Fran Lowry

October 19, 2011

October 19, 2011 (Boston, Massachusetts) — Babies who are breastfed wake more often at night and have more fragmented sleep than bottle-fed babies, but these sleep disruptions resolve over time, according to research presented here at the American Academy of Pediatrics (AAP) 2011 National Conference and Exhibition.

These disrupted sleep patterns stabilize and by 6 months, infants who were exclusively breastfed had equal sleep skills, including falling asleep, staying asleep, and total sleep time at night, said senior author Jodi Mindell, PhD, associate director of the Sleep Center at the Children's Hospital of Philadelphia, Pennsylvania.

"Mothers who breastfeed should not be concerned about establishing any long-term sleep issues...[and] are not setting their children up for bad sleep habits," Dr. Mindell told Medscape Medical News.

"This information should be reassuring to patients. Although you may be having more sleep difficulties currently, while you are nursing, later on, your baby is going to be just fine," she said.

In the study, 89 mothers of exclusively breastfed infants and 54 mothers of exclusively formula-fed infants (ages 3 to 12 months) completed the Brief Infant Sleep Questionnaire at baseline and at 4 follow-up visits — 3, 6, 9, and 12 to 18 months later.

In the beginning, the study found that infants who were exclusively breastfed had significantly more night wakings (P = .002) and were less likely to wake up in their own bed (P < .001). These infants also took more frequent naps during the day (P = .003) than the formula-fed infants.

These differences persisted 3 months later. Additionally, formula-fed infants had significantly longer stretches of sleep at night (P = .007). But at the 6-month follow-up, the only significant difference between breastfed and formula-fed babies was that breastfed infants were less likely to wake up in their own bed.

By 9 months, all differences in sleep patterns had disappeared. They continued to be the same 12 to 18 months later.

"We really want to support breastfeeding and...encourage parents to continue breastfeeding as long as possible. Right now, the AAP standards are up to 12 months," Dr. Mindell said.

Lori Feldman-Winter, MD, MPH, division head of adolescent medicine at Cooper University Hospital in New Jersey, agreed that the results of this study are good news for parents who have concerns about breastfeeding.

"A lot of people say that if you are breastfeeding and the baby is waking up all the time, you are going have disrupted sleep, the baby is going to have disrupted sleep forever, and you are never going to have normal sleep in your house again. It is reassuring that in the end, by 9 months, there were no differences," Dr. Feldman-Winter told Medscape Medical News.

This study was sponsored by Johnson & Johnson. Dr. Mindell reports a financial relationship with Johnson & Johnson. Dr. Feldman-Winter has disclosed no relevant financial relationships.

American Academy of Pediatrics (AAP) 2011 National Conference and Exhibition: Abstract 14024. Presented October 17, 2011.

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