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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.”
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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“‘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]
In the citing paper
“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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Metadata
- 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 › Medicine › Pediatrics, Perinatology and Child Health › 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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