There is an established methodology for conducting survey research that aims to ensure rigorous research and robust outputs. With the advent of easy-to-use online survey platforms, however, the quality of survey studies has declined. This article summarizes the pros and cons of online surveys and emphasizes the key principles of survey research, for example questionnaire validation and sample selection. Numerous texts are available to guide researchers in conducting robust survey research online, however this is neither a quick nor easy undertaking. While online survey websites and software are useful for assisting in questionnaire design and delivery, they can also introduce sources of bias. Researchers considering conducting online surveys are encouraged to read carefully about how the principles of survey research can be applied to online formats in order to reduce bias and enhance rigor. In addition to alerting researchers to the pitfalls of online surveys this article also aims to equip readers of this journal with the knowledge of how to critically appraise publications based on online surveys.
An understanding of the role of infant feeding practice on infant sleep and parental caregiving at night is a crucial element in breastfeeding promotion and enhancement of infant health. Health professionals should discuss safe bed-sharing practices with all parents.
Twenty years ago a new area of inquiry was launched when anthropologists proposed that an evolutionary perspective on infancy could contribute to our understanding of unexplained infant deaths. Here we review two decades of research examining parent-infant sleep practices and the variability of maternal and infant sleep physiology and behavior in social and solitary sleeping environments. The results challenge clinical wisdom regarding ''normal'' infant sleep, and over the past two decades the perspective of evolutionary pediatrics has challenged the supremacy of pediatric sleep medicine in defining what are appropriate sleep environments and behaviors for healthy human infants. In this review, we employ a biocultural approach that integrates diverse lines of evidence in order to illustrate the limitations of pediatric sleep medicine in adopting a view of infants that prioritizes recent western social values over the human infant's biological heritage. We review what is known regarding infant sleeping arrangements among nonhuman primates and briefly explore the possible paleoecological context within which early human sleep patterns and parent-infant sleeping arrangements might have evolved. The first challenges made by anthropologists to the pediatric and SIDS research communities are traced, and two decades of studies into the behavior and physiology of mothers and infants sleeping together are presented up to the present. Laboratory, hospital and home studies are used to assess the biological functions of shared mother-infant sleep, especially with regard to breastfeeding promotion and SIDS reduction. Finally, we encourage other anthropologists to participate in pediatric sleep research using the unique skills and insights anthropological data provide. By employing comparative, evolutionary and cross-cultural perspectives an anthropological approach stimulates new research insights that influence the traditional medical paradigm and help to make it more inclusive. That this review will potentially stimulate similar research by other anthropologists is one obvious goal. That this article might do so makes it ever more possible that anthropologically inspired work on infant sleep will ultimately lead to infant sleep scientists, pediatricians, and parents becoming more informed about the consequences of caring for human infants in ways that are not congruent with their evolutionary biology. Yrbk Phys Anthropol 50: 133-161, 2007. V
Aims: To investigate the characteristics of parent-infant bed-sharing prevalence in England. Methods: Data on night-time sleeping practices from a two year, local, longitudinal study and a threeyear, national, cross-sectional study were obtained. A total of 261 infants in North Tees were followed up at 1 and 3 months of age, as were 1095 infants aged 1 week to 1 year from five English health regions. Results: Data from both studies found that almost half of all neonates bed-shared at some time with their parents (local = 47%, 95% CI 41 to 54; national = 46%, 95% CI 34 to 58), and on any one night in the first month over a quarter of parents slept with their baby (local = 27%, 95% CI 22 to 33; national = 30%, 95% CI 20 to 42). Bed-sharing was not related to younger mothers, single mothers, or larger families, and was not more common in the colder months, at weekends, or among the more socially deprived families; in fact bed-sharing was more common among the least deprived in the first months of life. Breast feeding was strongly associated with bed-sharing, both at birth and at 3 months. Bed-sharing prevalence was uniform with infant age from 3 to 12 months; on any one night over a fifth of parents (national = 21%, 95% CI 18 to 24) slept with their infants. Conclusion: Bed-sharing is a relatively common practice in England, not specific to class, but strongly related to breast feeding.
