Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving

Abstract

Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Previous research indicates that UK parents would value an approach that facilitates meeting their infants' needs while supporting their own sleep-related well-being throughout their infant's first year. Six initial stakeholder meetings were held with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The Possums Sleep Program developed and delivered in Brisbane, Australia in a GP clinic setting, was chosen as an appropriate approach. Working collaboratively with a stakeholder group, we translated the Possums Sleep Program into an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Parent and practitioner views of the initial materials were obtained via feedback questionnaires and the tool was revised. The intervention was then field-tested by 164 practitioners who delivered it to at least 535 new parents and babies over 5 UK locations, to capture anonymous parent and practitioner views of the intervention concept, the materials, and their experiences with both. The intervention helps parents recalibrate their expectations of infant sleep development, encourages responsive parenting and experimentation to meet their infant's needs, offers parents strategies for supporting the development of their babies' biological sleep regulators and promote their own well-being, and teaches parents to manage negative thinking and anxiety that can impede sleep using the principles of Acceptance and Commitment Therapy. The 'Sleep, Baby & You' discussion tool, a 14 page illustrated booklet for parents, was field-tested and evaluated by practitioners and parents who offered enthusiastic feedback. Practitioners reported the 'Sleep, Baby & You' materials were easy for them to explain and for parents to understand, and were a good fit with the responsive parenting approaches they employed in other areas of their work. Parents who received the intervention postnatally understood the material and found the suggestions easy to follow. All parents who provided feedback had implemented one or

Infant sleep as a topic in healthcare guidance of parents, prenatally and the first 6 months after birth: a scoping review

“… 20. Ball et al (2020) [ 28 ] United Kingdom A description of the development of a new approach to support parental wellbeing and responsive infant caregiving in UK. Responses were given by 164 health practitioners and 535 new parents.…”

“…Although highlighted safe sleep recommendations seem to be widely known and recommended, research shows that parents tend to form their own practice in their home environments [ 22 , 28 , 29 , 47 ]. This applies particularly to the sharing of the same bed surface.…”

“…There seems to be a lack of studies addressing which topics of sleep advice should be addressed and when. When screening publications over the last 20 years, we detected interventions initiated during pregnancy [ 26 ], maternity wards [ 27 ], and postnatal care [ 28 , 29 ]. Research shows some inconsistencies in advice and the factors that influence parents` adherence to safe sleep guidelines, and many parents do not use safe sleep practices at home [ 30 , 31 ].…”

Correlates of Canadian mothers’ anger during the postpartum period: a cross-sectional survey

“…Taken together, the study findings suggest that 1) it is critical to screen mothers and infants for sleep problems because they can be associated with mood problems [ 11 , 84 ] and that 2) clinicians ought to provide education about infant sleep patterns and teach psycho-behavioral interventions to parents to promote maternal-infant sleep and manage sleep problems. Talking to parents about parental and infant sleep is a low-barrier and stigma free way for clinicians to initiate conversations about daily functioning and mental health [ 85 ]. Addressing maternal and infant sleep problems can contribute to managing postpartum mood problems given the empirical support for psycho-behavioral education around sleep contributing to improved maternal mental health [ 83 , 86 ].…”

Longitudinal changes in wellbeing amongst breastfeeding women in Australia and New Zealand during the COVID-19 pandemic

“…Anticipatory antenatal and early postnatal education that includes typical infant sleep patterns may assist parents in forming realistic expectations. Approaches that promote parents’ understanding of normal infant sleep patterns while supporting their own sleep and wellbeing are reported to be easy to implement and helpful [ 52 , 53 ]. As mental health challenges and concerns about infant sleep are amplified during times of increased stress [ 54 ], such approaches must be made widely available through a variety of media, including telehealth, to support women regardless of the availability of face-to-face professional support.…”