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Association of Early Introduction of Solids With Infant Sleep: A Secondary Analysis of a Randomized Clinical Trial.

Perkin, MR; Bahnson, HT; Logan, K; Marrs, T; Radulovic, S; Craven, J; Flohr, C; Lack, G (2018) Association of Early Introduction of Solids With Infant Sleep: A Secondary Analysis of a Randomized Clinical Trial. JAMA Pediatr, 172 (8). e180739. ISSN 2168-6211 https://doi.org/10.1001/jamapediatrics.2018.0739
SGUL Authors: Perkin, Michael Richard

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Abstract

Importance: The World Health Organization recommends exclusive breastfeeding for 6 months. However, 75% of British mothers introduce solids before 5 months and 26% report infant waking at night as influencing this decision. Objective: To determine whether early introduction of solids influences infant sleep. Design, Setting, and Participants: The Enquiring About Tolerance study was a population-based randomized clinical trial conducted from January 15, 2008, to August 31, 2015, that included 1303 exclusively breastfed 3-month-old infants from England and Wales. Clinical visits took place at St Thomas' Hospital, London, England, and the trial studied the early introduction of solids into the infant diet from age 3 months. Interventions: The early introduction group (EIG) continued to breastfeed while nonallergenic and then 6 allergenic foods were introduced. The standard introduction group (SIG) followed British infant feeding guidelines (ie, exclusive breastfeeding to around age 6 months and to avoid any food consumption during this period). Main Outcomes and Measures: Secondary analysis of an a priori secondary outcome of the effect of early food introduction on infant sleep using the standardized Brief Infant Sleep Questionnaire. Results: Of the 1303 infants who were enrolled in the Enquiring About Tolerance study, 1225 participants (94%) completed the final 3-year questionnaire (618 SIG [95%] and 607 EIG [93%]). Randomization was effective and there were no significant baseline differences between the 2 groups. Following the early introduction of solids, infants in the EIG slept significantly longer and woke significantly less frequently than infants in the SIG. Differences between the 2 groups peaked at age 6 months. At this point, in the intention-to-treat analysis infants in the EIG slept for 16.6 (95% CI, 7.8-25.4) minutes longer per night and their night waking frequency had decreased from 2.01 to 1.74 wakings per night. Most clinically important, very serious sleep problems, which were significantly associated with maternal quality of life, were reported significantly more frequently in the SIG than in the EIG (odds ratio, 1.8; 95% CI, 1.22-2.61). Conclusions and Relevance: In a randomized clinical trial, the early introduction of solids into the infant's diet was associated with longer sleep duration, less frequent waking at night, and a reduction in reported very serious sleep problems. Trial Registration: isrctn.org Identifier: ISRCTN14254740.

Item Type: Article
Additional Information: This is an open access article distributed under the terms of the CC-BY License. ©2018 Perkin MR et al. JAMA Pediatrics.
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: JAMA Pediatr
ISSN: 2168-6211
Language: eng
Dates:
DateEvent
August 2018Published
9 July 2018Published Online
8 March 2018Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
T07051Food Standards Agencyhttp://dx.doi.org/10.13039/501100000354
MC_G1001205Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
NIHRCS/01/2008/009National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
FS101178Food Standards Agencyhttp://dx.doi.org/10.13039/501100000354
PubMed ID: 29987321
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110002
Publisher's version: https://doi.org/10.1001/jamapediatrics.2018.0739

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