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Hershon M, Kiafar A, Laganière C, Pokhvisneva I, Gaudreau H, Pennestri MH. To sleep or to breastfeed: Associations between feeding method and sleep in infants and children. Acta Paediatr 2024; 113:1540-1545. [PMID: 38597251 DOI: 10.1111/apa.17237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024]
Abstract
AIM This study aimed to understand the association between feeding method, specifically breastfeeding versus non-breastfeeding, at 6 and 12 months and infant sleep over the first 3 years of life. METHODS A sample of 444 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment cohort were analysed. Based on retrospective maternal reports between 3-24 months, infants' breastfeeding status was determined at 6 and 12 months. Nocturnal sleep duration, longest period of consecutive sleep, and total sleep over 24 h were measured by maternal reports at 6, 12, 24 and 36 months. RESULTS Generalized Estimating Equations revealed no significant association between feeding status, both at 6 and 12 months, and nocturnal sleep duration or total sleep over 24 h between 6-36 months (p > 0.05). However, breastfeeding at both 6 and 12 months was associated with shorter periods of consecutive sleep, at 6 and 12 months (p < 0.05) but not at 24 and 36 months (p > 0.05). CONCLUSION Our findings suggest that breastfeeding seems to be associated with more infant sleep fragmentation but not with total sleep duration in early infancy. However, this sleep fragmentation does not persist into later infancy and early toddlerhood.
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Affiliation(s)
- Malka Hershon
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Once Upon a Night Sleep Laboratory CIUSSS du Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, Québec, Canada
| | - Anita Kiafar
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Once Upon a Night Sleep Laboratory CIUSSS du Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, Québec, Canada
| | - Christine Laganière
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Once Upon a Night Sleep Laboratory CIUSSS du Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, Québec, Canada
| | - Irina Pokhvisneva
- Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Hélène Gaudreau
- Once Upon a Night Sleep Laboratory CIUSSS du Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, Québec, Canada
| | - Marie-Hélène Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Once Upon a Night Sleep Laboratory CIUSSS du Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, Québec, Canada
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Abuhammad S, Bani Younis A, Ahmed AH. Impact of a structured sleep education program on mothers' knowledge and attitudes toward infant sleeping. Heliyon 2024; 10:e29885. [PMID: 38711628 PMCID: PMC11070819 DOI: 10.1016/j.heliyon.2024.e29885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/08/2024] Open
Abstract
Introduction Sleeping is necessary for the infant growth and development. Sufficient and quality of sleep can have an impact on physical, cognitive, and emotional functioning. Infancy is a critical time for establishing healthy habits and routines. However, many infants were suffering from sleeping issues that impact their health. Objectives This study aims to evaluate the effect of educational programs given to mothers regarding their infants' sleep on mothers' knowledge and attitudes toward infant's sleeping. Method A quasi-experimental design for nonequivalent groups was used, and data was collected from 208 mothers with infants aged 5-12 months from all Jordanian governorates who had not been exposed to educational programs prior to this study. Data was collected in two stages: pre-test and post-test, with two weeks in between for both groups. Results The final results indicated that the educational intervention had a significant impact on mothers' knowledge over time. It was found that mothers in the intervention group had significantly higher mean of infant sleep health knowledge at follow up time compared to their baseline time (B = 0.236, P 0.001). Also, the yielded analysis showed that there was no significant change in mothers' mean attitudes toward infants sleeping over time (P = 0.011). The mothers' measured sleep health knowledge correlated positively and significantly statistically with their sleep health attitudes score (r = 0.436, P 0.010).
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Affiliation(s)
- Sawsan Abuhammad
- Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Alaa Bani Younis
- Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Azza H. Ahmed
- Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States
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Boedker I, Ball HL, Richter M, South TL, Roberts SGB. Construction of the Views oN Infant Sleep (VNIS) Questionnaire. Early Hum Dev 2024; 191:105989. [PMID: 38513547 DOI: 10.1016/j.earlhumdev.2024.105989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
Parents' beliefs about infant sleep behaviour vary over time and across cultures. No validated instrument exists to understand parents' pre- and postnatal views on infant sleep behaviours, which may influence their caregiving decisions. The Views oN Infant Sleep Questionnaire (VNIS) will be a tool to assess parents' beliefs in order to facilitate tailored perinatal care, increase the reliability of postnatal self-report measures, allow for cross-cultural comparisons, and provide a baseline for researchers to use in longitudinal studies. We recruited an online sample of 971 female participants who were resident in the United Kingdom, at least 28 weeks pregnant, and at least 18 years of age. The initial questionnaire consisted of 31 questions about infant independence, night-waking, infant feeding, touch, and safety, and items were rated on a 5-point Likert scale. The item pool was reduced to 12 using principal component analysis and a structure was found for the three components "Closeness", "Independence", and "Night-waking". Overall, these results suggest that the VNIS can provide a brief scale to measure different aspects of individuals' beliefs about infant sleep. In further research the VNIS needs to be validated with a confirmatory factor analysis in another sample, and to be tested as a cross-cultural instrument.
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Affiliation(s)
- Ingrid Boedker
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom.
| | - Helen L Ball
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Michael Richter
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Tina L South
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sam G B Roberts
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
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Dobson A, Hornsey S, Ghio D, Latter S, Santer M, Muller I. 'Either something's wrong, or I'm a terrible parent': A systematic review of parent experiences of illness-related interpretations for unsettled babies. J Adv Nurs 2024. [PMID: 38528428 DOI: 10.1111/jan.16166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/09/2024] [Accepted: 03/11/2024] [Indexed: 03/27/2024]
Abstract
AIMS To explore parents' experiences of unsettled babies and medical labels. DESIGN Qualitative systematic review, thematic synthesis and development of a conceptual model. REVIEW METHODS Systematic review and thematic synthesis of primary, qualitative research into parents' experiences of unsettled babies <12 months of age. 'Unsettled' was defined as perception of excessive crying with additional feature(s) such as vomiting, skin or stool problems. The Critical Appraisal Skills Programme (CASP) checklist was used to assess trustworthiness. DATA SOURCES Structured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023. RESULTS Ten eligible studies were included across eight countries contributing data from 103 mothers and 24 fathers. Two analytical themes and eight descriptive themes were developed. Firstly, parents expressed fearing judgement, feeling guilty and out of control as a result of babies' unsettled symptoms and seeking strategies to construct an 'Identity as a "Good Parent"'. This desire for positive parenting identity underpinned the second analytical theme 'Searching for an explanation' which included seeking external (medical) causes for babies' unsettled behaviours. CONCLUSION Parents can become trapped in a cycle of 'searching for an explanation' for their baby's unsettled behaviours, experiencing considerable distress which is exacerbated by feelings of guilt and failure. IMPACT AND IMPLICATIONS FOR PATIENT CARE Insight gained from this review could inform interventions to support parents, reducing inaccurate medicalization. Health visiting teams supporting parents with unsettled baby behaviour could focus on supporting a positive parenting identity by managing expectations, normalizing the continuum of infant behaviours, reducing feelings of guilt or uncertainty and helping parents regain a feeling of control. REPORTING METHOD ENTREQ guidelines were adhered to in the reporting of this review. PATIENT OR PUBLIC CONTRIBUTION Parent input was crucial in the design phase; shaping the language used (e.g., 'unsettled babies') and in the analysis sense-checking findings.
