Professor, Department of Family and Social Medicine
I conduct research on pediatric sleep and parent-child interventions. My research on early childhood sleep problems includes cohort analyses of >11,000 children, in which behavior difficulties at 7 years (Pediatrics, March 2012) and special education at 8 years (Pediatrics, Sept. 2012), were linked to having had sleep problems prior to 5 years. I have extensive experience with clinical trials of anticipatory guidance- sleep, breastfeeding, bottle-weaning, oral health, and child maltreatment.
Currently, I am the Principal Investigator (pending NoA) or "Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach." This NIH-funded R01 This study aims to empower families in early childhood programs with the knowledge and self-management skills needed to obtain healthy sleep via interpersonal, organizational, community, and policy level interventions. A stepped wedge cluster randomized trial in Head Start will test effects upon child, parent, and classroom outcomes; a policy evaluation will assess the impact of knowledge translation strategies.
I have managed all phases of large-scale NIH, R01, and R01-equivalent studies. I have led formative research to create materials for low-income and racial/ethnic minority families. My bottle-weaning trial, e.g., created a parent brochure, educational flipchart, and video, as we propose here. I have a proven ability to recruit/retain participants, and to collect process, fidelity, and outcomes data. My R01 breastfeeding promotion trial(s), e.g., enrolled ≈1,000 pregnant women, with 95% follow-up at 6 months post-partum. I am the author of 70 peer-reviewed manuscripts.
Peer Review Publications: Recent (since 2012) and Selected (from > 70)
Bottles as Early Risk for Overweight: Pilot and Epidemiological Research
Bottles have long been implicated in early childhood caries (ECC). Their design (soft nipples, non-spill) promotes at-will consumption of liquids, beverages and foods containing fermentable carbohydrates (e.g. juice drinks, milk, and starches) that promote ECC. The same facets of the bottle that promote ECC, can also promote intake of excess calories. I led several pilot studies and analyses of NHANES data to explore this link. Our work affirmed such a link, later found by other researchers.
Bottle-Weaning RCT: Effects on Bottle-Use, Dietary Intake, and Weight
Using the above work as the foundation, I designed and obtained funding to conduct an RCT of a bottle-weaning intervention, based in the WIC program (nutrition voucher and counseling program for low-income pregnant and parenting women, and their children up to age 5 years). The trial enrolled children at 12 months of age, who were drinking 2+ non-water bottles/day. This 1-time, WIC clinic based intervention led to a sharp decline in use of bottles and caloric intake, but did not result in fewer children being < 85% weight-for-length. The intervention group’s increased use of sippy cups may have attenuated an effect upon overweight.
Breastfeeding Promotion: Randomized Controlled Trials
Though breastfeeding’s benefits are well known, few women breastfeed for as long or as exclusively as recommended. This is especially true for racial/ethnic minority and low-income women; my breastfeeding promotion research focuses on this population. My first trial of a lactation consultant intervention was reported in Pediatrics in 2005. I then refined the intervention and follow-up strategies for two NIH-funded trials that integrated lactation consultants into routine prenatal and hospital care. These interventions yielded 3-folded increases in exclusive and high intensity breastfeeding- far surpassing effects reported in USPSTF and Cochrane reviews (Amer. J. Public Health 2014) and the AHRQ Health Care Innovations Exchange.
Pediatric Sleep: Effects of Problem Sleep and Sleep Education
My work on pediatric sleep includes cohort analyses of >11,000 children, in which behavior difficulties at 7 years (Pediatrics, March 2012) and special education at 8 years (Pediatrics, Sept. 2012), were linked to having had sleep problems prior to 5 years. My 2014 paper established that short sleep duration and sleep- disordered breathing in early childhood are robust, independent predictors of obesity through 15 years of age (J Pediatrics). I am excited to implement my anticipated R01 funded by NICHD: “Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach” (score= 15, percentile= 3rd), which includes a stepped wedge randomized controlled trial (individual & interpersonal); classroom outcomes (organizational); local outreach/education (community) and knowledge translation (policy).
Peer Review Manunscripts: Selected from > 70
Pediatric Sleep Research
Child Maltreatment: Attachment-Based Interventions
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NPR’s Shots blog interviews Dr. Karen Bonuck about her study that found lack of sleep and sleep-disordered breathing doubled kids’ risk for obesity.
Is ADHD caused by bad sleep? U.S. News & World Report interviews Dr. Karen Bonuck about her research linking nighttime breathing and ADHD.