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The impact of crying, sleeping, and eating problems in infants on childhood behavioral outcomes: A meta-analysis
Britta Galling1,2, Hannah Brauer2, Pia Struck3
1Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Insights
Infants with regulatory problems (RPs) like excessive crying or sleep issues have a higher risk of developing childhood behavioral issues. Early detection and support can promote parent-child relationships and prevent future problems.
Area of Science:
- Developmental Psychology
- Child Psychiatry
- Behavioral Science
Background:
- Regulatory problems (RPs) in infancy, including excessive crying, sleeping, and feeding difficulties, are increasingly linked to childhood behavioral issues.
- This meta-analysis investigates the strength and characteristics of the association between infant RPs and subsequent behavioral problems.
Purpose of the Study:
- To quantify the association between infant regulatory problems and the incidence and severity of behavioral problems in childhood.
- To examine differences in behavioral outcomes based on the type and number of RPs experienced in infancy.
Main Methods:
- A systematic literature search was conducted on PubMed/PsycInfo for longitudinal prospective studies.
- Included studies involved infants with RPs and follow-up assessments of behavioral problems (2-14 years).
- Meta-analysis, subgroup analysis, and meta-regression were used to analyze cumulative incidence and symptom severity.
Main Results:
- 30 studies with 34,582 participants were meta-analyzed.
- The cumulative incidence of behavioral problems in children with RPs was 23.3%.
- Infants with RPs showed significantly more pronounced behavioral problems compared to controls (SMD=0.381), especially those with multiple RPs.
Conclusions:
- Infant regulatory problems are associated with increased risks of externalizing, internalizing, and ADHD symptoms in childhood.
- While underlying factors remain unclear, early identification of infants with RPs can inform supportive interventions.
- Targeted support can enhance parent-child relationships and mitigate the development of behavioral problems.
Background:
There is increasing evidence that regulatory problems (RPs), such as excessive crying, sleeping or feeding problems in infancy, could be associated with the development of behavioral problems in childhood. In this meta-analysis we aimed to investigate the strength and characteristics of this association.
Methods:
A systematic literature search (PubMed/PsycInfo, until 15/08/2021) for longitudinal prospective studies of infants with RPs and at least one follow-up assessment reporting incidence and/or severity of behavioral problems was conducted. The primary outcomes were (i) the cumulative incidence of behavioral problems in children (2-14 years) with previous RPs and (ii) the difference between children with/without previous RPs with regard to the incidence and severity of externalizing, internalizing and/or attention-deficit/hyperactivity disorder (ADHD) symptoms. Additionally, we analyzed behavioral problems of children with previous single, multiple or no RPs and with respect to age at follow-up. Subgroup and meta-regression analyses were added.
Results:
30 meta-analyzed studies reported on 34,582 participants (nRP = 5091, ncontrol = 29,491; age: baseline = 6.5 ± 4.5 months, follow-up = 5.5 ± 2.8 years) with excessive crying (studies = 13, n = 1577), sleeping problems (studies = 9, n = 2014), eating problems (studies = 3, n = 105), any single (studies = 2, n = 201) or multiple RPs (studies = 9, n = 1194). The cumulative incidence for behavioral problems during childhood was 23.3% in children with RPs. Behavioral problems were significantly more pronounced in infants with RPs compared to healthy controls (SMD = 0.381, 95% CI = 0.296-0.466, p < .001), particularly with multiple RPs (SMD = 0.291, p = 0.018).
Conclusions:
Findings suggest that RPs in infancy are associated with overall behavioral problems (externalizing or internalizing behavior and ADHD symptoms) in childhood. Our data cannot explain linked developmental trajectories and underlying factors. However, detection of affected infants may help to adapt supportive measures to the individual familial needs to promote the parent-child-relationship and prevent the development of child behavioral problems from early on.
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