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Meighan KA, Bovbjerg ML, Benyshek DC, Cheyney MJ, Crittenden AN. Prevalence and Predictors of Postpartum Cosleeping Practices after Midwife-Led Births in the US. J Pediatr 2022; 248:46-50.e1. [PMID: 35660492 DOI: 10.1016/j.jpeds.2022.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate patterns of mother-infant sleeping behaviors among US-based mothers who received care from midwives and breastfed their infants the majority of time at 6 weeks postpartum. STUDY DESIGN Infant sleep locations were reported for 24 915 mother-infant dyads followed through 6 weeks postpartum, following midwife-led singleton births. Using data derived from medical records, we used multinomial logistic regression to identify predictors of sleep location. RESULTS The median maternal age was 31 years (IQR, 27-34 years). The majority were White (84.5%), reported having a partner or spouse (95%), had a community birth (87%), and reported bedsharing with their infant for part (13.2%) or most of the night (43.8%). In the adjusted analysis, positive predictors of always bedsharing included increasing maternal age (OR, 1.17; 95% CI, 1.13-1.21; per 5 years), cesarean birth (OR, 1.49; 95% CI, 1.18-1.86), Medicaid eligibility (OR, 1.76; 95% CI, 1.62-1.91), and maternal race/ethnicity (Black OR, 1.40 [95% CI, 1.09-1.79]; Latinx OR, 1.53 [95% CI, 1.35-1.74]; multiracial OR, 1.69 [95% CI, 1.39-2.07]). Negative predictors of bedsharing included having a partner/spouse (OR, 0.66; 95% CI, 0.56-0.77) and birth location in hospitals (OR, 0.56; 95% CI, 0.49-0.64) or birthing centers (OR, 0.48; 95% CI, 0.44-0.51). Partial breastfeeding dyads were less likely to bedshare than those who were exclusively breastfeeding (always bedsharing OR, 0.48 [95% CI, 0.41-0.56]; sometimes bedsharing OR 0.69 [95% CI, 0.56-0.83]). CONCLUSIONS These data suggest that cosleeping is common among US families who choose community births, most of whom exclusively breastfeed through at least 6 weeks.
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Affiliation(s)
| | - Marit L Bovbjerg
- Epidemiology Program, College of Public Health & Human Sciences, Oregon State University, Portland, OR
| | | | - Melissa J Cheyney
- Department of Anthropology, School of Language, Culture, and Society, Oregon State University, Portland, OR
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Gettler LT, Kuo PX, Sarma MS, Lefever JEB, Cummings EM, McKenna JJ, Braungart-Rieker JM. US fathers' reports of bonding, infant temperament and psychosocial stress based on family sleep arrangements. Evol Med Public Health 2022; 9:460-469. [PMID: 35154780 PMCID: PMC8830308 DOI: 10.1093/emph/eoab038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background and objectives Evolutionary-grounded sleep research has been critical to establishing the mutual dependence of breastfeeding and nighttime sleep proximity for mothers and infants. Evolutionary perspectives on cosleeping also often emphasize the emotional motivations for and potential benefits of sleep proximity, including for parent-infant bonding. However, this potential link between infant sleep location and bonding remains understudied for both mothers and fathers. Moreover, in Euro-American contexts bedsharing has been linked to family stress and difficult child temperament, primarily via maternal reports. We know relatively little about whether paternal psychosocial dynamics differ based on family sleep arrangements, despite fathers and other kin often being present in the cosleeping environment across cultures. Here, we aim to help address some of these gaps in knowledge pertaining to fathers and family sleep arrangements. Methodology Drawing on a sample of Midwestern U.S. fathers (N=195), we collected sociodemographic and survey data to analyze links between infant nighttime sleep location, paternal psychosocial well-being, father-infant bonding, and infant temperament. From fathers’ reports, families were characterized as routinely solitary sleeping, bedsharing, or roomsharing (without bedsharing). Results We found that routinely roomsharing or bedsharing fathers, respectively, reported stronger bonding than solitary sleepers. Bedsharing fathers also reported that their infants had more negative temperaments and also tended to report greater parenting-related stress due to difficulties with their children. Conclusions These cross-sectional results help to highlight how a practice with deep phylogenetic and evolutionary history, such as cosleeping, can be variably expressed within communities with the potential for family-dependent benefits or strains. Evolutionary-grounded cosleeping research has elucidated the intimate connections between mother-infant sleep proximity and breastfeeding. However, some Euro-American research indicates that bedsharing can coincide with family strain and stress. Here, U.S. fathers who routinely roomshared or bedshared, respectively, reported stronger bonds to their babies than solitary sleeping fathers, but bedsharing fathers also reported more negative infant temperament.
