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  • Anticipatory guidance to prevent infant sleep problems within a randomised controlled trial: infant, maternal and partner outcomes at 6 months of age

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Paediatrics
Research
Anticipatory guidance to prevent infant sleep problems within a randomised controlled trial: infant, maternal and partner outcomes at 6 months of age
  1. Barbara C Galland1,
  2. Rachel M Sayers1,
  3. Sonya L Cameron1,
  4. Andrew R Gray2,
  5. Anne-Louise M Heath3,
  6. Julie A Lawrence1,
  7. Alana Newlands3,
  8. Barry J Taylor1,
  9. Rachael W Taylor4
  1. 1 Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
  2. 2 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  3. 3 Department of Human Nutrition, University of Otago, Dunedin, New Zealand
  4. 4 Department of Medicine, University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr Barbara C Galland; barbara.galland{at}otago.ac.nz

Abstract

Objective To evaluate the effectiveness of sleep education delivered antenatally and at 3 weeks postpartum to prevent infant sleep problems at 6 months of age.

Design Sleep intervention within a randomised controlled trial for the Prevention of Overweight in Infancy (POI) study.

Participants 802 families were randomly allocated to one of four groups: usual care (control), sleep intervention (sleep), food, activity and breastfeeding intervention (FAB), and combined group receiving both interventions (combination).

Interventions All groups received standard Well Child care. The sleep intervention groups (sleep and combination) received an antenatal group education session (all mothers and most partners) emphasising infant self-settling and safe sleeping, and a home visit at 3 weeks reinforcing the antenatal sleep education. FAB and combination groups received four contacts providing education and support on breast feeding, food and activity up to 4 months postpartum.

Outcome measures Here we report secondary sleep outcomes from the POI study: the prevalence of parent-reported infant sleep problems and night waking, and differences in sleep duration. Additional outcomes reported include differences in infant self-settling, safe sleep practices, and maternal and partner reports of their own sleep, fatigue and depression symptoms.

Results Linear or mixed linear regression models found no significant intervention effects on sleep outcomes, with 19.1% of mothers and 16.6% of partners reporting their infant’s sleep a problem at 6 months. Actigraphy estimated the number of night wakings to be significantly reduced (8%) and the duration of daytime sleep increased (6 min) in those groups receiving the sleep intervention compared with those who did not. However, these small differences were not clinically significant and not observed in 24 hours infant sleep diary data. No other differences were observed.

Conclusion A strategy delivering infant sleep education antenatally and at 3 weeks postpartum was not effective in preventing the development of parent-reported infant sleep problems.

  • actigraphy
  • night wakings
  • safe sleep
  • settling techniques
  • sleep duration

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014908

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    Footnotes

    • Contributors BJT, BCG and RMS led the sleep intervention, and RWT and ALMH led the FAB intervention. ARG designed and completed all statistical analyses and wrote the relevant sections of the manuscript. JAL coordinated and led the management of the study. All remaining authors contributed to writing the manuscript, study design and/or data collection. All authors had intellectual input into the manuscript, commented on drafts and approved the final version.

    • Funding This study was funded by the Health Research Council of New Zealand (Grant 08/374) and the Southern District Health Board. RWT is supported by the KPS Fellowship in Early Childhood Obesity. SLC was supported by a University of Otago Health Sciences postdoctoral fellowship. The funders had no role in study design; or in the collection, analysis and interpretation of data; or in the writing of the report or the decision to submit the article for publication.

    • Competing interests None declared.

    • Ethics approval The study was approved by the New Zealand Lower South Regional Ethics Committee (LRS/08/12/ 063), and all adult participants gave written informed consent on behalf of themselves and their babies.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected theseerrors and the correct publishers have been inserted into the references.