title: Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study.
abstract: BACKGROUND
  Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old.
  
  
  METHODS
  This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length.
  
  
  RESULTS
  Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage.
  
  
  CONCLUSIONS
  Our data based on caregiver's self-report suggested that partial breastfeeding and bed-sharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.
authors.affiliation: Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Xiao-Na
authors.initials: XN
authors.lastname: Huang
authors.affiliation: Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hui-Shan
authors.initials: HS
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA.
authors.forename: Jen-Jen
authors.initials: JJ
authors.lastname: Chang
authors.affiliation: The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. linhong@chinawch.org.cn.
authors.forename: Lin-Hong
authors.initials: LH
authors.lastname: Wang
authors.affiliation: Bronchoscopy Center, Affiliated Children Hospital of Beijing Capital Medical University, Beijing, China.
authors.forename: Xi-Cheng
authors.initials: XC
authors.lastname: Liu
authors.affiliation: Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jing-Xiong
authors.initials: JX
authors.lastname: Jiang
authors.affiliation: Department of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: An
mesh_terms: D044466:Asian People; D001942:Breast Feeding; D015331:Cohort Studies; D005248:Feeding Methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D011446:Prospective Studies; D012890:Sleep
keywords: breast feeding; feeding method; infant sleep; sleep arrangement