Breast-Feeding vs Other Feeding Methods May Not Affect Maternal Sleep

http://www.medscape.com/viewarticle/732066

"Breast-feeding mothers do not get less or worse sleep than mothers using formula feeding, according to the results of a study published online November 8 in Pediatrics.

"Breastfed infants are reported to awaken more often and to sleep less," write Hawley E. Montgomery-Downs, PhD, from the Departments of Psychology and Pediatrics, School of Medicine, West Virginia University in Morgantown, and colleagues. "Because of its well-established benefits for both infants and mothers, any perceived disadvantage of breastfeeding should be evaluated carefully. Feeding method effects on maternal sleep are relatively unknown."

The goal of the study was to evaluate maternal sleep measured actigraphically, subjective sleep reports, and daytime functioning, and their association with feeding method status during postpartum weeks 2 through 12. Outcomes included objectively measured total sleep time, sleep efficiency, and sleep fragmentation; and subjectively reported numbers of nocturnal awakenings, total nocturnal wake time, and sleep quality. The fatigue visual analog scale, the Stanford Sleepiness Scale, or the Epworth Sleepiness Scale allowed determination of sleepiness and fatigue.

Women who were exclusively breast-feeding, exclusively formula feeding, or using both methods did not find differences in these outcomes, although the study had sufficient power to detect such differences.

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It makes sense to me, but what do I know?

:hi:

baby sleeps better when I give her formula, but that's only because my breast milk isn't fully in. She had to go to the NICU for a brief period after I was released from the hospital, which made
it very difficult to continue to breast feed her while I was gone. I'd pump as much as I could, but I couldn't keep up a good supply. So now I"m working toward breast feeding solely, but I do
supplement at night. Because I'm making only about an ounce or an ounce and a half when I pump, it's not enough to sustain her through a three hour sleep. (Formula does) When I breast feed
her soley, she wants to feed every hour or hour and a half.

The pediatrician told me to supplement an ounce of formula after a feeding to make sure she gains the proper amount of weight. And she's doing well so far, so the system is working. But
I'm hoping to fully wean her off the formula soon.

(My anecdote is just that... but I wonder if that's where the perception that babies don't sleep as well on breast milk comes from... because in the early days the mom may not be making as much
milk, prompting the baby to feed more often... which prompts the breast to produce more milk...... Once the breast milk regulates, it's seems to be all the same.)

I've known a few moms who have had similar experiences to yours, so your anecdote is interesting, and worth exploring, IMO. I also wondered if more breast feeding moms co-sleep than formula feeding moms. I have no idea if they do or not, but if they did that may be an interesting addition to this research. Again, it's very anecdotal, but the moms I've know who breast fed and co-slept seem to have reported fairly good sleep, at least in our discussions. They weren't fully awakened by a hungry child, as they could position themselves for feeding and lay their heads back down on the pillow. Or at least that's what they told me, and it does make sense, although it's all anecdotal and highly speculative.

Thanks for your post. You bring up some very interesting points.

your baby has had her fill, to increase your supply. I had a preemie with a weak suck who had to be taught how to nurse and I have thyroid disease so I ended up using a breast pump both to bring in my supply and to boost it while I was nursing my daughter.

Sleep? I was a zombie. I had large breasts and a preemie, so co-sleeping didn't work well and I had to use the damned pump afterwards, anyway. I've always assumed most of my zombie-ness was the postpartum thyroiditis from hell. I got used to it after about six weeks and my daughter started skipping that ~1am feeding at the same age as the formula fed kids. I still got up at 1 to pump because my body was used to producing milk and with those hands-free pumping kits you only have to be sort of awake although you have to be careful about what size collection bottles you use. You don't want to doze off and wake to find you've overfilled and wasted milk. :-)

Congrats on your new baby!

She's a joy and we're so happy she's healthy and her trip to the NICU was precautionary more than anything else.

But while there, we rented a hospital grade pump (The Medela Symphony) which I do use after a feeding to increase production -- when I can). It's difficult balancing the feedings and the pumping and the supplementation. The good news is that she's doing much better with the breast feeding. I'm able to take the time to feed her on demand right now, so when she demands the hourly feedings (She's a cluster feeder), we can do it. Her pediatrician is a big fan of breast feeding, so he's helping me through it all. And there are local meetings at the hospital only 6 blocks from where I live, and the specialists there are superbly helpful. So we're hoping to make this work. (And keep her one 5 hour sleep cycle in the middle of the night intact!) LOL!

Obviously I find these studies interesting because I'm going through it all right now.

I remember the "but didn't you just eat?" feeling because I also fed on demand, but the clustered feedings usually meant my daughter was either about to have a growth spurt or give up a feeding. Either way, a good thing, although I felt like I was living in "the mama chair".

Hospital-grade pumps rock. I had a double-electric home pump that was almost that good, and let me tell you, it felt really odd the first time I went on a business trip with no baby and no pump. Like... where's all the stuff I'm supposed to be schlepping around...?

so I can only comment on that experience. But you don't have to wake fully up to nurse a baby, unlike getting up and fixing a bottle and getting it warm enough.

So many things go into the amount of sleep a new mom (or dad, for that matter) gets besides how the baby is fed. Some babies sleep for long periods of time. Some don't. When my oldest was about a year old, someone asked my husband if he'd gotten a decent night's sleep since he was born, and all of a sudden I recalled (what I'd totally forgotten because of EVERYTHING that surrounds childbirth and that first year) that my husband himself did not sleep through the night, and he was about 29 at the time. His parents, then in their 70's (they were in their 40's when he was born) did not sleep through the night. In fact, it was a family joke that a stoplight was needed in the bedroom hallway to control the traffic of all the family members who were up and roaming in the middle of the night. With that as his genetic background, how could I possibly expect that after merely a year in this life he could possibly be sleeping through the night? I realized that for him the nighttime sleep was just a series of naps, and it totally took the stress off the thing about when he was "supposed" to sleep through the night.

As adults we have widely and wildly varying sleep habits, even without any sleep disturbances or problems. Hardly any of us go to sleep at the same time every night, and often we are quite different in our adult lives from night to night as to whether and when we wake up. Once I figured that out, and stopped worrying about my son sleeping through the night, it was a lot easier. I think he started sleeping through the night around age four, but I don't really recall because it wasn't very important to me. And I haven't a clue when his younger brother did so, because again it just wasn't very important to me.

What matters most is that they are thriving and developing normally, no matter how they are fed or what their sleep pattern is.

is going to be much more disruptive to your sleep than breastfeeding.

I know - I've done both - two home-made breastfed kids, one adopted.


Tip to those whose milk doesn't seem to be satisfying baby: Express some milk into a small clear glass (like a little juice glass) - at least like a 1/4" depth. Let it sit overnight. In the morning - check for "cream" - the whiter layer on the top. If there's "very little" or almost none at all - you're not taking in enough nutrients nor enough fat in your own diet. Also make sure your drinking plenty of fluids, too.

I'm also always breast feeding the baby before I supplement formula for her. We're working on increasing, but it's a slow process. And she needs the calories to make sure she doesn't lose weight again. (Reason for her NICU trip at the beginning of her life was because she lost over 10% of her body weight in two days AND was constantly spitting up/Vomiting.) The doctor has me breast feeding for 20-25 minutes, then supplementing. Luckily she doesn't seem to have any nipple confusion, as she'll jump on whatever is placed right in front of her!!!! I'm trying to have her work on one breast at a time to get in some foremilk and hindmilk. We'll see if that works out for her, though.

try pumping on the right side while she nurses from the left, etc. You may find you'll get more expressed milk that way. My daughter liked to nurse from only one side at a feeding so this was a great time-saver when I was getting ready for work in the morning. After she'd had her fill, I'd only need to pump the breast she'd nursed from for about five minutes to finish emptying it.