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Updated: Aug 9, 2026

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood
Published on: February 11, 2017
Excessive crying beyond 3 months may herald other features of multiple regulatory problems
Rüdiger von Kries1, Helen Kalies, Mechthild Papousek
1Division of Pediatric Epidemiology at the Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich, Germany. prof.von.kries@gmx.de
Objective:
To assess duration of excessive crying and its relation to sleep and eating disturbances in a population sample of infants.
Design:
Cross-sectional study.
Setting:
Random digit-dialing survey, enrolling birth cohorts between 1999 and 2003, in Germany.
Participants:
Children aged 4 years and younger.
Main Exposures:
Excessive crying, retrospectively ascertained according to modified Wessel's criteria, and duration of excessive crying.
Main Outcome Measures:
Severe eating or sleeping problems at interview.
Results:
The participation rate in the random digit-dialing survey was 62%. The analysis was confined to 1865 children with complete data. The observed prevalence for excessive crying ever was 16.3% (95% confidence interval [CI], 14.7-18.1), beyond 3 months 5.8% (95% CI, 4.8-6.9), and beyond 6 months 2.5% (95% CI, 1.9-3.3). Excessive crying only in the first 3 months did not increase the prevalence of sleep or eating disturbances whereas crying beyond 6 months did; prevalence of eating disorders was 19.1% (95% CI, 9.1-33.3) and prevalence of sleeping disorders was 12.8% (95% CI, 4.8-25.7) compared with 2.7% (95% CI, 1.9-3.6) and 3.6% (95% CI, 2.7-4.6), respectively, in children without excessive crying.
Conclusions:
Persistence of crying beyond the first 6 months heralded a higher prevalence of eating or sleeping difficulties in children with excessive crying than in children without excessive crying. These parents should be offered support and counseling over a broader spectrum of features related to multiple regulatory problems.
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