Preventing early infant sleep and crying problems and postnatal depression: A randomized trial
Abstract
OBJECTIVE: To evaluate a prevention program for infant sleep and cry problems and postnatal depression. METHODS: Randomized controlled trial with 781 infants born at 32 weeks or later in 42 well-child centers, Melbourne, Australia. Follow-up occurred at infant age 4 and 6 months. The intervention including supplying information about normal infant sleep and cry patterns, settling techniques, medical causes of crying and parent self-care, delivered via booklet and DVD (at infant age 4 weeks), telephone consultation (8 weeks), and parent group (13 weeks) versus well-child care. Outcomes included caregiver-reported infant night sleep problem (primary outcome), infant daytime sleep, cry and feeding problems, crying and sleep duration, caregiver depression symptoms, attendance at night wakings, and formula changes. RESULTS: Infant outcomes were similar between groups. Relative to control caregivers, intervention caregivers at 6 months were less likely to score >9 on the Edinburgh Postnatal Depression Scale (7.9%, vs 12.9%, adjusted odds ratio [OR] 0.57, 95% confidence interval [CI] 0.34 to 0.94), spend >20 minutes attending infant wakings (41% vs 51%, adjusted OR 0.66, 95% CI 0.46 to 0.95), or change formula (13% vs 23%, P < .05). Infant frequent feeders (>11 feeds/24 hours) in the intervention group were less likely to have daytime sleep (OR 0.13, 95% CI 0.03 to 0.54) or cry problems (OR 0.27, 95% CI 0.08 to 0.86) at 4 months. CONCLUSIONS: An education program reduces postnatal depression symptoms, as well as sleep and cry problems in infants who are frequent feeders. The program may be best targeted to frequent feeders.
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Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers.
“Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers.”
From Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving (2020) · cites this paper as [7]
Parental fatigue and sleep disruption can lead to the development of mood disorders in both mothers and fathers and exacerbate existing mental and physical health problems.
“There is also ample evidence that parental fatigue and sleep disruption can lead to the development of mood disorders in both mothers and fathers [3,5–8] and exacerbate existing mental and physical health problems [9,10].”
From Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving (2020) · cites this paper as [7]
'Limit-setting' educational approaches have been unsuccessful in achieving their primary outcome of increasing the duration of infant night-time sleep.
“but have been unsuccessful in achieving their primary outcome of increasing the duration of infant night-time sleep”
From Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving (2020) · cites this paper as [7]
'Limit-setting' educational approaches designed to support the development of 'settled infant night-time behaviour' have been examined as preventative interventions.
“‘Limit-setting’ educational approaches designed to support the development of ‘settled infant night-time behaviour’ have been examined as preventative interventions [7,24,26]”
From Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving (2020) · cites this paper as [7]
Hiscock et al. reported an odds ratio of .57 with regard to the prevention of maternal symptoms of depression in the intervention group.
“Hiscock et al. [67] reported an odds ratio of .57 with regard to the prevention of maternal symptoms of depression in the intervention group.”
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- Authors
- Hiscock, H., Cook, F., Bayer, J., Le, H. N., Mensah, F., Cann, W., Symon, B., & St James-Roberts, I.
- Affiliations
- Royal Children's Hospital (AU)
- Parenting Research Centre (AU)
- La Trobe University (AU)
- Deakin University (AU)
- The University of Adelaide (AU)
- Thomas Coram Research Unit, Institute of Education, University of London, United Kingdom
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2014-02-01
- Volume
- 133
- Issue
- 2
- Pages
- e346-e354
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2119074209
- Cited by
- 147
- References
- 41
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 9 · 2023: 6 · 2022: 13 · 2021: 7 · 2020: 22 · 2019: 17 · 2018: 12 · 2017: 12 · 2016: 17 · 2015: 11 · 2014: 4
- FWCI
- 34.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- infant sleep problems, infant crying, postpartum depression, prevention programs, parent education, infant feeding frequency, nocturnal awakenings, telephone consultation, well-child care
- MeSH terms
- Adult, Age Factors, Crying, Female, Humans, Infant, Infant, Newborn, Male, Sleep Wake Disorders, Depression, Postpartum
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