Feeding, Parental Mental Health, and Sleep: An Integrated View of Contributors to Infant Sleep Problems

Background: Parental feeding styles and mental health are associated with infant sleep patterns. Responsive feeding is related to lower obesity risk while restrictive feeding and parental depression/anxiety relate to infant night wakings, shorter sleep, and disrupted sleep schedules. This study examines whether feeding styles and parental depression and anxiety predict sleep problems in at-risk infants within the first two years of life. Methods: Parents of infants under 2 years (N=24, Mage = 10.33 months) undergoing polysomnography for sleep disturbances were enrolled. Responsive, restrictive, pressuring, and laissez-faire parental feeding styles were assessed via the Infant Feeding Styles Questionnaire. Sleep disturbance was measured via the Pediatric Insomnia Severity Index (PISI) and parental anxiety and depression were measured via the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure. Correlations between parental mental health, feeding styles, and child sleep disturbance were conducted and multivariate linear regression was used to determine the relative impact of feeding styles on pediatric sleep when considering parental mental health. Results: More restrictive feeding was moderately correlated with less insomnia (r = -0.32) while more responsive feeding was moderately correlated with worse insomnia (r = .33). Pressuring and laissez-faire styles had very weak correlations with (r’s = 0.02 and 0.08 respectively). Worse parental mental health was moderately correlated with worse infant sleep disturbances (r = 0.34). Regression analyses found that greater responsive and less restrictive feeding significantly predicted increased insomnia scores (b = 2.47 and -1.90, respectively, p’s > .05) controlling for parental mental health problems and other feeding styles.