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Breastfeeding improves sleep and is linked to a lower risk of ADHD in children, two studies find
A Japanese study found that babies fed breast milk during their first six months of life had better sleep quality, while a Norwegian study found an association between breastfeeding and a lower risk of ADHD symptoms in childhood.
Japanese researchers observed that children who received breast milk during their first six months of life slept better at the age of one than those fed exclusively with formula. Adequate sleep during infancy is considered important for healthy physical and psychological development. “The WHO widely promotes breastfeeding, and most people are aware of its many health benefits,” explained Yuri Nakagawa, the study’s lead author. “Nevertheless, misconceptions persist that breastfed babies sleep less or that formula-fed babies sleep longer. We wanted to provide concrete evidence to dispel this myth.”
Breastfeeding and better sleep quality: the findings of a Japanese study
Lo studio, pubblicato sull’European Journal of Clinical Nutrition ha analizzato i dati di oltre 82.918 coppie madre-bambino. All’età di sei mesi dei bambini, alle madri sono stati somministrati dei questionari sulle pratiche di alimentazione seguite nei primi sei mesi di vita dei loro bambini. I bambini sono stati poi suddivisi in quattro gruppi in base al metodo di alimentazione. Il primo gruppo era composto da neonati allattati esclusivamente con latte artificiale. Il secondo gruppo comprendeva i neonati allattati al seno per meno di sei mesi. Il terzo gruppo includeva i neonati allattati al seno per tutti i sei mesi, con integrazione di latte artificiale. Il quarto gruppo era composto da neonati allattati esclusivamente al seno per sei mesi. Al compimento del primo anno di età, i genitori hanno compilato un altro questionario indicando la durata del sonno del bambino.
The study, published in the European Journal of Clinical Nutrition, analysed data from more than 82,918 mother-child pairs. When the babies were six months old, mothers were given questionnaires about the feeding practices followed during the first six months of their children’s lives. The children were then divided into four groups according to feeding method. The first group consisted of babies fed exclusively with formula. The second included babies breastfed for less than six months. The third included babies breastfed throughout the first six months, with formula supplementation. The fourth consisted of babies exclusively breastfed for six months. When the children turned one, their parents completed another questionnaire reporting how long they slept.
All groups of breastfed children were less likely to have insufficient sleep than babies fed exclusively with formula. While babies fed only with formula during their first six months had a 12.2 per cent probability of insufficient sleep, the risk among babies breastfed for less than six months was only 10.2 per cent. Among babies breastfed for the full six months and supplemented with formula, the risk fell further to 9.7 per cent. The lowest risk of insufficient sleep at the age of one was found among children exclusively breastfed for the first six months, at 8.8 per cent. After adjusting the data for a wide range of maternal, infant and environmental factors, babies exclusively breastfed for six months were 23 per cent less likely to have a short sleep duration than those fed only with formula.
The results also showed a gradual association, with longer breastfeeding linked to a progressively lower likelihood of insufficient sleep. “This study disproves the widespread belief that breastfed babies sleep less because breast milk is digested more quickly,” Nakagawa said. “Our findings suggest that such concerns should not discourage parents from considering breastfeeding and its many well-documented benefits.”
Possible explanations for the link between breast milk and better sleep
The researchers proposed several possible explanations for the association between breast milk and sleep quality. While the nutritional composition of formula remains relatively constant, breast milk adapts to the baby’s changing needs. To help establish and regulate the baby’s biological clock and sleep-wake cycle, melatonin—a hormone that promotes sleep and improves sleep quality—is secreted into breast milk during the night. Because babies produce only small amounts of melatonin, the melatonin contained in breast milk may help support the development of a healthy sleep-wake rhythm.
Breast milk also contains tryptophan, an amino acid used to produce melatonin. Tryptophan concentrations in breast milk are also higher at night. Researchers further suggest that differences in the gut microbiota of breastfed and formula-fed babies may contribute to the development of healthy sleep-wake rhythms and better sleep quality.
Breastfeeding and a lower risk of ADHD symptoms: the findings of a Norwegian study
Norwegian researchers found that breastfeeding up to the age of six months was associated with a reduced risk of ADHD symptoms between the ages of three and eight. The study, published in the journal Biological Psychiatry, used data from 37,600 families. Six months after giving birth, mothers reported through a questionnaire the duration of exclusive breastfeeding, partial breastfeeding and the introduction of other liquids or solid foods. These data were used to calculate the number of months each child had been exclusively breastfed.
“We found that the longer a child was exclusively breastfed—up to six months—the lower their level of ADHD symptoms at the ages of three, five and eight,” said Berit Skretting Solberg, one of the study’s authors. The association was observed in both boys and girls. It was strongest at the ages of three and five and slightly weaker at eight. All types of breastfeeding appeared to have an effect, but the effect increased with the duration and intensity of breastfeeding and was strongest with exclusive breastfeeding for up to six months.
The study accounted for known genetic risk of ADHD and sociodemographic factors. Researchers also carried out analyses between siblings, comparing different breastfeeding patterns within the same family. “Even after these adjustments, a clear, although moderate, protective effect emerged between the duration of exclusive breastfeeding and later ADHD symptoms,” Solberg explained.
As with other observational studies, it is difficult to draw definitive conclusions about causality, and further research is needed. The researchers explained that heredity is probably the most important risk factor for ADHD. However, because ADHD—like other neurodevelopmental conditions—is influenced by multiple factors, the study suggests that breastfeeding frequency may also help protect against the development of ADHD symptoms in young children.
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