Maternal sleep and feeding methods studied

Some good information because perceptions can be deceiving.

November 8, 2010 — Breast-feeding mothers do not get less or worse sleep than mothers using formula feeding, according to the results of a study published online November 8 in Pediatrics.

"Breastfed infants are reported to awaken more often and to sleep less," write Hawley E. Montgomery-Downs, PhD, from the Departments of Psychology and Pediatrics, School of Medicine, West Virginia University in Morgantown, and colleagues. "Because of its well-established benefits for both infants and mothers, any perceived disadvantage of breastfeeding should be evaluated carefully. Feeding method effects on maternal sleep are relatively unknown."

The goal of the study was to evaluate maternal sleep measured actigraphically, subjective sleep reports, and daytime functioning, and their association with feeding method status during postpartum weeks 2 through 12. Outcomes included objectively measured total sleep time, sleep efficiency, and sleep fragmentation; and subjectively reported numbers of nocturnal awakenings, total nocturnal wake time, and sleep quality. The fatigue visual analog scale, the Stanford Sleepiness Scale, or the Epworth Sleepiness Scale allowed determination of sleepiness and fatigue.

Women who were exclusively breast-feeding, exclusively formula feeding, or using both methods did not find differences in these outcomes, although the study had sufficient power to detect such differences.

Limitations of this study include lack of generalizability to depressed or anxious women, possible selection bias, and lack of validation of the Epworth Sleepiness Scale for use with postpartum women.

"Efforts to encourage women to breastfeed should include information about sleep," the study authors write. "Specifically, women should be told that choosing to formula feed does not equate with improved sleep. The risks of not breastfeeding should be weighed against the cumulative lack of evidence indicating any benefit of formula feeding on maternal sleep."

The National Institutes of Health supported this study. The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online November 8, 2010.