Do formula-fed infants sleep longer through the night than breastfed infants?

Last updated: February 20, 2022
There is no consensus in the literature on this question. We encourage you to read the study summaries below or the studies themselves if you have access.
This short answer was generated by aggregating the answers that each of the studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.
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YES ANSWERS
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Chart summary of 13 studies examining this question
Showing up to 10 at a time

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SUMMARIES OF STUDIES
Total studies in list: 13
Sorted by publication year
1
Association Between Breastfeeding and Sleep Patterns in Infants and Preschool Children
"Background Although most studies have reported unfavorable short-term effects of breastfeeding on early-childhood sleep-wake behaviors that potentially attenuate over time, findings have remained inconsistent. Objectives We assessed associations of breastfeeding with longitudinal day-, night-, and total-sleep trajectories and with sleep-wake behaviors in healthy infants and preschoolers. Methods Caregivers of naturally conceived, term, singleton infants (n = 654) completed the Brief Infant Sleep Questionnaire (3, 6, 9, 12, 18, and 24 mo) and/or Children's Sleep Habits Questionnaire (54 mo), and provided information on their infants’ breastfeeding status at 3 mo. Trajectory analyses derived 4 day- (n = 243), 3 night- (n = 248), and/or 4 total- (n = 241) sleep trajectories, each differing in length of sleep duration (short/moderate/long) and variability (variable/consistent). Sleep-wake behaviors from 3 to 24 mo (day/night/total-sleep durations and duration/number of night awakenings) were also assessed for associations with breastfeeding. Results After adjusting for potential covariates, formula-fed infants, relative to fully breastfed (predominant or exclusive) infants, were significantly less likely to exhibit moderate (OR: 0.28; 95% CI: 0.11, 0.70) and long consistent (OR: 0.18; 95% CI: 0.07, 0.50) night-sleep trajectories and less likely to exhibit moderate (OR: 0.21; 95% CI: 0.07, 0.61) and long consistent (OR: 0.12; 95% CI: 0.04, 0.38) and long variable (OR: 0.16; 95% CI: 0.05, 0.56) total-sleep trajectories, instead of short variable night- and total-sleep trajectories. Partially breastfed infants did not differ from fully breastfed infants for both night- and total-sleep trajectories. No significant differences were found between all groups for day-sleep trajectories. Fully breastfed infants had longer night- (6, 9, 12, and 24 mo) and total- (3 and 12 mo) sleep durations than formula-fed infants, albeit a greater number of night awakenings (from 6 to 12 mo). Conclusions Despite more night awakenings, fully breastfed infants have overall longer night- and total-sleep durations (sleep trajectories) than formula-fed infants."
AUTHOR
Nur K Abdul Jafar
PUBLISHED
2021 The American Journal of Clinical Nutrition
High Quality Source
No
No
2
Exclusive breastfeeding at three months and infant sleep-wake behaviors at two weeks, three and six months
"OBJECTIVE: This study assessed infant sleep-wake behavior at two weeks, three and six months as function of feeding method at three months (exclusively breastfed, partially breastfed, and exclusively formula fed infants). METHOD: Mothers of 163 first-born, full-term, normal birth weight, healthy infants completed socio-demographic, depression, anxiety, and infant sleep-wake behavior measures. RESULTS: No effects were found for sleep arrangements, depression or anxiety, on feeding methods and sleep-wake behavior at three months. At two weeks exclusively breastfed infants at three months spent more hours sleeping and less hours awake during the 24-h period than partially breastfed infants. At three months, exclusively breastfed infants had a shorter of the longest sleep period at night than exclusively formula fed infants. At six months, exclusively breastfed infants at three months spent more hours awake at night than partially breastfed infants, awake more at night than exclusively formula fed infants, and had a shorter sleep period at night than partially breastfed and exclusively formula fed infants. CONCLUSIONS: This study showed differences in sleep-wake behaviors at two weeks, three and six months, when exclusively breastfed infants are compared with partially breastfed and exclusively formula fed infants at three months, while no effects were found for sleep arrangements, depression or anxiety."
