Prevalence, Stability, and Outcomes of Cry-Fuss and Sleep Problems in the First 2 Years of Life: Prospective Community-Based Study

To report the prevalence and stability of cry-fuss problems during the first 4 months of life and sleep problems from 2 to 24 months and relationships between the persistence of cry-fuss and sleep problems and outcomes at 24 months. The study was a prospective cohort study in maternal and child health centers in 3 local government areas in Melbourne, Australia. A total of 483 first-born infants were monitored prospectively from 2 weeks through 2, 4, 8, 12, 18, and 24 months. Child behavior, maternal depression, parenting stress, and marital quality were assessed. Predictor variables were parent reports of moderate or greater cry-fuss problems (2 and 4 months) and sleep problems (8, 12, 18, and 24 months) and parent-reported, 24-hour, sleep/cry-fuss diaries (2, 4, and 12 months). The response rate was 68% (483 of 710 infants); the attrition rate was or =3 of these ages. In multivariate analyses, cry-fuss/sleep problems at > or =3 previous time points (but not 1 or 2 time points) contributed significantly to depression (2.8% of variance), total behavior (1.4% of variance), and total stress (4.6% of variance) scores. Repeated problems had a greater impact than a concurrent sleep problem on depression and stress scores, whereas the reverse was true for behavior scores. Most cry-fuss and sleep problems in the first 2 years of life are transient. Persistent, rather than transient, problems contribute to maternal depression, parenting stress, and subsequent child behavior problems.