I’m frequently asked about the relationship between breastfeeding and sleep so I thought I’d share some recent studies exploring sleep and breastfeeding. Some of you might know that the reason I first got into sleep is that I kept noticing that mothers blamed breastfeeding for their child’s fragmented sleeping patterns. I coined the term ‘sleep scapegoat’ to explain the idea that often, when a child wakes in the night and wants one form of parental support over all others, this ends up getting the blame. This continues to be an issue, and a major reason for breastfeeding modification or cessation. Of course, if you’ve stuck with me for a while, the issue here is not that we want to persuade more mothers to breastfeed. The issue is that many mothers stop before they actually wanted to, and often find that stopping breastfeeding didn’t improve either their sleep, or their child’s sleep anyway.
So here’s a roundup of some recent studies that have (once again) found no difference in the sleep of breast or formula feeding mothers.
Atlas and Özerdoğan (2022) studied 100 mothers (50 breastfeeding and 50 formula feeding). They found that while poorer sleep quality was associated with higher levels of fatigue, but the sleep quality scores did not differ by method of feeding.
Davis et al (2022) measured postpartum anxiety, as well as infant sleep quality (using the brief infant sleep questionnaire) and levels of exclusive breastfeeding. They found that higher rates of postnatal anxiety were associated with worse perception of infant sleep, and also shorter duration of breastfeeding. They did find that shorter durations of exclusive breastfeeding were associated with better perception of infant sleep but noted, especially in light of the other findings, that this may be due to a widely held public perception that formula fed babies sleep better. In this study, it appears that higher levels of anxiety are associated with less exclusive breastfeeding, and also poorer infant sleep. It’s possible that anxiety is the bigger factor in sleep quality perception, rather than infant feeding type.
Bay et al (2022) found that the sleep quality of breastfeeding mothers improved over time. Breastfeeding mothers reported better-quality sleep, and better-quality sleep was in turn associated with longer durations of breastfeeding. They also measured levels of breastfeeding self-efficacy and found that better sleep quality is correlated with higher levels of self-efficacy. This essentially is a self-fulfilling prophecy. Breastfeeding seems to assist mothers in returning more promptly to sleep, therefore their sleep is more protected, despite being disrupted, enabling them to continue breastfeeding (which is empowering) for longer. Interestingly, breastfeeding being associated with better quality sleep is a finding that has been reported in other previous studies as well.
So what’s the bottom line? Breastfeeding doesn’t mess up sleep. Looking after little people disturbs sleep. This is really hard, and can exacerbate feelings of anxiety, fatigue and dissatisfaction. But the solution is not to be found in stopping breastfeeding. Sure, if mothers want to stop breastfeeding, they need compassionate and practical advice to do that. But let’s keep on reassuring parents that breastfeeding should not be a sleep scapegoat. In fact, stopping a mothering behaviour that is going well may in fact reduce sleep quality and worsen anxiety. And that isn’t what we want at all.
If you’d like more support, check out my 0-18 month sleep guide, my Sleep Transitions Guide, and my Responsive Sleep Support Class. If you’re looking to gently ease away from feeding at night (breast or bottle) then try my Gentle Night Weaning webinar and also Still Awake.
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