AUTHOR
Bárbara Figueiredo
PUBLISHED
2017 Infant Behavior and Development
Yes
Yes
3
Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study
"BACKGROUND: Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old. METHODS: This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length. RESULTS: Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage. CONCLUSIONS: Our data based on caregiver's self-report suggested that partial breastfeeding and bed-sharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding."
AUTHOR
Xiao-Na Huang
PUBLISHED
2016 World Journal of Pediatrics
Yes
Yes
4
Infant Sleep and Night Feeding Patterns During Later Infancy: Association With Breastfeeding Frequency, Daytime Complementary Food Intake, and Infant Weight
"Infant sleep is a common concern for new parents. Although many expect a newborn infant to wake frequently, encouraging a baby to sleep through the night by a few months of age is seen as both a developmental aim and a parenting success. Many new mothers believe that their infants' diet is related to their sleep; formula milk or increased levels of solid food are often given in an attempt to promote sleep. However, the impact of these in later infancy is not understood. In the current study 715 mothers with an infant 6-12 months of age reported their infants' typical night wakings and night feeds alongside any breastfeeding and frequency of solid meals. Of infants in this age range, 78.6% still regularly woke at least once a night, with 61.4% receiving one or more milk feeds. Both night wakings and night feeds decreased with age. No difference in night wakings or night feeds was found between mothers who were currently breastfeeding or formula feeding. However, infants who received more milk or solid feeds during the day were less likely to feed at night but not less likely to wake. The findings have important implications for health professionals who support new mothers with infant sleep and diet in the first year. Increasing infant calories during the day may therefore reduce the likelihood of night feeding but will not reduce the need for parents to attend to the infant in the night. Breastfeeding has no impact on infant sleep in the second 6 months postpartum."
AUTHOR
Amy Brown
PUBLISHED
2015 Breastfeeding Medicine
High Quality Source
No
No
5
Breastfeeding, Bed-Sharing, and Infant Sleep
"BACKGROUND: Expectations for infant sleep development and for the appropriate degree of parental proximity for infant sleep are culturally weighted and historically shifting aspects of parenting behavior, and are known to affect breastfeeding prevalence and duration. This paper examined how new parents managed night-time feeding in the first 4 months, with a particular focus on the relationship between breastfeeding, infant sleep location, and sleep bout duration. METHODS: Sleep logs and semistructured interviews were used with a sample of 253 families in North Tees, United Kingdom, to explore how parents responded to their infant's sleep patterns, how breastfeeding parents managed night-time feeding, and whether bed-sharing was a common strategy. RESULTS: Two-thirds of the babies in the study slept through the night at the end of the third month–almost all of these babies (94%) were formula-fed. While 79% of formula-fed 3-month-olds in the study slept through the night, only 15% of breastfed 3-month-olds did."
AUTHOR
Helen L Ball
PUBLISHED
2013 Birth: Issues in Perinatal Care
Yes
Yes
6
Breastfeeding and infant sleep patterns: an Australian population study
"OBJECTIVE: Our purpose was to determine if babies breastfed at 6 months of age were more likely to wake at night and less likely to sleep alone than formula-fed babies. PATIENTS AND METHODS: Data were drawn from the first wave of The Longitudinal Study of Australian Children, an ongoing, nationally representative study of the growth and development of Australia's children. The 4507 participants met the criteria for this study. The measures examined infant sleep problems as the outcome and breastfeeding at 6 months of age as the exposure in addition to the demographic data, maternal mental health, infant birthweight and gestational age at delivery. RESULTS: After adjustment for covariates, reports by mothers of infants that breastfed at 6 months of age suggested infants were 66% more likely to wake during the night and 72% more likely to report difficulty sleeping alone. However, breastfeeding had a strongly protective effect on wheezing, coughing, snoring and breathing problems, and it was not associated with restless sleep or problems getting to sleep for the infant. CONCLUSIONS: Breastfeeding was found to be associated with increased night waking and this is consistent with other studies. There are biological reasons why this might be required to ensure breastfeeding continues to 6 months and beyond. The current low rates of sustained breastfeeding in many Western countries needs to be reconsidered in relation to parental and public health practices promoting prolonged nocturnal infant sleep patterns."
