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Racial/ethnic differences in the contextual factors influencing infant sleep: a qualitative study


Sleep Medicine and Disorders: International Journal
Tayla Ash,1,2 Janae Best,3 Neha Khandpur,4,7 Susan Redline,5 Elsie M Taveras,6,7 Kirsten K Davison8

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Abstract

Objective: To qualitatively examine contextual factors contributing to differences in infant sleep across race/ethnicity. 
 
Method: We conducted semi-structured interviews with 37 mothers of 7-12-month-old infants across four strata: high-income white, low-income white, high-income Hispanic and/or black, and low-income Hispanic and/or black. Mothers were asked about influences on their infant’s daytime and nighttime sleep, including questions about feeding, sleep parenting, and their household structure. We used thematic analysis to analyze the data.
 
Results: We identified four unique themes of influences to infant sleep that varied by race/ethnicity: environmental influences, maternal stressors and supports, parenting approach or philosophy, and sleep parenting practices. Hispanic and black mothers were more likely to describe disruptions from environmental factors, state that their stress level impacted their infant’s sleep, put their infant to sleep later so that they could sleep later themselves, and be influenced by family tradition or specific cultural sleep parenting practices. Hispanic and black mothers were also more likely to engage in sleep parenting practices that have previously been associated with short sleep duration in infants (e.g. feeding infants to sleep, exposing infants to television), likely influenced by the broader context in which they parent.
 
Conclusion: Results from this study suggest that sleep interventions targeting black or Hispanic mothers of infants could target household stress and parenting practices as levers for improving infant sleep.

Keywords

sleep, infant, race/ethnicity, disparities, mothers

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