is going to be able to breast feed her baby and there is personal choice as well, we do want to support the mothers that are doing their best to offer breast milk to their babies, not only in those first few months but beyond this.
The Australian National Infant Feeding Survey (2017) found that 90% of mothers initiated breastfeeding, but only 15.4% were exclusively breastfeeding by 6 months. (http://www.health.gov.au/breastfeeding). At Caroline’s Angels, we come to many families that are finding breastfeeding very difficult due to a wakeful baby, and are considering weaning their baby in the hope that the family will get more sleep as a result. Mother’s are trying to implement the information imparted to them from health professionals to ‘demand feed’ their baby, but this often translates to feeding their baby whenever they grizzle, are tired and each time they wake overnight. When a baby is beginning to tire, they will often start to suck their fingers, this can be often misinterpreted by a parent to think that they are hungry.
As a breastfeeding mother will often be unsure of how adequate her milk supply is or how much milk her baby is taking, especially if the baby is tired and irritable or frequently snack feeding. She is more likely to offer a quick ‘top up’ feed to ensure her baby is well satiated prior to sleep, and hoping that extra milk will keep the baby full enough to sleep for a long period of time. This feed just prior to sleep can then reinforce to a baby of what to expect to ‘feel’ and expect around going to sleep.
For babies, going to sleep is a very sensory experience. Let’s look at an example of mother Miranda and baby Liam. For a moment, imagine what baby Liam feels like being offered a feed at sleep time. Take a look at the above picture of Liam in Miranda’s arms while feeding to sleep, this will help you. Liam is tired, then sits with Miranda, one of Liam’s favourite people and also the one person he gets used to putting him to sleep as she is the only one that can feed him. There is nipple in the Liam’s mouth and a sucking motion with the taste of milk and a ‘full’ feeling in his little belly. Miranda has hold of him and gently hums and sings as well as rocks in her feeding chair. Liam relaxes as he can smell his mum’s skin and hears her heart beat. He has a lot of sensory input and gently drifts off to sleep. All of Liam’s five senses are being engaged while he is falling to sleep.
Miranda gently puts him down into the cot after falling asleep on her. Liam then stirs from a sleep cycle, which is very normal for babies to do. This is often 20-50 minutes in the day and around hourly overnight. He stirs and quickly identifies that he is not where he remembered being when he fell to sleep. He also works out very quickly that he doesn’t feel the same anymore and does not know what to do with these feelings that he has in the cot. He is tired but can’t put himself back to sleep. Liam cries not knowing what do next. Liam’s dad Nic, comes into help and give Miranda a much needed break as she is exhausted. Liam realises that this is not Miranda who can feed him back to sleep and gets very upset with Nic. Nic is patient and trying very hard but seems to be making the situation worse. Miranda comes to assist. Immediately Liam calms down when Miranda picks him up and tries to settle him. Liam then again becomes upset and Miranda then offers him a breast to calm him and he immediately goes quiet, suckles and then falls to sleep. She has tried on many nights to try and get him back to sleep without offering the breast. On some nights she has persisted for hours on end and then out of exhaustion and frustration she offers a breast and Liam immediately calms and settles. She knows as he comes up to 6 months of age that he may still need overnight feeds, but not 6-8 feeds overnight. Despite her efforts to restrict the feeds overnight, Liam just won’t settle until he gets to feed at her breast.
With Liam having 6-8 feeds overnight, Miranda is doubting her milk supply and is considering weaning him in the hope of being able to get more sleep and less feeds for both her and Liam. Miranda is thinking she has a feeding problem rather than a sleeping issue. She is also concerned that he doesn’t feed well in daylight hours and therefore needs to keep feeding him often at night as he might be hungry.
