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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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Otten L, Schelker E, Petersen H, Nomayo A, Conzade R, Günther J, Grieger A, Jochum F. Gastrointestinal Tolerance of an Infant Formula Manufactured from Extensively Hydrolysed Protein in Healthy Term Infants. Nutrients 2023; 15:4674. [PMID: 37960327 PMCID: PMC10647512 DOI: 10.3390/nu15214674] [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: 10/04/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The evaluation of secondary parameters of a prospective, randomised, controlled, multicentre intervention trial aimed to analyse gastrointestinal tolerance of an infant formula manufactured from extensively hydrolysed whey protein (eHF) compared to intact cow's milk protein (control formula, CF) in healthy term infants. Infants ≤ 25 days of age, who were exclusively formula-fed, were randomised to receive eHF or CF for at least three months up to 120 days of age. An exclusively breastfed reference group (BF) was included for descriptive comparison. Infants' gastrointestinal tolerance was evaluated based on stool parameters, the Amsterdam Infant Stool Scale (AISS), the Infant Gastrointestinal Symptom Questionnaire (IGSQ), and sleeping patterns. Of 359 infants included, 297 randomised (eHF: n = 149, CF: n = 148) and 41 BF infants completed the study per protocol. All tolerance parameters were comparable between eHF and CF. Stool was predominantly soft and yellow in colour. Stool was more frequently green in eHF than CF. BF infants had more frequent stools, which were mainly watery or soft and yellow, and comparable IGSQ scores (descriptive). Irrespective of group, all gastrointestinal and sleep parameters showed signs of maturation with increasing age. In conclusion, eHF showed gastrointestinal tolerance as good as CF in healthy infants. Both formulae were well-tolerated.
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Affiliation(s)
- Lindsey Otten
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany
| | - Elisabeth Schelker
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany
| | - Hanna Petersen
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany
| | - Antonia Nomayo
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany
| | - Romy Conzade
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany
| | - Julia Günther
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany
| | - Andrea Grieger
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany
| | - Frank Jochum
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany
- Department of Pediatrics, Faculty of Medicine, Brandenburg Medical School Theodor Fontane (MHB), Fehrbelliner Str. 38, 16816 Neuruppin, Germany
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Harskamp-van Ginkel MW, Imkamp NLE, van Houtum L, Vrijkotte TGM, Ben Haddi-Toutouh Y, Chinapaw MJM. Parental Discontent with Infant Sleep During the First Two Years of Life. Behav Sleep Med 2023; 21:727-740. [PMID: 36625550 DOI: 10.1080/15402002.2022.2156867] [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: 01/11/2023]
Abstract
BACKGROUND Problematic sleep in infants can have a high impact on families. We examined parental discontent with infant sleep in the first six months of life and parent-perceived problematic sleep during the second year of life. METHODS We used Sarphati Cohort data of 1471 children. During periodic youth health care visits in the first six months of life, professionals registered parental discontent with infant sleep. In the second year of life, parents filled out the Brief Infant Sleep Questionnaire (BISQ), from which we defined parent-perceived problematic sleep and BISQ-defined problematic sleep. We examined the association of parental discontent with infant sleep during the first six months with both BISQ-derived outcomes up to age two, using multivariable logistic regression analysis. RESULTS 26% of parents were discontented with infant sleep during the first six months of life. During the second year of life, 27% of the parents perceived their child's sleep as problematic, and 9% of the infants had BISQ-defined problematic sleep. Early parental discontent with infant sleep was associated with parent-perceived problematic sleep [adjusted OR 2.50 (95% CI 1.91-3.28)], and BISQ-defined problematic sleep [adjusted OR 1.88 (1.11-3.17)]. CONCLUSIONS Early registered parental discontent with infant sleep was a predictor of parent-perceived problematic sleep in early toddlerhood. Registering parental discontent during infancy might enable professionals to identify a group of infants at risk for later problematic sleep. We recommend screening and parental support for sleep difficulties in an early stage.
