Infant and mother sleep patterns during 4th postpartum week.

Using modified Barnard and Eyres (1979) Sleep/Activity Records, 44 mothers recorded diurnal sleep and awake times for themselves and their infants during the 4th week postpartum. Independent two-way analyses of variance, using a two-factor design (3a x 2b), compared data from each mother and each infant. Independent variables were (a) parity groups (mothers feeding their first, second, or third infant) and (b) feeding method (breast vs. bottle). A statistically significant difference (alpha = .05) was apparent between breast-fed and bottle-fed babies regarding the number of awakenings and the hours of night sleep, with breast-fed babies awakening more and sleeping less at night. But there was no statistically significant difference in the hours of total sleep diurnally. Mothers exhibited corresponding differences in sleep patterns, with a statistically significant increase in night waking for breast-feeding mothers. Infants in this study averaged 14.6 hr of sleep in 24 hr, which is in contrast to the 15.5 to 17.3 hr of sleep commonly reported in nursing texts based on studies from the 1960s.

Contraceptive practices before conception and after the birth of a child with a chronic health problem.

Sexual and marital relations as well as family functioning may be altered by the birth of a child with a chronic health problem. After the birth of a child with a health problem, mothers have varied responses from an urgent desire to have another baby to a firm desire to avoid pregnancy. Mothers of healthy infants and mothers of infants who had been placed on apnea monitors for at least 5 months were surveyed on their contraceptive practices, family functioning, their marital satisfaction and sexual satisfaction, as well as their desire to have or not have another child. Surveys were conducted at 6 months and 12 months after delivery. The type of contraception used varied significantly between the two groups of mothers. There was an increase in the use of oral contraception after birth for the women whose infants were on apnea monitors. Frequency in the use of contraception varied between the two groups, with the mothers of healthy infants reporting more consistent use prior to the pregnancy, which was also more frequently planned than in the apnea group. Correlation matrices demonstrated a significant relationship between type of contraception and marital satisfaction, employment, and spousal support. The findings reinforce the need for health professionals to assist families in identifying how the birth of a child with chronic health problems has affected the family. Contraception counseling as well as marital counseling may be needed for some families.

PIP: In a US Midwest urban area, nurse researchers compared data on 50 mother-father dyads of healthy infants with data on 20 mothers and 17 fathers of infants at risk for apnea (ARFA) to learn their contraceptive practices, family functioning, marital satisfaction, sexual satisfaction, and future fertility preferences. By 12 months, none of the ARFA infants needed the apnea monitor. Mothers of healthy infants were significantly more likely to be satisfied with their marriage than ARFA mothers at 6 and 12 months (p = .031 and .004, respectively). In fact, between 6 and 12 months, marital satisfaction decreased considerably for ARFA mothers (p = .027). Parents of healthy infants had just slightly more sexual satisfaction than ARFA parents at 6 and 12 months. Contraceptives varied significantly between the 2 groups (p + .027). At 6 months, ARFA mothers accepted oral contraceptives (OCs) (42%) significantly more often than any other contraceptive method. In fact, between preconception and the postpartum period, OC use for this group increased 24%. Just 2 mothers of healthy infants at 6 months and none at 12 months used OCs. Parents of healthy infants were more likely to use condoms than ARFA parents (28% vs. 10%). Little difference existed between the 2 groups in use of diaphragms (20% for healthy and 27% for ARFA). Mothers of healthy infants were more likely to use contraception prior to conception of index infant the ARFA mothers (72% vs. 40%). At 12 months, ARFA parents who received emotional support from their spouses and who were more satisfied with their marriage were significantly more likely to not use contraceptives than those who did not receive support and were unsatisfied with their marriages. This relationship did not exist for parents of healthy infants. These findings support the need for health providers to help families learn how an infant affects the family as well as the parental relationship, so they can arrange for appropriate counseling, including contraception counseling.