{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:26:13Z","timestamp":1768343173398,"version":"3.49.0"},"reference-count":73,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T00:00:00Z","timestamp":1691020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Breastfeeding rates fall short of public health goals, but barriers are poorly understood. We examined whether excessive sleepiness during pregnancy and the postpartum period was associated with breastfeeding intentions, attitudes, initiation, and continuation in a tobacco-exposed sample participating in a randomized controlled trial to reduce smoke exposure (n = 399). We used the Epworth Sleepiness Scale (ESS) to examine associations between excessive sleepiness in early (12\u201316 weeks gestation) and late (32 weeks gestation) pregnancy and at 6 months postpartum, with breastfeeding attitudes using the Mitra index, intentions, initiation, and continuation, as well as other infant feeding practices using the Infant Feeding Questionnaire. Logistic regression models adjusted for age, racial\/ethnic identity, parity, marital status, and maternal education showed that excessive sleepiness in late pregnancy was associated with less favorable attitudes toward breastfeeding. In addition, in unadjusted models, excessive sleepiness at 6 months postpartum was associated with less of a tendency to use feeding to calm a fussy infant. Excessive sleepiness was not associated with intent, initiation, or continuation of breastfeeding. Assessing excessive sleepiness in late pregnancy may assist in identifying individuals with negative attitudes to breastfeeding and lead to novel approaches to promoting breastfeeding in populations with lower breastfeeding rates.<\/jats:p>","DOI":"10.3390\/nu15153435","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T11:13:06Z","timestamp":1691061186000},"page":"3435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Associations between Perinatal Sleepiness and Breastfeeding Intentions and Attitudes and Infant Feeding Behaviors and Beliefs"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7621-3545","authenticated-orcid":false,"given":"Tayla","family":"von Ash","sequence":"first","affiliation":[{"name":"Department of Behavioral and Social Science, Brown School of Public Health, Providence, RI 02903, USA"},{"name":"Center for Health Promotion and Health Equity, Brown School of Public Health, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Alikhani","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Social Science, Brown School of Public Health, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1743-0704","authenticated-orcid":false,"given":"Katherine M.","family":"Sharkey","sequence":"additional","affiliation":[{"name":"Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI 02906, USA"},{"name":"Department of Medicine, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Solano","sequence":"additional","affiliation":[{"name":"Brown University, Providence, RI 02912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Morales Aquino","sequence":"additional","affiliation":[{"name":"Brown University, Providence, RI 02912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-1931","authenticated-orcid":false,"given":"Patricia","family":"Markham Risica","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Social Science, Brown School of Public Health, Providence, RI 02903, USA"},{"name":"Center for Health Promotion and Health Equity, Brown School of Public Health, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1542\/peds.2004-2283","article-title":"Full breastfeeding duration and associated decrease in respiratory tract infection in US children","volume":"117","author":"Chantry","year":"2006","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"020416","DOI":"10.7189\/jogh.05.020416","article-title":"Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: Systematic review and meta-analysis","volume":"5","author":"Shi","year":"2015","journal-title":"J. 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