Sleep research

Since nursing babies that wake at night usually want to breastfeed, nighttime waking concerns are often seen as a breastfeeding problem. A new study in Pediatrics presents information about how babies sleep that could lead to problems for breastfeeding families if it is seen as how babies should sleep. It says in summary:

CONCLUSIONS The most rapid consolidation in infant sleep regulation occurs in the first 4 months. Most infants are sleeping through the night at 2 and 3 months, regardless of the criterion used. The most developmentally and socially valid criterion for sleeping through is from 22:00 to 0:600 hours. At 5 months, more than half of infants are sleeping concurrently with their parents.

Unfortunately this study does not talk about feeding choices. Many breastfeeding mothers find that milk production drops significantly when they go for many hours without breastfeeding or pumping. The Academy of Breastfeeding Medicine has just blogged about problems with this study – particularly if it is used as a guide for parents:

I am dismayed by the publication of the study of Henderson et al which ostensibly documents the normal patterns of sleep in infants in the first year of life. The population studied was non-random, self selected and not representative of the varied ethnic, cultural, socioeconomic diversity of a normal population. Thus, just on these grounds this inevitable selection bias precludes any conclusions.

Anthropologists and sleep researchers Helen Ball and James McKenna write in their letter to the editor:

The publication of this paper perpetuates the western cultural notion that infants can and should sleep “through the night” from a very young age. However, encouraging young babies to sleep “through the night” is one of the most effective means of killing a mother’s ability to sustain breastfeeding and denies a young infant a third of its daily nutrient intake. Regular nighttime suckling is crucial for successful lactation and is an important modulator of infant sleep architecture and arousal patterns. How can a research paper published in 2010 on infant sleep development possibly overlook or ignore the relevance of night-time breastfeeding? How could the reviewers overlook or ignore such a fundamental omission?

I hope that this study does not get used to undermine breastfeeding by making parents feel like there is something wrong with their breastfed babies that do not sleep through the night in the first year.

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