Excessive crying at 3 months of age and behavioural problems at 4 years age: a prospective cohort study
Iná S Santos1, Alicia Matijasevich2, Marcelo F Capilheira1
1Post-graduate Program in Epidemiology, Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Insights
Excessive infant crying is linked to later behavioral issues. This study in a middle-income country found crying babies had a higher risk of clinical behavioral problems at age four.
Area of Science:
- Developmental Psychology
- Pediatrics
- Epidemiology
Background:
- Excessive infant crying is linked to behavioral problems in high-income countries.
- Research on this association in low- and middle-income countries is limited.
Purpose of the Study:
- To investigate the association between excessive infant crying and behavioral problems in a middle-income country.
- To assess the long-term impact of early infant crying on child behavior.
Main Methods:
- The 2004 Pelotas Birth Cohort study followed 4231 children.
- Infants were classified as 'crying babies' at 3 months if mothers perceived excessive crying.
- Child behavioral problems were assessed using the Child Behavior Checklist (CBCL) at 48 months.
Main Results:
- 11.9% of infants were classified as excessive criers at 3 months.
- Excessive criers showed higher proportions of clinical range behavioral problems at 4 years (31.2% total, 12.9% internalizing, 37.5% externalizing).
- After adjusting for confounders, excessive crying was associated with increased risk for total (OR=1.34), internalizing (OR=1.55), and externalizing (OR=1.29) problems.
Conclusions:
- Excessive infant crying is a potential risk factor for behavioral problems in early childhood.
- Findings highlight the importance of addressing infant crying in public health initiatives in middle-income settings.
Background:
Excessive crying in early infancy has been associated with behavioural problems among preschool children from high income countries but studies in low income and middle income countries are scarce.
Methods:
The 2004 Pelotas Birth Cohort is a population-based study planned to enrol all live births occurring in Pelotas that year and comprises 4231 children who so far have been followed up at 3, 12, 24, 48 and 72 months of age. Several familial, maternal and child characteristics were gathered in every follow-up. At the 3-month follow-up, infants whose mothers perceived them as crying more than others of the same age were classified as 'crying babies'. Child behavioural problems were assessed through the Child Behavior Checklist (CBCL) applied to the mother at the 48-month follow-up. Crude and adjusted ORs with 95% CIs were calculated by logistic regression.
Results:
Prevalence of excessive crying at 3 months was 11.9% (10.9% to 13.0%). Among children with excessive crying at 3 months the proportion in the clinical range for CBCL total, internalising and externalising problems at 4 years of age was 31.2%, 12.9% and 37.5%, respectively, against 20.6%, 6.8% and 29.6%, respectively, among non-crying babies. After controlling for confounders crying babies presented increased risk of being in clinical range of CBCL total (OR=1.34; 1.03 to 1.74), internalising (OR=1.55; 1.09 to 2.21) and externalising problems (OR=1.29; 1.01 to 1.64) than infants without excessive crying.
Conclusions:
Excessive crying in early infancy may represent one important risk factor for developing behavioural problems in later phases of early childhood.
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