Effects of feeding patterns on sleep of infants aged 0-5 months / 中华围产医学杂志

ABSTRACT

Objective:To investigate the sleep of infants aged 0 to 5 months and explore its association with feeding patterns.Methods:A cross-sectional survey on infant sleep was conducted from February to August 2019 using "Brief Infant Sleep Questionnaire" posted on a WeChat public account, which mainly included two dimensions of sleep duration and habits. In addition, information on maternal and infant characteristics as well as feeding patterns was also collected. Multiple linear regression and multinomial logistic regression were used to analyze the association between sleep and feeding patterns.Results:This study included 28 444 singleton infants aged 0 to 5 months and their mothers from 31 provincial-level administrative regions in mainland China. The median sleep duration of infants at night and during the day was 9 h and 6 h, respectively. These infants sharing the bed with their parents accounted for 53.5% (15 221/28 444). Of all infants, 46.0% (13 092/28 444) slept on their backs; 84.7% (24 078/28 444) woke up two times or more at night; 58.3% (16 597/28 444) stayed awake 2 h or more at night; 89.7% (25 523/28 444) had a sleep latency of 1 h or more. Falling asleep while being fed was the most common way to fall asleep (40.2%, 11 426/28 444). The numbers of infants who were exclusively breastfed, exclusively formula-fed and mixed-fed were 7 164 (25.2%), 4 097 (14.4%) and 17 183 (60.4%), respectively. Compared with exclusively breastfed infants, exclusively formula-fed infants slept for shorter periods at night (a β=－0.14, 95% CI－0.22 to－0.06, P<0.05), while mixed-fed infants slept longer (a β=0.08, 95% CI 0.02-0.13, P<0.05). Exclusively formula-fed infants had less overall sleep time than recommended ( aOR=1.10, 95% CI 1.00-1.21, P<0.05). Exclusively formula-fed and mixed-fed infants were less likely to sleep in cribs in separate rooms ( aOR=0.50, 95% CI 0.44-0.56; aOR=0.35, 95% CI 0.32-0.38; both P<0.05). Exclusively formula-fed infants were less likely to share the bed with their parents ( aOR=0.91, 95% CI 0.83-0.99, P<0.05), but the likelihood in mixed-fed infants was high ( aOR=1.19, 95% CI 1.11-1.27, P<0.05). Mixed-fed infants were more likely to sleep on their backs ( aOR=1.12, 95% CI 1.06-1.18, P<0.05). Exclusively formula-fed infants were more likely to stay awake for four hours or more at night ( aOR=1.12, 95% CI 1.01-1.25, P<0.05). Conclusions:Exclusively breastfeeding was the best feeding pattern for infant sleep quantity. But much attention should be paid to sleeping habits including sleeping place and sleeping position associated with exclusively breastfeeding to improve infant sleep and feeding.