1. Introduction
sleepiness, excessive sleepiness
RESPIRATORY INFECTIONS, LATE PREGNANCY, SECONDARY, EXCESSIVE SLEEPINESS, REGRESSION, EXCESSIVE SLEEPINESS
Breastfeeding rates fall short of public health goals, but barriers are poorly understood. We examined whether excessive sleepiness during pregnancy and the postpartum period was associated with breastfeeding intentions, attitudes, initiation, and continuation in a tobacco-exposed sample participating in a randomized controlled trial to reduce smoke exposure (n = 399). We used the Epworth Sleepiness Scale (ESS) to examine associations between excessive sleepiness in early (12–16 weeks gestation) and late (32 weeks gestation) pregnancy and at 6 months postpartum, with breastfeeding attitudes using the Mitra index, intentions, initiation, and continuation, as well as other infant feeding practices using the Infant Feeding Questionnaire. Logistic regression models adjusted for age, racial/ethnic identity, parity, marital status, and maternal education showed that excessive sleepiness in late pregnancy was associated with less favorable attitudes toward breastfeeding. In addition, in unadjusted models, excessive sleepiness at 6 months postpartum was associated with less of a tendency to use feeding to calm a fussy infant. Excessive sleepiness was not associated with intent, initiation, or continuation of breastfeeding. Assessing excessive sleepiness in late pregnancy may assist in identifying individuals with negative attitudes to breastfeeding and lead to novel approaches to promoting breastfeeding in populations with lower breastfeeding rates.Breastfeeding is associated with a decreased risk of infant and child respiratory infections [One factor that may be associated with breastfeeding but has not been thoroughly researched is maternal sleep. A few studies examining how breastfeeding impacts maternal sleep duration found that exclusive breastfeeding is associated with decreased sleep duration [The purpose of this secondary data analysis is to explore associations between maternal sleepiness and breastfeeding. Beyond being the first to examine this relationship, this analysis addresses additional gaps in the breastfeeding sleep literature. First, while one study found that poor sleep quality during pregnancy is associated with lower rates of breastfeeding initiation [