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Babies put on solids early ‘sleep longer and wake less often’

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Babies introduced to solid foods early have been found to sleep longer, wake less frequently at night and suffer fewer serious sleep problems than those exclusively breastfed for the first six months.

The finding was revealed in a study by King’s College London and St George’s University of London, which was published today in the journal JAMA Pediatrics.

“We found a small but significant increase in sleep duration and less frequent waking at night”

Michael Perkin

Researchers noted that current government advice was that mothers should try to exclusively breastfeed until around six months of age. However, 75% of British mothers introduce solids before five months, with 26% citing infant night time waking as influencing their decision.

In addition, present guidance on the NHS Choices website states that starting solid foods will not make babies more likely to sleep through the night and the Department of Health and Social Care advises that infants be introduced to solids when they are ready.

The Enquiring About Tolerance (EAT) study – funded by the Food Standards Agency and the Medical Research Council – took place at St Thomas’ Hospital between January 2008 and August 2015.

It involved 1,303 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.

“This study suggests that this advice needs to be re-examined in light of the evidence we have gathered”

Gideon Lack

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 Organization measures of physical and psychological health, social relationships and environment.

The study found that infants in the group that 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 two hours longer per week), and their night waking frequency decreased from just over twice per night to 1.74.

Feedback about maternal wellbeing showed sleep problems, which were significantly linked with maternal quality of life, were reported less frequently in the solids before six months group.

“We are encouraging all women to stick to existing advice to exclusively breastfeed for around the first six months”

FSA statement

Lead study 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,” he said.

Co-lead author Dr Michael Perkin, from St George’s, 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,” he said. “Given that infant sleep directly affects parental quality of life, even a small improvement can have important benefits.”

“There is no physiological reason why introducing solid foods early would help a baby sleep”

Amy Brown

The Food Standards Agency said the EAT Study, which was originally designed to look at allergy risk, had “helped expand our knowledge”, but added that it had limitations.

“We are encouraging all women to stick to existing advice to exclusively breastfeed for around the first six months of age,” said the FSA.

Meanwhile, Amy Brown, professor of child public health Swansea University, challenged the study findings and said much of the previous evidence published in this area “actually shows the opposite”.

University of Swansea

UK ‘not breastfeeding friendly’ warns academic

Amy Brown

“There is no physiological reason why introducing solid foods early would help a baby sleep,” said Professor Brown.

She argued that “great care must be taken in generalising” the findings from the new study by the London researchers.

She said: “The research begs the question, does introducing solids early – with all its associated risks – really carry more weight if it comes with a few minutes of sleep every night? It seems to me that we should be asking why parents are struggling with sleep so much and seek better ways to support them instead.”

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Readers' comments (1)

  • This study didn't take into account future health outcomes for the child which is why the current guidance not to offer solid food until 6month is there. There is a link between early feeding and increased incidence of allergies and inflammatory bowel disorders.

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