Miranda is so exhausted and overwhelmed she is contemplating giving up breastfeeding as she just can’t manage with Liam. He catnaps all day, twenty minutes here, thirty minutes there, and is cranky most of the day. With so many feeds at night she finds he is difficult to feed in the day and the only way she can see to improve the situation is to wean from breastfeeding. She knows that breast milk is the best option for Liam but can’t see how this situation will improve and everyone has told her things would be better by now. She talks to Nic about this who is very happy to support Miranda, but is also at a loss, as Liam won’t have a bar of him around sleep and settling. Nic is also finding it hard to see Miranda so tired and frustrated. Miranda has sought advice and has been told to keep demand feeding her baby.
Before Miranda weans Liam, we suggested that she try a few things. Firstly, we asked her to move the breast feed away from settling. We helped Miranda get as good of a feed in as possible, then offer a top up milk feed, by offering her breast again, a little before bedtime as she was not convinced that Liam had taken enough milk. We did ask her to offer this top up out in the living area and keep him awake. Then to have a break of 20 minutes before taking him to the bedroom and settle him to sleep. We suggested she still hold Liam as he was used to being in her arms but without a feed. The first day or two was harder than usual to settle Liam, but he accepted that he would would fall asleep without a breastfeed and this too gave Miranda confidence that he didn’t need the feed in order to settle. The nights started to improve and with Miranda keeping a diary of feeds and sleeps, she noted things were a lot better. She noted that feeds had dropped to 2-3 per night and Liam was sleeping longer overnight as well as a longer sleep once per day too.
With baby Liam now sleeping longer in the day, he was waking hungry and rested. This gave him gave him the energy and focus to take one a full breast feed. With less feeds at night and the energy to feed well, this was helping him feel more full for longer and in turn helped him sleep longer both night and day. With snack feeding in the day, Liam would get to sleep and then as he roused from a sleep cycle, he quickly identified that he was feeling hungry, woke and had another feed which reinforced is snack feeding. By addressing his sleep, Miranda had helped Liam to sleep longer, and extended his feeds out in both the day and night. Miranda now felt more in control of her breastfeeding as she could start to predict when Liam would take a feed. She also noticed an improvement in her supply as both her breasts were being emptied off regularly by Liam, which send hormonal feedback to Miranda’s brain to stimulate a greater production of milk. With all these positive improvements, the breastfeeding relationship between Miranda and Liam was going really well.
He was feeding better in the day and Miranda was feeling a little more rested and starting to enjoy feeding Liam again. There was no more fighting during the day to get him to take milk. After a another week, Miranda was feeling better with more rest and was keen to tweak a few more areas of Liam’s settling routine for further improvement. The upside was that Miranda’s mental health had improved, her milk supply had increased and she had decided to continue breastfeeding Liam. Miranda and Nic both marvelled at how one simple change had helped improve so many aspects of life with Liam. For Liam it was a replication overnight of how he fell to sleep. He started to expect to feel like he was feeding when he stirred from sleep cycles overnight. When he realised those feeling were not present he persisted with his parents until those feels were replicated for him and then he could identify how to fall back to sleep. As Nic was not able to breastfeed Liam, he protested loudly until Miranda came and offer what Liam understood he needed in order to return to sleep. Once the milk feed was spaced away from settling, these feelings were no longer connected to sleep and Liam was able to return to sleep without needing to breastfeed, he also accepted Nic’s help on occasion. Sometimes he still needed Miranda and Nic to assist him, other times he did it on his own, and the number of feeds soon reduced overnight as a result.
We checked in again with Miranda six months later. She was still breastfeeding Liam and would do so indefinitely.
With the breastfeeding rates dropping so sharply from birth to just before six months of age, we need to look at how we can support breastfeeding families. When babies are rested because they are getting adequate sleep, and waking hungry from day naps in particular, we find that babies hungrily feed with nutritive sucking. Drawing off their mother’s milk and emptying the breasts regularly. This will in turn satisfy the baby’s appetite and be able to last a few hours rather than want to snack feed all day. When breasts are emptied, hormones travel to the mother’s brain to alert her body to start producing more milk as stores are now low and this keeps her breast milk supply up. With a satisfied tummy and the breastfeed well away from settling this cycle of rested + hungry baby = nutritive and good feeds. In our work as baby sleep specialists, we are find that by spacing breast feeds away from sleep, that mother’s are able to continue breastfeeding as well as manage more sleep from their baby, which in turn leads to more rest for them.
