A comparison of the sleep-wake patterns of cosleeping and solitary-sleeping infants

Bed-sharing at 3 months and breast-feeding at 1 year in southern Brazil

OBJECTIVE

To investigate the association between bedsharing at age 3 months and breastfeeding (BF) at age 12 months.

STUDY DESIGN

Almost all children born in Pelotas, Brazil in 2004 (99.2%) were enrolled in a cohort study. At birth, age 3 months, and age 12 months, mothers were interviewed to gather information on sociodemographic, reproductive, BF, and bedsharing characteristics. Bedsharing was defined as habitual sharing of a bed between mother and child for the entire night or part of the night. The analysis was limited to children from single births who were breastfed at 3 months. Multivariate analyses were carried out using Poisson regression.

RESULTS

Of 4231 live births, 2889 were breastfed at age 3 months. The prevalence of BF at age 12 months was 59.2% in the children who bedshared at 3 months and 44% in those who did not (adjusted prevalence ratio [PR] for weaning= 0.75; 95% confidence interval [CI] = 0.69-0.81; P < .001). Among children who were exclusively breastfed at 3 months, 75.1% of those who also bedshared were still breastfed at age 12 months, versus 52.3% of those who did not bedshare (adjusted PR = 0.63; 95% CI = 0.53- 0.75; P < .001). The adjusted PR was 0.74 (95% CI = 0.60-0.90; P = .003) in children who were predominantly breastfed and 0.83 (95% CI = 0.76-0.90; P < .001) in those who were partially breastfed.

CONCLUSIONS

Bedsharing at 3 months protected against weaning up to age 12 months.

Inner-city caregivers' perspectives on bed sharing with their infants

OBJECTIVE

To understand parents' motivations for bed sharing with their infants aged 1-6 months, their beliefs about safety concerns, and their attitudes about bed-sharing advice.

METHODS

We conducted 4 focus groups with primary caregivers of infants ages 1-6 months who regularly shared beds with their infants. We recruited participants from an inner-city primary care center in Pittsburgh, serving primarily African American families who received medical assistance. Discussions were audiotaped and transcribed. Two investigators coded the transcripts and identified themes in an iterative process to achieve agreement between coders.

RESULTS

A total of 28 caregivers aged 17-50 participated. The majority were African American (86%), female (93%), single (50%), and high school graduates (71%). Eleven percent of participants breast-fed their infants. We identified 5 themes, common to all groups, to explain parents' motivations for bed sharing: 1) better caregiver and infant sleep, 2) convenience, 3) tradition, 4) child safety, and 5) parent and child emotional needs. Parents expressed divergent views about the safety of bed sharing: 1) ambivalence regarding balancing risks of overlaying and suffocation with benefits of bed sharing, or 2) assertion that bed sharing poses no risks for their child. Common to all groups was the finding that clinicians' advice against bed sharing did not influence parents' decision, but advice to increase safety when bed sharing would be appreciated.

CONCLUSIONS

Parents' motivation to bed share outweighed the concerns and the warnings of others. An understanding of parents' perspectives on bed sharing should inform counseling to promote safe sleeping practices.

Maternal reports of sleep in 6-18 month-old infants from Nepal and Zanzibar: association with iron deficiency anemia and stunting

BACKGROUND

Infants with iron deficiency anemia (IDA) and stunting explore and interact less with their environment. They may also be fatigued more often, suggesting their sleep may be affected. It is unclear whether fatigue in these infants is due to poor nighttime sleep or if it is compensated for with frequent naps or longer sleep.

AIMS

In 2 studies from Pemba Island, Zanzibar and 1 from Nepal we investigated the relationship between IDA, stunting, and maternal reports of sleep in 6-18 mo old infants.

METHODS

Parents reported on the number and duration of naps, hours of nighttime sleep, and frequency of night waking. Anemia was defined as Hb<10 g/dL, iron deficiency as zinc protoporphyrin (ZPP > or = 90 micromol/mol heme), stunting as HAZ<-2 SD, and IDA as Hb<10 g/dL and ZPP > or = 90 micromol/mol heme.

RESULTS

The prevalence of IDA and stunting was 34-84% and 22-37%, respectively. Most infants napped during the day and took approximately 1.5 naps (mean nap duration 1.4-1.7 h). Mean nighttime sleep duration was 8.3-9.7 h and infants awoke 2.1-2.5 times per night. Both IDA and stunting were associated with differences in reported sleep characterized by shorter night sleep duration and higher frequency of night waking; stunting was also related to shorter nap duration.

CONCLUSIONS

We found reduced sleep duration and increased night waking among infants with IDA and stunting. Because sleep plays an essential role in infant development, our findings indicate a clear need for further research into these relationships.

State change in preterm infants in response to nursing caregiving: possible gender effects

PURPOSE

To describe the effect of nursing caregiving on infant sleep-wake states by gender in preterm infants.

DESIGN

Descriptive measures at 34 weeks postmenstrual age and at discharge.

SAMPLE

Twenty-two hospitalized preterm infants.

MAIN OUTCOME VARIABLE

Infant state and caregiving episodes were coded in 15-second intervals from video recordings of approximately three hours duration. Time plots of state and caregiving were analyzed visually to summarize spontaneous state changes and state change associated with caregiving.

RESULTS

Sleep and wake state distribution did not differ statistically by gender; however, the rate of state change in male infants was twice that of females (p=.012) at discharge. At discharge, male infants received approximately twice as many care episodes as females. At discharge, the rate of state change in response to caregiving in male infants was four times that of female infants (p=.026). Males exhibited a greater percentage of caregiving episodes related to state change than did females at discharge (p=.018). Findings suggest further exploration of possible gender differences in state regulation and state change in response to caregiving.