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Journal of Pediatric Psychology Advance Access published online on December 19, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn132
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

A Transactional Model of Sleep–Wake Regulation in Infants Born Preterm or Low Birthweight

A.J. M. Schwichtenberg, PhD1 and Julie Poehlmann, PhD2

1M.I.N.D. Institute, University of California and 2Waisman Center, University of Wisconsin

All correspondence concerning this article should be addressed to A.J. M. Schwichtenberg, M.I.N.D. Institute, University of California–Davis, 2825 50th Street, Rm 2101, Sacramento, CA 95817, USA. E-mail: ajschwichtenberg{at}ucdavis.edu


  Abstract

Objective To test a transactional model of sleep–wake development in infants born preterm or low birthweight (PT LBW), which may inform clinical practice, interventions, and future research in this at risk population. Methods One hundred and twenty-eight mother–infant dyads participated from hospital discharge to 4 months postterm. Assessments of prematurity, infant sleep–wake patterns, maternal interaction quality, depression, feeding route, and sociodemographic factors were conducted. Results Path analyses revealed that maternal interactions directly related to infant sleep patterns and family sociodemographic risks related to less optimal parenting. In addition, bottle fed infants experienced fewer night wakings and more nighttime sleep. Conclusions Two potential pathways to sleep patterns in PT LBW infants were identified. The findings suggest directions for clinical work, such as supporting healthy infant sleep through parenting interventions or supporting interpersonal relations between parents and their PT LBW infants by encouraging more daytime naps. Additionally, clinicians should assess parents’ nighttime sleep concerns within the larger sociodemographic and feeding context.

Key words: low birthweight; preterm; sleep; transactional development.

Received June 19, 2008; revision received November 14, 2008; accepted November 19, 2008


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