Overview: Parenting skills training can help multiple babies in the same family sleep longer, giving parents some much-needed extra rest.
Source: Penn State
Over the past decade, researchers and collaborators working on Penn State’s INSIGHT study have trained new mothers in skills that — among other things — help newborns get more sleep at night.
New research from Penn State’s Center for Childhood Obesity Research (CCOR) shows that second children in these families also slept longer.
New parents often want babies to sleep because the parents are tired, but sleep is critical to health and development. The researchers in CCOR study sleep because it influences the development of obesity in children.
Sleep also affects a child’s ability for emotional regulation and cognitive development. In addition, research shows that sleep-deprived parents are more likely to become depressed and involved in traffic accidents. A baby’s sleep can be important to the health and well-being of the entire family.
Responsive Parenting
The INSIGHT study — an acronym for interventional nurses who grow babies on a healthy trajectory — began in 2012 with CCOR researchers training 279 mothers of firstborn babies in responsive parenting practices. Responsive parenting means that children respond in a timely, sensitive and age-appropriate manner based on the child’s current needs.
In INSIGHT, mothers learned how to respond to baby’s behavioral states, such as nervousness, alertness (feeding and interactive play), drowsiness and sleeping. The training included several specific recommendations about bedtime routines and responding to nighttime awakenings.
Children in the INSIGHT intervention group slept longer each night and were more likely to put themselves to sleep than children in the control group. Significantly, these children also had lower body mass indices (BMIs) for the first three years of their lives.
Understanding spillover effects
As the INSIGHT study progressed, it led the researchers to investigate whether the training also affected children born later in INSIGHT families.
“A lot of parents say things like, ‘Oh, I did everything right with my first child, and then I didn’t have time for the others,'” explains Emily Hohman, assistant research professor at CCOR.
“So, to understand whether the effects of INSIGHT spill over to other siblings, we launched a new study in which we do not provide training or intervention to parents or children. We only keep information about second-born children in families where mothers have received INSIGHT training for their first-born.”
Hohman led a team of researchers examining data from 117 mothers from the original INSIGHT study who had a second child, about half of whom had received the responsive parenting training with their firstborn child. The team used a short questionnaire to assess second-born children’s sleep behavior and duration of sleep when the children were three, 16 and 52 weeks old.
In a recent publication in the journal Pediatrics, the researchers showed that second-born children in INSIGHT families slept on average 40 minutes longer per night than second-born children in the control group. The second-born INSIGHT children also slept more than 50 minutes longer in each 24-hour period, went to bed earlier in early life, and were more likely to fall asleep within 15 minutes.
This is not the first study to show that the effects of INSIGHT spill over to second-born children. Other studies have shown that second-born children in INSIGHT families have lower body-mass indices (BMIs) as infants than children in the control group. In addition, the parental feeding habits and nutritional intake of infants were healthier than those of children from control groups.
How Parents Can Promote Better Sleep for Their Babies (and Themselves)
The INSIGHT study trained mothers, but responsive parenting skills are useful for anyone caring for children. Before bedtime, responsive parenting involves establishing healthy routines, responding to children based on their development and needs, and teaching children to calm themselves down as much as possible.
For parents who know nothing about responsive parenting, Hohman recommends starting by establishing a bedtime. “People sometimes think that if they keep their babies with them later in the evening, the baby will sleep later. But the research shows that early setting a bedtime between 7 and 8 a.m. will help babies sleep longer,” Hohman says.
Once a regular bedtime has been established, research shows that consistent bedtime routines also promote longer sleep. The routine should be soothing and include things like bathing and reading, while avoiding overly stimulating activities like boisterous play. The routine helps the child prepare for sleep. In addition, babies who are not yet rolling over can be swaddled to increase their sense of calm.
To help children put themselves to sleep, parents are encouraged to put their children to bed while they are sleepy but still awake. Self-soothing is a valuable skill, and the sooner children learn it, the better they and their parents will sleep.
