Five-Year Follow-up of Harms and Benefits of Behavioral Infant Sleep Intervention: Randomized Trial

BA(Hons), Centre for Community Child Health, The Royal Children's Hospital, Flemington Rd, Parkville VIC 3052, Australia. .
PEDIATRICS (Impact Factor: 5.47). 09/2012; 130(4):643-51. DOI: 10.1542/peds.2011-3467
Source: PubMed


Randomized trials have demonstrated the short- to medium-term effectiveness of behavioral infant sleep interventions. However, concerns persist that they may harm children's emotional development and subsequent mental health. This study aimed to determine long-term harms and/or benefits of an infant behavioral sleep program at age 6 years on (1) child, (2) child-parent, and (3) maternal outcomes.
Three hundred twenty-six children (173 intervention) with parent-reported sleep problems at age 7 months were selected from a population sample of 692 infants recruited from well-child centers. The study was a 5-year follow-up of a population-based cluster-randomized trial. Allocation was concealed and researchers (but not parents) were blinded to group allocation. Behavioral techniques were delivered over 1 to 3 individual nurse consultations at infant age 8 to 10 months, versus usual care. The main outcomes measured were (1) child mental health, sleep, psychosocial functioning, stress regulation; (2) child-parent relationship; and (3) maternal mental health and parenting styles.
Two hundred twenty-five families (69%) participated. There was no evidence of differences between intervention and control families for any outcome, including (1) children's emotional (P = .8) and conduct behavior scores (P = .6), sleep problems (9% vs 7%, P = .2), sleep habits score (P = .4), parent- (P = .7) and child-reported (P = .8) psychosocial functioning, chronic stress (29% vs 22%, P = .4); (2) child-parent closeness (P = .1) and conflict (P = .4), global relationship (P = .9), disinhibited attachment (P = .3); and (3) parent depression, anxiety, and stress scores (P = .9) or authoritative parenting (63% vs 59%, P = .5).
Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.

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Available from: Anna Price, Feb 10, 2015
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    • "But recent publications seem to intentionally mislead parents about what is good for babies. Recently, the AAP's journal published a poorly wrought paper that claimed: " Behavioral sleep techniques have no marked long-lasting effects (positive or negative) " (Price et al., 2012). The authors drew this very strong conclusion even though they looked at only one and not all possible effects. "
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