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Rüdiger von Kries, MD, MSc; Helen Kalies, MSc, MPH; Mechthild Papouek, MD

Arch Pediatr Adolesc Med. 2006;160:508-511.

Objective  To assess duration of excessive crying and its relation to sleep and eating disturbances in a population sample of infants.

Design  Cross-sectional study.

Setting  Random digit-dialing survey, enrolling birth cohorts between 1999 and 2003, in Germany.

Participants  Children aged 4 years and younger.

Main Exposures  Excessive crying, retrospectively ascertained according to modified Wessel's criteria, and duration of excessive crying.

Main Outcome Measures  Severe eating or sleeping problems at interview.

Results  The participation rate in the random digit-dialing survey was 62%. The analysis was confined to 1865 children with complete data. The observed prevalence for excessive crying ever was 16.3% (95% confidence interval [CI], 14.7-18.1), beyond 3 months 5.8% (95% CI, 4.8-6.9), and beyond 6 months 2.5% (95% CI, 1.9-3.3). Excessive crying only in the first 3 months did not increase the prevalence of sleep or eating disturbances whereas crying beyond 6 months did; prevalence of eating disorders was 19.1% (95% CI, 9.1-33.3) and prevalence of sleeping disorders was 12.8% (95% CI, 4.8-25.7) compared with 2.7% (95% CI, 1.9–3.6) and 3.6% (95% CI, 2.7-4.6), respectively, in children without excessive crying.

Conclusions  Persistence of crying beyond the first 6 months heralded a higher prevalence of eating or sleeping difficulties in children with excessive crying than in children without excessive crying. These parents should be offered support and counseling over a broader spectrum of features related to multiple regulatory problems.

Author Affiliations: Division of Pediatric Epidemiology at the Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich, Germany.

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