Maternal Sleepiness and Risk of Infant Drops in the Postpartum Period

In-Hospital Newborn Falls Associated With a Sleeping Parent: The Case for a New Paradigm

“…50 Fathers experienced higher levels of measured sleepiness than mothers and, in some instances, had a higher propensity for falling asleep than mothers. 43 In a study of sleepiness for in-hospital mothers after delivery, researchers found that the mothers slept, on average, 3.7 hours daily, 21 well below the 6 hours recommended by the National Sleep Foundation. Using a standardized, validated tool, the investigators found sleepiness scores peaked at 0400, with scores trending downward at 0700 to a level considered to be low risk.…”

“…Using a standardized, validated tool, the investigators found sleepiness scores peaked at 0400, with scores trending downward at 0700 to a level considered to be low risk. In the Bittle et al 21 study, 50% of the participant mothers experienced sleepiness that required interventions to ensure safe sleep conditions. They found mothers sleeping while holding their infants had higher median sleepiness scores and longer hours of sleep.…”

“…They found mothers sleeping while holding their infants had higher median sleepiness scores and longer hours of sleep. 21 In addition to extreme fatigue, the physiology of sleep underscores why parents are unable to stay awake during nighttime feedings. Sleeping at night is a normal physiologic response to circadian rhythms.…”

“…12,13,[16][17][18]20,25,28,29 In several studies, clinicians identified cases of sleeping mothers feeding or holding their infants when staff intervened before the infant fell. 7,13,16,18,21 The nuance that they had detected the mother after she fell asleep, instead of before she fell asleep (as intended), was not seen as an indicator of bundle failure. In the QI studies, the researchers interpreted the lack of an infant fall as proof of success.…”

“…12,16,18,25 The new mother had been informed not to sleep with her newborn, if only she had listened. Reinforcement about safe sleep practices was the most frequently recommended preventive strategy, 6,[11][12][13][14]17,21 and, so, for .1 decade, in the literature, it was declared that if the bundle was managed, this adverse event Lipkke et al 18 Ainsworth et al 13 Miner 25 Galuska 20 Hodges and Gilbert 17 Lahey et al 12 Hantske 16 Parental education was preventable. ‖‖ However, the data from the QI studies (Table 2) tell a different story.…”