Use of Child Care Attenuates the Link Between Decreased Maternal Sleep and Increased Depressive Symptoms.

Journal Article (Journal Article)

OBJECTIVE: Sleep disruption is common among postpartum women and is linked with depression. Child care may alleviate parenting stress and protect new mothers against symptoms of depression. METHODS: Mothers from the NURTURE study, a birth cohort of 666 women of full-term infants, completed questionnaires during home visits when their infants were 3, 6, 9, and 12 months old. The Edinburgh Postnatal Depression Scale and the Perceived Stress Scale were used to measure depressive symptoms and stress, respectively. Mothers reported total nightly sleep duration for themselves and their infants, child care arrangements, marital status, and income. We used mixed-effects models adjusting for income, marital status, and child age to examine the indirect effect of infants' sleep on maternal mental health through mothers' sleep and assessed whether patterns differed depending on child care. RESULTS: Decreased maternal sleep mediated the association between infant sleep and maternal mental health. When infants slept 1 hour less than usual, mothers slept 7 fewer minutes (B = 0.19, 95% confidence interval [CI], 0.01 to 0.27) and reported more depressive symptoms (B = -0.27, 95% CI, -0.43 to -0.11) and stress (B = -0.33, 95% CI -0.58 to -0.09). Child care moderated the indirect effect; decreased maternal sleep was not associated with increased depressive symptoms (and was not a mediator) when mothers had child care (indirect effect = -0.001, 95% CI, -0.03 to 0.03). CONCLUSION: Use of infant child care reduced the link between maternal sleep and depressive symptoms. Regular access to child care may be a method to mitigate feelings of depression for new mothers.

Full Text

Duke Authors

Cited Authors

  • Armstrong, B; Weaver, RG; Beets, MW; Østbye, T; Kravitz, RM; Benjamin-Neelon, SE

Published Date

  • June 2022

Published In

Volume / Issue

  • 43 / 5

Start / End Page

  • e330 - e338

PubMed ID

  • 35075045

Pubmed Central ID

  • PMC9177505

Electronic International Standard Serial Number (EISSN)

  • 1536-7312

Digital Object Identifier (DOI)

  • 10.1097/DBP.0000000000001048


  • eng

Conference Location

  • United States