Breastfeeding a baby has benefits to both mother and child. Professor Jane Scott of Curtin University, recently described these on air with ABC journalist Penny Johnston.(Aug 4th, 2018) Prof Scott contributed to the Australian infant feeding guidelines. She is also a practicing dietician. The ABC Baby Talk podcast covered that apart from the benefit of nutrition, the baby’s immune system is strengthened by breast milk. That when a baby is affected by childhood illness such as a chest infection or diarrhoea, the severity of the illness may well be reduced if the baby is breastfed. This then reduces the chance that the infant needs to be hospitalised. For mothers, the benefits are that there is a reduced risk of breast and ovarian cancer. Breast milk has bioactive components in them which are not found in other animal milk or formula. Podcast link http://www.abc.net.au/radio/programs/babytalk/babytalk-the-politics-of-breastfeeding/10047992
Professor Scott went onto discuss that having support for mothers in the early days of initiating breastfeeding and ongoing, can also help improve the longevity of breastfeeding between an infant and it’s mother. Caroline’s Angels ensure’s that all of our practitioner’s have a background in either Midwifery or Maternal Child Health so they can support you if you are struggling with feeding and sleep. We wish to support, promote and protect breastfeeding. If you are wishing to formula feed or express and offer your milk via bottles, we will also support you 100% on your parenting journey.
Twenty years ago I had the wildest, most wakeful baby, nothing helped to calm him and help him sleep. He thrashed, he fought he screamed day and night. My husband and I were a mess and I was overwhelmed, exhausted and not the mother I had wanted to be. I engaged services to assist me, but the harshness of controlled crying just made my son worse. He regressed further each time this was attempted, and I was left with a traumatised baby, that slept less than ever before. While I was told, and saw other babies in a residential parent facility that in three nights my baby would improve, It didn't. He was worse than ever before. I saw everyone else going home with rested babies, but not mine. After several residential visits, I asked if we could approach my son's sleeping (or severe lack there of) from a different angle. Were there other methods, models, strategies we could implement? I was repeatedly told no, this was it. To come back in three months when he is a little older and try again.
I was frustrated and exhausted. I could barely think of the next three hours let alone the next three months. Defeated and deflated, I limped home with my fractious boy and tried to carry on as best as I could.
I knew there must be an alternative for babies like I had and for parents that didn't find the abrupt extinction model an acceptable one to implement, but I couldn't find anything.
I then went on to have my second son a few years later. While he didn't have the severity of wakefulness as his brother, he was still a very wakeful baby. Again I sought help as much of what I had learned that assisted my first baby, did not help my second. I remember clearly ringing a parent help centre and being told that with all the help they gave me with my first son, surely I could figure out what to do with my second son. I put down the phone and never called them again. I was clearly a failure of a mother to them.
What I now know is that I had a child before, but this particular baby was new to me and had his own set of preferences. I had to understand my new baby and what he responded to. It had not occurred to me that I would be challenged so much with my second son.
To address a child and it's unique strengths and weaknesses are important.
With Dynamic Sleep Connection, it allows us to look at each baby in this unique limelight. Even twins, will differ in their preferences and should be viewed individually. That by having a principle to aim toward to improve sleep is important but tailoring it specifically to the child is a must.
From adversity comes strength.
Many years later after repeatedly seeing other families struggle with sleep as mine had done, I fell into moving from a clinical career in Midwifery to branching out independently to assisting families. I joined forces with Midwife/Maternal Child Health Nurse, Caroline Radford to successfully create ‘Caroline’s Angels Baby Sleep Specialists’ It was within our journey as sleep specialists that we found that babies needed a basic set of 5 Principles to be present for healthy sleep. It was HOW we applied those principles to each unique child that was the key to our success. To support and create confidence for a baby and parents become a paramount feature in improving sleep with the families that we worked with. Dynamic Sleep Connection Infant Sleep Model was born out of a need to restructure our beliefs around how we managed wakeful babies and our expectations of what is reasonable and kind in doing so. The DSC model is the cornerstone for our practice as Baby Sleep Specialists.