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Affiliation(s)
- Amy Dobson
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Samantha Hornsey
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Susan Latter
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Ingrid Muller
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
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Manková D, Švancarová S, Štenclová E. Does the feeding method affect the quality of infant and maternal sleep? A systematic review. Infant Behav Dev 2023; 73:101868. [PMID: 37572515 DOI: 10.1016/j.infbeh.2023.101868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/01/2023] [Accepted: 07/27/2023] [Indexed: 08/14/2023]
Abstract
Breastfeeding brings many benefits to both mother and infant. Although, many women stop breastfeeding their infants too soon. The perceived association between breastfeeding and sleep may influence their decision to terminate breastfeeding. In our systematic review, we focused on mapping the relationship between infant feeding method and total sleep time (TST), number of nocturnal awakenings, awakenings after sleep onset (WASO) of mothers and infants and sleep quality of mothers. We searched four databases according to selected keywords and inclusion criteria - articles published in peer-reviewed journals between 2012 and 2022; English language; a sample consisting of mothers, infants, or both (without psychiatric and health problems); a comparison of the sleep quality of breastfed and formula-fed children or breastfeeding and formula-fed mothers. We read 260 full texts of selected articles. A total of 35 articles were included in this review. Due to significant heterogeneity, meta-analysis was not possible to accomplish. The results are processed according to narrative synthesis. Most studies agree that breastfed infants wake up more often at night. Total sleep time and time spent awake during the night (WASO) did not differ between breastfed and non-breastfed infants. We observed identical results in sleep variables among mothers. Additionally, there was no difference in maternal sleep quality. The synthesis revealed that the results may have differed due to using subjective, objective methods or the infant's age. It is important to remember that night waking is a more complex concept. Infants wake for many reasons, not just due to breastfeeding. The narrative synthesis indicated that the chosen study design, measurement method, the variables, and the infant's age could influence outcomes. In addition, other variables appeared that may affect the entire process. Therefore, we recommend that attention be paid to this in future studies.
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Affiliation(s)
- Denisa Manková
- Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic.
| | - Soňa Švancarová
- Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic
| | - Eliška Štenclová
- Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic
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D'Souza L, Cassels T. Contextual considerations in infant sleep: Offering alternative interventions to families. Sleep Health 2023; 9:618-625. [PMID: 35768320 DOI: 10.1016/j.sleh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 10/17/2022]
Abstract
Infant sleep problems are one of the commonly reported reasons parents seek professional help, yet what constitutes a "sleep problem" depends on the models used to explain the development of infant sleep. The current models are based on research conducted in the western context where infant solitary sleeping is the norm. Parent-child co-sleeping is the norm in many cultures around the world. We argue that the primary focus of current research on parent-child interactions as the mediating context for the development of infant sleep problems has inherently made these models and ensuing interventions less sensitive and applicable to infant sleep problems in the context of co-sleeping families. When families present for help with infant sleep difficulties, extinction based behavioral interventions or interventions focused on reducing parental presence at bedtime are commonly recommended. These recommendations may not always align with cultural values and parenting practices of all families, therefore precluding these families from getting necessary help. In attempting to provide families with choices that depart from behavioral based interventions, this paper draws on research and adapts current models to propose an alternative to conceptualize perceptions of infant sleep problems that may be sensitive to and applied across various cultural and personal contexts. We attempt to provide a rationale for interventions that are inclusive and sensitive to families where reduced parental nighttime responsiveness may not be a preferred choice.
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Affiliation(s)
- Levita D'Souza
- Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia.
| | - Tracy Cassels
- Evolutionary Parenting, 116 County Rd, 16 Milford, ON, K0K 2P0, Canada
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Zimmerman D, Bartick M, Feldman-Winter L, Ball HL. ABM Clinical Protocol #37: Physiological Infant Care-Managing Nighttime Breastfeeding in Young Infants. Breastfeed Med 2023; 18:159-168. [PMID: 36927076 PMCID: PMC10083892 DOI: 10.1089/bfm.2023.29236.abm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
A central goal of the Academy of Breastfeeding Medicine (ABM) is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The ABM empowers health professionals to provide safe, inclusive, patient-centered, and evidence-based care. Pregnant and lactating people identify with a broad spectrum of genders, pronouns, and terms for feeding and parenting. There are two reasons ABM's use of gender-inclusive language may be transitional or inconsistent across protocols. First, gender-inclusive language is nuanced and evolving across languages, cultures, and countries. Second, foundational research has not adequately described the experiences of gender-diverse individuals. Therefore, ABM advocates for, and will strive to use language that is as inclusive and accurate as possible within this framework. For more explanation, please read ABM Position Statements on Infant Feeding and Lactation-Related Language and Gender (https://doi.org/10.1089/bfm.2021.29188.abm) and Breastfeeding As a Basic Human Right (https://doi.org/10.1089/bfm.2022.29216.abm).
