Nighttime feeding in Turkish children and its association with anemia

Metin Trabzon, Melih Abdullah Turunçkapı, Öner Özdemir, Melike Sultan Özgönenel, Damla İnce, Bülent Özgönenel

Department of Pediatrics, G?ztepe Research and Training Hospital, Istanbul, Turkey.
Department of Pediatrics, Okmeydan? Training and Research Hospital, Istanbul, Turkey.
Family Health Center of Ilgaz, ?ank?r?, Turkey.
Hematology/Oncology, Carman and Ann Adams Children’s Hospital of Michigan, Wayne State University, Detroit, USA.

DOI: 10.4236/ojped.2012.21011                

Abstract

Background: Children who continue to wake up at night to be fed after 6 months of age are called trained nighttime feeders. Nighttime feeding may be associated with dental and medical complications, in addition to causing sleep deprivation in children and parents, as well as with iron-poor nutrition. Methods: We surveyed 614 Turkish children aged 6 months to 5 years from three centers (2 urban and 1 rural) to determine the prevalence of nighttime feeding. We also sought to determine factors associated with continuation of nighttime feedings after 6 months of age. Results: Fifty percent of the participants were night- time feeders. Nighttime feedings were given once, twice, and three times or more to 19.9%, 15.6%, and 14.5% of the participants, respectively. The rural population had a higher rate of nighttime feeding (57.0% rural vs 46.6% urban, p = 0.016). 168 urban children (median age 25 months) had blood count data. Fifty percent of these children were given night-time feedings: 19.6% once, 17.9% twice, and 12.5% three times or more. Nighttime meals were breast-feeding in 51.2%, cow’s milk by bottle in 33.3%, and other in 15.5%. Mean hemoglobin level of nighttime feeders was significantly lower: 11.3 ± 1.3 g/dL vs 12.2 ± 1.0 g/dL in non-nighttime feeders (p < 0.001), even dropping to 10.8 ± 1.4 g/dL in those that were fed 3 times or more at night (p < 0.001). 31.0% of nighttime-feeders were anemic compared to 17.9% in those that did not receive nighttime feedings (p = 0.048). We also noted that intense nighttime feeding was associated with lower MCV (p < 0.001) and lower ferritin levels (p < 0.001). Conclusions: Nighttime feeding is prevalent among Turkish children, especially among the rural population. Nighttime feeding was also noted to be associated with anemia in this study. Nighttime feeding should be screened for and treated in children after 6 months of age.

Keywords

Survey; Nighttime Feeding; Pediatric Sleep Disorder; Anemia; Iron Deficiency

Conflicts of Interest

The authors declare no conflicts of interest.

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