Elsevier

Sleep Medicine Clinics

Volume 2, Issue 3, September 2007, Pages 363-375
Sleep Medicine Clinics

Infant Crying and Sleeping: Helping Parents to Prevent and Manage Problems

https://doi.org/10.1016/j.jsmc.2007.05.015Get rights and content

This article summarizes the current understanding of infant crying and sleeping problems, together with the implications of this understanding for services and research, with a focus on the first months of infancy.

Section snippets

Impacts and costs of infant crying and sleeping problems

Babies who cry a lot or are unsettled at night impact parents and health services in a variety of ways. First, because many parents find their baby's crying or sleep-waking behavior hard to manage, these problems are troublesome for parents and costly for health services. For instance, in a national survey, 74% of American parents of infants 4 to 9 months old reported discussing infant night waking and fussing with pediatricians [1]. In the United Kingdom, the professional time devoted to

Distinguishing infant crying from sleep-waking behaviors and infant from parental problems

Although crying and sleeping problems usually are not distinguished, they present differently, at different ages, often in different infants, and may well have distinct causes. Infant crying and parental concern about it peak at around 5 to 6 weeks of age, with most of the crying taking place in the daytime and particularly the evenings [9], [10], [11]. In contrast, infant “sleeping problems” occur mainly at night, after 3 months of age [12], [13]. Most babies wake at night for feeding in the

Infant colic and the infant crying peaks

Prolonged unexplained crying in early infancy traditionally has been attributed to gastrointestinal pain, as reflected in the term “infant colic” [27]. Recent studies have challenged this assumption and led to a reconceptualization.

First, although prolonged crying can be caused by food intolerance and other organic disturbances during the first 3 months, these factors are absent in 90% of cases [18], [19]. Furthermore, the evidence about the main organic conditions believed to cause

Infant sleeping and sleeping problems

Van Gelder [62] summarizes contemporary knowledge of sleep-wake mechanisms in adult mammals. There is extensive evidence that the brain's suprachiasmatic nucleus provides the biologic clock on which sleep-wake and other circadian cycles are based. Environmental stimuli, particularly the effects of light through the photoreceptors in the eye, can reset the clock. Other environmental stimuli are less well understood, but dynamic interplay between a variety of external and endogenous regulatory

Crying, sleeping, and other problems in infants over three months of age

Beyond 3 months of age, there is growing evidence of a third and at least partly distinct group of infants who have multiple disturbances rather than crying or sleeping problems alone. For example, von Kries and colleagues [21] found that infants more than 6 months of age who cried a lot were 6.6 times more likely than other infants to have sleeping problems and 8.9 times more likely to eating difficulties, according to parental reports. These infants also tend to have far poorer outcomes than

Implications for professionals: helping parents to manage infant crying and sleeping

There is a longstanding debate in the research and popular literature about the relative merits of forms of parenting that respond to babies' perceived needs, for example by breastfeeding on demand and cosleeping (often called “infant-demand” or “infant-led” care) and forms of parenting that seek to impose routines and constraints on babies' behavior (“routine-based,” “scheduled,” or “structured” care [85]). The evidence reviewed here goes some way toward explaining why this debate has

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