A transactional model of sleep-wake regulation in infants born preterm or low birthweight.
OBJECTIVE
To test a transactional model of sleep-wake development in infants born preterm or low birthweight (PT LBW), which may inform clinical practice, interventions, and future research in this at risk population.


METHODS
One hundred and twenty-eight mother-infant dyads participated from hospital discharge to 4 months postterm. Assessments of prematurity, infant sleep-wake patterns, maternal interaction quality, depression, feeding route, and sociodemographic factors were conducted.


RESULTS
Path analyses revealed that maternal interactions directly related to infant sleep patterns and family sociodemographic risks related to less optimal parenting. In addition, bottle fed infants experienced fewer night wakings and more nighttime sleep.


CONCLUSIONS
Two potential pathways to sleep patterns in PT LBW infants were identified. The findings suggest directions for clinical work, such as supporting healthy infant sleep through parenting interventions or supporting interpersonal relations between parents and their PT LBW infants by encouraging more daytime naps. Additionally, clinicians should assess parents' nighttime sleep concerns within the larger sociodemographic and feeding context.
Schwichtenberg
A J M
AJ
MIND Institute, University of California Davis, Sacramento, CA 95817, USA. ajschwichtenberg@ucdavis.edu
Poehlmann
Julie
J
D000786:Anger; D001903:Bottle Feeding / Q000523:psychology; D001942:Breast Feeding / Q000523:psychology; D002940:Circadian Rhythm; D003142:Communication; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D004493:Education; D005260:Female; D006791:Hostility; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008425:Maternal Behavior / Q000523:psychology; D008960:Models, Psychological; D009034:Mother-Child Relations; D009769:Object Attachment; D016487:Parenting / Q000523:psychology; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D012959:Socioeconomic Factors