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Unsettled Baby Consultation Intake Form


About you and your baby

The unsettled baby consultation looks at 5 areas: Feeding, Sleeping, Co-Regulation, Play/ Connection and your enjoyment in parenting. Please read through the options and select the description which fits you and your baby best.

Feeding

Sleeping

i.e. do you think they are getting enough sleep overall?
An easy sleeper might be someone who can fall asleep anywhere e.g. trains / buses / hotels etc. A sensitive sleeper might be someone who sleeps well but only really in their own environment (own bed, own home, in the dark).

Regulation / Crying / Unsettled Behaviour

This is full crying, not fussing
About 20% of people are more sensitive to sensory experiences (e.g. loud noises / lights / smells / other people's emotions etc) and pick up more information at lower levels than others

Play & Tummy Time

Does your baby enjoy eye contact and making connections with you. For an older baby do they initiate play?
This could be on your chest / a sling / a carrier / over your arm / knee etc?

Enjoying

Thank you for the answers

Thank you for filling in the intake form. This will help me to plan for your consult. If you have any other information you would like to add about what specifically is worrying you with your baby, please do add it in the text box below so that I can really tailor the consult to exactly what you want and need. I look forward to seeing you soon.

Important Information

All material on this website is provided for educational purposes only. Online information cannot replace an in-person consultation with a qualified, independent International Board Certified Lactation Consultant (IBCLC) or your health care provider. If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation.

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