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Affiliation(s)
- Margreet W Harskamp-van Ginkel
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Nicola L E Imkamp
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Mai J M Chinapaw
- Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan The Netherlands
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Silveira KSRD, Serra-Negra JM, Prado IM, Abreu LG, Reis TVD, Auad SM. Sleep disturbances are associated with feeding practices and age in preterm infants. Sleep Med 2023; 111:2-8. [PMID: 37696121 DOI: 10.1016/j.sleep.2023.08.030] [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: 06/15/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Preterm infants are under risk of several shortcomings including sleep disturbances (SD). This cross-sectional study evaluated factors associated with SD in preterm and low birth weight infants in a reference center for preterm children at a University Hospital, southeastern Brazil. METHODS A hundred-four dyads of mothers-infants 0-3 years participated. Mothers answered an online questionnaire (Google Forms®) evaluating childbirth characteristics, gestational age, breastfeeding, bottle feeding, non-nutritive sucking habits and sociodemographic information. The Brazilian version of the Brief Infant Sleep Questionnaire (BISQ) evaluated SD. Bivariate and Logistic Regression analyses were performed (p < 0.05). RESULTS SD was present in 45.2% of the sample. Multivariate Logistic Regression Model showed that infants breastfed ≥3 times at night had 5.006 more chances to have SD (CI 95% = 1.229-20.400) compared to those who did not breastfeed at night. Infants who were bottle-fed 3 ≥ times at night had 6.952 more chances to have SD (CI = 95% = 1.364-35.427) compared to those who were bottle fed less frequently. The chance of SD decreased 6.6% (CI 95% = 0.889-0.982) for each increase of a month in infant's age, and infants from families with higher income had 3.535 more chances to have SD (CI 95% = 1.006-12.416). CONCLUSION The younger the child, a higher frequency of night feeding and belonging to higher income families were associated with SD. Recognizing the associated factors with SD in newborns and infants can aid families to better deal with this issue, promote better sleep quality and individualized counseling.
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Affiliation(s)
| | - Junia Maria Serra-Negra
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ivana Meyer Prado
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thaliny Vitória Diniz Reis
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sheyla Marcia Auad
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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梁 雅, 马 洁, 张 裕, 张 敏, 何 海, 王 守, 黄 月. [Sleep patterns of infants and young children and their association with breastfeeding: a study based on K-means clustering]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:1154-1160. [PMID: 36305118 PMCID: PMC9627993 DOI: 10.7499/j.issn.1008-8830.2205027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/29/2022] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To investigate the sleep patterns and characteristics of infants and young children and the association between sleep patterns and breastfeeding. METHODS A general information questionnaire, Brief Infant Sleep Questionnaire (BISQ), and a questionnaire on feeding were used to investigate the sleep quality and feeding patterns of 1 148 infants and young children aged 7-35 months. The K-means clustering method was used to identify sleep patterns and characteristics. A multivariate logistic regression analysis was used to investigate the association between sleep patterns and breastfeeding. RESULTS Three typical sleep patterns were identified for the 1 148 infants and young children aged 7-35 months: early bedtime and long sleep time; short sleep latency and moderate sleep time; late bedtime, prolonged sleep latency, and insufficient sleep time. The third pattern showed sleep disorders. The multivariate logistic regression analysis showed that compared with formula feeding, exclusive breastfeeding within 6 months after birth reduced the risk of sleep disorder patterns by 69% (OR=0.31, 95%CI: 0.11-0.81). The risk of sleep disorder patterns was reduced by 40% (OR=0.60, 95%CI: 0.38-0.96) in the infants receiving breastfeeding for 4-6 months compared with those receiving breastfeeding for 1-3 months. CONCLUSIONS There are different sleep patterns in infants and young children, and breastfeeding can reduce the development of sleep disorder patterns.
