Feeding and Sleeping: A complex picture
Most new parents, especially mothers, lose sleep over how best to feed their baby – and hunger for ways to ensure everyone gets a good night’s sleep.
Czech researchers in the Psychology Department at Palacký University Olomouc sought to answer a seemingly simple question: ‘Which improves the sleep of infants and mothers - breastfeeding or formula feeding?’ They discovered the answer is anything but simple or clear.
Their systematic review of the available evidence is a fine example of how to comprehensively seek and present all the published findings, rather than ’cherry-picking’ the professional literature to support a predetermined conclusion. The researchers’ methods are scrupulously detailed, sensible and transparently offered (including being open about limitations).
They initially gathered thousands of articles/reports published in English language peer-reviewed journals over the past decade. Their systematic review narrowed the field down first to 260 and eventually to the 36 most relevant ones. Studies of infants and/or mothers with major medical conditions were excluded.
Sleep quality proved to be a complex, multifaceted phenomenon. The authors created four dimensions for mothers and/or infants: night sleep duration; number of night awakenings; total sleep time; and time spent awake during the night. What each of the 35 studies revealed is explained in a series of detailed charts.
The ‘bottom line’ is that there is no universal, evidence-validated answer about whether breastfeeding or formula feeding consistently improve the quality of sleep for mothers and/or infants. From individual variations to circumstantial realities (e.g., infants wake up during the night for reasons other than to feed) to societal differences (such as breastfeeding for the first year being dramatically higher in Sweden than the UK), these researchers paint a portrait of complexity.
The authors state the implications of their review, as follows:
“We believe that information about how breastfeeding may or may not affect the sleep of babies and mothers is relevant to address the expectations of mothers about normal infant sleep. Founded information is also germane to promoting the benefits of breastfeeding in accordance with WHO recommendations. In addition, we believe that not enough attention is currently paid to sleep during prenatal preparation, social support, and postpartum care services and that parents are exposed to many myths that may not be in accordance with the latest research findings.
Breastfeeding brings many benefits to both mother and infant. Yet, many women stop breastfeeding their infants too soon. The perceived association between breastfeeding and sleep may influence their decision to terminate breastfeeding.”
Mankova, D., Svancarov, S., Stenclova, E. (2023) Does the feeding method affect the quality of infant and maternal sleep? A systematic review. Infant Behavior and Development, 73. DOI.org/10.1016/j.infbeh.2023.101868