title: Preventing early infant sleep and crying problems and postnatal depression: a randomized trial.
abstract: OBJECTIVE
  To evaluate a prevention program for infant sleep and cry problems and postnatal depression.
  
  
  METHODS
  Randomized controlled trial with 781 infants born at 32 weeks or later in 42 well-child centers, Melbourne, Australia. Follow-up occurred at infant age 4 and 6 months. The intervention including supplying information about normal infant sleep and cry patterns, settling techniques, medical causes of crying and parent self-care, delivered via booklet and DVD (at infant age 4 weeks), telephone consultation (8 weeks), and parent group (13 weeks) versus well-child care. Outcomes included caregiver-reported infant night sleep problem (primary outcome), infant daytime sleep, cry and feeding problems, crying and sleep duration, caregiver depression symptoms, attendance at night wakings, and formula changes.
  
  
  RESULTS
  Infant outcomes were similar between groups. Relative to control caregivers, intervention caregivers at 6 months were less likely to score >9 on the Edinburgh Postnatal Depression Scale (7.9%, vs 12.9%, adjusted odds ratio [OR] 0.57, 95% confidence interval [CI] 0.34 to 0.94), spend >20 minutes attending infant wakings (41% vs 51%, adjusted OR 0.66, 95% CI 0.46 to 0.95), or change formula (13% vs 23%, P < .05). Infant frequent feeders (>11 feeds/24 hours) in the intervention group were less likely to have daytime sleep (OR 0.13, 95% CI 0.03 to 0.54) or cry problems (OR 0.27, 95% CI 0.08 to 0.86) at 4 months.
  
  
  CONCLUSIONS
  An education program reduces postnatal depression symptoms, as well as sleep and cry problems in infants who are frequent feeders. The program may be best targeted to frequent feeders.
authors.affiliation: Centre for Community Child Health, The Royal Children's Hospital, Parkville, Australia;
authors.forename: Harriet
authors.initials: H
authors.lastname: Hiscock
authors.forename: Fallon
authors.initials: F
authors.lastname: Cook
authors.forename: Jordana
authors.initials: J
authors.lastname: Bayer
authors.forename: Ha N D
authors.initials: HN
authors.lastname: Le
authors.forename: Fiona
authors.initials: F
authors.lastname: Mensah
authors.forename: Warren
authors.initials: W
authors.lastname: Cann
authors.forename: Brian
authors.initials: B
authors.lastname: Symon
authors.forename: Ian
authors.initials: I
authors.lastname: St James-Roberts
mesh_terms: D000328:Adult; D000367:Age Factors; D003448:Crying; D019052:Depression, Postpartum / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012893:Sleep Wake Disorders / Q000517:prevention & control*
keywords: colic; infant; postpartum depression; randomized controlled trial; sleep