AUTHOR
Megan Galbally
PUBLISHED
2013 Journal of Paediatrics and Child Health
Yes
Yes
7
Long-Term Relationship Between Breastfeeding and Sleep
"The aim of this study was to assess the relationship between breastfeeding and sleep in a longitudinal study of infants. Ninety-two mothers of exclusively breast-fed (n = 36) and exclusively formula-fed (n = 56) infants completed the Brief Infant Sleep Questionnaire at baseline (age of enrollment = 3 to 12 months) and at four follow-up visits (3, 6, 9, and 12 to 18 months). Breast-fed infants had more disrupted sleep at baseline including increased night wakings and sleep fragmentation; however, these differences disappeared by the 9-month follow-up. Furthermore, by the 6-month follow-up, parental presence at sleep onset played a more important role in sleep outcomes than breastfeeding. These findings suggest that sleep disruptions associated with breastfeeding resolve over time."
AUTHOR
Jodi A. Mindell
PUBLISHED
2012 Children's Health Care
Yes
Yes
8
Effect of current breastfeeding on sleep patterns in infants from Asia-Pacific region
"AIM: The aim of this study was to assess the relationship between breastfeeding and sleep patterns in infants from Asia-Pacific region. METHODS: Parents of 10,321 infants (0-11 months) from Australia, China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand and Vietnam completed an expanded version of the Brief Infant Sleep Questionnaire. RESULTS: Overall, 4714 (45.72%) were currently being breastfed; 61.3% of those between 0 and 5 months and 36.6% of those between 6 and 11 months. Currently breastfed infants, when compared with not currently breastfed infants, had a significant increase in the number and duration of night-time wakings and less consolidated sleep. Interestingly, currently breastfed infants less than 6 months also showed longer duration of daytime sleep and obtained more sleep overall. Of note, of those who were currently breastfed, those infants who were nursed back to sleep during night, woke up more often at night (2.41 vs. 1.67 times) and had shorter continuous night-time sleep period (5.58 vs. 6.88 h; P < 0.001). There was no significant difference between breastfeeding and non-breastfeeding infants in the number of night wakings, when the nursing to sleep variable was controlled for in the analysis of variance. CONCLUSION: Breastfeeding is associated with reduced sleep consolidation in infants. This relationship, however, may be moderated by parenting practices of nursing to sleep and back to sleep during the night. Thus, parents of infants with night waking problems should be encouraged to limit the association between nursing and falling to sleep, to improve sleep while maintaining breastfeeding."
AUTHOR
Mahesh Babu Ramamurthy
PUBLISHED
2012 Journal of Paediatrics and Child Health
Yes
Yes
9
Breastfeeding May Improve Nocturnal Sleep and Reduce Infantile Colic: Potential Role of Breast Milk Melatonin
"Exclusive breastfeeding is associated with reduced irritability/colic and a tendency toward longer nocturnal sleep. Breast milk (nocturnal) consists of substantial melatonin levels, whereas artificial formulas do not. We speculate that melatonin which is supplied to the infant via breast milk plays a role in improving sleep and reducing colic in breast-fed infants compared to formula-fed ones."
