title: Excessive crying beyond 3 months may herald other features of multiple regulatory problems.
abstract: OBJECTIVE
  To assess duration of excessive crying and its relation to sleep and eating disturbances in a population sample of infants.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Random digit-dialing survey, enrolling birth cohorts between 1999 and 2003, in Germany.
  
  
  METHODS
  Children aged 4 years and younger.
  
  
  METHODS
  Excessive crying, retrospectively ascertained according to modified Wessel's criteria, and duration of excessive crying.
  
  
  METHODS
  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.
authors.affiliation: Division of Pediatric Epidemiology at the Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich, Germany. prof.von.kries@gmx.de
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Helen
authors.initials: H
authors.lastname: Kalies
authors.forename: Mechthild
authors.initials: M
authors.lastname: Papousek
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003448:Crying / Q000502:physiology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology