Skip to main content

Advertisement

Log in

Exploring Maternal Perceptions of Infant Sleep and Feeding Method Among Mothers in the United Kingdom: A Qualitative Focus Group Study

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Background

In a context with strong rhetorical support for breastfeeding in the health system, yet extremely low rates of breastfeeding after hospital discharge, UK women’s decisions about infant feeding reflect the reality of competing priorities in their lives, including obtaining adequate sleep. Popular wisdom in the UK tightly links breastfeeding and inadequate night-time sleep. Mothers are advised by peers and family to introduce formula or solid foods to infants to promote longer sleep.

Objectives

The first objective of this study was to investigate women’s understandings of the nature of infant sleep and their perceptions of links between infant feeding method and sleep. The second was to explore how these perceptions influence infant feeding and sleep practices. Underpinning our work is the understanding that infant care choices result from trade-offs by which mothers strive to balance infant- and self-care.

Methods

We conducted seven focus groups with mothers of infants in two regions of the UK. Verbatim transcripts were thematically coded and emergent themes were identified.

Results

We found clearly diverging narratives between breastfeeding and formula-feeding mothers. Breastfeeding mothers viewed the fragmentary nature of infant sleep as natural, while mothers who were formula feeding felt this was a problem to be fixed.

Conclusions and Practice

The strategies used to promote infant and maternal sleep in each group were aligned with their underlying perception of how infant sleep works. Maternal perceptions of the nature of infant sleep and its relation to infant feeding method impact infant care practices in the first year of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ball, H. L. (2003). Breastfeeding, bed-sharing, and infant sleep. Birth Issues in Perinatal Care, 30(3), 181–188.

    Article  Google Scholar 

  2. Bartick, M., & Smith, L. J. (2014). Speaking out on safe sleep: Evidence-based infant sleep recommendations. Breastfeeding Medicine, 9(9), 417–422.

    Article  PubMed  Google Scholar 

  3. Brown, A., & Harries, V. (2015). Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breastfeeding Medicine, Early Online, 10(5), 264–252.

    Google Scholar 

  4. Burgard, S. A. (2011). The needs of others: Gender and sleep interruptions for caregivers. Social Forces, 89(4), 1189–1215.

    Article  Google Scholar 

  5. Chianese, J., Ploof, D., Trovato, C., & Chang, J. C. (2009). Inner-city caregivers’ perspectives on bed sharing with their infants. Academic Pediatrics, 9(1), 26–32.

    Article  PubMed  Google Scholar 

  6. Clayton, H. B., Li, R., Perrine, C. G., & Scanlon, K. S. (2013). Prevalence and reasons for introducing infants early to solid foods: Variations by milk feeding type. Pediatrics, 131(4), E1108–E1114.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Doan, T., Gardiner, A., Gay, C. L., & Lee, K. A. (2007). Breast-feeding increases sleep duration of new parents. Journal of Perinatal and Neonatal Nursing, 21(3), 200–206.

    Article  PubMed  Google Scholar 

  8. Doering, J., & Durfor, S. L. (2011). The process of “persevering toward normalcy” after childbirth. MCN The American Journal of Maternal Child Nursing, 36(4), 258–265.

    Article  PubMed  Google Scholar 

  9. Douglas, P. S., & Hill, P. S. (2013). Behavioral sleep interventions in the first six months of life do not improve outcomes for mothers or infants: A systematic review. Journal of Developmental and Behavioral Pediatrics: JDBP, 34(7), 497–507.

    Article  PubMed  Google Scholar 

  10. Galbally, M., Lewis, A. J., McEgan, K., Scalzo, K., & Islam, F. M. A. (2013). Breastfeeding and infant sleep patterns: An Australian population study. Journal of Paediatrics and Child Health, 49(2), E147–E152.

    Article  PubMed  Google Scholar 

  11. Galland, B. C., Taylor, B. J., Elder, D. E., & Herbison, P. (2012). Normal sleep patterns in infants and children: A systematic review of observational studies. Sleep Medicine Reviews, 16(3), 213–222.

    Article  PubMed  Google Scholar 

  12. Giallo, R., Rose, N., & Vittorino, R. (2011). Fatigue, wellbeing and parenting in mothers of infants and toddlers with sleep problems. Journal of Reproductive and Infant Psychology, 29(3), 236–249.

    Article  Google Scholar 

  13. Goyal, D., Gay, C., & Lee, K. (2009). Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Archives of Women’s Mental Health, 12(4), 229–237.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gross, R. S., Fierman, A. H., Mendelsohn, A. L., Chiasson, M. A., Rosenberg, T. J., Scheinmann, R., et al. (2010). Maternal perceptions of infant hunger, satiety, and pressuring feeding styles in an urban Latina WIC population. Academic Pediatric, 10(1), 29–35.

    Article  Google Scholar 

  15. Hoddinott, P., Craig, L. C. A., Britten, J., & McInnes, R. M. (2012). A serial qualitative interview study of infant feeding experiences: Idealism meets realism. BMJ Open, 2(2), e000504.

    PubMed  PubMed Central  Google Scholar 

  16. Kennedy, H. P., Gardiner, A., Gay, C., & Lee, K. A. (2007). Negotiating sleep—A qualitative study of new mothers. Journal of Perinatal and Neonatal Nursing, 21(2), 114–122.

    Article  PubMed  Google Scholar 

  17. Kurth, E., Spichiger, E., Stutz, E. Z., Biedermann, J., Hoesli, I., & Kennedy, H. P. (2010). Crying babies, tired mothers—Challenges of the postnatal hospital stay: An interpretive phenomenological study. BMC Pregnancy and Childbirth, 10, 21.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lopez, K. A., & Willis, D. G. (2004). Descriptive versus interpretive phenomenology: Their contributions to nursing knowledge. Qualitative Health Research, 14(5), 726–735.

    Article  PubMed  Google Scholar 

  19. Marchand, L., & Morrow, M. H. (1994). Infant feeding practices: Understanding the decision-making process. Family Medicine, 26(5), 319–324.

    PubMed  CAS  Google Scholar 

  20. McAndrew, F., Thompson, J., Fellows, L., Large, A., Speed, M., & Renfrew, M. J. (2012). Infant feeding survey 2010. Leeds: Health and Social Care Information Centre.

    Google Scholar 

  21. McCoy, R., McKenna, J. J., Gartner, L., Chantry, C. J., Howard, C. R., Lawrence, R. A., et al. (2008). ABM clinical protocol #6: Guideline on co-sleeping and breastfeeding revision, March 2008. Breastfeeding Medicine, 3(1), 38-U50.

    Google Scholar 

  22. Montgomery-Downs, H. E., Clawges, H. M., & Santy, E. E. (2010). Infant feeding methods and maternal sleep and daytime functioning. Pediatrics, 126(6), E1562–E1568. doi:10.1542/peds.2010-1269.

    Article  PubMed  Google Scholar 

  23. Moon, R. Y., Darnall, R. A., Goodstein, M. H., Hauck, F. R., Willinger, M., Shapiro-Mendoza, C. K., et al. (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128(5), 1030–1039.

    Article  PubMed  Google Scholar 

  24. Muscat, T., Thorpe, K., & Obst, P. (2012). Disconfirmed expectations of infant behaviours and postnatal depressive symptoms among parents. Journal of Reproductive and Infant Psychology, 30(1), 51–61.

    Article  Google Scholar 

  25. National Institute for Health and Care Excellence. (2014). Addendum to clinical guideline 37, postnatal care: Routine postnatal care of women and their babies. Clinical guideline addendum 37.1, (pp. 1–85). London: National Institute for Clinical Excellence.

  26. National Institute of Child Health and Human Development. (2014). How can I reduce the risk of SIDS? Retrieved 05/29, 2015, from https://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/reduce-risk.aspx

  27. Quillin, S. I. M., & Glenn, L. L. (2004). Interaction between feeding method and co-sleeping on maternal-newborn sleep. JOGNN Journal of Obstetric Gynecologic and Neonatal Nursing, 33(5), 580–588.

    Article  Google Scholar 

  28. Redsell, S. A., Atkinson, P., Nathan, D., Siriwardena, A. N., Swift, J. A., & Glazebrook, C. (2010). Parents’ beliefs about appropriate infant size, growth and feeding behaviour: Implications for the prevention of childhood obesity. BMC Public Health, 10, 11.

    Article  Google Scholar 

  29. Rosen, L. A. (2008). Infant sleep and feeding. JOGNN-Journal of Obstetric Gynecologic and Neonatal Nursing, 37(6), 706–714.

    Article  Google Scholar 

  30. Rosenwasser, A. M. (2009). Functional neuroanatomy of sleep and circadian rhythms. Brain Research Reviews, 61(2), 281–306.

    Article  PubMed  Google Scholar 

  31. Sadeh, A., Mindell, J., & Rivera, L. (2011). “My child has a sleep problem”: A cross-cultural comparison of parental definitions. Sleep Medicine, 12(5), 478–482.

    Article  PubMed  Google Scholar 

  32. Spencer, R. L. (2008). Research methodologies to investigate the experience of breastfeeding: A discussion paper. International Journal of Nursing Studies, 45(12), 1823–1830.

    Article  PubMed  Google Scholar 

  33. St James-Roberts, I., Alvarez, M., Csipke, E., Abramsky, T., Goodwin, J., & Sorgenfrei, E. (2006). Infant crying and sleeping in London, Copenhagen and when parents adopt a “proximal” form of care. Pediatrics, 117(6), E1146–E1155.

    Article  PubMed  Google Scholar 

  34. Tully, K. P., & Ball, H. L. (2013). Trade-offs underlying maternal breastfeeding decisions: A conceptual model. Maternal and Child Nutrition, 9(1), 90–98.

    Article  PubMed  PubMed Central  Google Scholar 

  35. World Health Organization. (2001). Expert consultation on the optimal duration of exclusive breastfeeding. In Conclusions and recommendations. 28 to 30 March. WHO/NHD/01.09, WHO/FCH/CAH/01.24, pp. 1–10. Geneva: WHO.

Download references

Acknowledgments

We would like to acknowledge the assistance of Jane Herron and Lucy Firth in carrying out the focus groups. We would also like to thank the leaders of the pre-existing groups that we visited for their organisational support, and all the participants who shared their thoughts during the focus groups for their generosity and time.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alanna E. F. Rudzik.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rudzik, A.E.F., Ball, H.L. Exploring Maternal Perceptions of Infant Sleep and Feeding Method Among Mothers in the United Kingdom: A Qualitative Focus Group Study. Matern Child Health J 20, 33–40 (2016). https://doi.org/10.1007/s10995-015-1798-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1798-7

Keywords

Navigation