Caffeine and Breastfeeding

If anyone needs a little caffeine, it’s a new mom. My labor with Cee took me through two mostly sleepless nights, and when she finally arrived, we took a little time to nurse and get to know one another, and then our whole little family took a long nap. When we woke up, the first thing I did was send my husband to get me a latte. The second thing I did was breastfeed my new baby again. That dose of caffeine felt like good therapy to me, but what about for Cee? Was it good for her?

caffeine structure

Source: Wikimedia Commons

A few weeks ago, I wrote about the safety of caffeine in pregnancy, and several readers wanted to know about the postnatal effects of caffeine – how mom’s caffeine intake might affect her breastfed baby. I promised to take a look at the literature and report back, and so here we are.

 

When you drink a cup of coffee, how much caffeine ends up in your breast milk?

Several studies have examined this question, and although they are small, they give us a general idea of the transfer of caffeine from mom’s blood to her milk. After a cup of coffee, caffeine is rapidly absorbed into mom’s blood and then passively diffuses across the epithelial layers of the mammary gland. Caffeine appears in milk within 15 minutes of consumption and peaks within an hour. The concentration of caffeine in breast milk ends up being about 80-90% of that in mom’s plasma. However, taking into account the amount of breast milk consumed and adjusting for body weight, studies have estimated that the infant receives no more than 10% of the maternal dose of caffeine, and likely much less (see here, here, and here).

Is this amount of caffeine safe for a baby?

Just because levels of caffeine in breast milk are low relative to what adults normally consume doesn’t mean that these amounts are necessarily safe to a baby. Another important factor is how efficiently a baby can metabolize caffeine, and it turns out that newborn caffeine metabolism is really slow. Whereas the half-life of caffeine in adults is around 2-6 hours, it is an average of 3-4 days in newborns and can be even slower in premature babies. In other words, a morning cup of coffee for mom will easily clear her blood by bedtime, but caffeine may linger in her breastfed newborn for much longer. Metabolism gradually ramps up as the baby matures and the necessary enzyme levels come on board, and most babies can metabolize caffeine at rates similar to adults by 5-6 months of age. Continue reading

How My 3-Year-Old’s Sleep Fell Apart

A couple of weeks ago, I wrote that after I finished my book, I needed a sort of parenting reset with Cee. One of the big areas that we needed to work on was sleep. Bedtime had become a battle, and it was taking Cee a long time to fall asleep. This was leaving us all frustrated at the end of the day, and Cee was waking up grumpy in the mornings. I didn’t have the energy and attention to work on it while I was trying to finish my book, although in hindsight I’m not sure why we waited this long. Over the last couple of weeks, we’ve made some big changes to get us back to happy bedtimes.

Let me back up and tell you how we got into trouble with sleep in the first place. Last August, we moved to a new house. By this time, Cee had been in a toddler bed for almost a year, but she had no problem staying in it at bedtime or through the night. We had a sweet bedtime routine that ended with kisses goodnight, turning off the light, and then good sleep for Cee. After we moved, Cee started talking about being afraid of things like the deer and turkeys that wandered through the yard of our new house. We talked about these fears, got her a night light, and spent a little more time with her before saying goodnight, singing a couple of rounds of Twinkle, Twinkle and rubbing her back for a few minutes. All of that was fine.

Then Cee started getting out of her bed after we left her room for the night. She’d pad into the living room or my office to find me. I’d walk her back to bed and tuck her in again, but some nights this happened over and over. I would be shocked to see her in my office door at 9:00 or 9:30 PM, long after her 8:00 bedtime. She was also waking up during the night, coming into our room, and patting my shoulder until I woke up. I would walk her back to her room, often lying down next to her until she went back to sleep. Alternatively, I’d pull her into bed with me, but neither of us slept very well this way. All of this was adding up to fewer hours and less restful sleep for both of us.

When did the sweetness of a good nap become something to resist?

When did the sweetness of a good nap become something to resist?

Things seemed to get worse around the holidays. Cee was getting out of bed more and more after bedtime, and she was having a hard time separating when we tucked her back in. She started asking us to sit with her while she fell asleep, and this actually seemed like a reasonable solution. At least if we sat in her room we could make sure that she stayed in her bed, and maybe she would fall asleep easier and get more rest this way. I reminded myself that she was just 3, and if she was asking for more support in her transition to sleep, why shouldn’t we give that to her? (Never mind that she had been falling asleep on her own since she was a baby.)

