We’re very pleased to share an interview with Kathleen Kendall-Tackett, Ph.d, IBCLC, FAPA on her research on breastfeeding and sleep. Kathleen is the author of Breastfeeding Made Simple and numerous other publications. She specializes in synthesizing current research on breastfeeding, trauma, and health psychology.
The answers below are based on Kathleen’s findings on mother-infant sleep from a survey of over 6,000 moms. Kathleen is conducting a webinar on the topic of mother-infant sleep on January 17th called Sense & Sensibility in Mother-Infant Sleep: Beyond the Rhetoric, What Does the Science Really Say about Safe Infant Sleep?
In your survey of over 6,000 mothers, what did you find about the amount of sleep mothers are getting who are exclusively breastfeeding, breast and formula feeding, and exclusively formula feeding?
The breastfeeding mothers were reporting significantly more sleep than even mixed-feeding mothers. There was no significant difference between the mixed- and formula-feeding mothers. It wasn’t a huge difference in terms of time (maybe 15 minutes), but it seemed to be enough that breastfeeding mothers were reporting more daily energy, better physical health, etc. than the other two groups. But they were still tired–just a bit less. The full article is available here.
How can that be, if breastfed babies wake for feedings more frequently than formula feeding babies? And what about the quality of breastfeeding mothers’ sleep?
We looked at a couple of sleep parameters, such as how many minutes it took for mothers to get to sleep. Breastfeeding mothers get to sleep faster. Longer time to get to sleep is a major risk factor for depression. We also looked at mothers’ reported hours of sleep: also better. To answer your question, I think breastfeeding mothers become more efficient at sleep, which helps them cope during the day.
What would you say to the advice that breastfeeding mothers avoid nursing at night in order to reduce their risk of depression?
There can be times when a mom needs to do this. I’ve had mothers I’ve worked with who have been right on the edge and really needed to get some sleep. My concern is when mothers are universally told to do this. I don’t think that the evidence supports that. In fact, it suggests just the opposite: that it would be making things worse for her, not better. And many mothers I’ve spoken with about this said that they’ve been getting pressured to wean. So if a mother is in this situation, I’d urge her to get some support from one or two key people who can help stand against this advice. Look at the research for yourself and enlist your partner, mother, good friend, or whoever supports you to help you with this.
What did you learn about where mothers and babies sleep?
That was also very interesting. According to a lot of previous research, white folks don’t sleep with their babies. But guess what we found? At least 60% sleep with their babies at least part of the night. The question you have to ask is “where does your baby end the night”? That paper is also online if you’d like to see it.
You found that over half of the mothers surveyed are breastfeeding their babies at night in places other than the bed, such as chairs, recliners and couches, and that over 40% of these mothers say that they fall asleep during these feedings, Why do you think mothers are choosing these locations, and why is falling asleep in these places a cause for concern?
Unfortunately, a lot of mothers have heard the “never bedshare” message from just about everyone. So some will really try to not bedshare. That means they are out in the middle of the night on the couch. They are really fighting biology here and have a good chance of falling asleep. The concern is that this greatly increases the chance of accidental infant death. In one study, it was 67 times more likely if baby was sleeping with anyone on a couch, recliner, or other place where they are feeding their babies in the middle of the night. We also found that the highly educated and higher income mothers were the ones most likely to report that they had fallen asleep in these unsafe places. 44% of the mothers who fed their babies someplace besides bed said that they had fallen asleep while doing it. That’s 25% of the total sample. I’d also like to mention that the most current AAP statement on bedsharing says that mothers (and others) must avoid sleeping with their babies on those surfaces. My objection to the “never bedshare” message is that mothers who are trying to avoid it are engaging in a far more dangerous behavior–and that is genuinely frightening.