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Study finds that babies introduced to solids early slept longer and woke less frequently

July 09, 2018

A study by King's College London and St George's University of London has found that babies introduced to solid foods early, slept longer, woke less frequently at night and suffered fewer serious sleep problems, than those exclusively breastfed for around the first six months of life. The research is published today in JAMA Pediatrics.

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.'
-end-
Note to editors: For further information please contact Garfield Myrie in the King's College London press office at: garfield.myrie@kcl.ac.uk / 0207 848 4334

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

King's College London is one of the top 10 UK universities in the world (QS World University Rankings, 2018/19) and among the oldest in England. King's has more than 29,600 students (of whom nearly 11,700 are graduate students) from some 150 countries worldwide, and some 8,000 staff. King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF), eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*).

Since our foundation, King's students and staff have dedicated themselves in the service of society. King's will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King's strategic vision for the next 12 years to 2029, which will be the 200th anniversary of the founding of the university.

World-changing ideas. Life-changing impact: https://www.kcl.ac.uk/news/headlines.aspx

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.

Our three research institutes focus on biomedical and scientific discovery, advancing the prevention and treatment of disease in the fields of population health, heart disease and infection - three of the greatest challenges to global health in the 21st century.

We provide a world-class multi-professional health sciences education that equips our graduates to meet today's healthcare needs through relevant scientific research, clinical excellence, strong interpersonal skills and team-based working.

Sharing a clinical environment with a major London teaching hospital, our innovative approach to education results in well-rounded, highly skilled clinicians, scientists, and health and social care professionals.

St George's is ranked top for graduate employability in the country in The Times and Sunday Times Good University Guide as well as in the Complete University Guide, with 93.6% of St George's graduates going straight into employment or further study.

King's College London

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