Previous studies have found that demand feeding produces better outcomes in terms of preterm babies’ growth and health; breastfeeding duration and exclusivity and infants’ psychological adjustment. Many current popular childcare books recommend feeding babies to a schedule, claiming that schedules lead to happier babies, lower levels of stress and fatigue for parents, and an easier experience of parenting. However, no large-scale study has previously examined the effects of schedule-feeding.
Researchers examined the relationship between feeding infants to a schedule and two sets of outcomes: mothers’ wellbeing and children’s longer-term cognitive and academic development. They used a sample of 10,419 children from the Avon Longitudinal Study of Parents and Children, a cohort study of children born in the 1990s in Bristol, UK.
Mothers were asked at 4 weeks whether their baby was fed on a regular schedule. A total of 7.2% of mothers reported that they always fed to a schedule, 23.4% tried to and 69.4% fed on demand. Maternal wellbeing indicators included measures of sleep sufficiency, maternal confidence and depression, collected when babies were between 8 weeks and 33 months. Children’s outcomes were measured by standardised tests at ages 5, 7, 11 and 14, and by IQ tests at age 8.
The researchers found that mothers who fed to a schedule scored more favourably on wellbeing measures apart from depression. However, schedule-fed babies went on to do less well academically than demand-fed babies. After controlling for a wide range of confounders, schedule-fed babies performed around 17% of a standard deviation below demand-fed babies in standardised tests at all ages 5-14, and 4 points lower in IQ tests at age 8 years. All differences in test scores between schedule- and demand-fed children were very highly significant (P < 0.001).
The researchers conclude that feeding infants to a schedule is associated with higher levels of maternal wellbeing, but with poorer cognitive and academic outcomes for children. They acknowledge that this is the first research on this issue and it is difficult at this stage to infer cause. It may be, for example, that the findings on maternal wellbeing arise from reverse causality — perhaps mothers who were getting more sleep or felt more confident were more likely to initiate and succeed in establishing a schedule. They recommend further research in order that the reasons behind the outcomes noted can be investigated.
Iacovou M and Sevilla A (2012) Infant feeding: the effects of scheduled vs. on-demand feeding on mothers’ wellbeing and children’s cognitive development. Eur J Public Health first published online March 14, 2012 doi:10.1093/eurpub/cks012