H L Ball1, M P Ward-Platt, E Heslop, S J Leech, K A Brown. 1. Parent-Infant Sleep Laboratory & Medical Anthropology Research Group, Department of Anthropology, Durham University, Durham, UK. H.L.Ball@dur.ac.uk
Abstract
OBJECTIVE: To determine whether postnatal mother-infant sleep proximity affects breastfeeding initiation and infant safety. DESIGN: Randomised non-blinded trial analysed by intention to treat. SETTING:Postnatal wards of the Royal Victoria Hospital (RVI), Newcastle upon Tyne, UK. PARTICIPANTS: 64 newly delivered mother-infant dyads with aprenatal intention to breastfeed (vaginal deliveries, no intramuscular or intravenous opiate analgesics taken in the preceding 24 h). INTERVENTION: Infants were randomly allocated to one of three sleep conditions: baby in mother's bed with cot-side; baby in side-car crib attached to mother's bed; and baby in stand-alone cot adjacent to mother's bed. MAIN OUTCOME MEASURES: Breastfeeding frequency and infant safety observed via night-time video recordings. RESULTS: During standardised 4-h observation periods, bed and side-car crib infants breastfed more frequently than stand-alone cot infants (mean difference (95% confidence interval (CI)): bed v stand-alone cot = 2.56 (0.72 to 4.41); side-car cribv stand-alone cot = 2.52 (0.87 to 4.17); bed v side-car crib = 0.04 (-2.10 to 2.18)). No infant experienced adverse events; however, bed infants were more frequently considered to be in potentially adverse situations (mean difference (95% CI): bed v stand-alone cot = 0.13 (0.03 to 0.23); side-car crib v stand-alone cot = 0.04 (-0.03 to 0.12); bed v side-car crib = 0.09 (-0.03-0.21)). No differences were observed in duration of maternal or infant sleep, frequency or duration of assistance provided by staff, or maternal rating of postnatal satisfaction. CONCLUSION:Suckling frequency in the early postpartum period is a well-known predictor of successful breastfeeding initiation. Newborn babies sleeping in close proximity to their mothers (bedding-in) facilitates frequent feeding in comparison with rooming-in. None of the three sleep conditions was associated with adverse events, although infrequent, potential risks may have occurred in the bed group. Side-car cribs are effective in enhancing breastfeeding initiation and preserving infant safety in the postnatal ward.
RCT Entities:
OBJECTIVE: To determine whether postnatal mother-infant sleep proximity affects breastfeeding initiation and infant safety. DESIGN: Randomised non-blinded trial analysed by intention to treat. SETTING: Postnatal wards of the Royal Victoria Hospital (RVI), Newcastle upon Tyne, UK. PARTICIPANTS: 64 newly delivered mother-infant dyads with a prenatal intention to breastfeed (vaginal deliveries, no intramuscular or intravenous opiate analgesics taken in the preceding 24 h). INTERVENTION: Infants were randomly allocated to one of three sleep conditions: baby in mother's bed with cot-side; baby in side-car crib attached to mother's bed; and baby in stand-alone cot adjacent to mother's bed. MAIN OUTCOME MEASURES: Breastfeeding frequency and infant safety observed via night-time video recordings. RESULTS: During standardised 4-h observation periods, bed and side-car crib infants breastfed more frequently than stand-alone cot infants (mean difference (95% confidence interval (CI)): bed v stand-alone cot = 2.56 (0.72 to 4.41); side-car crib v stand-alone cot = 2.52 (0.87 to 4.17); bed v side-car crib = 0.04 (-2.10 to 2.18)). No infant experienced adverse events; however, bed infants were more frequently considered to be in potentially adverse situations (mean difference (95% CI): bed v stand-alone cot = 0.13 (0.03 to 0.23); side-car crib v stand-alone cot = 0.04 (-0.03 to 0.12); bed v side-car crib = 0.09 (-0.03-0.21)). No differences were observed in duration of maternal or infant sleep, frequency or duration of assistance provided by staff, or maternal rating of postnatal satisfaction. CONCLUSION: Suckling frequency in the early postpartum period is a well-known predictor of successful breastfeeding initiation. Newborn babies sleeping in close proximity to their mothers (bedding-in) facilitates frequent feeding in comparison with rooming-in. None of the three sleep conditions was associated with adverse events, although infrequent, potential risks may have occurred in the bed group. Side-car cribs are effective in enhancing breastfeeding initiation and preserving infant safety in the postnatal ward.
Authors: Eric Herschel Fein; Scott Friedlander; Yang Lu; Youngju Pak; Rie Sakai-Bizmark; Lynne M Smith; Caroline J Chantry; Paul J Chung Journal: Hosp Pediatr Date: 2019-01-03
Authors: Olukunmi O Balogun; Elizabeth J O'Sullivan; Alison McFadden; Erika Ota; Anna Gavine; Christine D Garner; Mary J Renfrew; Stephen MacGillivray Journal: Cochrane Database Syst Rev Date: 2016-11-09