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Study: Feeding Infants Less Helps Sleep

But Not Everyone Agrees, Say Stick to Standard Advice
By
WebMD Health News

Jan. 22, 2003 - For any parent who's spent many a sleepless night tending to a crying baby, finding a way to help their child sleep through the night would be very welcome. Now, some British researchers think they have a solution --- much to the dismay of some experts.

In a new study in the February issue of Archives of Childhood Disease, the British researchers say the main reason why 3-month-old infants don't sleep through the night is a feeding schedule during their first week of life that falls within recommended guidelines of the American Academy of Pediatrics and other experts.

The researchers report that 12-week-old infants who had at least 11 feedings within a 24-hour period were nearly three times more likely to have disrupted sleep - and more nighttime crying bouts - than those getting fewer feedings. The AAP recommends eight to 12 breastfeedings within 24 hours, and other experts say up to 15 feedings is perfectly normal and healthy.

"Many parents will probably not be bothered if their baby does not sleep through the night by 12 weeks of old - they have other priorities," researcher Ian St. James-Roberts, PhD, tells WebMD. "[But] by adopting a behavioral approach we've described, they should be able to increase the likelihood that their baby sleeps through the night."

That approach results from a study of 600 breast and bottle-fed babies. One-third of the babies were enrolled in a program in which their parents were taught to establish for their infants specific daytime and nighttime activities. In addition to delaying feedings when the baby awoke at night, "they were asked to settle a baby judged to be asleep in a cot or similar place, and to avoid feeding or cuddling the child to sleep at night," says St. James-Roberts, a professor of child psychology at the University of London.

At 12 weeks, four in five breast and bottle-fed infants assigned to the program slept through the night - and developed normally, says St. James-Roberts - compared to three in five babies whose parents received "non-prescriptive" information attained through a booklet and telephone helpline. A third group of babies experienced no difference in nighttime wake-ups who were assigned to "routine services" in which healthcare providers visit the home to evaluate the child's development and the children got routine checkups at health clinics. There were about 200 infants in each group, most enrolled at age 1 week.

But other experts sharply criticized the strategies outlined in the British study - and questioned the benefit they would offer the infants.

"The assumption put forth by the authors of this study absolutely, 100 percent, can contribute to the very problem that they claim to be solving," says James McKenna, PhD, director of the Mother-Baby Sleep Laboratory at the University of Notre Dame, who has researched how breastfeeding relates to infant sleep for more than 20 years. "They start with a cultural set of assumptions that to a great degree pathologizes what is really normal, healthy human infant behavior. It's akin to blaming the victim for the crime."

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