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Affiliation(s)
- Lee T Gettler
- Department of Anthropology, University of Notre Dame, Notre Dame, IN, USA.,Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.,William J. Shaw Center for Children and Families, University of Notre Dame, South Bend, IN, USA
| | - Patty X Kuo
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Mallika S Sarma
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - E Mark Cummings
- William J. Shaw Center for Children and Families, University of Notre Dame, South Bend, IN, USA.,Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - James J McKenna
- Department of Anthropology, Santa Clara University, Santa Clara, CA, USA
| | - Julia M Braungart-Rieker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
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Carrillo-Díaz M, Ortega-Martínez AR, Ruiz-Guillén A, Romero-Maroto M, González-Olmo MJ. Impact of Breastfeeding and Cosleeping on Early Childhood Caries: A Cross-Sectional Study. J Clin Med 2021; 10:1561. [PMID: 33917683 PMCID: PMC8067957 DOI: 10.3390/jcm10081561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
The type and duration of breastfeeding can be key factors in the development of early childhood caries (ECC). The association between nighttime feeding and ECC was investigated. Specifically, whether cosleeping is a potential mediator of children's oral health was investigated, considering many of the etiological factors of caries. In this cross-sectional study, 212 children (aged 2-4 years) from Madrid (Spain) who breastfed at night were examined to assess the mean decayed/filled primary teeth (dft) index, and a questionnaire was administered to the mothers to collect data on the practice of breastfeeding and cosleeping and its duration, the number of nighttime feeding sessions, sugar content in the diet, dental hygiene habits, and age at first dental visit. The dft index was lower in the group that breastfed for less than 18 months (p = 0.02). In addition, there were significant differences in the dft index in the group breastfeeding for more than 18 months between those who coslept for 18 months or more and those who coslept for less than 18 months (p < 0.05), as well as between those who coslept for 18 months or more and those who did not cosleep (p < 0.01). In conclusion, breastfeeding at night from 18 months onwards is considered a risk factor for ECC.
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Affiliation(s)
- María Carrillo-Díaz
- Department of Nursing and Dentistry, Rey Juan Carlos University, 28922 Alcorcón, Spain;
| | | | - Ana Ruiz-Guillén
- Department of Nursing and Dentistry, Rey Juan Carlos University, 28922 Alcorcón, Spain;
| | - Martín Romero-Maroto
- Department of Orthodontics, Rey Juan Carlos University, 28922 Alcorcón, Spain; (M.R.-M.); (M.J.G.-O.)
| | - María José González-Olmo
- Department of Orthodontics, Rey Juan Carlos University, 28922 Alcorcón, Spain; (M.R.-M.); (M.J.G.-O.)
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Stiffler D, Matemachani SM, Crane L. Considerations in Safe to Sleep® messaging: Learning from African-American mothers. J SPEC PEDIATR NURS 2020; 25:e12277. [PMID: 31742922 PMCID: PMC6980322 DOI: 10.1111/jspn.12277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/19/2019] [Accepted: 10/11/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to identify why African-American mothers do not tend to follow the Safe to Sleep® recommendations and to begin to identify a way to frame the Safe to Sleep® message so that African-American mothers might be more likely to follow these recommendations. DESIGN We recruited African-American mothers with infants over the age of 6 months to participate in two focus groups facilitated by a community engagement manager experienced in focus group facilitation. We used ethnography to find shared patterns of behavior and beliefs in African-American women related to safe sleep. RESULTS We identified 14 concepts and formulated them into three categories: it's just easier; can't fight culture and grandma; and Effectively teaching mother. From these we were able to identify the shared value of multifaceted learning. PRACTICE IMPLICATIONS African-American mothers say that they are generally aware of the Safe to Sleep® recommendations, even though the majority of mothers do not follow them. The reasons they give for not following them are that they are not comfortable doing so, they feel they are unable to do so, or find it unnecessary. Many of the mothers attempted to follow the Safe to Sleep® recommendations but abandoned the effort due to the stress of their crying infant. Trying to follow the Safe to Sleep® recommendations were stressful for the mothers, even though there was concern expressed by some that their infant could indeed suffocate or die from sudden infant death syndrome. The mothers gave suggestions on how they would change the message or the delivery of the message.
