title: Nighttime breastfeeding behavior is associated with more nocturnal sleep among first-time mothers at one month postpartum.
abstract: OBJECTIVE
  To describe sleep duration and quality in the first month postpartum and compare the sleep of women who exclusively breastfed at night to those who used formula.
  
  
  METHODS
  We conducted a longitudinal study in a predominantly low-income and ethnically diverse sample of 120 first-time mothers. Both objective and subjective measures of sleep were obtained using actigraphy, diary, and self-report data. Measures were collected in the last month of pregnancy and at one month postpartum. Infant feeding diaries were used to group mothers by nighttime breastfeeding behavior.
  
  
  RESULTS
  Mothers who used at least some formula at night (n = 54) and those who breastfed exclusively (n = 66) had similar sleep patterns in late pregnancy. However, there was a significant group difference in nocturnal sleep at one month postpartum as measured by actigraphy. Total nighttime sleep was 386 ± 66 minutes for the exclusive breastfeeding group and 356 ± 67 minutes for the formula group. The groups did not differ with respect to daytime sleep, wake after sleep onset (sleep fragmentation), or subjective sleep disturbance at one month postpartum.
  
  
  CONCLUSIONS
  Women who breastfed exclusively averaged 30 minutes more nocturnal sleep than women who used formula at night, but measures of sleep fragmentation did not differ. New mothers should be encouraged to breastfeed exclusively since breastfeeding may promote sleep during postpartum recovery. Further research is needed to better understand how infant feeding method affects maternal sleep duration and fragmentation.
  
  
  BACKGROUND
  Doan T; Gay CL; Kennedy HP; Newman J; Lee KA. Nighttime breastfeeding behavior is associated with more nocturnal sleep among first-time mothers at one month postpartum.
authors.affiliation: San Francisco State University, School of Nursing, San Francisco, CA.
authors.forename: Therese
authors.initials: T
authors.lastname: Doan
authors.affiliation: University of California, San Francisco, Department of Family Health Care Nursing, San Francisco, CA.
authors.forename: Caryl L
authors.initials: CL
authors.lastname: Gay
authors.affiliation: Yale University School of Nursing, New Haven, CT.
authors.forename: Holly P
authors.initials: HP
authors.lastname: Kennedy
authors.affiliation: Newman Institute of Breastfeeding, Toronto, Canada.
authors.forename: Jack
authors.initials: J
authors.lastname: Newman
authors.affiliation: University of California, San Francisco, Department of Family Health Care Nursing, San Francisco, CA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D010298:Parity; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D057566:Self Report; D012890:Sleep; D012892:Sleep Deprivation / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Actigraphy; breastfeeding; infant formula; maternal; sleep