Helping parents to manage infant crying and sleeping: a review of the evidence and its implications for services

Infant crying and night waking are common concerns for parents, costly problems for health services and may trigger infant abuse or lead to serious child disturbances. Parents are given contradictory advice on how to manage infant crying and sleeping, indicating the need for evidence‐based guidance. This review of recent research draws distinctions between infant crying and sleeping problems, between the problem identified by parents and the infant behaviour underlying the problem, between different types of crying behaviour and their causes, and between the types of cases which present at different ages. It proposes that the two main approaches to parenting advocated by baby‐care experts, ‘infant‐demand’ and ‘structured’ parenting, have different benefits, and costs. Comparative studies have found that infant‐demand parenting is associated with low amounts of fussing and crying in the first three months of age, but with night waking which continues beyond three months. Randomised controlled trials have provided evidence that structured parenting leads to more overall fussing and crying during the first three months, but reduced night waking and crying after that. The findings are translated into recommendations for preventing and treating infant crying and sleeping problems, for policy debate, and for further research. Copyright © 2007 John Wiley & Sons, Ltd.