Can routine feedings boost baby’s sleep?

Our recent study led by Christophe Mühlematter and Salome Kurth, sheds light on the connection between infants’ sleep and eating routines. This longitudinal study, published in PLOS One, shows that baby’s eating and sleep possibly affects each other.¹

In this research, 162 healthy infants were measured at 3, 6, and 12 months of age. With ankle movement sensors, sleep diaries, and analysis of stool microbiota we explored eating habits, sleep patterns, and the composition of bacteria in the digestive tract. 

What did this study show?

• Infant nighttime sleep less fragmented with consistent eating routines. The study showed that infants with regular eating across days not only have more consistent sleep-wake patterns, but they also have less disrupted nighttime sleep. This shows that consistently regular eating habits could possibly lead to infants sleeping through the night.
• Age-Dependent Dynamics: As infants grow, the relationship between eating regularity and sleep evolves: at 6 months of age this connection was found, but not yet as young as 3 months.
• Parental Influence: Surprisingly, the connection between regular eating and sleep patterns persisted even when considering how parents structure their infants’ routines. Thus, meal timing seems to be a very strong driver of infant’s uninterrupted nighttime sleep. 
• Gut Microbiota: Simple gut microbiota diversity markers were not mediating this relationship. However, the study found hints that infants with irregular eating have different gut microbiota compared to those with regular mealtimes.

What does this mean?

These discoveries show that sticking to consistent feeding schedules might support the infant in finding a rhythm.

What role does breast milk play? Does it contribute to better microbiota and improve infant sleep better than formula? 

In our research, we concentrated on infants primarily fed with breast milk at the study’s start.¹ Earlier research has hinted at potential links, such as breastfeeding affecting gut microbiota composition and possibly influencing night wakings.^2,3 However, the precise interplay between these factors remains a subject of ongoing investigation, and is crucial for a more comprehensive understanding of infant well-being.

When do infants develop mature sleep rhythms?

The journey towards mature sleep patterns is a complex interplay of circadian ‘clock-dependent’ and homeostatic ‘sleep-wake-dependent’ sleep regulators. This process, well-examined through the Two-Process Model of Sleep Regulation, prominently unfolds during infancy and early childhood.⁴ The development of the circadian system likely already starts during the prenatal phase. By midgestation, as the central circadian pacemaker in the suprachiasmatic nucleus of the brain is already present in primates.⁵ Postnatal gradual maturation of the circadian system then supports the establishment of sleep-wake patterns and hormone secretion, which typically begins around two months of age. Very obvious is that Infants exhibit polyphasic sleep patterns, characterized by multiple sleep bouts throughout the day.⁶ The transition to a single nighttime monophasic sleep period begins at birth and continues through the first years, typically reaching stability around the age of five.⁷  

Our recent study thus captures these intriguing sleep transitions, assessing infants at 3, 6, and 12 months of age, examining both circadian and homeostatic sleep regulators.¹ Understanding these processes is essential for helping parents and caregivers establish useful routines for their little ones that support the sleep maturation process.

Is there a takeaway for adults to improve their sleep?

The key message for adults facing ongoing sleep challenges is that also as adults we have the power to enhance our sleep quality and quantity by aligning our biology too the 24-hour day with various time cues. Established factors, such as adhering to regular light-dark cycles, are known to be effective in this regard. Moreover, meal timing that aligns with our biological rhythm, also plays a crucial role in achieving better sleep in adults. Further, recent research emphasizes that sleep quality significantly outweighs sleep duration in its impact on overall life quality – according to this, sleeping more regular seems more important than sleeping long hours. ⁸

Support our research on the mystery of infant sleep  

• Participate or spread the word: Contact babysleep@unifr.ch to join ongoing studies.
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• Leave a comment to share your insights.

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References

1. Mühlematter, C. et al. Not simply a matter of parents—Infants’ sleep-wake patterns are associated with their regularity of eating. PLoS ONE 18, e0291441 (2023).
2. Bergstrom, A. et al. Establishment of Intestinal Microbiota during Early Life: a Longitudinal, Explorative Study of a Large Cohort of Danish Infants. Applied and Environmental Microbiology 80, 2889–2900 (2014).
3. Galbally, M., Lewis, A. J., McEgan, K., Scalzo, K. & Islam, F. A. Breastfeeding and infant sleep patterns: an A ustralian population study. J Paediatrics Child Health 49, (2013).
4. Borbély, A. A. A two process model of sleep regulation. Hum Neurobiol 1, 195–204 (1982).
5. Rivkees, S. A. & Hao, H. Developing circadian rhythmicity. Seminars in Perinatology 24, 232–242 (2000).
6. Galland, B. C., Taylor, B. J., Elder, D. E. & Herbison, P. Normal sleep patterns in infants and children: A systematic review of observational studies. Sleep Medicine Reviews 16, 213–222 (2012).
7. Iglowstein, I., Jenni, O. G., Molinari, L. & Largo, R. H. Sleep Duration From Infancy to Adolescence: Reference Values and Generational Trends. Pediatrics 111, 302–307 (2003).
8. Kudrnáčová, M. & Kudrnáč, A. Better sleep, better life? testing the role of sleep on quality of life. PLoS ONE 18, e0282085 (2023).