Infant feeding practices and sleep development in pre‐schoolers from the EDEN mother–child cohort

Abstract

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.

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

“…In very young infants, Macknin et al (1989) showed that feeding infants cereals in the bottle before bedtime was not associated with infant's sleep at age 5 weeks or 4 months. This lack of association was also observed in later infancy in the EDEN study, showing no association between the age of baby cereal introduction with sleep quantity or quality trajectories between age 2 and 5 years (Murcia et al, 2019).…”

“…However, only 42% of the children achieved the protocol in the early introduction group. The EDEN mother–child cohort also showed that CFI before age 4 months was related to low risk of short sleep duration between age 2 and 5 years (Murcia et al, 2019). However, other studies found the opposite, with introduction of solid food before 4 months being associated with short sleep duration at age 1 (Nevarez et al, 2010).…”

“…Others showed that infants who were fed solid food during the day between 6 months and 1 year of age were less likely to be fed at night but not less likely to wake, with no difference in infant sleep observed between formula‐fed and breastfed infants (Brown & Harries, 2015). Besides the feeding methods or the introduction of solid foods, adding baby cereals into infants' bottles before bedtime among 1‐ to 4‐month‐old infants was not associated with their sleep (Macknin, Medendorp, & Maier, 1989; Murcia et al, 2019). The introduction of solids during the day showed no association with night waking frequency, but it was associated with low frequency of infant night feeding (Brown & Harries, 2015).…”

“…The introduction of solids during the day showed no association with night waking frequency, but it was associated with low frequency of infant night feeding (Brown & Harries, 2015). In the literature, one study focused on thickened formula and infant sleep and reported no association with sleep developmental trajectories between age 2 and 5 years (Murcia et al, 2019).…”

“…By comparing actigraphy data and maternal reports, a recent study showed that mothers who formula-fed between age 1 and 4.5 months tended to overestimate their infants' night sleep duration as compared with mothers who breastfed (Rudzik, Robinson-Smith, & Ball, 2018). More recently, predominant breastfeeding for more than 4 months was found associated with low risk of persistent reported sleep-onset difficulties between age 2 and 5 years (Murcia et al, 2019).…”