We love answering your sleep questions! This month's Facebook fan question is 'Do breastfed babies wake more?'
The trouble with this question is it does not say 'compared to what exactly'. So to answer this question thoroughly I will need to answer a few others such as:
- What is normal with regards to night time waking?
- Does switching to formula help babies sleep longer? and
- Does introducing solids help a baby sleep longer?
So much of our behaviour as parents depends on whether or not we think our baby is normal. If a parent believes that sleeping through should be achieved by a particular age, then often different strategies will be attempted to 'fix' the deviant behaviour.
Infant sleep studies are fabulous at helping parents to figure out where there baby falls in relation to both the 'average' and within the normal range. Here is what the science reveals and what health professionals who guide new parents need to know.
Question 1: What is normal with regards to night waking?
Answer: There is a wide range of normal sleep behaviour in infants the same age, but a baby that wakes at night is the norm, not the exception.
In the study 'The sleep patterns of normal children', Armstrong et al (Med J Aust. 1994 Aug 1;161(3):202-6.) discovered that babies' sleep varied drastically in the first few weeks, first few months and long after the 6 month mark. It did not matter what they were fed or how often they were fed, the baby's sleep patterns varied.
This confirmed findings from the study 'Sleep patterns of New Zealand infants in the first twelve months of life' by Wooding et al (J Paediatr Child Health. 1990 Apr;26(2):85-8.) who found that sleeping patterns of babies the same age varied greatly. For example, at the four month mark babies slept an average of 14,8 hours per 24 hours, but the range varied from 11 hours to 19 hours per day. Of the 874 infants studied, 77% experienced night wakings.
The normal experience of multiple night wakings was confirmed in 'A longitudinal study of infant waking in the first year' by Scher (Child Care Health Dev 1991 Sep-Oct;17(5):295-302.) who released this very useful table:
% babies waking at night
Other interesting sleep facts from these three studies:
- Some babies slept through* from four weeks.
- Waking up frequently at night was the norm from four to 12 months.
- Day time sleep became less regular with increasing age.
- Getting a child back to sleep after a night waking became more difficult from 18 months where parental intervention was more necessary.
*Sleeping through is defined as a long stretch of sleep without disruptions. It can be 4-8 hours long. It is usually the first sleep of the night ie. from 7pm-12pm.
Question 2: Do formula-fed babies sleep longer?
Answer: A shocking NO.
The study 'Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight' by Brown & Harries (Breastfeed Med. 2015 Jun;10(5):246-52.)revealed some startling facts.
- For starters there was no difference in the number of night wakings or number of night feeds found between mothers who were currently breastfeeding or formula feeding.
- Infants who received more milk or solid feeds during the day were less likely to feed at night, but not less likely to wake. So increasing infant calories during the day may reduce the likelihood of night feeding but it will not reduce the need for parents to attend to the infant in the night.
- 78.6% of infants aged between 6-12 months woke regularly at least once a night.
- 61.4% of infants aged between 6-12 months received one or more milk feeds at night.
- Both night waking and night feeding decreased with age.
However, after 12 months, during the second year of life, a study by Elias et al, entitled 'Sleep/wake patterns of breastfed-infants in the first two years of life' (Pediatrics. 1986 Mar;77(3):322-9.) showed that babies who continued to breastfeed in the second year woke more over a 24 hour period than their peers who were previously breastfed but had subsequently been weaned.
Question 3: Does introducing solids help babies sleep better?
Answer: No, in fact it may do more harm than good, as an immature gut is likely to experience gastro-intestinal complaints as a result.
What Brown & Harries found in their study regarding the day time vs night time feeding and waking was confirmed by Macknin et al in the study 'Infant sleep and bedtime cereal' (Am J Dis Child. 1989 Sep;143(9):1066-8.) where they found no link between sleep and the introduction of bedtime cereal. Both the infants at 5 weeks and the infants at 4 months showed no difference to their peers who did not receive a bedtime cereal feed.
Incorrect perceptions of 'what is normal' or the idea that your baby 'should sleep through from 6 months' creates great anxiety amongst parents. Sleeping through is seen as a developmental milestone as well as a sign of good parenting, when it is really a slow, non-linear maturational process governed by genetic variation and developing sleep cycles. What we know is that all babies are different and that there is no dietary intervention that can help babies sleep through at an earlier age.
Healthy babies wake at night to feed and to find comfort. At times they will be cold or hot, thirsty or hungry and at times they may be feeling physical or psychological pain. What is needed is a consistent response from parents who are bolstered by these two scientific truths-
1. Breastfeeding and demand feeding does not cause your baby to wake more.
2. It will get better with age.
Want to find out more about what does influence your baby waking?
Want to find more research-based advice regarding breastfeeding? Check out Kelly Mom.