Dream feeding: An evidence-based guide to helping babies sleep longer

Dream feeding: An evidence based guide to helping babies sleep longer

© 2018 GWEN DEWAR, PH.D., ALL RIGHTS RESERVED

Dream feeding has been defined as the practice of feeding a sleeping infant, with the aim of encouraging the baby to sleep longer.

The term has also been used to describe any big meal (delivered during sleep or waking) that is timed to occur immediately before the parent falls asleep.

Are these measures helpful?

There is reason to think they could provide you with more time to sleep uninterrupted.

However, dream feeds by themselves probably play only a modest role in infant sleep development. To promote mature sleep patterns, the most promising approach is to combine dream feeds with other sleep-friendly practices.

Here is an overview of the subject -- the definitions, the evidence, the pros and cons, and frequently asked questions.

What exactly is dream feeding?

Tracey Hogg, who first coined the term, defines dream feeding as feeding a young infant while he or she sleeps.

To accomplish this, you gently hold your sleeping baby in a feeding position, and try to stimulate the rooting reflex by stroking your baby's mouth and offering your baby a breast or bottle. Many babies can feed in this way without waking up (Hogg and Blau 2005).

But some people use the term "dream feed" differently.

For instance, in a blog post, Harvey Karp makes reference to deliberately awakening an infant: "Dream feeding is when you wake your baby to feed one more time before you turn in for the night" (Karp, n.d.).

Others use the label "dream feed" to describe any attempt to get your baby to "tank up" before you yourself go to bed. Whether the baby is asleep or awake is unspecified. What's crucial is that the meal happens just before the parent falls asleep.

And that's the common denominator for all these definitions -- the idea of getting a baby to take in a big meal before you doze.

The scientific argument for dream feeds

Newborns awaken easily and frequently, in part because they are hungry. If you begin sleeping shortly after your baby has "tanked up," you may get a bit more time before your baby awakens again. 

And every bit helps, especially if it enables you to sleep uninterrupted for at least 4 hours.

Our brains are designed to prioritize the most restorative stage of sleep -- NREM3, or deep, slow wave sleep -- during the first few sleep cycles of the night. So if you could protect only one portion of your nightly sleep bout from interruptions, it should be the first 4-5 hours of sleep.

In the days immediately after childbirth, achieving this ideal state is impossible for many parents. If that's your situation, you should take heart: When people are seriously sleep-deprived -- suffering a big deficit of NREM3 -- their brains often respond by increasing the intensity of short naps. 

If you can grab a couple of 30-minute naps during the day, you may come away with enough NREM3 to counteract many of the adverse effects of sleep deprivation (Farout et al 2015).

But getting your baby to sleep longer -- to experience at least one, 4-5 hour sleep bout that begins around your own bedtime -- can make your life easier. It will give you the opportunity to secure the most essential, minimum amount of sleep you need to maintain well-being. And it may be an important step towards mature, nighttime sleep patterns for your baby.

But does dream feeding work? Does it actually lead to longer infant sleep bouts?

Father provides bottle for dream feeding infant

Many parents who have tried it have the impression that it works. As the weeks go by, their babies sleep in longer, more consolidated bouts. 

But of course we'd expect that to happen anyway. When all goes well, young infants develop more consolidated sleep patterns at night.

To establish that dream feeding is helpful, we need controlled, randomized experiments -- studies designed to test the specific effects of "tanking up."

Unfortunately, such research is lacking.

For example, one randomized study tracked the effects of a comprehensive sleep education program on approximately 125 families with young infants. Compared with the control group, these babies appeared to sleep longer at night (Paul et al 2016).

The education program included instructions for giving dream feeds to newborns, but it also featured more than 20 additional recommendations, including tips for swaddling, using pacifiers, using white noise, implementing bedtime routines, avoiding overstimulation, and allowing infants time to self-soothe. 

Which of these tactics were responsible for sleep improvements?  We can't be sure.

That leaves us with a much smaller study that tested dream feeds as part of a three-component intervention. In this study, researchers randomly assigned 13 parents to employ all three of these practices:

  1. Administer a big feed to newborns sometime between 10pm and midnight. 
  2. Gradually lengthen intervals between night feedings by first "carrying out alternative caretaking behaviors" like reswaddling, diapering, and walking.
  3. "Maximize environmental differences between day and nighttime" by minimizing infant exposure to social stimulation and artificial light at night. 

At eight weeks postpartum, all 13 of the parents who had carried out this three-part strategy reported that their babies were sleeping quietly each night between midnight and 5am. 

By contrast, only 3 of the 13 parents in the control group reported this milestone (Pinilla and Birch 1993).

So there's reason to think that the intervention was helpful, but we don't know how much of the outcome was caused by dream feeding. Independent studies suggest that the other two tactics used (#2 and #3) can help babies develop more mature sleep patterns. It's therefore likely that dream feeding was just one of several contributing factors.

Weighing the pros and cons of dream feeding: A good bet for most families, especially when combined with other sleep-friendly practices

The fact that nobody yet has conducted a proper test of dream feeding -- a randomized, controlled experiment designed to isolate its effects on family sleep outcomes -- shouldn't deter you from trying it. 

It might be helpful, and there's no reason to think it could hurt -- not if your baby is getting enough to eat overall, and not if you avoid waking your baby. 

If you are waking your baby each night to feed, then we have to wonder: Could these parent-initiated night wakings interfere with the development of consolidated, nighttime sleep? The question hasn't been tested by rigorous experiments, so we don't yet know.