Caroline Radford and I have put all of our knowledge into an online course so that as a health professional you can learn from our vast experience and develop your own style to support the families you work with. Our model is evidence based practice that is current and most of all is successful. We understand so much more about Infant Mental health than fifty years ago and we need to factor this into moving forward with models dealing with baby sleep. By addressing the underpinning and foundations of healthy sleep, we find that improvement is a natural consequence to these changes. That by supporting and teaching a baby how to sleep is more gentle, effective and has longer term benefits.
We are delighted to launch our online Dynamic Sleep Connection™ course for you to participate in wherever you are in the world. We have launched different packages to offer you the level of learning and support that you feel you need.
To see more or purchase your package, please visit
You may also wish to contact Caroline McMahon on 0400209195 or email@example.com
The conversation about revolutionising the way infant sleep is being addressed has started. Please join in and make this a better way for families to address this difficult subject.
A few months ago, Caroline's Angels Baby Sleep Specialists expanded into Melbourne and has their own consultant, Rebecca Gray now available to see clients in the Melbourne CBD area or phone/email work throughout Victoria.
Bec is a Registered and Maternal Child Health Nurse with a young family of her own. So both her academic and practical levels are very current.
Bec has enjoyed meeting clients and doing a range of phone/email clients, Please feel free to call her on
0488048092 or email firstname.lastname@example.org .
We are excited to announce that Caroline McMahon and Rebecca will be presenting at the Melbourne Baby Sleep Workshop Event on Tuesday 17th October. All details of venue, times and ticketing is below.
Caroline and Bec base their presentation on the Dynamic Sleep Connection™ infant sleep model, showing you how practical this method is and how to apply it to your own child. Bec is our more recent graduate of the Dynamic Sleep Connection Professional Portal learning course. The DSC professional portal will soon be available to non employees of Caroline's Angels.
Caroline and Caroline look forward to hosting Professional Portal Sleep Workshops for health professionals both in Perth and Melbourne in 2018. You can register your interest in the Professional Portal course or workshop by emailing
The Perth Baby Sleep Workshop Event will be on Wednesday October 11th. See www.carolinesangels.com.au for further details or ticket purchases for either workshop.
Some exciting news for everyone waiting to hear about the progress of our Dynamic Sleep Connection online learning modules. We are only a matter of weeks away from being able to offer our course to the public.
The final stages of linking our module platform to the website and all the final content are all coming together nicely.
Be patient, not long to go now!
Caroline R and I have been busy working on the Professional Portal Modules. We are really excited to be bringing a learning forum to health professionals that will then assist parents with their children.
We have been lucky enough of late to be meeting up with other health professionals who have all showed an interest in DSC and showing a great hunger for this knowledge. Chiropractors, Dieticians, Child Health Nurses and Midwives, all keen to know more about our modules, and we just can't wait to deliver our new concept to others.
I will keep you updated on our progress and we look forward to having our modules ready to go very soon.
Dynamic Sleep Connection. What is it?
Sleep for babies is a constantly moving and changing area. All babies are unique, and no one size fits all approach to sleep support, will meet the needs of all children. Each baby engages their senses in learning and development, and sleep is no different. As parents and health professionals, we need to move on from outdated sleep models that are not child focused and expect all babies to conform to a single method of teaching. Rather, to really look at each child, and acknowledge their sensory feelings engaged in sleep for that particular child. To allow time and room for growth, adaptation and change in a supported, learning environment, rather than abrupt extinction methods that quite often challenges a child too fast and too quickly, that ends up seeing a regression in their sleep and overall wellbeing.
Join us on the journey as a health professional that is committed to working in a dynamic and progressive area of baby sleep.
We are offering a series of modules for participants to learn about babies and sleep. As a health professionals, to learn more about babies and sleep to support the families in your care and provide healthy discussion points for families seeking your guidance.