There was something else going on at this time, too. I thought that maybe Cee’s struggles with sleep were because I wasn’t there enough for her in the day. I was going through a really tough period, approaching the 1-year anniversary of our first miscarriage and beginning some fertility testing. Continue reading

Caffeine Safety in Pregnancy

My first trimester of pregnancy coincided exactly with the last three months before my book deadline. I was lucky to have only mild nausea during this time, but I was really, really tired, especially in the afternoon. I tried hard to get enough sleep at night, but my body also seemed to want a 2-hour nap after lunch, when I just couldn’t stay awake, much less think and write. Pre-pregnancy, I responded to a post-lunch slump by pouring myself a cup of coffee or, even better, spending the afternoon at my favorite coffee shop, where a latte and the people around me helped keep me focused for a productive afternoon. A cup of herbal tea in the same atmosphere just made me want to curl up in one of the comfy chairs and take a nap, even as my caffeine-fueled coffee shop friends typed energetically around me.

But now I was pregnant, after 18 month of trying and several miscarriages, and I wanted to do all I could to minimize the risks of losing this pregnancy. In previous pregnancies I’d just given up most caffeine, and that wasn’t that hard to do. In this one, I was more afraid than ever of a miscarriage, but I also needed the caffeine boost more than ever to finish my book. I wanted to know what the research says about the safety of caffeine in pregnancy so that I could make an informed decision about whether to consume caffeine, and if so, how much.

Photo by Kevin Tuck

In her book, Expecting Better, Emily Oster includes an excellent discussion of caffeine in pregnancy. I consulted this for a quick answer to my question, and her analysis of the research on this topic helped me feel comfortable strategically drinking a little coffee in the afternoon. However, as much as I like and respect Oster’s book, I’ve also found that my approach to risk in pregnancy is a bit more conservative, and as soon as I had the chance, I wanted to look at the studies myself. Continue reading

Amylase in Infancy: Can Babies Digest Starch?

Several readers have emailed me to ask about babies’ ability to digest starch. Here’s one:

“I have noticed you recommending cereals for babies several times.  I am sure that you are aware that many people look at feeding a baby grains before the age of one or even two as if you have offered your child strychnine. One of the reasons cited is that they supposedly do not have amylase to digest grains before that time. I have often wondered what exactly is happening to the cereal if it is not being digested, but the only statement I could find is something about it “rotting” in the gut.

I would love to get information from a scientific point of view on this topic.  Everything I have been able to find thus far has been very biased towards one point of view or another. Either “cereal is the perfect first food. Easy to digest and enriched with iron” from the infant cereal companies or “Cereal is junk.  No infant should ever eat grains. It is not natural or traditional and they can’t digest it” from online parenting sites.

I need a little clarity and common sense.”

~Hope

I love the skepticism in Hope’s email, and I can also empathize with her frustration about how difficult it is to find good information about a seemingly simple question: Can babies digest starch? If you search for the answer to this question online, you will run into dire warnings of the dangers of giving starch to babies. But these sites might set off your woo detector – as they should. So, after receiving multiple emails about this question as well as seeing it mentioned in discussions on the Science of Mom Facebook page, I figured it was time to put some evidence-based information about babies and starch digestion on the Internet.

Researching this question has given me an excuse to read some classic nutrition physiology papers harkening back to the 1960’s and 1970’s, and it’s brought back memories of years in the lab, exploring nutrient digestion and metabolism. And starch digestion in infancy, it turns out, is a really neat story.

Let’s start with some basics about carbohydrate digestion.

What is starch? How is it digested?

Starch is a type of complex carbohydrate. Made from lots of glucose molecules bonded together in long, branching chains, it is a plant’s way of storing glucose – product of photosynthesis and source of energy – in a stable form. We find starch in grains, root vegetables, winter squashes, beans, and some fruits, like bananas. Starch is an important storage depot for the plant, and it also makes for tasty staple foods for cultures around the world.

One little section of starch, containing 3 glucose molecules. Wikimedia Commons, public domain.

A chain of 3 glucose molecules, like a tiny section of starch.

Glucose is the major fuel for the cells of the body. When we eat starch, we have to break the bonds in those chains of glucose molecules, liberating them to be absorbed from the small intestine into our blood. Starch digestion begins in the mouth, where salivary amylase starts chopping up those large glucose chains. When this partially digested starch gets to the small intestine, amylase made and secreted by the pancreas jumps in to do more bond-breaking and is responsible for most of starch digestion in adults. A suite of enzymes produced by the cells lining the small intestine, including sucrase, isomaltase, maltase, and glucoamylase, work on the remaining short chains, finishing up the job and making glucose available for absorption.

