Problems of feeding, sleeping and excessive crying in infancy: a general population study

Abstract

ObjectiveTo study regulatory problems (RPs) of feeding, sleeping and excessive crying in infancy, and explore the influence of maternal mental health problems and parent–child relationship problems.Design and settingData were collected in the general child health surveillance delivered to infant families by community health nurses (CHNs). Information on CHNs’ assessments and conclusions were obtained on 2598 infants and merged with data from national registers. Descriptive statistics and logistic regression models were used to study RPs in early and late infancy, and the influences due to child, family and parent–child relationship problems.ResultsCombined RPs (C-RPs), defined as two or more simultaneous problems of feeding, sleeping or excessive crying, was identified in 2.9% and 8.6% of the population between age 2–6 and 8–11 months, respectively. Low maternal schooling and immigrant parents were associated with an increased risk of late C-RPs, but RPs in early infancy stand out as the main predictor of late C-RPs OR 3.4 (95% CI 1.8 to 6.6), and the effect of early maternal mental health problems and parent–child relationship problems seem to be mediated by early C-RPs.ConclusionsCombined problems of feeding, sleeping or excessive crying may exist throughout infancy independently of exposures to maternal mental health problems and parent–child relationship problems. The results indicate that infants with RPs exceeding age 2 months need special attention, in clinical as well as community settings. Suggested intervention includes specific guidance to the parents to help them understand and regulate their infant’s sensitivity and reactions.

Persistence of infant crying, sleeping and feeding problems: need for prevention

“…Confidence in the validity of associations is increased when other studies with different designs (cohort studies, community studies) and methods of recording RPs in different settings (eg, countries, health systems) produce consistent findings. First, the findings by Olsen et al 3 are consistent with previous studies that reported persistence of RPs from 5 to 6 months onwards as well as further dysregulation across childhood 4. Second, parenting is considered as a major influence on the developing infant’s behaviour regulation.…”

“…This persistence was found irrespective of early mental health problems or parent-child relationship problems, although these problems co-occur often with RPs. This study3 demonstrates that information on RPs and parenting can be recorded within the usual health setting by child nurses. The strength of the study is the large sample size (>2500 children) while limitations are that interobserver reliability could not be recorded and the nurses were observing and also actively intervening, possibly reducing persistence of RPs.…”

“…The findings by Olsen et al 3 indicate that those who have not mastered the postnatal adaptation in crying, sleeping and feeding in the first 2–3 months as outlined above are at increased risk to continue to show poor regulatory control.…”

“…The study by Olsen et al 3 investigated whether problems in regulating crying, sleeping or feeding in early infancy persist across the first year of life. Furthermore, they studied whether RPs and their persistence may be explained by infant factors such as sex, preterm birth or parenting factors such as maternal mental health and parent-child relationship problems.…”

Infant sleep and child mental health: a longitudinal investigation

“…Despite evidence suggesting that poor sleep in infancy is associated with poorer mental health during childhood, little high-quality research has been carried out to investigate this association further. Treating infant sleep problems within the first 12 months may prevent both later sleep problems and mental health difficulties during childhood,7 but we do not know whether infant sleep problems continue to be associated with mental health past the age of 5, or whether specific psychiatric diagnoses are more prevalent for this group.…”