An evolutionary perspective on human infant sleep physiology suggests that parent-infant cosleeping, practiced under safe conditions, might be beneficial to both mothers and infants. However, cosleeping is not part of mainstream parenting ideology in the United States or the United Kingdom, and little evidence is available to indicate whether, and under what circumstances, parents sleep with their newborn infants. We present data from an anthropological investigation into the practices and attitudes of new and experienced parents of newborn infants regarding parent-infant sleeping arrangements in a community in the northeast of England. Despite not having contemplated cosleeping prior to the birth, new parents in our sample found it to be a convenient nighttime caregiving strategy, and one which was practiced regularly. Infants slept with both their parents, some being habitual all-night cosleepers, but commonly beginning the night in a cnb and sleeping with their parents for several hours following the early morning feed, [infant sleep, newborn, cosleeping, new parents\
Objective: To determine whether postnatal mother-infant sleep proximity affects breastfeeding initiation and infant safety. Design: Randomised non-blinded trial analysed by intention to treat. Setting: Postnatal wards of the Royal Victoria Hospital (RVI), Newcastle upon Tyne, UK. Participants: 64 newly delivered mother-infant dyads with a prenatal intention to breastfeed (vaginal deliveries, no intramuscular or intravenous opiate analgesics taken in the preceding 24 h). Intervention: Infants were randomly allocated to one of three sleep conditions: baby in mother's bed with cot-side; baby in side-car crib attached to mother's bed; and baby in stand-alone cot adjacent to mother's bed. Main outcome measures: Breastfeeding frequency and infant safety observed via night-time video recordings. Results: During standardised 4-h observation periods, bed and side-car crib infants breastfed more frequently than stand-alone cot infants (mean difference (95% confidence interval (CI)): bed v stand-alone cot = 2.56 (0.72 to 4.41); side-car crib v stand-alone cot = 2.52 (0.87 to 4.17); bed v side-car crib = 0.04 (22.10 to 2.18)). No infant experienced adverse events; however, bed infants were more frequently considered to be in potentially adverse situations (mean difference (95% CI): bed v stand-alone cot = 0.13 (0.03 to 0.23); side-car crib v stand-alone cot = 0.04 (20.03 to 0.12); bed v side-car crib = 0.09 (20.03-0.21)). No differences were observed in duration of maternal or infant sleep, frequency or duration of assistance provided by staff, or maternal rating of postnatal satisfaction. Conclusion: Suckling frequency in the early postpartum period is a well-known predictor of successful breastfeeding initiation. Newborn babies sleeping in close proximity to their mothers (bedding-in) facilitates frequent feeding in comparison with rooming-in. None of the three sleep conditions was associated with adverse events, although infrequent, potential risks may have occurred in the bed group. Side-car cribs are effective in enhancing breastfeeding initiation and preserving infant safety in the postnatal ward.A lthough the beneficial effects of early and frequent suckling and skin-to-skin contact on breastfeeding initiation are well known, [1][2][3][4][5][6] there has been little work on the effect of subsequent mother-infant contact in the initial postnatal days. Night-time rooming-in has been shown to enhance breastfeeding on demand in comparison with night-time nursery care 7 8 ; however, ''rooming-in'' involves babies sleeping in stand-alone cots that do not allow continuous contact or spontaneous feeding between mothers and infants. Yet, such contact may be of importance for mothers to understand their babies' signals and to respond effectively.Unhindered contact can only be provided for mother and baby at night in the postnatal ward through some arrangement whereby both of them can maintain continuous contact to allow spontaneous breastfeeding. Two forms of bedding-in currently practised in UK hospitals include either the ba...
. (2016) 'Exploring maternal perceptions of infant sleep and feeding method among mothers in the United Kingdom : a qualitative focus group study.', Maternal and child health journal., 20 (1). pp. 33-40. Further information on publisher's website:http://dx.doi.org/10.1007/s10995-015-1798-7Publisher's copyright statement:The nal publication is available at Springer via http://dx.doi.org/10.1007/s10995-015-1798-7.Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. In a context with strong rhetorical support for breastfeeding in the health system, yet extremely low rates of breastfeeding after hospital discharge, UK women's decisions about infant feeding reflect the reality of competing priorities in their lives, including obtaining adequate sleep. Popular wisdom in the UK tightly links breastfeeding and inadequate night-time sleep. Mothers are advised by peers and family to introduce formula or solid foods to infants to promote longer sleep. The first objective of this study was to investigate women's understandings of the nature of infant sleep and their perceptions of links between infant feeding method and sleep. The second was to explore how these perceptions influence infant feeding and sleep practices in the first year. Underpinning our work is the understanding that infant care choices result from tradeoffs by which mothers strive to balance infant-and self-care. We conducted seven focus groups with mothers of infants in two regions of the UK. Verbatim transcripts were thematically coded and emergent themes were identified. We found clearly diverging narratives between breastfeeding and formula-feeding mothers. Breastfeeding mothers viewed the fragmentary nature of infant sleep as natural, while mothers who were formula feeding felt this was a problem to be fixed. The strategies and approaches used to promote infant and maternal sleep in each group were aligned with this underlying perception of how infant sleep works. Maternal perceptions of the nature of infant sleep and its relation to infant feeding method impact infant care practices in the first year of life. SignificanceParents of infants under a year of age desire to obtain adequate sleep for themselves and their infants. Infant feeding and sleep are tightly connected in popular perception, yet little research has directly explored women's experiences of infant feeding and sleep. This study reveals that a divergence of perceptions of infant sleep and feeding between feeding groups underlies the use of different strategies for night-time s...
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