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Affiliation(s)
- Deena Zimmerman
- Maternal-Child and Adolescent Division, Public Health Service, Israel Ministry of Health, Jerusalem, Israel
| | - Melissa Bartick
- Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Lori Feldman-Winter
- Department of Pediatrics, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Helen L Ball
- Durham Infancy and Sleep Centre, Department of Anthropology, Durham University, Durham, United Kingdom
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Perrella SL, Dix-Matthews A, Williams J, Rea A, Geddes DT. Breastfeeding and Maternal Perceptions of Infant Sleep, Settle and Cry Patterns in the First 9 Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13098. [PMID: 36293676 PMCID: PMC9602824 DOI: 10.3390/ijerph192013098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
This study evaluated relationships between maternal perceptions of infant sleep, settling and crying patterns and breastfeeding. A prospective observational study of 91 mothers of healthy, term infants was conducted with follow ups over 9 months after discharge from a Western Australian maternity hospital. Feeding information, sleep, settle and cry behaviours, maternal bother at infant behaviours and confidence were measured using the Sleep and Settle Questionnaire. Breastfeeding confidence was measured using the Breastfeeding Self-Efficacy Scale-Short Form. Questionnaires were administered at 2 and 6 weeks, 3, 6 and 9 months. Linear mixed models were used to assess associations between maternal bother, feeding method and infant characteristics. The feeding method was not associated with maternal bother, and cessation of breastfeeding did not result in a change in bother scores (p = 0.34). Duration of infant crying in the day, evening and night, frequency of night waking and duration of settling to sleep in the day were associated with increased bother scores. Higher breastfeeding self-efficacy and maternal confidence were associated with lower bother scores (both p < 0.01). Maternal bother is associated with infant behaviours that require parental input, but not breastfeeding status. Resources that address parental expectations regarding infant sleep while providing strategies to support maternal wellbeing and breastfeeding are needed.
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Affiliation(s)
- Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Alice Dix-Matthews
- School of Medicine, The University of Western Australia, Crawley, WA 6009, Australia
| | - Julie Williams
- Neonatology Clinical Care Unit, King Edward Memorial Hospital, Subiaco, WA 6008, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia
| | - Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
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Zanetti N, D'Souza L, Tchernegovski P, Blunden S. Parents' perceptions of the quality of infant sleep behaviours and practices: A qualitative systematic review. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nina Zanetti
- Faculty of Education Monash University Clayton Victoria Australia
| | - Levita D'Souza
- Faculty of Education Monash University Clayton Victoria Australia
| | | | - Sarah Blunden
- Appleton Institute of Behavioural Science, School of Health, Medical and Applied Sciences Central Queensland University Rockhampton Queensland Australia
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Ruan H, Zhang Y, Tang Q, Zhao X, Zhao X, Xiang Y, Geng W, Feng Y, Cai W. Sleep duration of lactating mothers and its relationship with feeding pattern, milk macronutrients and related serum factors: A combined longitudinal cohort and cross-sectional study. Front Nutr 2022; 9:973291. [PMID: 36110402 PMCID: PMC9468784 DOI: 10.3389/fnut.2022.973291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Insufficient sleep is common in postpartum mothers. The main objectives of this study are to explore the sleep duration among Chinese lactating mothers and preliminarily investigate the relationship between sleep duration and feeding pattern. The secondary objectives are to investigate the relationships between sleep duration and milk macronutrients and between maternal-related indicators, including melatonin (MT), growth hormone (GH), ghrelin (GHRL), glucagon-like peptide-1 (GLP-1), prolactin (PRL), and cholecystokinin (CCK). Methods The present study comprises a longitudinal and a cross-sectional cohort from December 2019 to December 2021. Postpartum lactating women living in Shanghai were recruited through online and offline recruitment. The subjects were included in the longitudinal cohort or cross-sectional study based on their lactation period at the time of recruitment. The longitudinal cohort included a total of 115 mothers. Human milk and feeding pattern were measured and collected at 2–4 months and 5–7 months postpartum. At four predetermined follow-up time points, data on sleep duration was collected (at the time of recruitment, 2–4 months postpartum, 5–7 months postpartum, and 12–17 months postpartum). The cross-sectional study included 35 lactating mothers (2–12 months postpartum) who reported their sleep duration and provided blood samples. Mid-infrared spectroscopy (MIRS) method was used to analyze the macronutrients of breast milk, while MT, GH, GHRL, GLP-1, PRL, and CCK in maternal blood were determined by ELISA. Results The maternal sleep duration before pregnancy was 8.14 ± 1.18 h/d (n = 115), 7.27 ± 1.31 h/d (n = 113) for 2–4 months postpartum, 7.02 ± 1.05 h/d (n = 105) for 5–7 months postpartum, and 7.45 ± 1.05 h/d (n = 115) for 12–17 months postpartum. The incidence of insufficient sleep (<7 h/d) before pregnancy (12.17%) was significantly less than at any follow-up time after delivery (vs. 2–4 months postpartum, χ2 = 10.101, p = 0.001; vs. 5–7 months postpartum, χ2 = 15.281, p < 0.0001; vs. 12–17 months postpartum, χ2 = 6.426, p = 0.011). The percentage of insufficient maternal sleep was highest at 5–7 months postpartum (34.29%). No significant difference was found between the incidence of insufficient sleep at 5–7 months postpartum, 2–4 months postpartum (29.20%, χ2 = 0.650, p = 0.420), and 12–17 months postpartum (25.22%, χ2 = 2.168, p = 0.141). At 2–4 months postpartum, the frequency of formula feeding per day is related to reduced maternal sleep duration (Standardization coefficient β = −0.265, p = 0.005, Adjusted R2 = 0.061). At 2–4 months and 5–7 months postpartum, the relationship between macronutrients in breast milk and the mother's sleep duration was insignificant (all p > 0.05). Other than the positive correlation found between maternal GHRL and sleep duration (r = 0.3661, p = 0.0305), no significant relationship was observed between sleep duration and other indexes (all p > 0.05). Conclusions Postpartum mothers generally sleep less, but there is no correlation between insufficient sleep and the macronutrient content of breast milk. Formula feeding may be related to the mother's sleep loss, while breastfeeding (especially direct breastfeeding) may be related to increased maternal sleep duration. The findings suggest that sleep duration is related to maternal serum GHRL. More high-quality studies are needed to clarify the mechanism of these findings and provide a solid theoretical basis and support references for breastfeeding.
