The study objective was to investigate whether exclusively breast-fed infants could be taught to sleep through the night (defined from 12:00 AM to 5:00 AM) during the first 8 weeks of life. The design was shortterm longitudinal, from the last trimester of pregnancy until the eighth week after birth. Twenty-six first-time parents and their newborn were randomly assigned to treatment and control groups (13 in each group). Treatment parents were instructed to offer a "focal feed" (between 10 PM and 12 AM) to their infants every night, to gradually lengthen intervals between middle-of-the-night feeds by carrying out alternative caretaking behaviors (eg, reswaddling, diapering, walking), and to maximize environmental differences between day and nighttime. All parents kept 72-hour diaries of their infants' feeding and sleeping patterns every week from birth to 8 weeks of age and rated their infants' temperament at birth and at 8 weeks. By 3 weeks, treatment infants showed significantly longer sleep episodes at night. By 8 weeks 100% of treatment infants were sleeping through the night compared to 23% of control infants. Treatment infants were feeding less frequently at night but compensated for the relatively long nighttime interval without a feed by consuming more milk in the early morning. Milk intake for 24-hour periods did not differ between groups. Treatment infants were rated as more predictable on Bates' Infant Characteristics Questionnaire. It is concluded that parents can have a powerful influence on the development of their infants' sleep patterns. Frequent night waking in breast-fed infants often results in early termination of lactation. Parents can teach their breast-fed infants to lengthen their nighttime sleep bouts, making the continuation of breast-feeding easier for the new mother.
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