Starch Digestion in Infants

Infants go through some incredible nutritional transitions in the first months of life. Prior to birth, their growth and development is fueled almost entirely by glucose from mom, absorbed across the placenta. After birth, they have to abruptly transition to an exclusive milk diet, which is high in fat and lactose, still a relatively simple sugar. As they start solid foods, babies have to adapt to a much more complex and varied diet. Around the world, starch is a major source of energy in the diets of children and adults alike. But when infants are first introduced to starchy foods – often in the form of cereals and porridges – starch is a novel nutrient to their digestive tract. They need to turn it into glucose, but are they equipped to do this? Continue reading

Breastfeeding, Gluten Introduction, and Risk of Celiac Disease

A study published yesterday in the journal Pediatrics suggests that later introduction of gluten and breastfeeding beyond 12 months both increase the risk of a child developing celiac disease. These new findings add to the already muddy waters of our current understanding of the role of infant feeding in celiac disease.

Photo by Shree Krishna Dhital, via Wikimedia Commons

Celiac disease is an immune response to gluten, a protein found in wheat, barley, and rye. Celiac is characterized by inflammation and damage to the small intestine, leading to symptoms such as diarrhea and digestive pain. In the U.S., celiac disease is present in about 1 in 141 people, although many of these cases go undiagnosed. Infants that develop celiac disease often have poor growth or weight loss, because intestinal damage compromises nutrient absorption. They also may have chronic diarrhea and a swollen, painful belly.

Celiac can usually be treated with a gluten-free diet, but there isn’t a cure for the disease. Multiple genetic markers have been identified for celiac disease, but many genetically susceptible individuals tolerate gluten and never develop symptoms, leading to speculation about other risk factors, including early childhood nutrition.

This latest study was a large, prospective survey of infant feeding practices and development of celiac disease in Norwegian children. Parents were asked when they first introduced gluten and how long they breastfed their babies. Children that developed celiac disease were tracked through Norway’s national medical system. The study included 324 children with diagnosed celiac disease and 81,843 without celiac. The researchers then looked for patterns in the data that might help to explain why some children developed celiac disease and others did not.

There were two major findings to emerge from this study:

  1. Children that had not yet tried gluten by 6 months of age were more likely to develop celiac disease.
  2. Breastfeeding at the time of introduction to gluten did NOT appear to be protective. In fact, breastfeeding for longer than 12 months was associated with an increased risk, although it was borderline significant (P=0.046).

Both of these findings are contradictory to current infant feeding advice in the U.S. The AAP’s Section on Breastfeeding recommends exclusive breastfeeding for about 6 months before introducing solid foods, followed by “continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.” The same AAP policy goes on to say, “There is a reduction of 52% in the risk of developing celiac disease in infants who were breastfed at the time of gluten exposure.” But this Norwegian study effectively found that following the current advice of the AAP seems to increase a baby’s risk of celiac, not decrease it.

Obviously, we need more information here. And as usual, one study isn’t enough to give us the full picture of what we know and don’t know about this topic.

To understand the evolving hypotheses around celiac disease and infant feeding, we need to go back to Sweden in the mid-1980’s, when the rates of celiac disease in young kids suddenly quadrupled from an incidence of 1 in 1000 births to 4 in 1000 births over just a few years. It was an epidemic, and it appeared to be isolated to Sweden; neighboring countries weren’t affected. What’s more, celiac was showing up in really young kids. The median age of diagnosis during the epidemic was just about a year old. In 1995, celiac disease in Sweden plummeted back to pre-epidemic levels, and the median age of diagnosis increased to 4 years of age. Continue reading

The Magic and the Mystery of Skin-to-Skin

I meant to do skin-to-skin with Cee after her birth, I swear. It was in my birth plan. But after a long labor, Cee was born blue and limp, and the understandable concern about her health trumped any ideas I’d had about optimizing our postpartum experience. Cee was whisked away to a warmer on the other side of the room and encircled by the NICU team. Thankfully, I heard her cry within a few moments, and she was in my arms soon after. But by then, she was wrapped in a pink and blue flannel blanket, and I was too overwhelmed and taken with her to think of unwrapping her. Instead, I held her, and we gazed into each other’s eyes. She started rooting and was nursing within a couple of minutes. It was a magical first meeting, and it wasn’t until later that I realized that I’d screwed up and forgotten to do skin-to-skin.

