Exploring Maternal Perceptions of Infant Sleep and Feeding Method Among Mothers in the United Kingdom: A Qualitative Focus Group Study

Background In a context with strong rhetorical support for breastfeeding in the health system, yet extremely low rates of breastfeeding after hospital discharge, UK women's decisions about infant feeding reflect the reality of competing priorities in their lives, including obtaining adequate sleep. Popular wisdom in the UK tightly links breastfeeding and inadequate night-time sleep. Mothers are advised by peers and family to introduce formula or solid foods to infants to promote longer sleep. Objectives The first objective of this study was to investigate women's understandings of the nature of infant sleep and their perceptions of links between infant feeding method and sleep. The second was to explore how these perceptions influence infant feeding and sleep practices. Underpinning our work is the understanding that infant care choices result from trade-offs by which mothers strive to balance infant- and self-care. Methods We conducted seven focus groups with mothers of infants in two regions of the UK. Verbatim transcripts were thematically coded and emergent themes were identified. Results We found clearly diverging narratives between breastfeeding and formula-feeding mothers. Breastfeeding mothers viewed the fragmentary nature of infant sleep as natural, while mothers who were formula feeding felt this was a problem to be fixed. Conclusions and Practice The strategies used to promote infant and maternal sleep in each group were aligned with their underlying perception of how infant sleep works. Maternal perceptions of the nature of infant sleep and its relation to infant feeding method impact infant care practices in the first year of life.