If you have done all the right things and your child still will not sleep, this one is for you.

I am a huge fan of the fundamentals. A calm sleep space, whole foods throughout the day, and gentle settling matched to your child. I talk about it every week because for most families, getting those foundations right is what changes everything.

But some families do all of it, and do it well, and their child still does not sleep. When that is you, the checklist is not the answer. These questions are.

Before we start, one important thing. There are people far more qualified than me to diagnose many of what follows, and part of my job is knowing when to point you to them. So treat this as a list of things worth raising with your GP or qualified health professional, not a list to work through alone at 2am.

Is there an undiagnosed allergy, intolerance or sensitivity?

A gut that is quietly inflamed does not clock off at bedtime. If your child is uncomfortable in ways you have not fully pinned down, that discomfort can follow them into the night. It is worth a proper conversation if you suspect food sensitivities or allergies are at play.

Are they eating well but still low in key nutrients?

A diet can look great on the surface and still leave a child low in something that matters. Iron is the classic one. Low iron and low iron stores have been linked in research to restless, broken sleep, and to restless legs at night, even when a child is eating a varied diet.

You cannot tell iron levels by looking. A simple chat with your GP about whether testing makes sense is a good place to start.

Could something neurodevelopmental be at play?

Autistic children and children with ADHD very often have genuinely different sleep. That is not a failing of the child or of you. It means a lot of standard sleep advice, which was written for a different nervous system, simply may not fit.

If this is already on your radar, the right support and the right approach tailored to your child can make a real difference.

Could it be something like threadworms?

This one surprises people, but threadworms are extremely common in little ones. The classic sign is an itchy bottom that is noticeably worse at night, along with disturbed sleep and a tired, irritable child the next day.

Healthdirect and the Raising Children Network both describe exactly this pattern. The good news is that threadworms are easy to treat with medication from your pharmacy, so a quick check with your pharmacist or GP can rule it in or out fast.

How is your child breathing at night?

Sleep can be compromised before it even begins if breathing is not clear. Regular snoring, constant mouth breathing or noisy, laboured breathing overnight are all worth mentioning to your GP, who can decide whether anything further is needed.

Do you simply have a low sleep needs child?

If you are trying to fit twelve hours of sleep into a body that only needs ten, no technique on earth will fix that. Sometimes the number in your head is the thing to adjust, not the child in the cot. Working out your child's real sleep needs can take a lot of pressure off everyone.

Is the sleep arrangement right for your family?

Sometimes the setup itself is what needs to change, not your child. There is no single right way for a family to sleep, and the arrangement that finally gets everyone resting is well worth a proper look.

For some families, that looks like safely sharing sleep. I say that as a sleep consultant, without a disclaimer attached. Co sleeping is a normal and valid choice, and when it is the thing that helps your family rest, I would far rather help you do it well than pretend it is off the table. There are safer ways to set it up, and a few situations where it is not the right call, and working out which is which is exactly what I am here for. Red Nose Australia has helpful guidance on safer sleep sharing too, if you like to read around a decision.

None of this is about forcing your family into a setup that is quietly not working. It is about finding the one that actually fits, and making it as safe as it can be.

Why I share this

I do not share these questions to frighten you, or to send you chasing a hundred diagnoses over a few rough nights. I share them so you do not feel alone in the wilderness with a checklist that is not working.

Sleep is connected to everything else in your child's body. Sometimes the answer was never in the sleep advice at all. And you do not have to figure out which door to knock on by yourself.

If you have tried everything and you want a second set of eyes on the whole picture, sleep and nutrition together, you can book a one to one consultation at thegrowingyears.com.au/booking. Sometimes the most useful thing I do is help you work out where to look next.