IMG_3113

What’s wrong with this picture? (besides the fact that I hadn’t slept or brushed my hair in 48 hours)

I’ve been researching this topic for a chapter in my book about the postpartum period. I’m writing about what we know and don’t know about getting to know our newborns, establishing breastfeeding, rooming in, and yes, skin-to-skin. When I started working on this chapter, I thought the skin-to-skin thing was a slam-dunk, maybe even too obvious to be of much interest to my readers.

Modern-day interest in skin-to-skin, also called kangaroo care, began in 1978 in the NICU at San Juan de Dios hospital in Bogotá, Columbia. For every 10 premature babies born there, only 3 survived. There weren’t enough incubators or nurses. Babies were tucked two to three at a time in incubators, and infections were rampant. Parents weren’t encouraged to be involved in the babies’ care, and having little emotional connection to them, many abandoned their sickly babies at the hospital. Kangaroo care was a desperate attempt to care for these vulnerable babies. Mothers were essentially asked to be their babies’ incubators, holding them skin-to-skin 24 hours per day and breastfeeding on demand.

The results were astounding. The kangaroo care babies in Bogotá grew well, were more likely to be breastfed, and were less likely to get severe infections or be abandoned. The power of kangaroo care for low birth weight babies has since been confirmed in multiple studies. A 2011 Cochrane review concluded that skin-to-skin helps stabilize premature newborns, reduces mortality, infections, hypothermia, and length of stay in the hospital. These benefits are particularly clear in developing countries, but many hold in industrialized nations as well.

With the impressive success of skin-to-skin care for preemies, it seemed natural to assume that full term babies would benefit from it as well. But the research in this area is disappointing. Continue reading

What’s Your Feeding Style? (Fearless Feeding Review and Giveaway)

Do you have a feeding philosophy? What’s your feeding style?

These are not the most common topics in parenting discussions. We’re often too busy talking breast and bottle, baby led weaning or purees, organic or conventional, and how to get our kids to eat more vegetables. But the question of feeding style, I believe, matters more to children than any of these oft-discussed topics.

I am really pleased to have a new book on my shelf that covers the HOW and WHY of feeding children just as well as it covers WHAT to feed: Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School, by Jill Castle and Maryann Jacobsen. Both authors are registered dieticians, mothers, and bloggers. They take a long-term view on feeding – that we shouldn’t just be concerned with what our kids are eating today, but also about teaching kids to eat well for a lifetime.

9781118308592_Castle.inddFeeding style is one of the first topics in Fearless Feeding, so if you’re not sure how to describe your own feeding style, here’s your chance to give it some thought. Castle and Jacobsen discuss 4 feeding styles, analogous to parenting styles that may be familiar to you: Continue reading

SIDS and Bedsharing: A Pediatrician’s Perspective

I’ve been thinking about bedsharing and sleep safety for the last few months. I have devoted an entire chapter of my book to this topic. Not only is it an important question for parents, but it’s an issue with so much complexity — wrinkles and folds of factors like breastfeeding, bonding, instinct, culture, and just plain reality.

I think it is vitally important to understand the relationship between bedsharing behavior and risk of SIDS and accidental deaths. But our ability to tease apart every factor that might impact sleep safety is imperfect; there will always be factors that aren’t quantified in these studies, not to mention the fact that case control studies have some inherent limitations. You’ve probably heard about the study published this week by Carpenter et al. in BMJ. It combines 5 historic case control data sets from Europe, the U.K., and Australasia to specifically look at the risk of bedsharing in breastfed babies in nonsmoking households. It concludes that bedsharing poses an increased risk of SIDS, even in these ideal situations. I think it’s an important study, but it also has some limitations and doesn’t answer all of our questions with certainty. In fact, no study will probably ever do that. (You can read some critiques of the Carpenter study here and here.)

But even if we accept that bedsharing increases a baby’s risk of dying unexpectedly during sleep, we still have to answer the bigger question of how we translate this information to families living in the real, difficult world of infant sleep. Many families value bedsharing as a cultural practice; others choose it because it feels right. Still others bedshare because it is the only way that anyone gets any sleep at night, and we all know that sleep deprivation carries some risk, too, as does falling asleep on a couch with your baby. This is the reality.

