Category Archives: Sleep

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.

Mental health for mamas

There is loads to say about this – having a baby is a huge life stress as well as a welcome joy. Breastfeeding often gets blamed for lots of problems with lack of sleep being on of the biggies. According to an article by Kathleen Kendall-Tackett (one of my very favorite authors on the topic of stressed out mamas) we shouldn’t be blaming breastfeeding for our exhaustion after baby is born. The reality is that breastfeeding mothers get more sleep than bottle feeding mothers:

In a study of mothers and fathers at three months postpartum, data were collected via wrist actigraphy and using sleep diaries (Doan et al., 2007). The study compared sleep of exclusively breastfed infants vs. those supplemented with formula. In this sample, 67% were fed exclusively with breast milk, 23% were fed a combination of breast milk and formula, and 10% were exclusively formula fed. Mothers who exclusively breastfed slept an average of 40 minutes longer than mothers who supplemented. Parents of infants who were breastfed during the night slept an average of 40 to 45 minutes more than parents of infants given formula. Parents of formula-fed infants had more sleep disturbances. They concluded that parents who are supplementing with formula under the assumption that they are going to get more sleep should be encouraged to breastfeed so they will get an extra 30-45 minutes of sleep per night.

Sleep Survey Results

You may remember a post a while ago where I linked to a sleep survey for mothers of new babies. Kathleen Kendall-Tackett and Thomas Hale (authors of The Hidden Feelings of Motherhood and Medications and Mothers’ Milk respectively) have been collecting data about how new mothers sleep, where new babies sleep, how the babies are fed, and how tired mothers feel. Their preliminary results were published in the February 2009 Medications and More newsletter.

Since many people encourage mothers to give their babies formula to “get a break” or “get some rest”, I was interested to see this result

When asked to rate their energy on most days, 28.7% of breastfeeding mothers rated their energy as excellent or very good, compared to 19.4% of formula feeding mothers and 19.1% of women who combined methods.

Maybe breastfeeding is the way for new mothers to give themselves a break? Of course, one thing to notice is that even among the breastfeeding mothers only about 1 out of 4 reported having excellent or very good energy levels. Being a new mother is a tiring business…