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Affiliation(s)
| | | | - Lisa Crane
- Goodwill of Central and Southern Indiana, Nurse-Family Partnership, Indianapolis, Indiana
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Kim E, Lee R, Cain KC. Cosleeping, sleep disturbances, children's behavioral problems, and parenting self-efficacy among Korean American families. J Child Adolesc Psychiatr Nurs 2017; 30:112-120. [PMID: 28983997 DOI: 10.1111/jcap.12182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/05/2017] [Accepted: 09/10/2017] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to compare sleep disturbances of children and their mothers, children's behavioral problems, and parenting self-efficacy between Korean American families who coslept and those who did not cosleep. Forty-eight mothers of children between 3 and 8 years of age completed the following surveys: Children's Sleep Habits Questionnaire, Pediatric Symptom Checklist, Pittsburgh Sleep Quality Index, Parenting Self-Efficacy Questionnaire, and Acculturation Rating Scale for Mexican Americans II. Overall, 48% (n = 23) of families coslept, and families with younger children coslept more than families with older children (x2=12.48,p<.05). When the families were divided into non-cosleeping (i.e., rarely) and cosleeping (i.e., sometimes and usually) groups, 100% of the cosleeping children had sleep disturbances compared to 56% of the non-cosleeping children (x2=8.67,p<.01). For mothers, 28% (n = 7) of the non-cosleeping mothers reported sleep disturbances, compared to 52% (n = 12) of the cosleeping mothers (x2=2.93,p=.08). Children's behavioral problems were not different between the two groups (F = 1.78, p = NS). Cosleeping mothers reported lower parenting self-efficacy than non-cosleeping mothers (F = 6.26, p < .05). When providing care to Korean American families with young children, their cosleeping, sleep disturbances, and parenting self-efficacy need to be addressed.
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Affiliation(s)
- Eunjung Kim
- Department of Family and Child Nursing, University of Washington, Seattle, WA, USA
| | - Rachel Lee
- Seattle Public Schools, Seattle, WA, USA
| | - Kevin C Cain
- School of Nursing, University of Washington, Seattle, WA, USA
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Abstract
Prior studies have found that close mother-child sleep proximity helps increase rates of breastfeeding, and breastfeeding itself is linked to better maternal and infant health. In this study, we examine whether breastfeeding and infant bed-sharing are related to daily rhythms of the stress-responsive hormone cortisol. We found that bed-sharing was related to flatter diurnal cortisol slopes, and there was a marginal effect for breastfeeding to predict steeper cortisol slopes. Furthermore, mothers who breastfeed but do not bed-share had the steepest diurnal cortisol slopes, whereas mothers who bed-shared and did not breastfeed had the flattest slopes (P < .05). These results were significant after controlling for subjective sleep quality, perceived stress, depression, socioeconomic status, race, and maternal age. Findings from this study indicate that infant parenting choices recommended for infants (breastfeeding and separate sleep surfaces for babies) may also be associated with more optimal stress hormone profiles for mothers.
