There’s no formula for infant sleep

Parents shouldn’t buy into the idea that good babies rest through the night.

It’s not long before new parents get asked the loaded cultural question, “Is she a good baby?” Which all new parents understand as code for is the baby sleeping.

“Sleep is an issue parents of new babies struggle with, particularly when contemporary lifestyles, parental sleep needs and infant biology conflict,” says professor Helen Ball, head of anthropology and director of the Parent-Infant Sleep Laboratory at Durham University in the UK.

Ball, who is speaking at the Australian Breastfeeding Association’s seminar series in Hobart in February, has been researching infant sleep for the past 20 years, concentrating on the sleep ecology of infants, young children and parents.

She has conducted research in hospitals and the community and contributes to national and international policy and practice guidelines on infant care. In 2013, Ball received an award for Outstanding Impact in Society for her research from the UK’s Economic and Social Research Council.

“When we ask parents if their baby ‘sleeps through’, this reinforces the idea that prolonged sleep is important and should be achieved early,” Ball says. However, it fails to recognise the role of night feeding. The promotion of breastfeeding and of long periods of solitary sleep for infants – are at odds with each other. “Consequently, what we tell parents and infants about normal sleep, and how we provide support, requires reframing,” Ball says.

Parents are often unaware that sleep is a developmental process that matures throughout childhood. This development can vary immensely from baby to baby.

“Infants are not born with a functional circadian rhythm,” babies are only just beginning to recognise patterns of day and night by three months, with this maturation continuing in the first 12 months. Night-waking is a normal characteristic of infant sleep for the first year or more.

Ball notes that not all cultures interpret night-waking as abnormal or problematic. In many cultures it is simply an expected part of life with a baby.

“Perceptions of infant sleep are strongly influenced by cultural attitudes and beliefs,” she explains. “Interventions involving education and support offer the promise of both realigning parental expectations with the realities of infant sleep and providing parents with the opportunity to consider strategies for coping with and managing anticipated sleep loss.”

She points out that new parents need to be made aware that research demonstrates no difference in the amount of sleep mothers or babies get based on feeding mode. A common parental response to infant night-waking is to commence formula top-ups, prematurely introducing solid food and the cessation of breastfeeding. Friends and family often encourage this.

“Although it is normal for breastfed infants to wake regularly to feed in the night and for their mothers to experience more frequent night-waking than those who feed formula, the latter experience longer periods of wakefulness and the net outcome in terms of sleep duration is the same,” Ball says.

Ball has set up the Infant Sleep Information Source website (http://bit.ly/1BvKLhZ), which translates her research into evidence for use by parents and healthcare staff.

“There is a need for a consolidated source that explains what the wealth of infant sleep information can shed light on and which topics still require clarification,” she says. “Much myth and misinterpretation exists in popular ‘wisdom’ regarding infant sleep.”

Ball hopes her website will provide people who want evidence upon which to base decisions about infant sleep with the information they need from a source they will trust.

Barb Glare works in the infant feeding support service at a large rural hospital in Victoria.

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