Waking up at night is inevitable; newborns and infants wake up all night for many reasons, including hunger. This doesn’t mean that feeding should always be a parent’s first response when their baby wakes up.
Hohman and her colleagues encourage parents to use “lighter touch” soothing methods, such as offering a pacifier, reassuring words, and gentle touches. More involved sedatives, such as holding, rocking, and feeding, should only be used if the baby remains upset or shows signs of hunger.
“Nobody likes to hear their baby cry and everyone wants to go back to sleep as soon as possible,” Hohman says.
“But a baby can only learn to calm itself if it is not soothed by someone else. During the day, parents should feel free to use more active restful strategies, such as holding or rocking, but these should be used more judiciously at night to promote better sleep.
Helping families everywhere
The research results indicate that intervention by novice parents can be an efficient way to help multiple children in a family.
“Our results suggest that pediatricians may have a new tool to promote better infant sleep and prevent unhealthy weight gain in infants,” Hohman said.
“Pediatricians usually have a lot of visits with new families. If those clinicians help new parents build responsive parenting skills, the benefits could extend to the parents, their newborns, and any future children in those families.”
Jennifer Savage Williams, associate professor of nutritional sciences at Penn State and director of CCOR; Michele E. Marini, retired CCOR employee; Stephanie Anzman-Frasca, associate professor of pediatrics at the University at Buffalo; Orfeu M. Buxton, Elizabeth Fenton Susman Professor of Biobehavioral Health at Penn State; Eric Loken, associate professor of educational psychology at the University of Connecticut; and Ian M. Paul, professor of pediatrics and public health sciences at Penn State College of Medicine, all contributed to this research.
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Financing: This research was funded by the National Institute of Diabetes and Digestive and Kidney Diseases.
About this news about parenting and sleep research
Author: Katie Bohn
Source: Penn State
Contact: Katie Bohn – Penn State
Image: The image is in the public domain
Original research: Open access.
†Effect of the INSIGHT intervention in the first-born on the sleep of the second-bornby Emily Hohman et al. Pediatrics
Abstract
Effect of the INSIGHT intervention in the first-born on the sleep of the second-born
BACKGROUND AND OBJECTIVES:
The intervention nurses starting to grow infants on healthy trajectories (INSIGHT) responsive parenting (RP) intervention for new mothers improved the sleep of the firstborn baby compared to controls. The goals of this analysis were to test spillover effects of interventions on second-born siblings and to examine differences in birth order in infants’ sleep.
METHODS:
second-born (n = 117) of the INSIGHT mothers were included in an observational cohort, SIBSIGHT. The Infant Brief Sleep Questionnaire was collected at 3, 16 and 52 weeks. Generalized linear mixed models assessed differences between second-borns by first-born randomization, as well as differences in birth order at 16 and 52 weeks.
RESULTS:
The second-born of the RP group slept 42 minutes longer at night (95% confidence interval [95% CI]: 19–64) and a total of 53 minutes longer (95% CI: 17–90) than control twins. RP second-borns were more likely to self-soothe to sleep (odds ratio [OR] = 2.0, 95% CI: 1.1-3.7) and less likely to be put back to sleep after awakening (OR = 0.5, 95% CI: 0.3-0.9 ) than second-borns of control mothers. RP second-borns were more likely to sleep ≤20 hours at night at 3 (OR = 2.9, 95% CI: 1.1-7.7) and 16 weeks (OR = 4.7, 95% CI: 2 .0-11.0). Few differences in sleep parenting practices were observed when comparing siblings within families. Second-borns slept 37 minutes longer than first-borns at 16 weeks (CI: 7-67, p = .03).
CONCLUSIONS:
The INSIGHT RP intervention for new mothers had a spillover effect on second-borns, positively impacting sleep duration and behavior. Intervening with new mothers benefits both the firstborn and subsequent children.