STUDY: Preventing infant sleeping problems should be more cost-effective than treating them after they have arisen.

JOURNAL: Arch Dis Child. 2003;88:108-111

AUTHORS: M. Nikolopoulou and Ian St. James-Roberts

ABSTRACT: Newborn infants that feed too often are at high risk for disrupted night sleep. However, these infants may benefit from a simple preventive behavioral program.

COMMENTARY: Many Western parents find infant and child night waking to be a source of substantial stress, both for themselves and their relationships with their children.

In a community sample of 316 newborn infants, those who had more than 11 feeds per 24 hours at one week of age were 2.7 times (95% confidence interval, 1.5 - 4.8) more likely to fail to sleep through the night at 12 weeks of age.

The infants and their families were randomized to receive one of three interventions: a three-step behavioral program, an educational booklet and helpline access for sleeping problems, or routine services. The behavioral program consisted of maximizing the difference between night and day environments by minimizing light and social interaction at night; avoiding feeding or cuddling at night; and from the age of three weeks, gradually delaying feeds when the baby awoke at night.

At 12 weeks, 82% of at-risk infants who received the behavioral program slept through the night, compared with 61% of at-risk infants who received the other interventions. The findings were similar for both bottle- and breast-fed babies.

"Preventing infant sleeping problems should be more cost-effective than treating them after they have arisen," the authors write. "This study provides evidence that it is possible to identify infants who are at risk of failing to sleep through the night at an early age, and that a simple, three step, preventive behavioral program increases the number who sleep through the night by 21%."