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Affiliation(s)
- Huijuan Ruan
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yajie Zhang
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
- Shanghai Institute of Pediatric Research, Shanghai, China
| | - Qingya Tang
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuan Zhao
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuelin Zhao
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xiang
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Geng
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Feng
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Cai
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
- Shanghai Institute of Pediatric Research, Shanghai, China
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Wei Cai
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Exclusive Breastfeeding Duration and Perceptions of Infant Sleep: The Mediating Role of Postpartum Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084494. [PMID: 35457362 PMCID: PMC9029530 DOI: 10.3390/ijerph19084494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: Existing literature has identified associations between exclusive breastfeeding, maternal mental health, and infant sleep. This study aims to examine these relationships simultaneously and consider the mediating role of postpartum anxiety. (2) Methods: Participants completed validated measures of postpartum anxiety, infant sleep, and reported exclusive breastfeeding duration. Postpartum mothers with infants between six and twelve months (n = 470) were recruited to a cross-sectional online survey containing a battery of psychological measures. (3) Results: Correlation analyses examined the relationships between the predictor (exclusive breastfeeding duration), outcome (perceptions of infant sleep), and mediator (postpartum anxiety). Exclusive breastfeeding duration was significantly associated with postpartum anxiety (p < 0.05), postpartum anxiety was significantly associated with perceptions of infant sleep (p < 0.001), and exclusive breastfeeding duration was significantly associated with perceptions of infant sleep (p < 0.001). A simple mediation model was conducted, showing a significant total (B = −0.029 (0.010), p < 0.05), direct (B = −0.035 (0.009), p < 0.001), and indirect effect (B = 0.007, SE = 0.003, 95% CI = 0.000 to 0.014) of exclusive breastfeeding duration on perceptions of infant sleep via postpartum anxiety. (4) Conclusions: Associations were identified between exclusive breastfeeding duration, postpartum anxiety, and perceptions of infant sleep. The mediation model suggests postpartum anxiety may be an underlying mechanism which reduces exclusive breastfeeding duration and negatively affects maternal perceptions of infant sleep quality.
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Chae SM, Yeo JY, Chung NR. A qualitative study of the sleep ecology of infants under 2 years old and their mothers in South Korea. Sleep Health 2021; 8:101-106. [PMID: 34972676 DOI: 10.1016/j.sleh.2021.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/20/2021] [Accepted: 10/31/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES/DESIGN Infancy is a crucial period for establishing an individual's sleep pattern, and it is a common period during which infants and mothers experience sleep problems. The aim of this qualitative study was to explore the sleep ecology of infants under 2 years of age and their mothers. SETTING/PARTICIPANTS The study participants were 20 mothers with infants aged 3-19 months living in South Korea. METHODS Data were collected through in-depth interviews and analyzed using the thematic analysis. RESULTS Five themes related to the sleep of infants and their mothers emerged from the data: (1) changes in sleep patterns, (2) room-sharing, (3) environmental factors affecting sleep, (4) efforts to improve sleep quality, and (5) infant sleep and the mother's health. The sleep patterns of infants and their mothers were mutually interrelated, and were strongly affected by various environmental factors, including infants' biological maturity (a microsystem) as well as cultural factors (a macrosystem). Culture had an especially profound effect on sleep patterns of infants, similar to the effects of microsystem-level factors. CONCLUSIONS To improve the sleep quality of infants and mothers, an ecological approach considering the biological characteristics and cultural contexts of infants is required based on an understanding of sleep as a phenomenon that evolves in a relationship of mutual influence between infants and mothers.
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Affiliation(s)
- Sun-Mi Chae
- The Research Institute of Nursing Science, Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Ji-Young Yeo
- Hanyang University School of Nursing, Seoul, Republic of Korea.
| | - Na-Ry Chung
- The Research Institute of Nursing Science, Seoul National University College of Nursing, Seoul, Republic of Korea
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13
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Barry ES, McKenna JJ. Reasons mothers bedshare: A review of its effects on infant behavior and development. Infant Behav Dev 2021; 66:101684. [PMID: 34929477 DOI: 10.1016/j.infbeh.2021.101684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/05/2021] [Accepted: 12/09/2021] [Indexed: 11/05/2022]
Abstract
Bedsharing is controversial for nighttime caregiving in the U.S. today, as in most of the West. However, from the standpoint of evolutionary pediatrics, anthropology, and cultural psychology, bedsharing is not controversial at all, representing the context for human infant evolution and conferring a host of physiological benefits to the infant as well as the mother. In an effort to understand the rise in Western bedsharing in recent decades (and following Ball, 2002; McKenna & Volpe, 2007), Salm Ward (2015) systematically reviewed the literature on mother-infant bedsharing and identified ten reasons why mothers choose to bedshare: (1) breastfeeding, (2) comforting for mother or infant, (3) better/more sleep for infant or parent, (4) monitoring, (5) bonding/ attachment, (6) environmental reasons, (7) crying, (8) cultural or familial traditions, (9) disagree with danger, and (10) maternal instinct. The current paper offers the "review behind the review," highlighting the scientific evidence behind the reasons mothers give for their decision to bedshare, focusing on how mothers' decisions about infant sleep location influence infant behavior and development.
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Affiliation(s)
- Elaine S Barry
- Human Development & Family Studies, The Pennsylvania State University, Fayette, The Eberly Campus, USA.
| | - James J McKenna
- Mother-Baby Sleep Lab, Department of Anthropology, University of Notre Dame, South Bend, IN, USA; Department of Anthropology, Santa Clara University, Santa Clara, CA, USA
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14
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Noa C, Hanita K, Carmit K. "It is a matter of life or death": Spotlighting Children in the Context of HIPD as Perceived by Frontline Practitioners. ACTA ACUST UNITED AC 2021; 4:307-324. [PMID: 34368625 PMCID: PMC8329903 DOI: 10.1007/s42448-021-00082-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 11/29/2022]
Abstract
It is a wide consensus that high-intensity parental disputes (HIPD) might result in negative ramifications for children. The current study wishes to advance the knowledge regarding what children undergo during the acute time of the dispute, as portrayed by experienced frontline social workers mandated by the court to intervene with parents and their children in the context of HIPD. Ninety-four social workers participated in ten focus groups and five in-depth interviews. A thorough analysis of the narratives revealed three main themes. The first relates to their tremendous fear for the children's wellbeing, often displayed by the words "burn" and "death." The second theme addresses the practitioners' reflections with respect to the various experiences the children undergo during the acute time of HIPD and their risk assessments. The third theme addresses the practitioners' struggle in identifying how to protect the children during these times. The discussion spotlights the exposure of children to HIPD as a prolonged and chronic risk, with potentially adverse emotional and physical impacts. Key conclusions address the need to advance children's rights and the protection of children in the context of HIPD.