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Affiliation(s)
| | | | | | | | - 海燕 何
- 芜湖市妇幼保健计划生育服务中心(芜湖市妇幼保健院),安徽芜湖241000
| | - 守桂 王
- 芜湖市妇幼保健计划生育服务中心(芜湖市妇幼保健院),安徽芜湖241000
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Theiler M, Knöpfel N, von der Heydt S, Schwieger-Briel A, Luchsinger I, Smith A, Kernland-Lang K, Waelchli R, Neuhaus K, Kohler M, Gnannt R, Schoch SF, Weibel L, Kurth S. Sleep behavior of infants with infantile hemangioma treated with propranolol-a cohort study. Eur J Pediatr 2021; 180:2655-2668. [PMID: 34143243 PMCID: PMC8285307 DOI: 10.1007/s00431-021-04147-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
Sleep problems are frequently reported in infants treated with propranolol for infantile hemangiomas, possibly serving as a marker for a negative impact on central nervous system function. In this cohort study, we objectively investigate the sleep behavior of infants with infantile hemangiomas on propranolol compared to a healthy, untreated control group. Sleep of propranolol-treated infants and controls was investigated using ankle actigraphy and a 24-h diary for 7-10 days at ages 3 and 6 months. The main outcome measures were the Number of Nighttime Awakenings and Sleep Efficiency. The main secondary outcome measures included 24-hour Total Sleep, daytime sleep behavior, and parent-rated infant sleep quality and behavioral development based on the Brief Infant Sleep Questionnaire (BISQ) and the age-appropriate Ages-and-Stages Questionnaire (ASQ), respectively. Fifty-four term-born infants were included in each cohort. No group difference in any investigated parameter was seen at age 3 months. At age 6 months, the propranolol group exhibited a decrease in Sleep Efficiency and a trend towards an increased Number of Nighttime Awakenings compared to the control group. Treated infants at 6 months also had shorter daytime waking periods. 24-hour Total Sleep was unaffected by propranolol. No negative impact of propranolol on subjective sleep quality and behavioral development was noted.Conclusion: Propranolol exerts a measurable yet mild impact on objectively assessed infants' sleep measures. Behavioral developmental scores were unaffected. Our results support propranolol as first-line therapy for complicated infantile hemangiomas. What is Known: • Sleep disorders are frequently reported in infants with infantile hemangiomas treated with propranolol and often lead to treatment discontinuation. • Investigations of the sleep pattern in this patient group using objective measures are lacking. What is New: • The sleep pattern of propranolol-treated infants is assessed using actigraphy and a 24-h sleep diary and compared to healthy, untreated controls. • Propranolol leads to a decreased sleep efficiency at night and an increased demand of daytime sleep, yet effects are mild overall.
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Affiliation(s)
- Martin Theiler
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zurich, Switzerland. .,Vascular Anomalies Board Zurich, University Children's Hospital Zurich, Zurich, Switzerland. .,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Nicole Knöpfel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zurich, Switzerland. .,Vascular Anomalies Board Zurich, University Children's Hospital Zurich, Zurich, Switzerland. .,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Susanne von der Heydt
- Department of Pediatric Surgery, Charité University Medicine, Virchow Medical Center, Berlin, Germany
| | - Agnes Schwieger-Briel
- Pediatric Skin Center, Dermatology Department, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland ,Vascular Anomalies Board Zurich, University Children’s Hospital Zurich, Zurich, Switzerland ,Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Isabelle Luchsinger
- Pediatric Skin Center, Dermatology Department, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland ,Vascular Anomalies Board Zurich, University Children’s Hospital Zurich, Zurich, Switzerland ,Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Alexandra Smith
- Division of Pediatric Dermatology, Kantonsspital Winterthur, Winterthur, Switzerland
| | | | - Regula Waelchli
- Pediatric Skin Center, Dermatology Department, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland ,Vascular Anomalies Board Zurich, University Children’s Hospital Zurich, Zurich, Switzerland ,Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Kathrin Neuhaus
- Vascular Anomalies Board Zurich, University Children’s Hospital Zurich, Zurich, Switzerland ,Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland ,Pediatric Skin Center, Division of Plastic and Reconstructive Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Ralph Gnannt
- Vascular Anomalies Board Zurich, University Children’s Hospital Zurich, Zurich, Switzerland ,Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland ,Division of Pediatric Interventional Radiology, Department of Diagnostic Imaging, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Sarah F. Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland ,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Lisa Weibel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zurich, Switzerland. .,Vascular Anomalies Board Zurich, University Children's Hospital Zurich, Zurich, Switzerland. .,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Salome 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, 1700, Fribourg, Switzerland.
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