Pediatricians face this reality in their clinics every day, when they talk with parents of new babies about sleep. In my book, one of the questions I explore is how pediatricians handle this conversation, given that their professional organization, the American Academy of Pediatrics, recommends against bedsharing. Several months ago, I sent some questions to one of my favorite pediatrician bloggers, Dr. Melissa Arca of Confessions of a Dr. Mom. She had initially agreed to a Q&A, but then she didn’t respond with her answers. It was the height of the busy flu season, and I figured that she was just busy. Then, this week, she surprised me with her responses. She had been thinking about bedsharing given the news of this recent study, and she was inspired to restart this conversation. We’ve cross-posted our Q&A on both our blogs. Check out her post for more about her initial hesitancy to address these questions, and please feel free to share your experiences in the comments below.

Alice: How did sleep look for your two children?

Melissa: My first child was a challenge to say the least. He is the one who made me question the safety of bed-sharing in the first place. For the first 6 months of his life, sleep was virtually non-existent (or at least that’s the way it felt to me) because he needed my arms and constant soothing throughout the night. But I was terrified to bedshare. I was literally at the end of my sleep deprivation rope. I had tried everything. And instead of listening to my instincts, I was fighting them. Because I was scared.

I never envisioned myself as a bedsharing parent. As a pediatrician, I was adamantly against it. But it was exactly what my baby needed and we struggled and limped along until I finally realized that.

My second child was a breeze and that’s no lie. She was always (and still is) an “easy sleeper”. She needed her space and showed clear signs of being tired. When she was tired, that was it. I didn’t need to bedshare with her. She slept in her own bassinet next to our bed during her first few months of life before being transitioned to her own room.

They could not have been more different in the sleep department. Same parents. Same environment. Different children.

Alice: As a pediatrician, how did you feel about bedsharing before having children? Did becoming a mother change that?

Melissa: I didn’t think it was safe. At all. I had read the studies and the official recommendations. Back to sleep, crib and/or bassinet in the same room with no hazards such as loose bedding, pillows, etc.

I never thought in a million years I would have become a bedsharing parent. But kids don’t have our same agendas. Continue reading

Baby Meets World: A Conversation with the Author

Yesterday, I posted an excerpt from Nicholas Day’s new book, Baby Meets World. If you missed it, check it out to learn how modern hunter-gatherer societies raise children, and how that task is supported by not just by hard-working mothers but the entire culture. It’s good stuff.

After reading his book, I had lots of questions for author Nicholas Day. Today, I bring you our conversation about his book and on the roles of science, culture, and instinct in parenting.

Alice: Becoming a parent changes all of us. What was it about your particular transition to fatherhood that made you want to research and write this book, to dive into the history and the science of parenting in a way that extended beyond your own reality of parenting?

IMG_4413Nicholas: In a way, I think it was the part of me that wasn’t changed that led to this book: I had stupid questions about babies in the same way I have stupid questions about everything else. (It’s a personality flaw.) I didn’t see why I had to think of babies as simply problems to be solved. Most baby books have what I think of as the leaky faucet approach: if your baby is dripping, we recommend this socket wrench. And there were many, many times when all I wanted was that socket wrench. But I also thought babies were interesting subjects all on their own. I wanted a book that acknowledged that. And I wanted a book that was wide-angled. The study of infancy is highly compartmentalized: the different disciplines don’t talk to each other. The few good books about babies tend to be highly focused: they look at babies through the lens of a cognitive scientist, say, or a developmental psychologist. But there are so many lenses out there! It seemed a shame to only see a baby as like this or like that. There’s so much left outside the frame. So this book tries to show readers the many different versions of a baby that people have seen—and still see today.

It’s strange. You wouldn’t think that babies would be an obscure subject: they are everywhere. (In our highly fertile neighborhood, I sometimes feel like Hitchcock’s The Birds is being reenacted—but this time with babies.)  But they’ve been weirdly neglected. This is sort of hard to believe: any book about babies has to clear the high hurdle of being another damn book about babies. (Right? Like that’s what we need. Also, we totally need more diet books.) But I concluded that we really did need that. Babies are still strangers in our midst.

Alice: Your book focuses on four basic facts of infancy: “suck, smile, touch, toddle.” How did you choose these topics? Why not “eat, sleep, poop, cry,” for example?

Nicholas: I joke about this at the end of the book—that there’s so much going on in infancy I could easily have chosen spitting, shitting, screaming, sharing.

