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![Page 1: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/1.jpg)
Mother-infant Sleep Locations and Nighttime Feeding BehaviorsU.S. Data from the Survey of Mothers’ Sleep and Fatigue
Kathleen Kendall-Tackett, Ph.D., IBCLCThomas W. Hale, Ph.D.
Department of PediatricsTexas Tech University School of Medicine
Zhen Cong, Ph.D.Department of Human Development and
Family StudiesTexas Tech University
![Page 2: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/2.jpg)
• Maternal-infant bedsharing is a practice that continues to be mired in controversy
![Page 3: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/3.jpg)
• AAP 2005 Task Force on SIDS– No bedsharing– No sleeping with
baby on sofa or recliner
– Baby in parents’ room for the first 6 months
![Page 4: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/4.jpg)
AAP Task Force on SIDS
• Infants should not bed share during sleep • Infants may be brought into bed for nursing or
comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep
• Parents should not bring a baby to bed when they are overly tired or using medications or substances that could impair his or her alertness
• Infants’ cribs or bassinets should be placed in the parents’ bedroom
• No one should sleep with an infant on a couch or armchair because this is very dangerous
![Page 5: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/5.jpg)
• In the wake of local infant “cosleeping” deaths, regional health departments have translated AAP Statement into “One Message”
Never Bedshare
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![Page 7: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/7.jpg)
The Current Study
![Page 8: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/8.jpg)
• Online survey of 6,410 mothers with infants aged 0-12 months (Mean infant age=6.96 months)
• From 59 countries – U.S. (N=4,789) – European Union/Eastern
Europe (N=545),– Canada (N=416)– Australia/New Zealand
(N=186)– Middle East (N=56)– Central and South
America (N=32), – Asia (N=30)– Africa (N=13)
![Page 9: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/9.jpg)
• Sample recruited with the assistance of lactation specialists– WIC State
Breastfeeding Coordinators
– U.S. State Breastfeeding Coordinators
– La Leche League in the U.S., Canada, New Zealand, Great Britain
– Australian Breastfeeding Association
![Page 10: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/10.jpg)
Average age of mothers (M=31.16)
Range=13-50 years
![Page 11: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/11.jpg)
• Ethnicity– 91% White– 2.5% Black– 1.4% Latina– 1.5% Asian– 0.6% Native
American
![Page 12: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/12.jpg)
• Do others know where your baby sleeps?
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Do people know where baby ends the night? US Sample (N=4678)
0
10
20
30
40
50
60
Crib In Room In Bed
Χ2(2)=17.64, p<.0001
Infant Sleep Location
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Do people say negative things about where your baby ends the night?
US Sample (N=4337)
0
10
20
30
40
50
60
70
80
90
Crib In Room In Bed
Χ2(2)=681.64 p<.0001
Infant Sleep Location
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HCP does not know where baby ends the night
US Sample (N=4360)
0
10
20
30
40
50
60
70
% Mothers
Crib In Room In Bed
Baby Sleep Location
Χ2(2)=132.75, p <.0001
![Page 16: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/16.jpg)
• Reasons for Current Sleep Arrangements
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Right Way to Do It US Sample (N=2320)
0
10
20
30
40
50
60
70
Crib In Room In Bed
Χ2(2)=6.90, p<.032
Infant Sleep Location
![Page 18: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/18.jpg)
Only Way that Worked US Sample (N=2082)
0
10
20
30
40
50
60
70
Crib In Room In Bed
Χ2(2)=162.9, p<.0001
Infant Sleep Location
![Page 19: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/19.jpg)
• How mothers handle nighttime feedings
![Page 20: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/20.jpg)
0
10
20
30
40
50
60
70
80
% Mothers
In Bed On Chair/sofa
Feeding LocationΧ2(1)=163.08, p<.0001
Where Mothers Fall Asleep During Night
FeedingsUS Sample (N=2103)
![Page 21: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/21.jpg)
SIDS Cases in U.S.0.56 per 1000 (0.0005%)40% of these take place outside of cribs0.0002%
Of mothers who feed
at night on a chair, sofa or recliner
• 44.4% sometimes fall asleep there
• 24.7% of the entire sample
![Page 22: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/22.jpg)
Bottom line• 25% of U.S.
mothers in our sample are admitting to sometimes falling asleep in dangerous sleep locations, likely in an attempt to avoid bedsharing
![Page 23: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/23.jpg)
• Higher-income and highly educated mothers are the ones most likely to feed their babies in chairs/recliners at night
![Page 24: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/24.jpg)
Education by Night Feeding Location
4045505560
HighSch
ool
Some
CollBA
MA Dr
Pe
rce
nta
ge In
Bed
Chair,Sofa
X2(4)=12.465, p<.014
![Page 25: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/25.jpg)
Night Feeding Location by Income
3540455055606570
Per
cen
tag
e
Bed
Chair
X2(4)=29.558, p<.0001
![Page 26: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/26.jpg)
Take Away Message #1– The “Never-
Bedshare” message does not work
– These edicts are likely resulting in the highly dangerous behavior of sleeping with infants on chairs, recliners or sofas
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Take Away #2
• Bedsharing happens– Parents bedshare
for cultural, ideological and practical reasons
– Their behavior persists even when they are told not to
![Page 28: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/28.jpg)
Take Away #3
• Parents need individualized, culturally sensitive information about safe sleep regardless of where babies sleep
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Conclusions• Bedsharing is
common in the U.S. and persists despite considerable pressure
• Edicts to never bedshare have encouraged a far more dangerous and risky behavior
![Page 30: Mother-infant Sleep Locations and Nighttime Feeding Behaviors U.S. Data from the Survey of Mothers Sleep and Fatigue Kathleen Kendall-Tackett, Ph.D., IBCLC.](https://reader035.fdocuments.us/reader035/viewer/2022081602/551a04985503464c588b4d2d/html5/thumbnails/30.jpg)
• Parents need guidance on safe sleep behaviors that are effective and meet mothers’ and babies’ needs
• Sleeping on an adjacent surface is a possible and reasonable compromise
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• “As in most controversies, some value is found in both sides of the argument
• One must weigh the relative risk and benefits and provide evidence-based information to fit the individual needs and complex social, economic, and cultural context of the family”
Morgan et al. JOGNN 2006; 35: 684-691