Objective Infant sleep plays a critical role in normal development. Sleep problems, including sleep onset difficulties (SODs) and night waking (NW), range from 20% to 30% in infants and young children and can be persistent over time up to adulthood. Young French children seem to have longer sleep durations and less sleep troubles than their counterparts worldwide. Here, we aimed at describing infant sleep characteristics (total sleep time (TST)/24 h, NW, and SODs) and associated sleep habits in infants at age 1 year from the French nationwide birth cohort ELFE. Methods This study included 11,783 infants with information on both sleep characteristics and sleep habits (parental presence when falling asleep, eating to fall asleep, sucking a pacifier or finger to sleep and sleep arrangement and location). Associations were studied by multinomial logistic regression analyses adjusted for familial and infant characteristics. Results Mean TST was 13h36min including 2h54min of naps; 20% of the infants had TST ≤12h/24h. About 46% did not present SOD or NW, 16% had frequent SODs and 22% had NW >1 night in 2. Parental presence, feeding to fall asleep and infant sleep arrangements were frequent in infants with short sleep duration (≤12h/24h), NW and SODs. Non-nutritive sucking was associated with risk of NW, SOD and TST >14h/24h. Parental room sharing was associated with NW. Conclusion This work provides new information on infant sleep arrangements and nonnutritive sucking that should be accounted for when considering sleep behaviors. In addition, most identified sleep habits associated with poor sleep characteristics may be amenable to change.
Sleep problems affect 20%–30% of toddlers and preschoolers. Few longitudinal studies focused on the impact of infant feeding practices on sleep. We aimed to study the associations between feeding practices up to 8 months and trajectories of sleep quantity or quality from 2 to 5–6 years. Analyses included 1,028 children from the EDEN mother–child cohort. Data were collected by self‐administered questionnaires. Associations between feeding practices (breastfeeding, complementary feeding, use of thickened infant formula, night feeding) and sleep trajectories (sleep‐onset difficulties, night waking, nighttime in bed) were analysed by multiple logistic regressions. Predominant breastfeeding for more than 4 months was associated with lower risk for belonging to the persistent sleep‐onset difficulties trajectory. Night feeding at 4 months or at 2 years old was associated with higher risk for belonging to the persistent sleep‐onset difficulties trajectory, and night feeding at 8 months was associated with higher risk for night waking and higher risk for short nighttime in bed. Early introduction (< 4 months) to complementary foods (excluding baby cereals) was related to lower risk for short nighttime in bed. Use of baby cereals or thickened infant formula was related neither to sleep quality nor to sleep quantity. In conclusion, infant feeding practices are associated with sleep trajectories in preschoolers, with notably a potential protective role of breastfeeding. Further researches are needed to clarify the mechanisms of these relationships.
Sleep problems reported by parents affect 20% to 30% of infants. Few studies focused on the longitudinal association between infant feeding practices and sleep, especially in France. Analyses were based on 8,696 infants from the French national birth cohort ELFE. Collection of feeding practices from birth to 10 months allowed for the identification of trajectories of use of baby cereals and thickened formula by group‐based trajectory modelling and calculation of duration of any breastfeeding (BF) and age at complementary feeding introduction (CFI) excluding baby cereals. Total sleep duration (TSD), night waking (NW) and sleep onset difficulties (SOD) were reported at age 1. Associations between feeding and sleep were tested by multinomial logistic regressions. BF duration ≥6 months was associated with parent‐reported frequent NW, SOD and TSD ≤ 12 h/24 h at age 1. For TSD and SOD, this association was no longer significant after accounting for parental sleep‐related practices. Early use of baby cereals (≤5 months) was associated with poor sleep. Early CFI (<4 months) was associated with shorter TSD and SOD but not NW. Early use of thickened formula (only <6 months) was related to poor sleep at age 1 (NW and SOD), whereas late (around 6 months) use of thickened formula was associated with better sleep. BF duration ≥6 months was related to poor sleep at age 1 but not after adjustment on 1‐year parental sleep‐related practices except for NW. The use of baby cereals or early CFI was not related to better sleep at age 1.
Infant sleep plays a critical role in his/her normal development. Sleep problems, including sleep onset difficulties (SOD) and night waking (NW), ranges from 20% to 30% in infants and young children and are partially persistent over time up to adulthood. French young children seem to have longer sleep durations and less sleep troubles than their counterparts worldwide. We here aimed at describing infants sleep characteristics (duration/24h (TST), NW, and SOD) and associated sleep habits in infants aged 1 year old from the French nationwide birth cohort ELFE.
This study included 11,571 infants with information on both sleep characteristics and sleep habits (parental presence when falling asleep, eating to fall asleep, sucking pacifier or finger to sleep and the location where the infant falls asleep and ends his/her sleep). Associations were studied using multinomial logistic regressions adjusted for familial and infant characteristics.
Mean TST was 13hrs36 including 2hrs54 of naps, 20% of the infants had TST ≤12hrs/24h. About 46% did not present SOD or NW, while 16% had frequent SOD and 22% had NW > 1 night over 2. Parental presence, feeding to fall asleep and infants sleep location were more frequent in infants having short sleep duration (≤12h/24h), NW and SOD. Non-nutritive sucking was associated with NW, SOD and TST>14h/24h.
This work provides new information regarding infant sleep location and non-nutritive sucking that should be accounted for when considering sleep behaviors. In addition, most of identified sleep habits associated with poor sleep characteristics are accessible to prevention.
Key messages
French infants present better sleep characteristics than their counterparts. Most sleep habits associated with poor sleep are accessible to prevention.
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