AUTHOR
Anat Cohen Engler
PUBLISHED
2011 European Journal of Pediatrics
High Quality Source
No
No
10
Night waking in Thai infants at 3 months of age: association between parental practices and infant sleep
"BACKGROUND: Night waking is common among infants and can create sleep deficit in both parents and infants. Sleep practices are influenced by cultural variations which may affect the prevalence and associated factors of frequent night waking. PURPOSE: Our objective was to determine whether differences in parental practices related to infant sleep are associated with frequent night waking in Thai infants. METHODS: A cross-sectional survey based on interviews with parents of infants aged three months, birth weight greater than 2500 g, conducted under the Prospective Cohort study of Thai Children (PCTC). RESULTS: Of the total sample, 82.9% (3172 of 3826) of parents provided completed night waking information. The mean number (+/-standard deviation [SD]) of awakenings per night was 2.7+/-1.1, 47.3% awoke 1-2 times per night, and 46.9% awoke 3-4 times per night. The group of frequent night wakers (more than 14 night wakings per week, n=1634) was compared with the group of infrequent night wakers (n=1538). Significant and independent associations were present between frequent night waking and male gender (odds ratio [OR] of 1.5; 95% confidence interval [CI], 1.3-1.8), more than three naps per day (OR, 1.3; CI, 1.1-1.5), use of a swinging or rocking cradle (OR, 1.5; CI, 1.2-1.98), falling asleep while feeding (OR, 1.3; CI, 1.1-1.5), and breastfeeding only (OR, 1.2; CI, 1.1-1.4). No significant association was noted between frequent night waking and parental age, education, occupation, household income, type of parental response to infant's nighttime crying, or type of diaper. CONCLUSION: An association with frequent night waking was demonstrated with various factors of parental practice related to infant sleep, such as number of naps, use of a swinging or rocking cradle, breastfeeding only, and falling asleep while feeding. Further documentation of these associations may be clinically important. Implementing preventive interventions may be able to reduce frequent night waking in early infancy."
AUTHOR
Wanaporn Anuntaseree
PUBLISHED
2008 Sleep Medicine
High Quality Source
Yes
Yes
11
Differential Effects of Breast- and Formula-Feeding on Preterm Infants' Sleep-Wake Patterns
"OBJECTIVE: To compare sleep-wake patterns of breastfed and formula-fed preterm infants. DESIGN: Data were taken from an exploratory study of infant biorhythm maturation. Parents completed a 24-hour diary of infant Sleep, Awake, and Cry states and feedings, recorded at 30-minute intervals. Infant health data were collected from medical records and parents’ reports. SETTING: Infants were studied in the home after discharge from a neonatal intensive-care unit. PARTICIPANTS: The convenience sample included 12 breastfed and 25 formula-fed preterm infants (gestational age, 26–33 weeks; corrected postnatal age, 4–6 weeks). Groups were comparable in terms of gestational age, postnatal age, Apgar scores, maternal age, and home environment. MAIN OUTCOME MEASURE: The 24-hour recording period was divided into day (0600-1800) and night (1800-0600). Study variables were Day, Night, and 24-hour Sleep, Awake, and Cry. RESULTS: Breastfed preterm infants exhibited more Day Cry and 24-hour Cry than did formula-fed infants. Infants demonstrated a diurnal pattern in Cry, Awake, and Sleep. Breastfed preterm infants cried approximately 1 hour per day more than formula-fed infants. CONCLUSION: Preterm breastfed infants experienced more cry than did formula-fed infants. The relationship between feeding method and sleepwake pattern has implications for supporting lactation as well as for research design."
AUTHOR
Karen A. Thomas
PUBLISHED
2000 Journal of Obstetric, Gynecologic, & Neonatal Nursing
High Quality Source
Yes
Yes
12
Sleep patterns of infants in the first year of life
""RESULTS: A prospective study of 132 infants aged from 1 month to 1 year found that infantswho were breast fed or breast plus bottle fed were significantly more likely to wake at nightthroughout the first year. Social class of the family, parity of the mother, and the weight gain ofthe infant had no consistent effects. This increased waking was not due to mothers of wakefulinfants prolonging breast feeding to soothe their infants.""
AUTHOR
J Eaton-Evans
PUBLISHED
1998 Archives of Disease in Childhood
High Quality Source
Yes
Yes
13
Waking at night: the effect of early feeding experience
"METHODS: The mothers of 180 preschool children were interviewed in their homes in a survey of feeding preferences and sleeping behaviour. We report here on the differences in current sleeping patterns and the age at which night feeds were dropped. RESULTS: There are clear differences in these two behaviours according to whether the baby was breast or bottle fed, and this result is not explicable in terms of social class. Night feeds disappear more slowly in the breast fed infant, and the problem of night waking both in the first year of life and when at nursery school appears to be associated with earlier breast feeding. The importance of such a finding is discussed in relation to the advice offered to mothers by health professionals."
AUTHOR
P Wright
PUBLISHED
1983 Child: care, health and development
High Quality Source
Yes
Yes