Archives of Women's Mental Health

, Volume 19, Issue 2, pp 209–218 | Cite as

Infant sleep and feeding patterns are associated with maternal sleep, stress, and depressed mood in women with a history of major depressive disorder (MDD)

  • Katherine M. Sharkey
  • Ijeoma N. Iko
  • Jason T. Machan
  • Johanna Thompson-Westra
  • Teri B. Pearlstein
Original Article


Our goal was to examine associations of infant sleep and feeding patterns with maternal sleep and mood among women at risk for postpartum depression. Participants were 30 women (age ± SD = 28.3 ± 5.1 years) with a history of MDD (but not in a mood episode at enrollment) who completed daily sleep diaries, wore wrist actigraphs to estimate sleep, and had their mood assessed with the Hamilton Depression Rating Scale (HAM-D-17) during four separate weeks of the perinatal period (33 weeks pregnancy and weeks 2, 6, and 16 postpartum). They logged their infants’ sleep and feeding behaviors daily and reported postnatal stress on the Childcare Stress Inventory (CSI) at week 16. Mothers’ actigraphically estimated sleep showed associations with infant sleep and feeding patterns only at postpartum week 2. Shorter duration of the longest infant-sleep bout was associated with shorter maternal sleep duration (p = .02) and lower sleep efficiency (p = .04), and maternal sleep efficiency was negatively associated with the number of infant-sleep bouts (p = .008) and duration of infant feeding (p = .008). Neither infant sleep nor feeding was associated with maternal sleep at 6 or 16 weeks, but more disturbed infant sleep and more frequent feeding at 6 weeks were associated with higher HAM-D scores at 6 and 16 weeks and higher CSI scores. Sleep in the mother-infant dyad is most tightly linked in the early postpartum weeks, but mothers continue to experience disturbed sleep and infant sleep and feeding behaviors continue to be associated with mothers’ depressive symptoms and stress ratings as long as 16 weeks postpartum. These data imply that interventions designed to improve maternal sleep and postpartum mood should include both mothers and infants because improving infant sleep alone is not likely to improve maternal sleep, and poor infant sleep is linked to postpartum depression and stress.


Pregnancy Postpartum Depression Stress Sleep Infants 



This study was funded by K23-MH086689 from the National Institutes of Health and a J. Christian Gillin Award from the Sleep Research Society Foundation to KMS and a grant from the Brown University/Women and Infants Hospital National Center of Excellence in Women’s Health Seed Grant to KMS and TP. The authors thank Julie Quattrucci, Aubree Hoepper, and Emily Mepham for assistance with data collection. We acknowledge Christine Acebo, PhD and Mary A. Carskadon, PhD for helpful comments on the manuscript. Finally, we are grateful to the study participants and their families for participating in our study.

Ethical standards

This study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Participants gave informed consent prior to their inclusion in the study and were paid for their participation.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Katherine M. Sharkey
    • 1
    • 2
    • 5
    • 7
  • Ijeoma N. Iko
    • 3
    • 5
  • Jason T. Machan
    • 4
  • Johanna Thompson-Westra
    • 5
  • Teri B. Pearlstein
    • 2
    • 6
  1. 1.Department of MedicineRhode Island Hospital and Alpert Medical School of Brown UniversityProvidenceUSA
  2. 2.Department of Psychiatry & Human BehaviorAlpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Alpert Medical School of Brown UniversityProvidenceUSA
  4. 4.Departments of Orthopaedics and SurgeryRhode Island Hospital and Alpert Medical School of Brown UniversityProvidenceUSA
  5. 5.Sleep for Science Research LaboratoryProvidenceUSA
  6. 6.Women’s Medicine Collaborative, a Lifespan PartnerProvidenceUSA
  7. 7.Division of Pulmonary, Critical Care, and Sleep Medicine, Sleep for Science Research LaboratoryBrown University/Rhode Island HospitalProvidenceUSA

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