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Affiliation(s)
- Clarissa D Simon
- Northwestern University School of Education and Social Policy, Evanston, IL, USA Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network (CCHN)
| | - Emma K Adam
- Northwestern University School of Education and Social Policy, Evanston, IL, USA Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network (CCHN) Institute for Policy Research, Evanston, IL, USA
| | - Chelsea O McKinney
- Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network (CCHN) NorthShore University Health System Research Institute, Evanston, IL, USA
| | - Julie B Krohn
- Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network (CCHN) Lake County Health Department and Community Health Center, Waukegan, IL, USA
| | - Madeleine U Shalowitz
- Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network (CCHN) NorthShore University Health System Research Institute, Evanston, IL, USA
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Abstract
This paper describes home sleeping arrangements used by parents of twins and investigates whether room sharing (twins in the same room as parents) or cobedding (crib-sharing between twins) influences parental night time sleep duration or sleep quality. A secondary analysis of data obtained from a longitudinal study of sleep in 104 families with twins was undertaken. Over 65% of twins were cobedded at 4 weeks; this decreased to approximately 42% by 13 weeks of age. Approximately 64% of families practiced room sharing at 4 weeks, this decreased to approximately 40% by 13 weeks of age. Mothers and fathers who both room shared and cobedded their twins at 9 weeks of age were most likely to experience restricted sleep duration when compared to other sleeping arrangements. Results suggest that parents of twins may not be following the most recent AAP recommendations regarding safe infant sleep for multiple birth infants.
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Affiliation(s)
- Elizabeth G. Damato
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, 216-368-2597
| | - Jennifer A. Brubaker
- Center for Pediatric and Congenital Heart Disease, Children’s Hospital Cleveland Clinic, Cleveland, OH
| | - Christopher Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
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Gettler LT, McKenna JJ. Evolutionary perspectives on mother-infant sleep proximity and breastfeeding in a laboratory setting. Am J Phys Anthropol 2011; 144:454-62. [PMID: 21302271 PMCID: PMC3057899 DOI: 10.1002/ajpa.21426] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Accepted: 09/14/2010] [Indexed: 12/28/2022]
Abstract
Human maternal and infant biology likely coevolved in a context of close physical contact and some approximation of frequent, "infant-initiated" breastfeeding. Still, mothers and infants commonly sleep apart from one another in many western societies, indicating a possible "mismatch" between cultural norms and infant biology. Here we present data from a 3-night laboratory-based study that examines differences in mother-infant sleep physiology and behavior when mothers and infants sleep together on the same surface (bedsharing) and apart in separate rooms (solitary). We analyze breastfeeding frequency and interval data from the first laboratory night (FN) for 52 complementary breastfeeding mothers and infants (26 total mother-infant pairs), of which 12 pairs were routine bedsharers (RB) and 14 were routine solitary sleepers (RS). RB infants were 12.0 ± 2.7 (SD) weeks old; RS infants were 13.0 ± 2.4 weeks old. On the FN, RB mother-infant pairs (while bedsharing) engaged in a greater number of feeds per night compared to RS (while sleeping alone) (P < 0.001). RB also showed lower intervals (min) between feeds relative to RS (P < 0.05). When we evaluated data from all three laboratory nights (n = 36), post hoc, RB breastfed significantly more often (P < 0.01) and showed a trend towards lower intervals between feeds (P < 0.10). Given the widely known risks associated with little or no breastfeeding, the demonstrated mutually regulatory relationship between bedsharing and breastfeeding should be considered in future studies evaluating determinants of breastfeeding outcomes.
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Affiliation(s)
- Lee T Gettler
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA.
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Abstract
This study examined whether 3-15, month-old cosleeping infants displayed differences in time spent in active versus quiet sleep, and in the number/duration of nighttime awakenings when compared with solitary-sleeping infants; and also whether they spent the majority of the night sleeping face-to-face, as previously reported. Nine cosleeping and nine solitary-sleeping infants were matched on age, gender, ethnicity, maternal age, and family SES. Video recordings of nighttime sleep yielded percentage of time in active sleep, quiet sleep, and awake, number of wakenings, and the percentage of time cosleeping infants and mothers spent face-to-face. Across age, cosleeping infants had more awakenings per night mean 5.8(1.50) versus 3.2(1.95); t = 3.16, p = .006). The percent of the nighttime spent awake did not differ between groups, suggesting that cosleeping infants had shorter awakenings. Cosleeping infants spent 40% of the night face-to-face with their mothers.
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Affiliation(s)
- Amy Mao
- George Washington University
| | | | | | | | - Thomas F. Anders
- Address Correspondence to Thomas F. Anders, M.D., M.I.N.D. Institute, UC Davis Medical Center, 2825 50th St., Sacramento, CA 95817; e-mail:
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