Does introducing solids early affect sleeping patterns?

Michael G Burke, MD

Indeed it does, according to a randomized trial conducted during a 3-year period in England and Wales in more than 1300 exclusively breastfed infants.

The investigation found that infants who were gradually introduced to solid foods beginning at the age of 3 months-while continuing to breastfeed-slept significantly more at night and awoke less often than infants who were not introduced to solid food until they were aged 6 months.

Mothers of the early introduction group (EIG) were encouraged to continue breastfeeding while also introducing nonallergenic foods initially and then adding 6 allergenic foods to their infant’s diet. Mothers of the standard introduction group (SIG) remained with exclusive breastfeeding for about 6 months before introducing solid foods, although many mothers in this group fed their babies nonallergenic solids before this time. Each month families completed an online questionnaire about food consumption and breastfeeding frequency and duration until their child was a year old and then every 3 months until age 3 years.

Compared with infants in the SIG group, EIG infants slept significantly longer during the night from the time they were aged 5 months to beyond age 1 year. Investigators estimated that EIG infants slept a mean of 7.3 minutes more each night on average than their SIG peers during the duration of the study. The difference between the 2 groups peaked at about age 6 months when EIG infants slept 17 minutes longer than those in the SIG group and were waking at night 2 fewer times a week.

In addition, families of the SIG group were significantly more likely to report a sleep problem in their child, while parents of the EIG group reported fewer serious sleep problems. The 2 groups did not differ in how much they slept during the day (Perkin MR, et al. JAMA Pediatr. July 9, 2018. Epub ahead of print).

Thoughts from Dr. Burke

So, early introduction of solids in breastfeeding babies may increase duration of sleep, but just a little. On the other hand, a total of 2 hours per week of extra sleep in the family of a 6-month-old might make a real difference in the long run. It may be that the most significant difference between the 2 groups noted in this study is the parents’ report of fewer serious sleep problems in the EIG. I wonder if this is really a reflection of parents’ having less anxiety about their babies being hungry overnight.