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Affiliation(s)
- Cohen Noa
- Bob Shapell School of Social Work, Tel Aviv University, 69978 Tel Aviv, Ramat Aviv Israel
| | - Kosher Hanita
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Katz Carmit
- Bob Shapell School of Social Work, Tel Aviv University, 69978 Tel Aviv, Ramat Aviv Israel
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15
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Rudzik AEF, Ball HL. Biologically normal sleep in the mother‐infant dyad. Am J Hum Biol 2021; 33:e23589. [DOI: 10.1002/ajhb.23589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 01/13/2023] Open
Affiliation(s)
- Alanna E. F. Rudzik
- Department of Anthropology State University of New York College at Oneonta Oneonta New York USA
| | - Helen L. Ball
- Department of Anthropology, Infancy & Sleep Centre Durham University Durham UK
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16
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Ball HL, Taylor CE, Thomas V, Douglas PS. Development and evaluation of 'Sleep, Baby & You'-An approach to supporting parental well-being and responsive infant caregiving. PLoS One 2020; 15:e0237240. [PMID: 32764810 PMCID: PMC7413483 DOI: 10.1371/journal.pone.0237240] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022] Open
Abstract
Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Previous research indicates that UK parents would value an approach that facilitates meeting their infants’ needs while supporting their own sleep-related well-being throughout their infant’s first year. Six initial stakeholder meetings were held with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The Possums Sleep Program developed and delivered in Brisbane, Australia in a GP clinic setting, was chosen as an appropriate approach. Working collaboratively with a stakeholder group, we translated the Possums Sleep Program into an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Parent and practitioner views of the initial materials were obtained via feedback questionnaires and the tool was revised. The intervention was then field-tested by 164 practitioners who delivered it to at least 535 new parents and babies over 5 UK locations, to capture anonymous parent and practitioner views of the intervention concept, the materials, and their experiences with both. The intervention helps parents recalibrate their expectations of infant sleep development, encourages responsive parenting and experimentation to meet their infant’s needs, offers parents strategies for supporting the development of their babies’ biological sleep regulators and promote their own well-being, and teaches parents to manage negative thinking and anxiety that can impede sleep using the principles of Acceptance and Commitment Therapy. The ‘Sleep, Baby & You’ discussion tool, a 14 page illustrated booklet for parents, was field-tested and evaluated by practitioners and parents who offered enthusiastic feedback. Practitioners reported the ‘Sleep, Baby & You’ materials were easy for them to explain and for parents to understand, and were a good fit with the responsive parenting approaches they employed in other areas of their work. Parents who received the intervention postnatally understood the material and found the suggestions easy to follow. All parents who provided feedback had implemented one or more of the suggested changes, with the majority of changes (70%) being sustained for at least two weeks. Practitioners recommended development of digital and antenatal versions and offered feedback on circumstances that might challenge effective uptake of the intervention. ‘Sleep, Baby & You’ is a promising tool for promoting parental attitude and behaviour-change, that aims to adjust parental expectations and reduce negative thinking around infant sleep, promote responsive infant care in the face of infant-related sleep disruption and fatigue, and support parental well-being during the first year of parenthood. Initial field-testing provided insights useful for further development and subsequent testing via a randomised trial. Support exists for incorporating ‘Sleep, Baby & You’ into an anticipatory, universal intervention to support parents who may experience post-partum fatigue and infant sleep disruption.
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Affiliation(s)
- Helen L. Ball
- Infancy & Sleep Centre, Department of Anthropology, Durham University, United Kingdom
- * E-mail:
| | - Catherine E. Taylor
- Infancy & Sleep Centre, Department of Anthropology, Durham University, United Kingdom
| | - Victoria Thomas
- Dept Paediatrics, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
| | - Pamela S. Douglas
- Possums Education & Research Centre, Greenslopes, Brisbane, Australia
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17
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Bailey C, Tawia S, McGuire E. Breastfeeding Duration and Infant Sleep Location in a Cohort of Volunteer Breastfeeding Counselors. J Hum Lact 2020; 36:354-364. [PMID: 31237801 DOI: 10.1177/0890334419851801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Debate about mother and infant bed sharing has been polarized between supporters of bed sharing and public health policies that attempt to mitigate the risk of Sudden Infant Death Syndrome. Differences in group demographics may be an important aspect in co-sleeping acceptability. RESEARCH AIMS The first aim of this study was to investigate infant sleeping location in a dataset of mothers with strong breastfeeding outcomes. The second aim was to investigate the association between infant sleeping location and breastfeeding (exclusive breastfeeding to 6 months and total breastfeeding duration). Finally, we aimed to investigate predictors of breastfeeding duration. METHODS Participants comprised 174 women who had applied to train as counselors with the Australian Breastfeeding Association. Data were compiled from a survey of the participants' lactation histories, including questions related to the exclusivity and duration of breastfeeding, concerns about and problems encountered during breastfeeding, type of birth, medications during birth, demographics, and infant sleeping location. The study design was a cross-sectional, one-group survey design. RESULTS A high proportion of participants in this study bed shared and room shared: At 0-1 month (n = 58), 33% of participants bed-shared, which increased to 58% by 6-12 months (n = 80). Infants who co-slept were more likely to be exclusively breastfed at 6 months (χ2 (2, n = 116) = 4.83, p = .03) and had longer breastfeeding duration (t (62.61) = 3.81, p < .001). CONCLUSIONS Breastfeeding targets have been difficult to achieve globally, and innovative ideas are required to improve breastfeeding outcomes through public health messaging. There was a strong association in the current study between breastfeeding outcomes and degree of closeness of the infant to the mother at night. This finding should be brought into the discourse on breastfeeding and infant sleep arrangements, accompanied by evidence-based advice about safe sleeping and the promotion of breastfeeding.