Part of why I went with these topics was that I actually wanted answers about them: I really wanted to know where a smile comes from and what a first smile might mean, for example. But I also thought these subjects had been overlooked. There’s been an enormous amount written on sleep, for very obvious reasons: any new parent is obsessed with sleep. But there’s very little written about smiling or walking. It’s the leaky faucet problem: because a smile can’t be fixed, no one writes about it. Continue reading

Sleep Deprivation: The Dark Side of Parenting

Sleep deprivation is an inevitable part of having a baby, and surely that’s been true throughout the history of our species. But we also live in a culture that seems to take some amount of pride in getting by on little sleep. We think of sleep as time wasted, as lost productivity. We forget – or ignore – the biological necessity of sleep.

Becoming a parent only further stretches our already-too-thin sleep allotments. Newborn babies wake frequently to feed or for comfort during the night. We try to “sleep when the baby sleeps” and piece it together to come up with a reasonable amount, but it often doesn’t feel sufficient. And now more than ever, new parents are really isolated as they make this transition; they don’t have much in the way of backup resources to help with the 24/7 job of caring for a baby.

This month, the theme of our Carnival of Evidence-Based Parenting is Transition to Parenthood. (See the bottom of this post for links to other Carnival posts and here for summaries of them all.) Sleep deprivation is a universal part of that transition. What does the sleep deprivation of early parenthood really look like? How does it affect us? And what can we do to mitigate it?

Just How Bad Is It?

For many moms, sleep debt actually begins in pregnancy, when sleep needs may increase but discomfort and frequent trips to the bathroom interfere with a full night’s sleep. But by far, the biggest change happens in the immediate postpartum period. One study found that in the first week of the baby’s life (compared with late pregnancy), moms got 1.5 hours less sleep, fragmented into three times more sleep episodes per day. The early postpartum period is also characterized by lots of day-to-day variability in sleep. Sleeping with a new baby means unpredictability, with little to no control over whether tonight will be a good night or a bad one.

Mothers usually get the majority of our sympathy when it comes to postpartum sleep deprivation, but the research shows that fathers’ sleep takes a hit, too. A study of 72 San Francisco couples welcoming their first baby compared sleep in the last month of pregnancy to sleep in the first month postpartum (around 20 days of life).  Across this time span, mothers lost an average of 41 minutes of nighttime sleep, while dads lost just 18 minutes. Moms, however, gained 30 minutes per day in daytime napping; dads didn’t get a nap bump at all. In fact, in this study, dads actually slept less than moms – both in late pregnancy and in the postpartum period. Moms still had it harder; they were waking more during the night and had more sleep fragmentation than dads (and it’s quite possible that moms need more sleep, what with recovery from childbirth and the demands of breastfeeding). But regardless, in this and other studies, moms and dads both reported a similar level of fatigue during the day.

There’s some good news to come out of this research, however. It seems that experienced moms are better at handling sleep in the postpartum period. Despite juggling more responsibility at home, studies show that moms who had given birth at least once before tended to get more sleep at all stages of pregnancy and in the postpartum period. Their sleep was also more efficient, meaning that of the time they spend in bed, they spend most of it sleeping rather than tossing and turning – or laying awake listening to the grunts and sighs of new baby sleep. Somehow, experienced moms seem to prioritize sleep more, or they’re just so tired that they crash hard at every opportunity.

How does sleep deprivation affect new parents?

We know a lot about the effects of sleep deprivation but actually very little about the specific type of crap sleep experienced by new parents. Most sleep deprivation studies have been conducted in residential labs, where participants (often young, probably resilient, undergrads) are generally paid to live for a few nights or maybe weeks so that their sleep habits can be controlled and monitored. In a review paper entitled “Sleep Disruption and Decline in Marital Satisfaction Across the Transition to Parenthood,” Gonzaga professor Anna Marie Medina and colleagues make an important point: Lab study participants know that they’ll be subjected to sleep deprivation for a finite amount of time, and they know they can even drop out if it becomes too much for them.

“Understanding that one can end a study, and being certain of the temporal parameters of potential sleep deprivation, imbues the experience of sleep loss with a level of controllability that new parents seldom have. That is, (most) new parents realize they cannot opt out of the sleep disruption experience, and they have no certainty about when they may have an opportunity for sufficient sleep. The stress literature has suggested that such uncontrollability could amplify the mood and physiological consequences of sleep deprivation.”

In other words, most of what we know about the effects of lost sleep may be even worse in new parents. On that happy note, there are a few major areas of concern… Continue reading