Infant feeding practices and sleep at 1 year of age in the nationwide ELFE cohort

Abstract

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.

Regulatory problems and associated factors among infants in Arba Minch health and demographic surveillance system sites, southern Ethiopia

“…This study also demonstrated that infant feeding problems triple the likelihood of sleeping problems. This finding is consistent with the findings of Messayke et al (2021), who discovered that early initiation of baby cereals, thickened formula, and breastfeeding over six months are associated with poor sleep [ 53 ]. Field (2017) also ascribed that feeding problems are factors associated with isolated infant sleeping problems [ 54 ].…”

“Struggle at night – He doesn’t let me sleep sometimes”: a qualitative analysis of sleeping habits and routines of Hispanic toddlers at risk for obesity

“…Many mothers responded that they are co-sleeping (defined in this study as bedsharing): there is a difference in reactive co-sleeping due to necessity of limited sleep spaces, versus intentional co-sleeping to promote attachment [ 27 , 29 ]. Pediatricians should ask “Do you have a crib for her to sleep?” More mothers acknowledged co-sleeping in interviews than in surveys; perhaps theyknew this went against pediatrician recommendations [ 20 ], or perhaps they responded as to their intent at the start of the night rather than the reality of responding to night waking. Well-intentioned pediatricians may ask unhelpful leading questions; for example: “He always sleeps in his own crib, right?”.…”

“…Pediatricians should ask "Do you have a crib for her to sleep?" More mothers acknowledged cosleeping in interviews than in surveys; perhaps theyknew this went against pediatrician recommendations [20], or perhaps they responded as to their intent at the start of the night rather than the reality of responding to night waking. Well-intentioned pediatricians may ask unhelpful leading questions; for example: "He always sleeps in his own crib, right?".…”

“…Co-sleeping, defined here as bedsharing rather than room-sharing, has also been strongly associated with fragmented sleep for infants and toddlers; bedsharing is a strong predictor of nocturnal awakenings [12,24]. Bedsharing is a parent behavior that may also increase the feeding-to-sleep association [20,24]. The type of food offered at waking is also important: breastfeeding offered at waking is less obesogenic than formula [25], and co-sleeping is more closely associated with breastfeeding than formula feeding [26].…”

“…Nighttime wakings are influenced by parent behaviors: responding to night waking with feeding is most directly associated with infants’ not consolidating sleep [ 12 ]. Parents’ sleep-related behaviors such as presence when the child falls asleep, feeding to sleep, pacifier use, and room sharing, regardless of breastfeeding status, are associated with parent-reported infant sleep problems [ 20 , 21 ]. Additionally, if parents feed at each nighttime waking, toddlers may increase their overall daily energy intake: predominantly nighttime feeding increased BMI-for-age Z score in 12–24 month children [ 22 ].…”