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Affiliation(s)
- Cate Bailey
- 2541 Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Susan Tawia
- 110651 Australian Breastfeeding Association, Victoria, Australia
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18
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Blair PS, Ball HL, McKenna JJ, Feldman-Winter L, Marinelli KA, Bartick MC, Noble L, Calhoun S, Elliott-Rudder M, Kair LR, Lappin S, Larson I, Lawrence RA, Lefort Y, Marshall N, Mitchell K, Murak C, Myers E, Reece-Stremtan S, Rosen-Carole C, Rothenberg S, Schmidt T, Seo T, Sriraman N, Stehel EK, Wight N, Wonodi A. Bedsharing and Breastfeeding: The Academy of Breastfeeding Medicine Protocol #6, Revision 2019. Breastfeed Med 2020; 15:5-16. [PMID: 31898916 DOI: 10.1089/bfm.2019.29144.psb] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Peter S Blair
- Centre for Academic Child Health, University of Bristol, Bristol, United Kingdom
| | - Helen L Ball
- Infancy and Sleep Centre, Department of Anthropology, Durham University, Durham, United Kingdom
| | - James J McKenna
- Department of Anthropology, Santa Clara University, Santa Clara, California.,Mother-Baby Sleep Lab, Department of Anthropology, University of Notre Dame, South Bend, Indiana
| | - Lori Feldman-Winter
- Department of Pediatrics, Division of Adolescent Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Kathleen A Marinelli
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut.,Connecticut Children's Medical Center, Division of Neonatology, Hartford, Connecticut
| | - Melissa C Bartick
- Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge Massachusetts
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19
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The Mother-Infant Sleep Nexus: Night-Time Experiences in Early Infancy and Later Outcomes. THE MOTHER-INFANT NEXUS IN ANTHROPOLOGY 2020. [DOI: 10.1007/978-3-030-27393-4_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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20
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Marinelli KA, Ball HL, McKenna JJ, Blair PS. An Integrated Analysis of Maternal-Infant Sleep, Breastfeeding, and Sudden Infant Death Syndrome Research Supporting a Balanced Discourse. J Hum Lact 2019; 35:510-520. [PMID: 31184521 DOI: 10.1177/0890334419851797] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breastfeeding and the place of sleep for the mother and the infant have been controversial internationally due to reported concerns regarding infant deaths despite the known benefits of exclusive and prolonged breastfeeding, which are increased by breastfeeding at night. The aims of this integrated analysis were to (a) review breastfeeding and maternal and infant sleep research literature via historical, epidemiological, anthropological, and methodological lenses; (b) use this information to determine where we are currently in safeguarding both infant lives and breastfeeding; and (c) postulate the direction that research might take from this point forward to improve our knowledge and inform our policy and practice. Despite well-meaning but unsuccessful campaigns in some countries to dissuade parents from sleeping with their babies, many breastfeeding mothers and caregivers do sleep with their infants whether intentionally or unintentionally. Taking cultural contexts and socio-ecological circumstances into consideration, data supports policies to counsel parents and caregivers on safe sleep practices, including bed-sharing in non-hazardous circumstances, particularly in the absence of parental smoking, recent parental alcohol consumption, or sleeping next to an adult on a sofa. Further research with appropriate methodology is needed to drill down on actual rates of infant deaths, paying close attention to the definitions of deaths, the circumstances of the deaths, and confounding factors, in order to ensure we have the best information with which to derive public health policy. Introduction and use of the concept of "breastsleeping" is a plausible way to remove the negative connotations of "co-sleeping" and redirect ongoing data-driven discussions and education of best practices of breastfeeding and sleep.
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Affiliation(s)
| | - Helen L Ball
- 2 Infancy & Sleep Centre, Department of Anthropology, Durham University, Durham, UK
| | - James J McKenna
- 3 Mother-Baby Behavioral Sleep Laboratory, Department of Anthropology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Peter S Blair
- 4 Centre of Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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21
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Ball HL, Tomori C, McKenna JJ. Toward an Integrated Anthropology of Infant Sleep. AMERICAN ANTHROPOLOGIST 2019. [DOI: 10.1111/aman.13284] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Helen L. Ball
- Director, Parent–Infant Sleep LabDepartment of Anthropology, Durham University Durham DH1 3LE UK
| | - Cecilia Tomori
- Assistant Professor, Parent–Infant Sleep LabDepartment of Anthropology, Durham University Durham DH1 3LE UK
| | - James J. McKenna
- Director, Mother–Baby Sleep Lab, Department of AnthropologyUniversity of Notre Dame South Bend Indiana USA
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22
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Murcia L, Reynaud E, Messayke S, Davisse‐Paturet C, Forhan A, Heude B, Charles M, Lauzon‐Guillain B, Plancoulaine S. Infant feeding practices and sleep development in pre‐schoolers from the
EDEN
mother–child cohort. J Sleep Res 2019; 28:e12859. [DOI: 10.1111/jsr.12859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 03/05/2019] [Accepted: 03/10/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Luisa Murcia
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Eve Reynaud
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Sabine Messayke
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Camille Davisse‐Paturet
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Anne Forhan
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Barbara Heude
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Marie‐Aline Charles
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
| | - Blandine Lauzon‐Guillain
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INRAU1125 Paris France
| | - Sabine Plancoulaine
- Center for Research in Epidemiology and StatisticS (CRESS) Research team on EArly Origins of Health (EAROH) INSERMUMR1153 Paris France
- Univ Paris‐DescartesUMRS 1153 Paris France
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23
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Wang YC, Chen LC, Tung YC, Lee CC, Tsai SY. Physical activity and objectively assessed sleep in 6-month-old infants in Taiwan. Res Nurs Health 2019; 42:128-135. [PMID: 30620090 DOI: 10.1002/nur.21929] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 11/24/2018] [Indexed: 12/24/2022]
Abstract
Adequate physical activity is associated with improved sleep in adults. Such associations, however, vary greatly across studies in pediatric populations, with no studies involving infants found in the literature. This prospective observational study was designed, therefore, to examine the association between physical activity and sleep patterns in infants. A total of 183 healthy infants aged 6 months wore an actigraph for 7 days to measure physical activity and sleep. Parents and caregivers completed a sleep-activity diary over the same period documenting the different types of infant activities. Daily mean time spent in screen-time-or-limited physical activity, including screen-based (e.g., watching television or other electronic devices) and non-screen based activity (e.g., quiet play or restricted infant movement when carried by caregivers or seated in high chairs, swings, or bouncer seats), was 6.68 hr (SD = 1.99), which represented 47.50% of daytime waking hours (SD = 13.73). We found that 65 (35.5%) infants engaged in some screen time during the study, with 10 (5.5%) infants having an average daily screen time >30 min. In our multivariate linear regression model, more hours of screen-time-or-limited physical activity per day were significantly associated with a decrease in total daily 24 hr sleep duration (p < 0.01). Findings from our study suggest that reducing screen-time-or-limited physical activity might be an approach for promoting adequate sleep and lengthening infant daily sleep duration.
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Affiliation(s)
- Yi-Ching Wang
- Disease Control Division, Department of Health, New Taipei City Government, Taipei, Taiwan
| | - Li-Chiou Chen
- School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
| | - Shao-Yu Tsai
- School of Nursing, National Taiwan University, Taipei, Taiwan
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24
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Ball HL, Douglas PS, Kulasinghe K, Whittingham K, Hill P. The Possums Infant Sleep Program: parents' perspectives on a novel parent-infant sleep intervention in Australia. Sleep Health 2018; 4:519-526. [PMID: 30442320 DOI: 10.1016/j.sleh.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/06/2018] [Accepted: 08/16/2018] [Indexed: 01/06/2023]
Abstract
AIM To evaluate parental perspectives on the acceptability and usefulness of a 'cued-care' approach to infant sleep implemented in an Australian primary care setting. The Possums Infant Sleep Program aims to empower parents to better understand their infant's sleep and their responses to it, and optimize healthy function of the infant's biological sleep regulators to protect against excessive night-waking. METHODS The evaluation was undertaken by an independent infant sleep researcher, with no previous involvement in the Possums program. Parents' experiences of the sleep intervention were captured using a mixed methods approach involving (a) group discussions of sleep issues between parents and clinic staff, (b) discussions with parents who volunteered to provide face-to-face feedback, and (c) an online survey designed in light of the information gained from a and b. A one-year audit of clinic registrations provided contextual data. RESULTS Sixty-four clinic clients fully (45) or partially (19) provided answers to survey questions. Respondents were primarily mothers, mean age 34, with a postgraduate qualification and high family income. Their term infants were predominantly breastfed and attended the clinic for feeding and/or sleeping difficulties across the first year of life. Almost all embraced the Possums approach, describing it as challenging and life changing. Audit data confirmed the survey sample reflected the general clinic population. CONCLUSIONS The Possums Infant Sleep Program was acceptable to parents, and highly valued. Recipients reported reduced stress, less concern about perceived sleep problems (frequent night-waking, short-day-time naps, delayed sleep onset), and better quality of life.
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Affiliation(s)
- Helen L Ball
- Durham University, Infancy & Sleep Centre, Department of Anthropology, Dawson Building, Lower Mountjoy, Durham DH1 3LE, United Kingdom.
| | - Pamela S Douglas
- Possums Education, PO Box 5139 West End, Queensland 4101, Australia; Discipline of General Practice, The University of Queensland, Brisbane, Australia; Maternity, Newborn and Families Research Collaborative, MHIQ, Griffith University, Brisbane, Australia
| | | | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), UQ Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, Brisbane, Australia
| | - Peter Hill
- School of Public Health, The University of Queensland, Brisbane, Australia
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25
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Rudzik AEF, Robinson-Smith L, Ball HL. Discrepancies in maternal reports of infant sleep vs. actigraphy by mode of feeding. Sleep Med 2018; 49:90-98. [PMID: 30097331 DOI: 10.1016/j.sleep.2018.06.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/14/2018] [Accepted: 06/20/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Many studies of infant sleep rely solely on parentally-reported data, assuming that parents accurately report their infant's sleep parameters. The objective of this paper is to examine whether night-time sleep parameters of exclusively breastfed or exclusively formula-fed infants differ, and whether correspondence between parental reports and objective measures varies by feeding type. METHODS Mother-infant dyads intending to breastfeed or formula-feed exclusively for 18 weeks were recruited. Mothers were multiparas and primiparas, aged between 18 and 45 years. Infants were full-term, normal birthweight singletons. Maternal report and actigraphic data on infant sleep were collected fortnightly, from four to 18 weeks postpartum. Data were analysed cross-sectionally using t-tests and GLM analysis to control for interaction between feed-type and sleep location. RESULTS Actigraphy-assessed infant sleep parameters did not vary by feed-type but parentally reported sleep parameters did. Maternal report and actigraphy data diverged at 10 weeks postpartum and discrepancies were associated with infant feeding type. Compared to actigraphy, maternal reports by formula-feeding mothers (controlling for infant sleep location) over-estimated infant's Total Sleep Time (TST) at 10 weeks and Longest Sleep Period (LSP) at 10, 12 and 18 weeks. CONCLUSIONS These results raise questions about the outcomes of previous infant sleep studies where accuracy of parentally-reported infant sleep data is assumed. That parental reports of infant sleep vary by feeding type is particularly important for reconsidering previous studies of infant sleep development and intervention studies designed to influence sleep outcomes, especially where feed-type was heterogeneous, but was not considered as an independent variable.
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Affiliation(s)
- Alanna E F Rudzik
- Department of Anthropology, Durham University, Durham, UK; Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton-on-Tees, UK.
| | - Lyn Robinson-Smith
- Department of Anthropology, Durham University, Durham, UK; Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton-on-Tees, UK
| | - Helen L Ball
- Department of Anthropology, Durham University, Durham, UK; Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton-on-Tees, UK
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26
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Lan HY, Yang L, Hsieh KH, Yin T, Chang YC, Liaw JJ. Effects of a supportive care bundle on sleep variables of preterm infants during hospitalization. Res Nurs Health 2018; 41:281-291. [PMID: 29675875 DOI: 10.1002/nur.21865] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 01/18/2023]
Abstract
Sleep is important for preterm infants' brain development, but they are frequently exposed to painful procedures in the neonatal intensive care unit (NICU) that disturb their sleep cycle and affect their growth. The purpose of this study was to examine the prolonged effects of a supportive care bundle (modulation of the infants' states, non-nutritive sucking, facilitated tucking, and oral sucrose feeding) on preterm infants' sleep variables (sleep efficiency, total sleep time, sleep latency, and frequency of wake bouts) during hospitalization. The team recruited 65 preterm infants (gestational age at birth 28-36 weeks, average birth weight 1,652 g) from a Level III NICU at a medical center in Taiwan. Infants were randomly assigned to one of two treatment conditions to be administered while receiving intrusive procedures: (1) control condition (usual care, including routine procedures, positioning, and gentle touch); or (2) intervention condition in which the supportive care bundle was added to usual care. Sleep variables were measured using actigraphy for a baseline of three continuous days on the 6th to 8th days after birth and again for 3 continuous days when infants weighed ≧1,950 g. Two forms of generalized estimating equation analyses with control of significant covariates were used for data analysis. The supportive care bundle not only significantly increased sleep efficiency and total sleep time but also significantly decreased duration of sleep latency and frequency of wake bouts. These results provide evidence to support the incorporation of the supportive care bundle into NICU clinical practice during intrusive procedures.
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Affiliation(s)
- Hsiang-Yun Lan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Luke Yang
- Department of Social Work, Hsuan Chuang University, Taipei, Taiwan
| | - Kao-Hsian Hsieh
- Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan
| | - Ti Yin
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Song-Shan Branch, Tri-Service General Hospital, Taipei, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Jen-Jiuan Liaw
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
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27
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Wen SY, Ko YL, Jou HJ, Chien LY. Sleep quality at 3 months postpartum considering maternal age: A comparative study. Women Birth 2018; 31:e367-e373. [PMID: 29503219 DOI: 10.1016/j.wombi.2018.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/05/2018] [Accepted: 02/09/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Poor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors. METHODS A cross-sectional survey was conducted with 160 postpartum women who had given birth at a teaching hospital in Taiwan. The participants were assigned to two groups according to age (≥35 years, n=80; and 20-34 years, n=80). Sleep quality was measured using the Pittsburgh Sleep Quality Index with a cut-off score of 5. RESULTS The prevalence of poor sleep quality at 3 months postpartum was higher in older mothers (61.6%) than in younger mothers (38.4%, p<0.01). Multiple logistic regression revealed that poor sleep quality was positively correlated with the severity of postpartum physical symptoms, lack of exercise, and room-sharing with infants. After adjustment for those variables, older mothers were three times more likely to have poor sleep quality than younger mothers (odds ratio=3.08; 95% confidence interval 1.52-6.23). CONCLUSION Health care providers should pay attention to sleep problems among postpartum women, especially mothers of advanced maternal age. In particular, health care providers should evaluate sleep quality among postpartum women, instruct them not to share the bed with their infants at night, perform exercise, and manage their postpartum physical symptoms to improve the sleep quality.
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Affiliation(s)
- Shih-Yi Wen
- Department of Obstetrics and Gynecology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Yi-Li Ko
- Department of Nursing, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Hei-Jen Jou
- Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan.
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Hatton REM, Gardani M. Maternal perceptions of advice on sleep in young children: How, what, and when? Br J Health Psychol 2018; 23:476-495. [DOI: 10.1111/bjhp.12300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/21/2018] [Indexed: 11/29/2022]
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Maehara K, Mori E, Iwata H, Sakajo A, Aoki K, Morita A. Postpartum maternal function and parenting stress: Comparison by feeding methods. Int J Nurs Pract 2017. [DOI: 10.1111/ijn.12549] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kunie Maehara
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Emi Mori
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Hiroko Iwata
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Akiko Sakajo
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Kyoko Aoki
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Akiko Morita
- Graduate School of Nursing; Chiba University; Chiba Japan
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Ball HL, Howel D, Bryant A, Best E, Russell C, Ward-Platt M. Bed-sharing by breastfeeding mothers: who bed-shares and what is the relationship with breastfeeding duration? Acta Paediatr 2016; 105:628-34. [PMID: 26848117 DOI: 10.1111/apa.13354] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/15/2016] [Accepted: 01/28/2016] [Indexed: 12/22/2022]
Abstract
AIM To explore the link between breastfeeding duration and bed-sharing frequency among women reporting a prenatal intention to breastfeed. METHODS About 870 participants in a randomised breastfeeding trial, recruited at mid-pregnancy, provided weekly snapshots of breastfeeding and bed-sharing behaviour for 26 weeks following birth. Strength of prenatal breastfeeding intent was recorded at recruitment using Likert-type scales. RESULTS Outcomes were frequency of bed-sharing at home for at least one hour per week, and time to cessation of breastfeeding. There were insufficient data to classify bed-sharing pattern in 192/870 (22%) of mothers. Of the remainder, 44% (299/678) of participants 'rarely' or 'never' bed-shared, 28% (192/678) did so 'intermittently' and 28% (187/678) did so 'often'. These three groups did not differ significantly in marital status, income, infant gestational age, maternal age or delivery mode. Significantly, more participants who bed-shared 'often' reported strong prenatal breastfeeding intent (70% vs. 57% and 56% for 'intermittent' and 'rare' bed-share groups) and attached high prenatal importance to breastfeeding (95% vs. 87% and 82%). Significantly, more women who bed-shared frequently were breastfeeding at 6 months (p < 0.0001) than those who intermittently or rarely/never bed-shared. CONCLUSION Women with strong motivation to breastfeed frequently bed-share. Given the complex relationship between bed-sharing and sudden infant death syndrome (SIDS) appropriate guidance balancing risk minimisation with support for breastfeeding mothers is crucial.
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Affiliation(s)
- Helen L. Ball
- Parent-Infant Sleep Lab; Department of Anthropology; Durham University; Durham UK
| | - Denise Howel
- Institute of Health and Society; Baddiley Clark building; Newcastle University; Newcastle Upon Tyne UK
| | - Andy Bryant
- Institute of Health and Society; Baddiley Clark building; Newcastle University; Newcastle Upon Tyne UK
| | - Elspeth Best
- Department of Paediatrics; St John's Hospital; Howden Lothian Scotland
| | - Charlotte Russell
- Parent-Infant Sleep Lab; Department of Anthropology; Durham University; Durham UK
| | - Martin Ward-Platt
- Newcastle Neonatal Service; Royal Victoria Infirmary; Newcastle Upon Tyne UK
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