Nurturing care for early childhood sleep interventions with tailored care: the NEST Approach

Area of Science:

• Pediatrics
• Developmental Psychology
• Public Health

Background:

• Early childhood insomnia (ECI) affects 20-30% of children aged 6-36 months, representing the most prevalent sleep disturbance.
• Current interventions for ECI primarily focus on independent sleep via extinction-based behavioral methods.
• Broader socioecological factors, including caregiving quality and feeding practices, are often underemphasized in ECI management.

Purpose of the Study:

• To introduce a conceptual model for reframing Early Childhood Insomnia (ECI) interventions.
• To integrate the World Health Organization's Nurturing Care Framework (NCF) into ECI management strategies.
• To promote a holistic approach to sleep health within the broader caregiver ecosystem.

Main Methods:

• Development of a conceptual model based on the Nurturing Care Framework (NCF).
• Integration of NCF's five components (good health, adequate nutrition, safety and security, responsive caregiving, opportunities for learning) into sleep interventions.
• Outlining actionable strategies aligned with each NCF component.

Main Results:

• The proposed model views sleep health as integral to a broader caregiver ecosystem, moving beyond isolated behavioral problems.
• Breastfeeding is highlighted as a practice that supports all five NCF components.
• Responsive caregiving is identified as a key element supporting the other four NCF components, with sensory-motor nourishment and early learning opportunities promoting safety and self-regulation.

Conclusions:

• Reframing ECI interventions through the Nurturing Care Framework (NCF) offers a more comprehensive approach to managing infant sleep disturbances.
• The model provides guidance for researchers and practitioners, facilitating adaptation across diverse settings.
• Emphasizing socioecological influences and responsive caregiving can lead to improved sleep health outcomes for young children.