But if you administer the big feed when your infant is already awake -- or find that you can feed your sleeping infant without awakening him or her -- it seems you have nothing to lose by trying. Overall, the pros and cons look like this:

Pros

  • The post-feed sleep bout may last longer than usual, giving you more opportunity to grab some of that NREM3 sleep. Even an extra half hour could have an important impact on your health and well-being.
  • In combination with other tactics -- like protecting your baby from artificial lights at night -- the practice might help speed up the development of more mature nighttime sleep patterns. 

Cons

  • The tactic is inappropriate for babies who are underweight, or otherwise not thriving. Consult your pediatrician before attempting. 
  • If you regularly awaken your baby to administer a feed, you might be reinforcing your baby's tendency to wake frequently -- making it harder for your baby to develop more consolidated sleep patterns as time goes by.

Other questions

What if you try it, and it doesn't work?

Hunger isn't the only reason that babies awaken. Sleep research confirms that everyone experiences many, partial wakings during the night, and babies are no exception. In fact, for young babies, these arousals may help reduce the risk of sudden infant death syndrome, or SIDS.

So if your baby isn't sleeping for 5 hours straight at 8 weeks of age, that might make your life a lot harder, but it isn't unusual; nor is it a sign that something is wrong with your infant. As I explain in this article, there is a lot of individual variation in baby sleep patterns. Some babies sleep longer and more soundly than others.

And when you hear other parents bragging about the baby who "sleeps through the night," keep in mind: This isn't a super-baby who never wakes up. What's really happening is that the infant is keeping relatively quiet during night wakings, and falling back to sleep on his or her own.

That's your ultimate goal -- to help your baby learn this skill. "Tanking up" might make it easier, but it's probably just one factor among many. To cover your bases, combine dream feeds with a variety of other, well-supported tactics (like the ones mentioned above). If dream feeding is hard to implement, and doesn't seem to be working for you, give it a pass.

When should a parent stop dream feeding?

That's another one of those questions that hasn't been addressed by controlled scientific studies, and unfortunately, there is a lot of conflicting advice.

For instance, some recommend that dream feeds should stop after your baby is 16 weeks old (Paul et al 2016). Others, like Tracey Hogg, suggest that "tanking up" can remain useful until your baby is 6 months old (Hogg and Blau 2005).

Perhaps some of the disagreement stems from the different definitions that people use. People who argue for ending the practice early may be concerned about the effects of deliberating waking your sleeping baby at night to feed. That isn't an issue for Hogg, because she's talking about feeding a baby while it sleeps.

Is it necessary to burp your baby after feeding?  

It's hard to make generalizations that apply to everyone. Different babies may have different quirks and needs.  But overall, there is little evidence that burping a baby after a meal is beneficial.

In a controlled study of more than 70 mother-infant pairs, researchers found that burping had no impact on symptoms of infantile colic. And babies randomly assigned to the burping treatment actually showed an increased tendency to regurgitate afterwards (Kaur et al 2015).

So it seems best to avoid burping after a dream feed. You risk waking your baby up for a procedure that might be unnecessary, perhaps even counter-productive.

What about changing your baby's diaper?

If you baby is already awake, and has a soiled diaper, changing it is a good idea. But what if your baby is asleep? Should you change your diaper now -- in order to prevent him or her from awakening later?

Probably not, because experiments suggest that babies will happily sleep through a wet diaper (Zotter et al 2007). 

More information about baby sleep

For more tips about helping infants sleep, see these articles about newborn sleep, baby sleep patterns, and solving infant sleep problems.

In addition, consult this infant sleep chart for information about the normal range of infant sleep behavior -- including the timing of milestones. And read more about infant feeding here.


References

Faraut B, Nakib S, Drogou C, Elbaz M, Sauvet F, De Bandt JP, Léger D. 2015. Napping reverses the salivary interleukin-6 and urinary norepinephrine changes induced by sleep restriction. J Clin Endocrinol Metab. 100(3):E416-26.

Karp H. no date. "What is dream feeding? And how do I do it?" [blog post] Retrieved from https://www.happiestbaby.com/blogs/blog/what-is-a-dream-feed-and-how-do-i-do-it on 5 June 2018.

Kaur R, Bharti B, Saini SK. 2015. A randomized controlled trial of burping for the prevention of colic and regurgitation in healthy infants. Child Care Health Dev. 41(1):52-6.

Hogg T and Blau M. 2005. Secrets of the Baby Whisperer. Ballantine.

Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Mindell JA, Birch LL. 2016. INSIGHT Responsive Parenting Intervention and Infant Sleep. Pediatrics. 138(1). pii: e20160762.

Pinilla T and Birch LL. 1993. Help me make it through the night: behavioral entrainment of breast-fed infants' sleep patterns. Pediatrics. 91(2):436-44.

Zotter H, Urlesberger B, Pichler G, Mueller W, Kerbl R. 2007. Do wet diapers induce arousals in sleeping infants? Acta Paediatr. 96(3):452-3.

Note to readers. The following study tried to test "tanking up" as part of a package of tactics, but for some reason the parents in this study failed to implement the tactic, so the results were not included in the text of this article:

St James-Roberts I, Sleep J, Morris S, Owen C, Gillham P. 2001. Use of a behavioural programme in the first 3 months to prevent infant crying and sleeping problems. J Paediatr Child Health.  37(3):289-97.

Image credits

Image of breasfeeding newborn by danielpeinado.photo / flickr

Image of father feeding infant by Nate Davis / flickr



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