Association between breastfeeding and sleep patterns in infants and preschool children

Author:

Abdul Jafar Nur K1,Tham Elaine K H1,Pang Wei W2,Fok Doris2,Chua Mei C3,Teoh Oon-Hoe4,Goh Daniel Y T5,Shek Lynette P-C15,Yap Fabian4,Tan Kok H6,Gluckman Peter D17,Chong Yap-Seng12ORCID,Meaney Michael J18,Broekman Birit F P19,Cai Shirong12

Affiliation:

1. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore

2. Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

3. Department of Neonatology, Kandang Kerbau Women's and Children's Hospital, Singapore

4. Department of Paediatrics, Kandang Kerbau Women's and Children's Hospital, Singapore

5. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

6. Department of Maternal Fetal Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore

7. Liggins Institute, University of Auckland, Auckland, New Zealand

8. Department of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada

9. Department of Psychiatry, OLVG and Amsterdam UMC, VU University, Amsterdam, The Netherlands

Abstract

ABSTRACT Background Although most studies have reported unfavorable short-term effects of breastfeeding on early-childhood sleep-wake behaviors that potentially attenuate over time, findings have remained inconsistent. Objectives We assessed associations of breastfeeding with longitudinal day-, night-, and total-sleep trajectories and with sleep-wake behaviors in healthy infants and preschoolers. Methods Caregivers of naturally conceived, term, singleton infants (n = 654) completed the Brief Infant Sleep Questionnaire (3, 6, 9, 12, 18, and 24 mo) and/or Children's Sleep Habits Questionnaire (54 mo), and provided information on their infants’ breastfeeding status at 3 mo. Trajectory analyses derived 4 day- (n = 243), 3 night- (n = 248), and/or 4 total- (n = 241) sleep trajectories, each differing in length of sleep duration (short/moderate/long) and variability (variable/consistent). Sleep-wake behaviors from 3 to 24 mo (day/night/total-sleep durations and duration/number of night awakenings) were also assessed for associations with breastfeeding. Results After adjusting for potential covariates, formula-fed infants, relative to fully breastfed (predominant or exclusive) infants, were significantly less likely to exhibit moderate (OR: 0.28; 95% CI: 0.11, 0.70) and long consistent (OR: 0.18; 95% CI: 0.07, 0.50) night-sleep trajectories and less likely to exhibit moderate (OR: 0.21; 95% CI: 0.07, 0.61) and long consistent (OR: 0.12; 95% CI: 0.04, 0.38) and long variable (OR: 0.16; 95% CI: 0.05, 0.56) total-sleep trajectories, instead of short variable night- and total-sleep trajectories. Partially breastfed infants did not differ from fully breastfed infants for both night- and total-sleep trajectories. No significant differences were found between all groups for day-sleep trajectories. Fully breastfed infants had longer night- (6, 9, 12, and 24 mo) and total- (3 and 12 mo) sleep durations than formula-fed infants, albeit a greater number of night awakenings (from 6 to 12 mo). Conclusions Despite more night awakenings, fully breastfed infants have overall longer night- and total-sleep durations (sleep trajectories) than formula-fed infants.

Funder

Singapore National Research Foundation

National Medical Research Council

Singapore Institute for Clinical Sciences

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

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