Following birth, first-time mothers' sleep patterns change more dramatically than those of multiparous mothers (Dørheim et al. 2009) Gress et al. (2010) suggest that maternal perceptions of their own sleep quality are affected by the number of infant-related sleep disruptions, rather than the duration of infant care during the night.
Tiredness (a temporary state, relieved by a single sleep period) and fatigue (which continues despite rest, persisting through circadian rhythms) are commonly reported by parents in the postpartum period.
Both are attributed to infant-related sleep disturbance, and have been negatively associated with maternal physical and mental well-being (Gaillo et al. 2011; Ansara et al. 2005). Furthermore, maternal tiredness is a commonly cited reason for the early termination of breastfeeding (Heinig 2010; Kurth et al. 2010; Tarrant et al. 2011) and introduction of formula feeding. Changes in infant feeding are often driven by parental efforts to promote sleep duration for both their infant and themselves and to share night-time feeding responsibilities (Ball 2003; Pinilla & Birch 1993; Doan et al. 2007).
Minimising sleep disruption during the early postpartum period is not only a key concern for parents, but also for health-care providers in promoting the overall health and well-being of parents, and in supporting mothers in exclusively breastfeeding for at least 6 months as recommended by current health guidelines (Kramer & Kakuma 2002; DofH 2007).
Do parents of breastfed infants really experience less sleep and report more tiredness than those parents whose infants are not breastfed?
Recent research using actigraphy found that in exclusively breastfeeding families, both parents obtained greater overall sleep duration, in comparison to formula feeding families (Doan et al. 2007). Other research has reported that there is no difference in total maternal sleep duration between different infant feeding practices (Montgomery-Downs et al. 2010; Gay et al. 2004), despite reports that breastfeeding mothers experience more nocturnal wakening (Ball 2003) and lower sleep efficiency (Blyton et al. 2002).
Dørheim et al. (2009) found mothers who exclusively breastfed experienced better quality sleep than mothers who combination fed (where infant receives both human and formula milk) and sleep quality did not differ from mothers who solely gave their infants formula milk. Furthermore, breastfeeding mothers who sleep in close proximity to their infants obtain more sleep and report more weeks of breastfeeding than women who combine breastfeeding with separate mother-infant sleep locations (Ball 2003; Ball 2002). Parents therefore implement a variety of strategies to balance their own needs with those of their infants.
Parental fatigue and the workplace
Studies by Mellor and St John (2010; 2011) find that for a period postpartum, paternal work safety declines. This is likely due to this fatigue and sleep deprivation due to infant care. However this research is based upon more subjective data collection methods. Less research regarding maternal workplace safety and performance postpartum has been conducted. Nevertheless it is worth bearing this in mind for both mothers and fathers depending on type of work they do.