Sleep, critically important for new moms, eludes them even
after behavioral-educational interventions, according to a study published in
Taking care of the newborn for the first time is indeed
an overwhelming experience
. Sleep strategies and support given to first
time mothers failed to improve their sleep, and the baby's sleep. Early
interventions, though appreciated by the participants of the new study, did not
bring a marked increase in postpartum sleep.
Sleep disturbance is profound in the first twelve weeks
after giving birth, but for the first time mothers its worse. Postpartum sleep
deprivation increases the risk of mood disorders, fatigue, cognitive function
lapses, and decreased wellbeing. And
it's not only the mother who is affected.
While maternal sleep is affected by their infant's
sleep-wake activity, the activity of the newborns is also shaped by interaction
with their mother. Unfortunately, infant sleep problems can persist into
later childhood if not treated.
So, given the physical, emotional, and cognitive demands on
postpartum women, Robyn Stremler, assistant
professor at Lawrence S Bloomberg Faculty of Nursing, Toronto, Canada, and her
, conducted a study to evaluate the effectiveness of a
behavioral-educational sleep intervention in improving maternal and infant
sleep at 6 to 12 weeks after birth (postpartum). The idea was to promote sleep
rather than solve sleep problems that developed.
The researchers enrolled 246 new moms for the study. The new
moms were divided into two groups, where the control group did not receive the
intervention. The experiment group received the behavioral-educational
intervention from a nurse before they were discharged from hospital. Once at
home, moms were given follow up support at one, two and four weeks and booklets
regarding sleep related issues.
The topics covered in this intervention included - •
maternal sleep hygiene, •
strategies for increasing opportunities for maternal
maternal relaxation techniques, •
acknowledgement of the challenges of parenting and sleep
information on infant sleep structure and interpreting
infant cues, •
strategies for infant sleep promotion, and •
strategies for promoting infant night-day entrainment and
At 6 and 12 weeks, both, moms and their babies wore an
actigraph (moms on the wrist and babies around their ankles) for 4 days and
nights. Actigraph is a device for non-invasive monitoring of activity and
. Sleep problems such as sleep disorders and insomnia can be
effectively assessed with actigraphy data.
Behavioral-educational interventions use participatory
learning to develop knowledge and skills for change. 'We thought this would be
most successful in hospital in the early postpartum with the infant's and
mother's behavior and responses as exemplars,' says Stemler.
However, the study found no effect on sleep patterns in the
mother or child with this intervention delivered during the early
postpartum. Both groups averaged
6.5 hours of night time sleep. 'While the women who participated in our trial
valued receiving information about sleep, felt positive about their
participation, and reported using many of the suggested strategies, there were
no differences between groups on the main outcomes' according to the
The study thus concluded that behavioral-educational
interventions can be targeted after the first few months of postpartum since
the intervention did not work for the early postpartum stage
intervention program did not also have any effect on maternal depressive
symptoms, fatigue or breastfeeding rates.
Reference: Stremler, R. et al. Effect of
behavioural-educational intervention on sleep for primiparous women and their
infants in early postpartum: multisite randomised controlled trial. BMJ