P012 Maternal and infant stress during a bedtime separation: a pilot RCT

Abstract

Abstract Background Behavioural sleep interventions to improve infant sleep disturbance commonly include extinction where an unwanted behaviour (night time crying) is periodically ignored. There have been conflicting findings regarding the impact of extinction methods on infant stress levels as measured with cortisol and as perceived by mothers and only one that measured cortisol at the time of the separation. This study aimed to compare a responsive method to extinction (controlled crying) and a control group evaluating subjective and objective stress for mother/infant dyads at the time of bedtime separation. Methods Mother/infant dyads were randomly allocated to behavioural sleep interventions (Responsive - n= 7, Controlled Crying - n=6 or Controls - n=4). Cortisol (two oral swabs on two nights at T2), maternal self-reported stress (Subjective Units of Distress - SUDS), and perceived infant distress (PIS) were compared over eight weeks. Correlations tested relationships between PIS, SUDS and infant cortisol levels. Mixed models analysis were used for cortisol analyses. Results There were no significant differences in cortisol levels between groups across time points but significant inter and intra-individual variability. Maternal stress was positively correlated with infant cortisol and PIS (p<0.05) and mothers in the Responsive group were significantly less stressed (p=0.02). Conclusion In this small sample, infant cortisol during bedtime separation was variable, elevated in all sleep interventions and not significantly different. Mothers were less stressed in the Responsive group. Findings indicate responsive methods are comparable to extinction and less stressful for mothers offering a possible gentler choice at bedtime separation.