Current government advice is that mothers should try to exclusively breastfeed until around six months of age. However, 75% of British mothers introduce solids before five months, with a quarter (26%), citing infant night time waking as influencing their decision.
The current guidance on the NHS choices website state that starting solid foods won’t make babies more likely to sleep through the night. The UK Department of Health and Social Care advises that infants be introduced to solids when they are ready.
The Enquiring About Tolerance (EAT) study, which was funded by the Food Standards Agency and the Medical Research Council, took place at St Thomas' Hospital, London, between January 2008 and August 2015.
The population based randomised clinical trial involved 1303 exclusively breastfed three-month-olds from England and Wales who were divided into two groups. One group followed standard infant feeding advice and were encouraged to exclusively breastfeed for around six months. The second group, while continuing to breastfeed, were asked to introduce solid foods to their infants’ diet from the age of three months.
Parents completed online questionnaires every month until their baby was 12 months, and then every three months up to three years of age. The questionnaires recorded the frequency of food consumption and included questions about breastfeeding frequency and duration, as well as questions about sleep duration.
Maternal quality of life was also assessed using World Health Organisation measures of physical and psychological health, social relationships and environment.
Of the 1303 infants who took part in the study, 94 per cent (1225), completed the three-year questionnaire – 608 from the exclusive breastfeeding group, and 607 from the early introduction of food group.
The study found that infants in the group which had solids introduced early slept longer and woke less frequently than those infants that followed standard advice to exclusively breastfeed to around six months of age.
Differences between the two groups peaked at six months, with the early introduction group sleeping for a quarter of an hour (16.6 minutes) longer per night (almost 2 hours longer per week), and their night waking frequency decreased from just over twice per night to 1.74.
Feedback about maternal wellbeing showed that sleep problems (as defined by the parents), which were significantly associated with maternal quality of life, were reported less frequently in the group introducing solids before six months.
Speaking about the results lead author Professor Gideon Lack from King’s College London said: ‘The results of this research support the widely held parental view that early introduction of solids improves sleep.
‘While the official guidance is that starting solid foods won’t make babies more likely to sleep through the night, this study suggests that this advice needs to be re-examined in light of the evidence we have gathered.’
Co-lead author Dr Michael Perkin, from St George’s, University of London, said: ‘It is a commonly-held belief among mothers that introducing solids early will help babies sleep better, and our study supports this. We found a small but significant increase in sleep duration and less frequent waking at night. Given that infant sleep directly affects parental quality of life, even a small improvement can have important benefits.’
An FSA spokesperson said: ‘The FSA has an important role to play in funding research such as the EAT Study that helped expand our knowledge about how allergies develop. This further analysis of data collected during EAT could be of interest to parents, however, there are limitations to the findings.
‘We are encouraging all women to stick to existing advice to exclusively breastfeed for around the first six months of age. If there is any doubt about what’s best for your baby, please seek advice from your doctor or health professional.’
The paper: Association of Early Introduction of Solids with Infant Sleep. A secondary Analysis of a Randomized Clinical Trial is published in Jama Pediatrics.
Findings from the original EAT Study: Early Introduction of Allergenic Foods to Induce Tolerance can be found here: https://www.food.gov.uk/research/food-allergy-and-intolerance-research/eat-study-early-introduction-of-allergenic-foods-to-induce-tolerance
King’s College London
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St George’s, University of London
St George’s, University of London is the UK’s only university dedicated to medical and health sciences education, training and research.
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