Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2003 Feb;88(2):108–111. doi: 10.1136/adc.88.2.108

Preventing sleeping problems in infants who are at risk of developing them

M Nikolopoulou 1, J St 1
PMCID: PMC1719431  PMID: 12538307

Abstract

Aims: (1) To identify factors at 1 week of age which put infants at risk of failing to sleep through the night at 12 weeks of age. (2) To assess whether a behavioural programme increases the likelihood that these infants will sleep through the night at 12 weeks of age.

Methods: A community sample of 316 newborn infants was employed to identify the risk factors at 1 week of age which increased the likelihood of failing to sleep through the night at 12 weeks of age. Infants who met these risk criteria and were randomly assigned to a behavioural programme were compared with at risk infants in the control group on measures of sleeping, crying, and feeding at 12 weeks of age.

Results: Infants who had a high number (>11) of feeds in 24 hours at 1 week were 2.7 times (95% CI 1.5 to 4.8) more likely than other control group infants to fail to sleep through the night at 12 weeks of age. At 12 weeks, 82% of these at risk infants assigned to the behavioural programme, compared to 61% in the control group, slept through the night. The findings were similar in breast and bottle feeders.

Conclusions: Preventing infant sleeping problems should be more cost effective than treating them after they have arisen. This study provides evidence that it is possible to identify infants who are at risk of failing to sleep through the night at an early age, and that a simple, three step, preventive behavioural programme increases the number who sleep through the night by 21%.

Full Text

The Full Text of this article is available as a PDF (96.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anders T. F., Keener M. A., Kraemer H. Sleep-wake state organization, neonatal assessment and development in premature infants during the first year of life. II. Sleep. 1985;8(3):193–206. doi: 10.1093/sleep/8.3.193. [DOI] [PubMed] [Google Scholar]
  2. Bamford F. N., Bannister R. P., Benjamin C. M., Hillier V. F., Ward B. S., Moore W. M. Sleep in the first year of life. Dev Med Child Neurol. 1990 Aug;32(8):718–724. doi: 10.1111/j.1469-8749.1990.tb08432.x. [DOI] [PubMed] [Google Scholar]
  3. Barr R. G., Konner M., Bakeman R., Adamson L. Crying in !Kung San infants: a test of the cultural specificity hypothesis. Dev Med Child Neurol. 1991 Jul;33(7):601–610. doi: 10.1111/j.1469-8749.1991.tb14930.x. [DOI] [PubMed] [Google Scholar]
  4. Barr R. G., Kramer M. S., Boisjoly C., McVey-White L., Pless I. B. Parental diary of infant cry and fuss behaviour. Arch Dis Child. 1988 Apr;63(4):380–387. doi: 10.1136/adc.63.4.380. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bernal J. F. Night waking in infants during the first 14 months. Dev Med Child Neurol. 1973 Dec;15(6):760–769. doi: 10.1111/j.1469-8749.1973.tb04911.x. [DOI] [PubMed] [Google Scholar]
  6. Carey W. B. Letter: Breast feeding and night waking. J Pediatr. 1975 Aug;87(2):327–327. doi: 10.1016/s0022-3476(75)80616-0. [DOI] [PubMed] [Google Scholar]
  7. Hewlett BS, Lamb ME, Leyendecker B, Schölmerich A. Internal Working Models, Trust, and Sharing among Foragers. Curr Anthropol. 2000 Apr;41(2):287–297. [PubMed] [Google Scholar]
  8. James-Roberts I. S., Conroy S., Wilsher K. Bases for maternal perceptions of infant crying and colic behaviour. Arch Dis Child. 1996 Nov;75(5):375–384. doi: 10.1136/adc.75.5.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Keener M. A., Zeanah C. H., Anders T. F. Infant temperament, sleep organization, and nighttime parental interventions. Pediatrics. 1988 Jun;81(6):762–771. [PubMed] [Google Scholar]
  10. MOORE T., UCKO L. E. Night waking in early infancy. I. Arch Dis Child. 1957 Aug;32(164):333–342. doi: 10.1136/adc.32.164.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Minde K., Popiel K., Leos N., Falkner S., Parker K., Handley-Derry M. The evaluation and treatment of sleep disturbances in young children. J Child Psychol Psychiatry. 1993 May;34(4):521–533. doi: 10.1111/j.1469-7610.1993.tb01033.x. [DOI] [PubMed] [Google Scholar]
  12. Morrell J. M. The role of maternal cognitions in infant sleep problems as assessed by a new instrument, the maternal cognitions about infant sleep questionnaire. J Child Psychol Psychiatry. 1999 Feb;40(2):247–258. [PubMed] [Google Scholar]
  13. Morris S., James-Roberts I. S., Sleep J., Gillham P. Economic evaluation of strategies for managing crying and sleeping problems. Arch Dis Child. 2001 Jan;84(1):15–19. doi: 10.1136/adc.84.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. PARMELEE A. H., Jr, WENNER W. H., SCHULZ H. R. INFANT SLEEP PATTERNS: FROM BIRTH TO 16 WEEKS OF AGE. J Pediatr. 1964 Oct;65:576–582. doi: 10.1016/s0022-3476(64)80291-2. [DOI] [PubMed] [Google Scholar]
  15. Pinilla T., Birch L. L. Help me make it through the night: behavioral entrainment of breast-fed infants' sleep patterns. Pediatrics. 1993 Feb;91(2):436–444. [PubMed] [Google Scholar]
  16. Ramchandani P., Wiggs L., Webb V., Stores G. A systematic review of treatments for settling problems and night waking in young children. BMJ. 2000 Jan 22;320(7229):209–213. doi: 10.1136/bmj.320.7229.209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Scott G., Richards M. P. Night waking in 1-year-old children in England. Child Care Health Dev. 1990 Sep-Oct;16(5):283–302. doi: 10.1111/j.1365-2214.1990.tb00662.x. [DOI] [PubMed] [Google Scholar]
  18. St James-Roberts I., Sleep J., Morris S., Owen C., Gillham P. Use of a behavioural programme in the first 3 months to prevent infant crying and sleeping problems. J Paediatr Child Health. 2001 Jun;37(3):289–297. doi: 10.1046/j.1440-1754.2001.00699.x. [DOI] [PubMed] [Google Scholar]
  19. Zuckerman B., Stevenson J., Bailey V. Sleep problems in early childhood: continuities, predictive factors, and behavioral correlates. Pediatrics. 1987 Nov;80(5):664–671. [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

[Web-only Tables]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES