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Wang SH, Lin KL, Chen CL, Chiou H, Chang CJ, Chen PH, Wu CY, Lin KC. Sleep problems during early and late infancy: Diverse impacts on child development trajectories across multiple domains. Sleep Med 2024; 115:177-186. [PMID: 38367360 DOI: 10.1016/j.sleep.2024.02.018] [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: 09/21/2023] [Revised: 12/20/2023] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Child developmental rate holds predictive value for early-stage developmental trajectories, yet few studies explored how sleep problems during different infancy stages impact this rate. This study aims to investigate the correlation between sleep problems and child developmental trajectories. METHODS This study utilized a prospective national cohort of 5006 children in Taiwan. The developmental inventories covering motor, cognitive, language, and socioemotional domains were collected through questionnaire-based in-person home interviews conducted at 3, 12, 24, and 36 months. Sleep problems data, encompassing bedtime regularity, sleep duration, and sleep quality, were collected at 3 and 12 months. Child developmental rate was assessed by analyzing the slope of developmental ability estimates over a period of time. RESULTS Bedtime regularity and high-quality sleep at 3 and 12 months were found to be significantly associated with intercepts across all domains (estimate = -0.196∼0.233, p < 0.033). Children with high-quality sleep at 3 months showed enhanced developmental slopes in socioemotional domains (estimate = 0.032, p < 0.001). Atypical sleep duration at 3 and 12 months had differential detrimental association with child development in various domains (estimate = -0.108∼-0.016, p < 0.048). CONCLUSION The relationship between sleep problems and child development exhibited variability based on the timing of exposure to these issues. Early exposure to low-quality sleep was significantly related to developmental functions and socioemotional developmental rate, potentially leading to increased developmental disparities as children age. Inadequate sleep duration in late infancy and excessive sleep duration in early infancy were both negatively associated with child development trajectories. Policymakers can use these findings to design targeted sleep programs for optimal child development.
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Affiliation(s)
- Szu-Hua Wang
- Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC
| | - Kuang-Lin Lin
- School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC; Department of Pediatric Neurology, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; Graduate Institute of Early Intervention, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC.
| | - Hawjeng Chiou
- Department of Business Administration and Department of Educational Psychology and Counseling, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC
| | - Chien-Ju Chang
- Department of Child and Family Science, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC
| | - Po-Hsi Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC; Institute for Research Excellence in Learning Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC
| | - Ching-Yi Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; Department of Occupational Therapy, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, 17, F4, Xu Zhou Road, Taipei 100, Taiwan, ROC; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 7, Chung-shan South Road, Taipei 100, Taiwan, ROC
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Dias CC, Pinto TM, Figueiredo B. Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex. Behav Sleep Med 2023; 21:695-711. [PMID: 36533573 DOI: 10.1080/15402002.2022.2155162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex. METHODS The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems. RESULTS While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex. CONCLUSIONS Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.
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Affiliation(s)
| | - Tiago Miguel Pinto
- School of Psychology, University of Minho, Braga, Portugal
- Lusófona University, HEI-Lab, Porto, Portugal
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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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Beaugrand M, Jaramillo V, Markovic A, Huber R, Kohler M, Schoch SF, Kurth S. Lack of association between behavioral development and simplified topographical markers of the sleep EEG in infancy. Neurobiol Sleep Circadian Rhythms 2023; 15:100098. [PMID: 37424705 PMCID: PMC10329166 DOI: 10.1016/j.nbscr.2023.100098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
The sleep EEG mirrors neuronal connectivity, especially during development when the brain undergoes substantial rewiring. As children grow, the slow-wave activity (SWA; 0.75-4.25 Hz) spatial distribution in their sleep EEG changes along a posterior-to-anterior gradient. Topographical SWA markers have been linked to critical neurobehavioral functions, such as motor skills, in school-aged children. However, the relationship between topographical markers in infancy and later behavioral outcomes is still unclear. This study aims to explore reliable indicators of neurodevelopment in infants by analyzing their sleep EEG patterns. Thirty-one 6-month-old infants (15 female) underwent high-density EEG recordings during nighttime sleep. We defined markers based on the topographical distribution of SWA and theta activity, including central/occipital and frontal/occipital ratios and an index derived from local EEG power variability. Linear models were applied to test whether markers relate to concurrent, later, or retrospective behavioral scores, assessed by the parent-reported Ages & Stages Questionnaire at ages 3, 6, 12, and 24 months. Results indicate that the topographical markers of the sleep EEG power in infants were not significantly linked to behavioral development at any age. Further research, such as longitudinal sleep EEG in newborns, is needed to better understand the relationship between these markers and behavioral development and assess their predictive value for individual differences.
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Affiliation(s)
| | - Valeria Jaramillo
- University of Surrey, School of Psychology, Guildford, United Kingdom
| | - Andjela Markovic
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, Switzerland
| | - Malcolm Kohler
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah F. Schoch
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Salome Kurth
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
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Kumagai M, Shinohara H, Kodama H. Possible contribution of better maternal psychological well-being to the acquisition of sleeping through the night in infants during the early postpartum period. Infant Behav Dev 2023; 72:101872. [PMID: 37542836 DOI: 10.1016/j.infbeh.2023.101872] [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: 07/10/2022] [Revised: 07/07/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023]
Abstract
The objective of this study was to elucidate whether better maternal psychological well-being contributes to the acquisition of "sleeping through the night" (STN) in infants during the early postpartum period. Fifty-two primiparous mothers completed the General Health Questionnaire-28 (GHQ-28) in the third trimester (prenatal) and when the conceptional ages of their babies reached 8-9 weeks (hereafter, 2 months), 12-13 weeks (3 months), and 16-17 weeks (4 months). They also recorded babies' nocturnal sleep patterns in a timetable for 5 consecutive days each month postpartum. "Regular STN" was defined when the mean of longest nocturnal sleep duration for 5 consecutive days was > 8 h or between 6 and 8 h with < 1.0 nocturnal awakenings. According to these criteria, a total of 14 infants (27 %) acquired regular STN at 4 months (referred to as "STN infants"), with STN infants showing a marked increase in longest nocturnal sleep duration and a decrease in nocturnal awakenings from 2 to 3 months of age. The mothers of STN infants demonstrated steady reductions in postnatal GHQ-28 scores and had significantly lower prenatal GHQ-28 scores compared with the mothers of non-STN infants (3.7 ± 3.0 vs. 6.4 ± 4.1, p = 0.027). In random forest models for binomial classification, both prenatal and postnatal (at 4 months) GHQ-28 scores were identified as significant covariates for distinguishing STN infants, and other important covariates, including weeks of delivery, stepfamily, birth weight of the infant, and maternal co-sleeping at bedtime, were selected. Among these covariates, maternal co-sleeping at bedtime had relatively stronger correlations with both STN infants (r = - 0.440) and prenatal maternal GHQ-28 scores (r = 0.377). In conclusion, because prenatal maternal psychological well-being was thought to predict the acquisition of STN in infants, infants born from mothers with better psychological well-being appear to have some advantages in acquiring STN. These cross-lagged correlations suggest that the pathway from mothers to infants may be mediated by certain parenting behaviors, such as maternal co-sleeping at bedtime.
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Affiliation(s)
- Mayuko Kumagai
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Japan
| | | | - Hideya Kodama
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Japan.
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Cai T, Sutter C, Donovan SM, Fiese BH. The Relationship Between Maternal and Infant Sleep Duration Across the First Two Years. J Dev Behav Pediatr 2023; 44:e421-e428. [PMID: 37276363 PMCID: PMC10524561 DOI: 10.1097/dbp.0000000000001195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/03/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The first objective of this study was to determine how mother-infant sleep duration is related across the first 2 years of life. The second objective was to determine whether these relationships change across the first 2 years of life. The third objective was to understand demographic and health predictors of the relationship between maternal and child sleep. METHODS Parents of 464 infants from the STRONG Kids 2 study reported their own and infants' nocturnal sleep duration and other health information (i.e., breastfeeding) at 3, 12, 18, and 24 months postpartum. RESULTS Latent transition models revealed 2 mother-infant sleep profiles exist at 3 to 24 months. The low maternal sleep ( LMS ) pattern was characterized by lower maternal sleep duration than the recommended amount and lower infant sleep duration. The average maternal sleep ( AMS ) pattern was characterized by average maternal sleep duration meeting the recommended standard and average infant sleep duration. Approximately half of the mothers who started in the LMS profile transitioned to the AMS profile after 12 months postpartum. The sleep profiles stabilized after 12 months postpartum with limited transitions across 12 to 24 months. More infant-signaled nighttime wakings, later bedtimes, more infant sleep problems, and more exclusive breastfeeding were predictors of being in the LMS profile. CONCLUSION Mother-infant sleep profiles stabilized after age 12 months, and mother-infant sleep profiles are driven by infant sleep quality during the night. The findings suggest the need to establish a healthy sleep routine for mothers and infants in the first year of life to promote longer-term sleep hygiene.
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Affiliation(s)
- Tianying Cai
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | | | - Sharon M. Donovan
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Barbara H. Fiese
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois
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7
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Tauriello S, Moding K, Aronoff N, Kubiniec E, Anzman-Frasca S. Examining links between child temperament and feeding, eating, and weight outcomes: An updated systematic review of the literature. Eat Behav 2023; 49:101739. [PMID: 37209569 DOI: 10.1016/j.eatbeh.2023.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes. METHODS PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria. RESULTS Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs. CONCLUSIONS Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Kameron Moding
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States of America
| | - Nell Aronoff
- University Libraries, University at Buffalo, Buffalo, NY, United States of America
| | - Elizabeth Kubiniec
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, United States of America.
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Ruggiero CF, Marini ME, Llewellyn CH, McHale SM, Paul IM, Savage JS. Differences in sibling temperament are associated with differences in maternal use of food to soothe during infancy: A sibling analysis. Pediatr Obes 2022; 17:e12907. [PMID: 35243805 PMCID: PMC9283211 DOI: 10.1111/ijpo.12907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/01/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Firstborn children are more likely to have obesity than secondborns, which may partially be explained by differential use of food to soothe (FTS) infant distress, which has been inked to higher weight status. OBJECTIVES To test associations between the birth order and maternal FTS and whether differences in sibling temperament and body mass index (BMI) z-scores were associated differences in maternal FTS. METHODS Random effect models assessed associations between birth order and FTS. Linear regressions examined associations between differences in maternal FTS and sibling differences in temperament at 16 weeks and BMI z-scores at 1 year. RESULTS Mothers (n = 117) used contextual-based FTS more with firstborns than secondborns (2.70 vs. 2.38, p < 0.0001). Sibling differences in negative affect were associated with differences in maternal contextual-based (R2 = 0.09, p = 0.002) and emotion-based (R2 = 0.09, p = 0.001) FTS. Sibling differences in effortful control were associated with differences in maternal emotion-based FTS (R2 = 0.04, p = 0.04). Finally, differences in maternal emotion-based FTS were associated with sibling differences in BMI z-scores at age 1 year (R2 = 0.14, p = 0.006). CONCLUSIONS To promote healthy child weight, mothers should learn to respond to each child's temperament and use alternatives to FTS infant distress.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michele E Marini
- Center for Childhood Obesity Research, Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Clare H Llewellyn
- Research Department of Behavioral Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Susan M McHale
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Ian M Paul
- Department of Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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Hohman EE, Savage JS, Marini ME, Anzman-Frasca S, Buxton OM, Loken E, Paul IM. Effect of the INSIGHT Firstborn Parenting Intervention on Secondborn Sleep. Pediatrics 2022; 150:188273. [PMID: 35703026 PMCID: PMC9893513 DOI: 10.1542/peds.2021-055244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention for first-time mothers improved firstborn infant sleep compared with controls. The goals of this analysis were to test intervention spillover effects on secondborn siblings and examine birth order differences in infant sleep. METHODS Secondborns (n = 117) of INSIGHT mothers were enrolled in an observational cohort, SIBSIGHT. The Brief Infant Sleep Questionnaire was collected at 3, 16, and 52 weeks. Generalized linear mixed models assessed differences among secondborns by firstborn randomization, as well as birth order differences at 16 and 52 weeks. RESULTS The RP group secondborns slept 42 minutes longer at night (95% confidence interval [95% CI]: 19-64) and 53 minutes longer total (95% CI: 17-90) than control secondborns. RP secondborns were more likely to self-soothe to sleep (odds ratio [OR] = 2.0, 95% CI: 1.1-3.7) and less likely to be fed back to sleep after waking (OR = 0.5, 95% CI: 0.3-0.9) than secondborns of control mothers. RP secondborns were more likely to have a bedtime ≤8 pm at 3 (OR = 2.9, 95% CI: 1.1-7.7) and 16 weeks (OR = 4.7, 95% CI: 2.0-11.0). Few differences in sleep parenting practices were observed when comparing siblings within families. Secondborns slept 37 minutes longer than firstborns at 16 weeks (CI: 7-67, P = .03). CONCLUSIONS The INSIGHT RP intervention for first-time mothers had a spillover effect to secondborns, positively impacting sleep duration and behaviors. Intervening with first-time mothers benefits both firstborns and subsequent children.
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Affiliation(s)
- Emily E. Hohman
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA,Nutritional Sciences, Pennsylvania State University, University Park, PA
| | - Michele E. Marini
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA
| | | | - Orfeu M. Buxton
- Biobehavioral Health, Pennsylvania State University, University Park, PA
| | - Eric Loken
- Educational Psychology, University of Connecticut, Storrs, CT
| | - Ian M. Paul
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey PA
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Hines M, Hardy N, Martens A, Zimmerman E. Birth Order Effects on Breastfeeding Self-Efficacy, Parent Report of Problematic Feeding and Infant Feeding Abilities. JOURNAL OF NEONATAL NURSING : JNN 2022; 28:16-20. [PMID: 35095321 PMCID: PMC8797021 DOI: 10.1016/j.jnn.2021.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The goal of this prospective study was to identify effects of birth order on breastfeeding self-efficacy, parental-report of infant feeding behaviors, infant non-nutritive sucking and oral feeding skills in full-term infants at 3-months. Mothers were separated into primipara and multipara groups, and infants were grouped into siblings and no siblings groups. Parents completed the Breastfeeding Self-Efficacy Scale-Short Form, and Neonatal Eating Assessment Tool-Breastfeeding and Bottle-feeding scales. Non-nutritive sucking was assessed using a custom research pacifier and researchers completed the Oral Feeding Skills scale to assess feeding performance. Fifty-six mother-infant dyads (55% male) were included. Primipara mothers reported significantly lower breastfeeding self-efficacy and more feeding problems across breast and bottle-feeds on the Neonatal Eating Assessment Tool. There were no significant differences in non-nutritive sucking or oral feeding skills between infant groups. First-time mothers require more infant feeding support as they exhibited lower breastfeeding self-efficacy and reported more problematic feeding behaviors.
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Infant sleep and negative reactivity: The role of maternal adversity and perinatal sleep. Infant Behav Dev 2022; 66:101664. [PMID: 34958975 PMCID: PMC9162035 DOI: 10.1016/j.infbeh.2021.101664] [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: 05/25/2021] [Revised: 10/02/2021] [Accepted: 11/07/2021] [Indexed: 02/03/2023]
Abstract
Sleep during infancy contributes to the development and maintenance of infant regulatory functioning and may be an early risk marker for more difficult temperamental traits like negative reactivity. Further, maternal adverse childhood experiences (ACEs) may predispose individuals to greater sleep disturbances in adulthood and have been linked with sleep disturbances in both mothers and infants. Thus, examining maternal history of ACEs and maternal sleep difficulties during pregnancy and postpartum may provide insight into underlying risk factors affecting infant sleep difficulties and early temperament development. Fifty-nine mothers from a diverse, community sample (44% white) completed questionnaires on ACEs, maternal sleep, infant sleep, and infant temperament at 30-weeks gestation, 6-weeks postpartum, and 16-weeks postpartum. Results indicated that maternal ACES and sleep problems during pregnancy have long term implications for infant negative reactivity at 16-weeks, with significant indirect effects through maternal and infant sleep problems at 6-weeks. Addressing psychosocial functioning and prenatal sleep during pregnancy, particularly among women with high ACEs, may be a target of intervention to improve maternal and infant sleep health during the postpartum, and reduce the risk for difficult infant temperament.
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12
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Savage JS, Hochgraf AK, Loken E, Marini ME, Craig SJC, Makova KD, Birch LL, Paul IM. INSIGHT responsive parenting educational intervention for firstborns is associated with growth of second-born siblings. Obesity (Silver Spring) 2022; 30:183-190. [PMID: 34932886 PMCID: PMC8711608 DOI: 10.1002/oby.23301] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to test whether the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention, delivered to parents of firstborn children, is associated with the BMI of first- and second-born siblings during infancy. METHODS Participants included 117 firstborn infants enrolled in a randomized controlled trial and their second-born siblings enrolled in an observation-only ancillary study. The RP curriculum for firstborn children included guidance on feeding, sleep, interactive play, and emotion regulation. The control curriculum focused on safety. Anthropometrics were measured in both siblings at ages 3, 16, 28, and 52 weeks. Growth curve models for BMI by child age were fit. RESULTS Second-born children were delivered 2.5 (SD 0.9) years after firstborns. Firstborn and second-born children whose parents received the RP intervention with their first child had BMI that was 0.44 kg/m2 (95% CI: -0.82 to 0.06) and 0.36 kg/m2 (95% CI: -0.75 to 0.03) lower than controls, respectively. Linear and quadratic growth rates for BMI for firstborn and second-born cohorts were similar, but second-born children had a greater average BMI at 1 year of age (difference = -0.33 [95% CI: -0.52 to -0.15]). CONCLUSIONS A RP educational intervention for obesity prevention delivered to parents of firstborns appears to spill over to second-born siblings.
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Affiliation(s)
- Jennifer S Savage
- Center for Childhood Obesity Research, the Pennsylvania State University, University Park, Pennsylvania, USA
- Nutritional Sciences, the Pennsylvania State University, State College, Pennsylvania, USA
| | - Anna K Hochgraf
- Human Development and Family Studies, the Pennsylvania State University, State College, Pennsylvania, USA
| | - Eric Loken
- Educational Psychology, University of Connecticut, Storrs, Connecticut, USA
| | - Michele E Marini
- Center for Childhood Obesity Research, the Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sarah J C Craig
- Center for Medical Genomics, the Pennsylvania State University, State College, Pennsylvania, USA
- Department of Biology, the Pennsylvania State University, State College, Pennsylvania, USA
| | - Kateryna D Makova
- Center for Medical Genomics, the Pennsylvania State University, State College, Pennsylvania, USA
- Department of Biology, the Pennsylvania State University, State College, Pennsylvania, USA
| | - Leann L Birch
- Department of Foods and Nutrition, University of Georgia, Athens, Georgia, USA
| | - Ian M Paul
- Center for Medical Genomics, the Pennsylvania State University, State College, Pennsylvania, USA
- Department of Pediatrics and Public Health Sciences, Penn State College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
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13
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Schoch SF, Castro-Mejía JL, Krych L, Leng B, Kot W, Kohler M, Huber R, Rogler G, Biedermann L, Walser JC, Nielsen DS, Kurth S. From Alpha Diversity to Zzz: Interactions among sleep, the brain, and gut microbiota in the first year of life. Prog Neurobiol 2021; 209:102208. [PMID: 34923049 DOI: 10.1016/j.pneurobio.2021.102208] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/04/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
Sleep disorders have been linked to alterations of gut microbiota composition in adult humans and animal models, but it is unclear how this link develops. With longitudinal assessments in 162 healthy infants, we present a so far unrecognized sleep-brain-gut interrelationship. First, we report a link between sleep habits and gut microbiota: daytime sleep is associated with bacterial diversity, and nighttime sleep fragmentation and variability link with bacterial maturity and enterotype. Second, we demonstrate a sleep-brain-gut link: bacterial diversity and enterotype are associated with sleep neurophysiology. Third, we show that the sleep-brain-gut link is relevant in development: sleep habits and bacterial markers predict behavioral-developmental outcomes. Our results demonstrate the dynamic interplay between sleep, gut microbiota, and the maturation of brain and behavior during infancy, which aligns with the lately emerging concept of a sleep-brain-gut axis. Importantly, sleep and gut microbiota represent promising health targets since both can be modified non-invasively. As many adult diseases root in early childhood, leveraging protective factors of adequate sleep and age-appropriate gut microbiota in infancy could constitute a health promoting factor across the entire human lifespan.
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Affiliation(s)
- S F Schoch
- Department of PulmonOlogy, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | | | - L Krych
- Department of Food Science, University of Copenhagen, Denmark
| | - B Leng
- Department of Food Science, University of Copenhagen, Denmark
| | - W Kot
- Department of Plant and Environmental Sciences, University of Copenhagen, Denmark
| | - M Kohler
- Department of PulmonOlogy, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - R Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland
| | - G Rogler
- Department for Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - L Biedermann
- Department for Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - J C Walser
- Genetic Diversity Center, ETH Zurich, Zurich, Switzerland
| | - D S Nielsen
- Department of Food Science, University of Copenhagen, Denmark
| | - S Kurth
- Department of PulmonOlogy, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland; Department of Psychology, University of Fribourg, Fribourg, Switzerland.
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14
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Fu X, Lovell AL, Braakhuis AJ, Mithen RF, Wall CR. Type of Milk Feeding and Introduction to Complementary Foods in Relation to Infant Sleep: A Systematic Review. Nutrients 2021; 13:nu13114105. [PMID: 34836365 PMCID: PMC8625541 DOI: 10.3390/nu13114105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/10/2021] [Accepted: 11/13/2021] [Indexed: 11/29/2022] Open
Abstract
Inconsistent conclusions from infant sleep and feeding studies may influence parents feeding-related decisions. This study aimed to systematically review the existing literature on infant sleep and its relation to the timing of introduction to complementary foods and type of milk feeding to better understand their role(s) in infant sleep. Cohort, longitudinal, cross-sectional studies, and controlled trials were identified using online searches of five databases up to April 2020. Twenty-one articles with a total of 6225 infants under 12 months-of-age were eligible. Exclusively breastfed infants (≤6 months-of-age) had a greater number of night wakings, but most studies (67%) reported no difference in night-time and 24 h sleep duration compared to formula-fed infants. However, after 6 months-of-age, most studies (>65%) reported breastfed infants to sleep less in the night-time and over 24 h compared to formula-fed infants. Furthermore, studies reported no association between the timing of introduction to complementary foods and infant sleep duration (<12 months-of-age). Future studies using standardized methodologies and definitions, transdisciplinary expertise, and longitudinal design are required to better understand the complex role of feeding on sleep.
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Affiliation(s)
- Xiaoxi Fu
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand; (X.F.); (A.L.L.); (A.J.B.)
| | - Amy L. Lovell
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand; (X.F.); (A.L.L.); (A.J.B.)
| | - Andrea J. Braakhuis
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand; (X.F.); (A.L.L.); (A.J.B.)
| | - Richard F. Mithen
- The Liggins Institute, University of Auckland, Auckland 1142, New Zealand;
| | - Clare R. Wall
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand; (X.F.); (A.L.L.); (A.J.B.)
- Correspondence:
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15
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Ruggiero CF, McHale SM, Paul IM, Savage JS. Learned Experience and Resource Dilution: Conceptualizing Sibling Influences on Parents' Feeding Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115739. [PMID: 34071852 PMCID: PMC8199493 DOI: 10.3390/ijerph18115739] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
Studies from diverse cultures report mixed results in the relationship between birth order and risk for obesity. Explanations may thus lie in the postnatal period when growth is shaped by the family environment, including parental feeding practices, which may be affected by siblings. Consistent with a family systems perspective, we describe two processes that may explain birth order effects on parental feeding practices and child outcomes: learned experience and resource dilution. Parents learn from experience when earlier-born children influence their parents’ knowledge, expectations, and behavior toward later-born siblings through their behaviors and characteristics—which can have both positive and negative implications. Resource dilution is a process whereby the birth of each child limits the time, attention and other resources parents have to devote to any one of their children. The goal of this review is to provide a theoretical basis for examining potential sibling influences on parental responsive feeding toward developing recommendations for future research and practice aimed at preventing obesity throughout family systems.
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Affiliation(s)
- Cara F. Ruggiero
- The Center for Childhood Obesity Research, Penn State University, University Park, State College, PA 16802, USA;
- Department of Nutritional Sciences, Penn State University, University Park, State College, PA 16802, USA
- Correspondence:
| | - Susan M. McHale
- Department of Human Development and Family Studies, Penn State University, University Park, State College, PA 16802, USA;
| | - Ian M. Paul
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Jennifer S. Savage
- The Center for Childhood Obesity Research, Penn State University, University Park, State College, PA 16802, USA;
- Department of Nutritional Sciences, Penn State University, University Park, State College, PA 16802, USA
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16
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Morales-Muñoz I, Nolvi S, Virta M, Karlsson H, Paavonen EJ, Karlsson L. The longitudinal associations between temperament and sleep during the first year of life. Infant Behav Dev 2020; 61:101485. [PMID: 32956980 DOI: 10.1016/j.infbeh.2020.101485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
Abstract
Temperament and sleep in infants are related but also distinct concepts. The longitudinal effects of temperament on sleep in infancy remain unclear, although this information is potentially important for the prevention and treatment of early sleep problems. We examined how various temperament features influence sleep development during the first year of life in a large birth cohort. This study comprised mother-infant dyads with complete longitudinal data on sleep, temperament and sociodemographic measurements at six and 12 months (N = 1436). We observed that higher infant Negative Affectivity was related to several sleep problems, and that many subscales of Negative Affectivity and Orienting/Regulation predicted worse sleep and deterioration in sleep problems from six to 12 months. Few associations between Surgency and sleep were found. Our findings highlight especially Negative Affectivity as a risk factor for persistent and increasing sleep problems, and also the specific importance of the fine-grained aspects of temperament in predicting infant sleep development.
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Affiliation(s)
- Isabel Morales-Muñoz
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; Institute for Mental Health, School of Psychology, University of Birmingham, United Kingdom.
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku; Department of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Germany; Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Minna Virta
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku; Department of Psychiatry, Turku University Hospital and University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - E Juulia Paavonen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Child Psychiatry, Turku University Hospital and University of Turku, Finland
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17
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The relationship between parental behavior and infant regulation: A systematic review. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Ward AL, Reynolds AN, Kuroko S, Fangupo LJ, Galland BC, Taylor RW. Bidirectional associations between sleep and dietary intake in 0–5 year old children: A systematic review with evidence mapping. Sleep Med Rev 2020; 49:101231. [DOI: 10.1016/j.smrv.2019.101231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 01/11/2023]
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19
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Ragni B, De Stasio S, Barni D, Gentile S, Giampaolo R. Parental Mental Health, Fathers' Involvement and Bedtime Resistance in Infants. Ital J Pediatr 2019; 45:134. [PMID: 31675994 PMCID: PMC6824034 DOI: 10.1186/s13052-019-0731-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/13/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Around the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants' factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers' involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives. METHODS Sixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants' bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted. RESULTS With regard to infants' bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (β = -.35, p = .030) and paternal involvement at bedtime (β = -.45, p = .007). Instead infants' bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (β = .24, p = .04), infant involvement in constant bedtime routines (β = -.31, p = .01) and bedtime paternal involvement (β = -.27, p = .05). CONCLUSIONS The main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants' bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children's sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children's developing sleep patterns.
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Affiliation(s)
- Benedetta Ragni
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome, Italy
| | | | - Daniela Barni
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Rosaria Giampaolo
- Outpatient’s Unit, University Department of Pediatrics, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy
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20
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Lukowski AF, Eales L, Tsukerman D. Sleep Hygiene Mediates, but Does Not Moderate, Associations Between Temperament and Sleep Quality in University Students. Behav Med 2019; 45:282-293. [PMID: 30481141 DOI: 10.1080/08964289.2018.1509052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although there are theoretical reasons to expect associations among temperament, sleep hygiene behaviors (SHB), and global sleep quality (GSQ), these relations have not yet been examined despite their potential impact on undergraduate student well-being. The present study was conducted to (1) examine relations between temperament and GSQ in university students broadly recruited, (2) document associations between SHB and temperament in this sample, and (3) to determine whether associations among temperament, SHB, and GSQ were best explained by mediation or moderation models. One hundred fifty-two university students completed questionnaires that inquired about temperament, SHB, and GSQ. Correlations revealed that poorer SHB and GSQ were associated reduced effortful control; poorer SHB was also associated with increased negative affect (SHB and GSQ were unrelated to extraversion and orienting sensitivity). Mediation models assessing relations amongst temperament, SHB, and GSQ indicated that negative affect and effortful control may predispose university students to engage in fewer SHB, negatively impacting GSQ; variability in SHB did not moderate the impact of temperament on GSQ. Additional research is needed to confirm and extend these findings, with the ultimate goal of improving undergraduate GSQ (a) by reducing negative affect and increasing effortful control or (b) by improving SHB that are uniquely associated with these temperament profiles.
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Affiliation(s)
- Angela F Lukowski
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
| | - Lauren Eales
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
| | - Dmitry Tsukerman
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
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21
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Cook F, Mensah F, Bayer JK, Hiscock H. Prevalence, comorbidity and factors associated with sleeping, crying and feeding problems at 1 month of age: A community-based survey. J Paediatr Child Health 2019; 55:644-651. [PMID: 30311274 DOI: 10.1111/jpc.14262] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 08/23/2018] [Accepted: 09/16/2018] [Indexed: 12/01/2022]
Abstract
AIM To examine, in a community cohort of healthy one-month-old infants, (i) the prevalence of early infant sleeping, crying and feeding problems; (ii) the extent to which they co-exist; and (iii) infant and mother characteristics associated with each problem alone and with comorbid problems. METHODS A survey at 4 weeks of infant age examined the presence of infant sleeping, crying and feeding problems (yes/no); parenting self-efficacy; rating of self as a tense person; and doubts about parenting at bedtime. RESULTS A total of 770 mothers (39% of those approached) with a total of 781 infants (11 twins) took part. Infant sleeping, crying and feeding problems were reported by 38.5, 27.4 and 25.2% of mothers, respectively. On comorbidity, 25.5% reported one problem, 20.5% reported two and 7.3% reported all three problems. Mothers of first-born infants reported more crying problems and comorbid problems. Mothers who described themselves as a 'tense person' reported more infant feeding problems. Maternal doubt and low self-efficacy were consistently associated with each type of infant problem and comorbid problems (adjusting for other factors). CONCLUSION Mothers expressing doubt and low parenting self-efficacy may benefit from additional support and guidance on normal infant behaviour.
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Affiliation(s)
- Fallon Cook
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jordana K Bayer
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
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22
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Öztürk Dönmez R, Bayik Temel A. Effect of soothing techniques on infants’ self‐regulation behaviors (sleeping, crying, feeding): A randomized controlled study. Jpn J Nurs Sci 2019; 16:407-419. [DOI: 10.1111/jjns.12250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/16/2018] [Accepted: 11/05/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Ayla Bayik Temel
- Public Health Nursing Department, Nursing FacultyEge University Izmir Turkey
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23
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Abstract
Breastfeeding initiation is on the rise in New Mexico; however, breastfeeding duration here, and around the world, does not meet international recommendations. Misunderstanding a baby’s behavior is often an overlooked variable that decreases breastfeeding duration. Hoping to help parents better understand how child development impacts breastfeeding, 138 New Mexico Women, Infants, and Children (WIC) professionals recently completed HUG Your Baby's Roadmap to Breastfeeding Success—a 2-hour online program, with accompanying resources, that covers key information from birth to 1 year. After completing the course, participants demonstrated increased knowledge of how child development impacts breastfeeding, expressed a stronger intention to teach parents about normal child behavior, and reported greater confidence to do so. The course was viewed as evidence-based, its online format was well-received, and participants would recommend it to colleagues.
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24
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Plancoulaine S, Reynaud E, Forhan A, Lioret S, Heude B, Charles MA. Night sleep duration trajectories and associated factors among preschool children from the EDEN cohort. Sleep Med 2018; 48:194-201. [PMID: 30008301 DOI: 10.1016/j.sleep.2018.03.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 02/09/2018] [Accepted: 03/05/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Sleep duration may vary both interindividually and intraindividually over time. We aimed to identify night-sleep duration (NSD) trajectories among preschoolers and to study associated factors. METHODS NSD was collected within the French birth-cohort study EDEN at ages 2, 3, and 5-6 years through parental questionnaires, and were used to model NSD trajectories among 1205 children. Familial socioeconomic factors, maternal sociodemographic, health and lifestyle characteristics, as well as child health, lifestyle, and sleep characteristics at birth and/or at age two years were investigated in association with NSD using multinomial logistic regressions. RESULTS Five distinct NSD trajectories were identified: short (SS, <10 h, 4.9%), medium-low (MLS, <11 h, 47.8%), medium-high (MHS, ≈11.5 h, 37.2%), long (LS, ≥11.5 h, 4.5%) and changing (CS, ie, ≥11.5 h then <11 h, 5.6%) NSD trajectories. Multivariable analyses showed in particular that compared to the MHS trajectory factors associated with increased risk for the SS trajectory were male gender, first child, maternal age and working status, night-waking, parental presence when falling asleep, television-viewing duration, as well as both "Processed and fast foods" and the "Baby food" dietary patterns at age two years. Factors positively associated with the CS trajectory were maternal smoking, feeding at night, and the Processed and fast foods dietary pattern at age two years, whereas child's activity and emotionality scores at age one year were negatively associated. CONCLUSION We identified distinct NSD trajectories among preschoolers and associated early life factors. Some of them may reflect less healthy lifestyles, providing cues for early multi-behavioral prevention interventions.
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Affiliation(s)
- Sabine Plancoulaine
- INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health And Development Team (ORCHAD), Villejuif, France; University Paris-Descartes, UMRS 1153, Paris, France.
| | - Eve Reynaud
- INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health And Development Team (ORCHAD), Villejuif, France; University Paris-Descartes, UMRS 1153, Paris, France; Ecole des Hautes Etudes en Santé Publique (EHESP), Rennes, France
| | - Anne Forhan
- INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health And Development Team (ORCHAD), Villejuif, France; University Paris-Descartes, UMRS 1153, Paris, France
| | - Sandrine Lioret
- INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health And Development Team (ORCHAD), Villejuif, France; University Paris-Descartes, UMRS 1153, Paris, France
| | - Barbara Heude
- INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health And Development Team (ORCHAD), Villejuif, France; University Paris-Descartes, UMRS 1153, Paris, France
| | - Marie-Aline Charles
- INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health And Development Team (ORCHAD), Villejuif, France; University Paris-Descartes, UMRS 1153, Paris, France
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25
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Dias CC, Figueiredo B, Rocha M, Field T. Reference values and changes in infant sleep-wake behaviour during the first 12 months of life: a systematic review. J Sleep Res 2018; 27:e12654. [DOI: 10.1111/jsr.12654] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 12/04/2017] [Indexed: 01/03/2023]
Affiliation(s)
| | | | - Magda Rocha
- School of Psychology; University of Minho; Braga Portugal
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26
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Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Birken CS, MacLean JE, Aubert S, Sampson M, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:855. [PMID: 29219078 PMCID: PMC5773910 DOI: 10.1186/s12889-017-4850-2] [Citation(s) in RCA: 211] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The objective of this systematic review was to examine for the first time the associations between sleep duration and a broad range of health indicators in children aged 0 to 4 years. Methods Electronic databases were searched with no limits on date or study design. Included studies (published in English or French) were peer-reviewed and met the a priori determined population (apparently healthy children aged 1 month to 4.99 years), intervention/exposure/comparator (various sleep durations), and outcome criteria (adiposity, emotional regulation, cognitive development, motor development, growth, cardiometabolic health, sedentary behaviour, physical activity, quality of life/well-being, and risks/injuries). