Link Between Regulatory Problems in Infants and Later Childhood Issues

Parents are often worried about excessive crying, disturbances of sleep and feeding problems in their children. Such problems are collectively called regulatory problems. The present review is an analysis of the studies that have been done to investigate the relationship between prolonged and excessive regulatory problems in babies and the incidence of behavioral disturbances in them at a later age. This meta-analysis suggests that children with regulatory problems as babies are prone to have behavioral problems later in childhood.

Excessive crying without any apparent reason, failure to sleep throughout the night, and a lack of appetite are the common complaints that parents report to pediatricians. About 20 percent of all infants are reported to have such problems. Some studies have shown that children who have these problems often end up developing several behavioral problems. The present review analyzed studies that assessed the relationship between regulatory problems and behavioral disturbances, namely, anxiety-depression behavior, aggressive-destructive behavior, attention deficit hyperactivity disorder (ADHD), and general behavioral problems. Anxiety-depression behavior is an “internalizing behavior,” in which a child withdraws from most of his activities. Aggressive-destructive behavior is an externalizing problem where a child throws frequent temper tantrums. Children suffering from ADHD are inattentive and hyperactive. Apart from performing a behavioral study, the authors of this meta-analysis also looked at the risk factors such as negative parent-child interaction, depression in the mother, and social problems in a family that are responsible for inducing abnormal behavior in children.

A thorough search was done via Google Scholar, PubMed and PsycInfo databases to obtain articles on regulatory problems and abnormal behaviors in children. This review selected 22 studies conducted between 1987 and 2006. Out of these 22 studies, 10 were done to evaluate the effects of excessive crying, four were concerned with sleeping problems, three focused on feeding problems, and five were performed to investigate the long-term effects of multiple regulatory troubles. The average age of the infants analyzed was 5.2 months, and the follow-up period varied from 1.3 to 10 years. This study included 16,848 children, out of which 1,935 had some form of regulatory problem. The association between regulatory problems and abnormal behavior was assessed. Risk factors such as the growth of a child in problem-facing families were also noted.

Data/Results/Key findings
* It was found that “children with previous regulatory problems had more behavioral problems in childhood than controls.” Such problems were more likely to be associated with excessive crying. Feeding problems were associated the least with ill effects on behavior.
* Externalizing problems and ADHD were the most common behavioral problems observed in children who had regulatory problems in infancy.
* The incidence of behavioral problems was more frequent in children who grew up in problem-facing families.

Shortcomings/Next steps
The studies included in the present review were highly diverse and therefore comparing these studies with one another is difficult. Most of the studies used a “Child Behavior Checklist” to assess behavioral problems in children. The legitimacy of anxiety/depression score of this checklist is questionable. Although different regulatory problems coexist, most of the studies included in the present review concentrated on a single problem.

This review has proved that excessive crying, sleeping problems, and feeding problems in infants are associated with various behavioral problems in childhood. Hence, to decrease the occurrence of behavioral abnormalities such as ADHD and externalizing behaviors in children, the regulatory problems must be controlled early, preferably in infancy itself. Many studies have stressed on improvements in the behaviors and sensitivity of parents to reduce regulatory problems in infants. Hence, there is an urgent need to introduce programs aimed at improving parent-infant relationships. Further studies that consider multiple regulatory problems simultaneously and assess their relationship with various behavioral disturbances in childhood are necessary.

For More Information:
Associations between Problems with Crying, Sleeping and/or Feeding in Infancy and Long-term Behavioral Outcomes in Childhood: A Meta-Analysis
Publication Journal: Archives of Disease in Childhood, 2011
By Mirja Helen Hemmi; Dieter Wolke; University of Basel, Switzerland; University of Warwick, Enland

* FYI Living Lab Reports are a summary of the original report.

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