Objective To 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 setting Data 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.
Results Combined 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.
Conclusions Combined 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.
- regulatory problems
- sleeping problems
- feeding problems
- excessive crying
- parent–child relationship problems
- population study
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Contributors ALO conceptualised the study, drafted the initial manuscript, reviewed and revised the manuscript. JA carried out the initial analyses and reviewed and revised the manuscript. EMO carried out the final analyses and reviewed and revised the manuscript. AMS conceptualised and designed the study, critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding The study was supported by grants from the Tryg Foundation, and Mrs Herman’s Memorial Foundation.
Competing interests None declared.
Ethics approval The study has been presented for the Research Ethics Committee of the Capital Region of Denmark and has been approved by The Danish Data Protecting Agency (J.nr. 2010-54-1044).
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Not required.
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