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Due to high levels of heterogeneity across studies, narrative syntheses were employed. Results A total of 69 articles/studies (62 unique samples) met inclusion criteria. Data across studies included 148,524 unique participants from 23 countries. The study designs were randomized trials (n = 3), non-randomized interventions (n = 1), longitudinal studies (n = 16), cross-sectional studies (n = 42), or longitudinal studies that also reported cross-sectional analyses (n = 7). Sleep duration was assessed by parental report in 70% of studies (n = 48) and was measured objectively (or both objectively and subjectively) in 30% of studies (n = 21). Overall, shorter sleep duration was associated with higher adiposity (20/31 studies), poorer emotional regulation (13/25 studies), impaired growth (2/2 studies), more screen time (5/5 studies), and higher risk of injuries (2/3 studies). The evidence related to cognitive development, motor development, physical activity, and quality of life/well-being was less clear, with no indicator showing consistent associations. No studies examined the association between sleep duration and cardiometabolic biomarkers in children aged 0 to 4 years. The quality of evidence ranged from “very low” to “high” across study designs and health indicators. Conclusions Despite important limitations in the available evidence, longer sleep duration was generally associated with better body composition, emotional regulation, and growth in children aged 0 to 4 years. Shorter sleep duration was also associated with longer screen time use and more injuries. Better-quality studies with stronger research designs that can provide information on dose-response relationships are needed to inform contemporary sleep duration recommendations. Electronic supplementary material The online version of this article (10.1186/s12889-017-4850-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
| | - Casey E Gray
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Veronica J Poitras
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Reut Gruber
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, H3A 1A1, Canada
| | - Catherine S Birken
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - Joanna E MacLean
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
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Wolke D, Bilgin A, Samara M. Systematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants. J Pediatr 2017; 185:55-61.e4. [PMID: 28385295 DOI: 10.1016/j.jpeds.2017.02.020] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/06/2017] [Accepted: 02/07/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the mean duration of fussing and crying and prevalence of colic using modified Wessel criteria in infants in the first 3 months of life. STUDY DESIGN A systematic literature search was performed using the databases Medline, PsycINFO, and Embase. The major outcome measure was mean total fuss/cry duration during 24 hours at ages 1-2 weeks (11 samples), 3-4 weeks (6 samples), 5-6 weeks (28 samples), 8-9 weeks (9 samples), and 10-12 weeks (12 samples). RESULTS Of 5687 articles reviewed, 28 diary studies (33 samples) were suitable for inclusion in meta-analysis; these studies included 8690 infants. No statistical evidence for a universal crying peak at 6 weeks of age across studies was found. Rather, the mean fuss/cry duration across studies was stable at 117-133 minutes (SDs: 66-70) in the first 6 weeks and dropped to a mean of 68 minutes (SD: 46.2) by 10-12 weeks of age. Colic was much more frequent in the first 6 weeks (17%-25%) compared with 11% by 8-9 weeks of age and 0.6% by 10-12 weeks of age, according to modified Wessel criteria and lowest in Denmark and Japan. CONCLUSIONS The duration of fussing/crying drops significantly after 8-9 weeks of age, with colic as defined by modified Wessel criteria being rare in infants older than 9 weeks. Colic or excessive fuss/cry may be more accurately identified by defining fuss/cry above the 90th percentile in the chart provided based on the review.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
| | - Ayten Bilgin
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, London, United Kingdom
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28
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Rose CM, Savage JS, Birch LL. Patterns of early dietary exposures have implications for maternal and child weight outcomes. Obesity (Silver Spring) 2016; 24:430-8. [PMID: 26717908 DOI: 10.1002/oby.21349] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/12/2015] [Accepted: 09/01/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This article examines relations between patterns of dietary exposures at 9 months and infant and maternal weight status at 1 year postpartum. METHODS Participants were part of the Infant Feeding Practices Study II and included 1807 mothers participating through the first year postpartum. All data were self-reported monthly by mothers. Latent class analysis was conducted to identify patterns of infant dietary exposures at 9 months. Factors that predicted dietary pattern class membership were examined including infant sleep and parity. Dietary pattern membership was used to predict child and maternal weight outcomes at 1 year postpartum. RESULTS Five patterns of dietary exposures were identified, characterized by differences in milk-feeding and solid foods at 9 months: "Breastfed Fruits and Vegetables," "Breastfed Low Variety," "Formula-Fed Fruits and Vegetables," "Formula-Fed Low Variety," and "Mixed High Energy Density." Infants in the Mixed High Energy Density dietary pattern were more likely to be overweight at 1 year. CONCLUSIONS Dietary classes that capture different combinations of several aspects of infant feeding may be more useful than single dietary predictors, for example, breastfeeding, formula-feeding, or early introduction to solids, to describe differences in infants' early dietary experience and risk for overweight.
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Affiliation(s)
- Chelsea M Rose
- Center for Childhood Obesity Research, The Pennsylvania State University, State College, Pennsylvania, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, State College, Pennsylvania, USA
| | - Leann L Birch
- Department of Foods and Nutrition, The University of Georgia, Atlanta, Georgia, USA
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29
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Huang XN, Wang HS, Chang JJ, Wang LH, Liu XC, Jiang JX, An L. Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study. World J Pediatr 2016; 12:66-75. [PMID: 25754749 DOI: 10.1007/s12519-015-0012-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 05/13/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old. METHODS This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length. RESULTS Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage. CONCLUSIONS Our data based on caregiver's self-report suggested that partial breastfeeding and bed-sharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.
