Predictors of crying, feeding and sleeping problems: a prospective study

Child Care Health Dev. 2011 Jul;37(4):493-502. doi: 10.1111/j.1365-2214.2010.01201.x. Epub 2011 Feb 7.


Background: Infant regulatory problems, that is, excessive crying, feeding and/or sleeping difficulties, are precursors of adverse development. However, the aetiology of regulatory problems is still unclear. The aim of this study was to investigate pre-, peri- and post-natal neurophysiological and psychosocial predictors of single and multiple regulatory problems at 5 months of age.

Methods: This prospective longitudinal study included all children born at neonatal risk in a geographically defined area in southern Germany. The data of n = 5093 singleton infants (83.6%) were analysed using crude and multivariate logistic regression analyses. As outcome measures we used single and multiple regulatory problems, that is, crying, feeding and/or sleeping difficulties at 5 months of age, which were assessed via a standardized interview with the parents by study paediatricians as part of a neurodevelopmental examination.

Results: In total, 30.7% of the sample suffered from single or multiple regulatory problems at 5 months. Breastfeeding increased the odds of single sleeping problems 5.12-fold, but decreased the odds of single feeding problems [odds ratio (OR) 0.51; 95% confidence interval (CI) 0.35-0.74]. Very preterm birth was predictive of single feeding (OR 1.79; 95% CI 1.25-2.55) and multiple regulatory problems (OR 2.03; 95% CI 1.19-3.46), and foetal abnormalities increased the odds of single feeding and multiple regulatory problems from 1.53- to 1.64-fold. Family adversity and psychosocial stress factors were associated with single crying and multiple regulatory problems.

Conclusions: Pre-, peri- and post-natal neurophysiological and psychosocial factors are predictive of single and multiple regulatory problems. The results may be useful in terms of early recognition of at risk groups for regulatory problems.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding* / adverse effects
  • Child Development*
  • Crying*
  • Epidemiologic Methods
  • Feeding Behavior*
  • Feeding and Eating Disorders / epidemiology
  • Female
  • Germany / epidemiology
  • Humans
  • Infant
  • Infant Behavior*
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Male
  • Prospective Studies
  • Sleep Wake Disorders / epidemiology