Parents shouldn't worry if their infant doesn't sleep through the night by a year old

Study of close to 400 infants found no association between interrupted sleep and later developmental problems

November 14, 2018

Science Daily/McGill University

The authors of a study found that a large percentage of healthy babies don't start sleeping through the night even at a year old. The research team also examined whether infants who didn't sleep for six or eight consecutive hours were more likely to have problems with psychomotor and mental development, and found no association. The researchers also found no correlation between infants waking up at night and their mothers' postnatal mood.

New parents often expect their baby to start sleeping through the night by around six months of age. Indeed, they often receive messages from paediatricians and others about the importance of early sleep consolidation. But authors of a study in the December 2018 issue of Pediatrics found that a large percentage of healthy babies don't reach that milestone by six months of age, or even at a year old. The McGill-led research team also examined whether infants who didn't sleep for six or eight consecutive hours were more likely to have problems with psychomotor and mental development, and found no association. The researchers also found no correlation between infants waking up at night and their mothers' postnatal mood.

Study details

The researchers analyzed information from the Maternal Adversity, Vulnerability, and Neurodevelopment longitudinal birth cohort study, which recruited participants from obstetric clinics in Montreal, Québec and Hamilton, Ontario. Sleeping through the night was defined as either six or eight hours of sleep without waking up. Sleep measures were available for 388 infants at six months old, and 369 infants at a year old. At six months of age, according to mothers' reports, 38 percent of typically developing infants were not yet sleeping at least six consecutive hours at night; more than half (57 percent) weren't sleeping eight hours. At twelve months old, 28 percent of infants weren't yet sleeping six hours straight at night, and 43 percent weren't staying asleep eight hours. Researchers saw a difference between sleep patterns of boys and girls. At six months old, a slightly higher percentage of girls than boys slept for eight hours straight. (48 % vs. 39 %). Researchers also found no correlation between infants waking up at night and their mothers' postnatal mood. But they did discover that babies who didn't sleep for six or eight consecutive hours had a significantly higher rate of breastfeeding, which offers many benefits for babies and mothers.

A "gold standard" that may need to be revised

Sleeping through the night somewhere between six to twelve months is generally considered the "gold standard" in Western nations. Indeed, behavioural sleep training is popular among parents and professionals to encourage the children to sleep. But lead researcher, Marie-Hélène Pennestri, from McGill University's Department of Educational and Counselling Psychology and the Sleep Clinic at Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM) hopes that the results of the study will allay some parental worries:

"Our findings suggest parents might benefit from more education about the normal development of -- and wide variability in -- infants' sleep-wake cycles instead of only focusing on methods and interventions, especially for those who feel stressed about methods such as delayed response to crying." She says, "Maternal sleep deprivation is often invoked to support the introduction of early behavioural interventions, but it may be that mothers' expectations about being awakened at night along with the total number of hours they sleep over the course of a day are better predictors of maternal well-being. It is something that will need to be considered in future studies."

https://www.sciencedaily.com/releases/2018/11/181114160021.htm

Helping parents understand infant sleep patterns

December 19, 2014

Science Daily/Penn State

Most parents are not surprised by the irregularity of a newborn infant's sleep patterns, but by six months or so many parents wonder if something is wrong with their baby or their sleeping arrangements if the baby is not sleeping through the night. Health-care providers, specifically nurse practitioners, can help parents understand what 'normal' sleep patterns are for their child, according to researchers.

"Nurse practitioners are at the frontline of healthcare," said Robin Yaure, senior instructor of human development and family studies, Penn State Mont Alto. "They are in an ideal position to help parents understand infant sleep pattern norms. Thus, nurse practitioners can help parents understand that 'sleeping through the night' is not entirely likely in young infants and that infants' sleep patterns change during the first few years of life."

According to the researchers, there are four common areas of concern for both parents and practitioners: what constitutes "normal" infant sleep and waking patterns, whether nightwakings are a problem or not, is a parent's presence disruptive when an infant is falling asleep, and whether sleep training is safe and healthy for infants. Sleep training is one way to establish a sleep routine for a child, although the methods used may not be appealing to parents or in the best interests of the child, the researchers said.

Yaure and colleagues reviewed current research on infant sleep, focusing on the above four areas of concern, and specifically infant safety and the well being of both infant and mother during nighttime care. The researchers suggest how to best integrate parents' preferences for care and best practice information, and include conversation points for nurse practitioners recently online in the Journal of the American Association of Nurse Practitioners.

Infants' sleep patterns vary for at least the first three years of life. There are many reasons for this, including changes in infant health and mobility and the development of separation anxiety.

"Sharing this basic information with parents is one way of assuring parents that infants' waking does not necessarily mean that the parents are doing something wrong," the researchers wrote.

Parent presence at bedtime, sleep training and infant self-settling are frequently debated topics about which parents might look to healthcare professionals for advice. Yaure and colleagues again point to sharing information with parents -- for example, recent research suggests that the presence of parents at bedtime, specifically during the transition to sleep, may not trigger nightwakings as previously thought.

The researchers also point out that recent research on the nonresponsiveness of mothers during nighttime care can raise stress for both mom and baby. Elevated stress increases cortisol in the body, which may hurt the baby in the long run. Increased cortisol levels are associated with depression, aggression and attention problems, among other issues, in children and adults.

"I worry about parents who feel like they can't trust their own instincts," said Yaure. "Different parents have different goals and ideas for parenting, and we want parents to figure out how to incorporate best practices into their belief system. We have to be culturally aware and sensitive to different families and beliefs."

By encouraging nurse practitioners to talk about current knowledge on infant nightwakings and parental presence, among other things, Yaure hopes that parents will become more comfortable and confident with their nighttime care choices.

http://www.sciencedaily.com/releases/2014/12/141219104146.htm