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Affiliation(s)
- Xiao-Na Huang
- Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui-Shan Wang
- Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jen-Jen Chang
- Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA
| | - Lin-Hong Wang
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xi-Cheng Liu
- Bronchoscopy Center, Affiliated Children Hospital of Beijing Capital Medical University, Beijing, China
| | - Jing-Xiong Jiang
- Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin An
- Department of Public Health, Peking University Health Science Center, Beijing, China
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30
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Mindell JA, Lee C. Sleep, mood, and development in infants. Infant Behav Dev 2015; 41:102-7. [DOI: 10.1016/j.infbeh.2015.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/21/2015] [Accepted: 08/22/2015] [Indexed: 10/23/2022]
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31
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Sorondo BM, Reeb-Sutherland BC. Associations between infant temperament, maternal stress, and infants' sleep across the first year of life. Infant Behav Dev 2015; 39:131-5. [PMID: 25837288 DOI: 10.1016/j.infbeh.2015.02.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/19/2014] [Accepted: 02/10/2015] [Indexed: 11/28/2022]
Abstract
Effects of temperament and maternal stress on infant sleep behaviors were explored longitudinally. Negative temperament was associated with sleep problems, and with longer sleep latency and night wakefulness, whereas maternal stress was associated with day sleep duration, suggesting infant and maternal characteristics affect sleep differentially.
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Affiliation(s)
- Barbara M Sorondo
- Department of Psychology, Florida International University, 11200 SW 8th Street, DM 256, Miami, FL 33199, United States.
| | - Bethany C Reeb-Sutherland
- Department of Psychology, Florida International University, 11200 SW 8th Street, DM 256, Miami, FL 33199, United States.
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32
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Tedder J. The Roadmap to Breastfeeding Success: Teaching Child Development to Extend Breastfeeding Duration. J Perinat Educ 2015; 24:239-48. [PMID: 26834445 PMCID: PMC4718010 DOI: 10.1891/1058-1243.24.4.239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Although medical literature establishes the benefits of, recommendations for, and variables impacting breastfeeding duration, the belief that her baby is not satisfied causes many women to abandon breastfeeding. Infant behaviors commonly misinterpreted as breastfeeding problems include increased crying, hard to calm, difficult to wake up, "restless" sleeping, frequent awakenings at night, or seemingly inattentive to or uninterested in his or her mother. The Roadmap to Breastfeeding Success is an evidence-based, clinical project that integrates best practices in lactation support with child development theory. Using family-friendly concepts and language, The Roadmap to Breastfeeding Success gives childbirth, lactation, and early parenting professionals background information and innovative resources to help mothers meet their breastfeeding goals, thus promoting the health and well-being of mothers, babies, families, and communities.
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Paul IM, Williams JS, Anzman-Frasca S, Beiler JS, Makova KD, Marini ME, Hess LB, Rzucidlo SE, Verdiglione N, Mindell JA, Birch LL. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study. BMC Pediatr 2014; 14:184. [PMID: 25037579 PMCID: PMC4105401 DOI: 10.1186/1471-2431-14-184] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/09/2014] [Indexed: 12/15/2022] Open
Abstract
Background Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This “parenting” intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT’s central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent–child responsibility for feeding, reducing subsequent risk for overeating and overweight. Methods/Design 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the “parenting” or “safety” groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3–4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second-born siblings of INSIGHT participants will be enrolled in an observation-only study to explore parenting differences between siblings, their effect on weight outcomes, and carryover effects of INSIGHT interventions to subsequent siblings. Discussion With increasing evidence suggesting the importance of early life experiences on long-term health trajectories, the INSIGHT trial has the ability to inform future obesity prevention efforts in clinical settings. Trial registration NCT01167270. Registered 21 July 2010.
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Affiliation(s)
- Ian M Paul
- Department of Pediatrics, HS83, Penn State College of Medicine, 500 University Dr,, Hershey 17033, PA, USA.
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Kurth E, Kennedy HP, Zemp Stutz E, Kesselring A, Fornaro I, Spichiger E. Responding to a crying infant - you do not learn it overnight: a phenomenological study. Midwifery 2013; 30:742-9. [PMID: 23962640 DOI: 10.1016/j.midw.2013.06.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 06/09/2013] [Accepted: 06/30/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE to examine the views and practices of first-time and experienced mothers in response to infant crying during the first 12 weeks post birth. DESIGN longitudinal, qualitative study using an interpretive, phenomenological approach. SETTING postnatal hospital and home settings in Switzerland. PARTICIPANTS maximum variation sampling of 15 new mothers of diverse parity and educational background who had given birth to a full-term healthy neonate. METHODS participant observations in the postnatal ward and two narrative interviews at participants' homes at 6-8 and 12-14 weeks post partum. Data analysis used interpretive approaches of case analysis, thematic analysis and exemplars. FINDINGS first-time mothers showed some soothing skills from the beginning, but fine-tuned their practices of handling the crying infant and managing their own reactions. With growing experience mothers acquired a differentiated understanding of the crying's reason and urgency and used more successful soothing techniques. At the same time they learned to assess and mitigate their own stress reactions by self-soothing and adopting realistic expectations of normal infant behaviour. Experienced mothers knew the infant's frequent crying would diminish after a while whereas first-time mothers coped without this positive expectation. KEY CONCLUSIONS with increasing child-care experience mothers' skills and attitudes towards crying changed, leading to a calmer and less escalating response to their crying infant. IMPLICATIONS FOR PRACTICE inexperienced mothers need information on neonatal crying behaviour and on parents' stress response. They should be taught how to recognise and respond to the new-born's signals, and how to cope with their own stress. Postnatal care should provide novice mothers to learn from experienced role models.
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Affiliation(s)
- Elisabeth Kurth
- Zurich University of Applied Sciences, Institute of Midwifery, Technikumstr. 71, 8400 Winterthur, Switzerland; University of Basel, Institute of Nursing Science, Bernoullistr. 28, 4056 Basel, Switzerland; Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002 Basel, Switzerland.
| | - Holly Powell Kennedy
- Yale University School of Nursing, 100 Church Street South, New Haven, CT 06536, USA
| | - Elisabeth Zemp Stutz
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002 Basel, Switzerland; University of Basel, Switzerland
| | - Annemarie Kesselring
- University of Basel, Institute of Nursing Science, Bernoullistr. 28, 4056 Basel, Switzerland
| | - Isabel Fornaro
- University Hospital, Women's Clinic, Spitalstrasse 21, 4031 Basel, Switzerland
| | - Elisabeth Spichiger
- University of Basel, Institute of Nursing Science, Bernoullistr. 28, 4056 Basel, Switzerland; Inselspital, Bern University Hospital, 3010 Bern, Switzerland
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