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A Brief Parental Education for Shaping Sleep Habits in 4-Month-Old Infants

Institute of Behavioral Health, 3-29-11 Ishizaka, Dazaifu-city, Fukuoka 818-0118, Japan and The Association for Preventive Medicine of Japan, 1-19-10 Mohri, Kouto-ku, Tokyo 135-0001, Japan

Chifumi Sato, MD, PhD

Department of Analytical Health Science, Graduate School of Health Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

Noriko Nishino, MD

Kashiigaoka Rehabilitation Hospital, 2-24-36 Shimobaru, Higashi-ku, Fukuoka-city, Fukuoka 810-0073, Japan

Fumitake Ohryoji, MD

Center for Public Health and Welfare, Chuo-ku, Fukuoka 2-5-1-6F Maiduru, Chuo-ku, Fukuoka-city 810-0073, Japan

Junko Hayama, MA

Institute of Behavioral Health, 3-29-11 Ishizaka, Dazaifu-city, Fukuoka 818-0118, Japan and Institute of Comparative Studies of International Cultures and Societies, Kurume University, 1635 Mi-machi, Kurume-city, Fukuoka 839-8502, Japan

Toshiko Yamagami, MD, PhD

Sawara Hospital, 2-2-50 Meinohama, Nishi-ku, Fukuoka-City, Fukuoka 819-0002, Japan

Corresponding author: Yoshiko Adachi, MD, PhD, 3-29-11 Ishizaka, Dazaifu-city, Fukuoka 818-0118, Japan, Tel: +81-92-919-5717, Fax: +81-92-928-9522, Email:a_ibh{at}ybb.ne.jp

Abstract

Objective: To examine the effectiveness of a simple behavioral intervention with an educational booklet on the modification of parenting behaviors and the prevention of sleep disturbance in 4-month-old infants.

Design: A prospective cohort design with cluster sampling controls in a primary care setting. Participants: A total of 136 mothers with 4-month-old infants who visited a local health check-up clinic and responded to the 3-month follow-up survey

Methods: An intervention group was provided with 10 minutes of group guidance and a simple educational booklet, and a control group was provided with standard education alone at health check-up. The 2 groups were questioned 3 months later by a survey sent by mail. Main measurements were parenting behaviors of mothers and night waking of infants.

Results: Two undesirable maternal behaviors that reinforce night waking in infants exhibited a significantly greater improvement in the intervention group than in the control group. "Feed or check diaper promptly" behavior and "hold and soothe immediately" behavior after "night waking" in the infant were significantly decreased in the intervention group. The efforts of mothers to promote favorable sleep patterns were encouraged in the intervention group but not in the control group.

Conclusions: On the basis of our findings, it is suggested that the deterioration of night waking in infants was prevented in the intervention group. Our results indicate that the proportion of infant night waking was significantly increased in the control group, while there was also a tendency toward an increase in the proportion of infants who woke frequently and cried. These infant behaviors were not changed in the intervention group at the 3-month follow-up stage.

Key Words: Infant • Sleep • Early intervention • Parenting education • Community health services