The Effects of the New Baby on The Older Sibling

Abstract

Objectives: The aim of this study is to investigate the effects of the newborn sibling and the other factors’ contribution on previous sibling’s behaviors.
Materials and Methods: In this cross-sectional study, we interviewed with 312 mothers who had children under the age of one, between February-July 2012, in the well-child outpatient clinics of Gazi University Faculty of Medicine, Department of Pediatrics. A structured questionnaire was conducted, interviewing face to face with the mothers. Scores of jealousy behaviors questionnaire could range from 0-13. The cut-off score is accepted as 8 points and scores between 0-7 points were evaluated as normal or acceptable, whereas the scores of 8 points or more was evaluated as pathological jealousy behaviors. The numerical values of dependent and independent variables asked in the questionnaire were shown as number and percentage. Chi-square test, Fisher's exact test and Likelihood test were used to examine the effect of independent variables on jealousy behavior. The Spearman Rho correlation coefficient was calculated to examine the correlation between the age of the focus child and the jealousy score. Variables determined to affect jealousy behavior were examined by logistic regression model (enter method). With the model established, it was tried to determine the risk factors that could affect the jealousy of the firstborn child. In the Enter method, the probability of entry into the logistic regression model at each step was 0.05 and the probability of being extracted from the model was 0.10. Confidence intervals of 95% were determined for the Odds Ratio (OR) value obtained by logistic regression.

For statistical analysis, SPSS for Win. Ver. 15.0 (SPSS Inc., Chicago, ILL, USA) and for jealousy score calculation, tables and graphs MS-Excel 2016 programs were used. Significance level of p≤0.05 was accepted in statistical decisions.

Results: Mothers who participated in the study were found to have a median age of 30 (min: 20, max: 44, IQR: 6). Age of the previous children was 48 months (IQR: 24 months). The most common negative behaviors in the previous brothers were regression (77.74%), sleep changes (47.76%), violent behaviors (46.28%), changes in toilet habits (32%) and decrease in appetite (% 31). Children's jealousy behaviors decreased as age increased (Rho = -0.302; p <0.001). It was seen that the most important risk factors for jealousy were having a non-worker mother (OR: 0.19), decrease in time that is spent with father (OR: 4.43), and being at the risky age group (2-4 years) of the firstborn child (OR: 8.16).

Conclusion: A newly joined baby causes some negative behavior patterns on the previous sibling. Attitudes of parents to their children can affect this situation. It is important in terms of primary care medicine to question how the previous children of the families who have or have plans to have a new baby responded to this situation and how to control the child's jealousy behavior by resolving the concerns of the family.

Full text

AnkaraMedJ,2018;(3):286‐99
DOI:10.17098/amj.461653
DağcıoğluAnkaraMedJ,Vol.18,Num.3,2018
286

TheEffectsoftheNewBabyontheOlderSibling

AileyeYeniKatılanBebeğinBirÖncekiKardeşÜzerineEtkisi

BasriFurkanDağcıoğlu1

1AnkaraYıldırımBeyazıtUniversity,FacultyofMedicine,DepartmentofFamilyMedicine

Abstract
Objectives:Theaimofthisstudyistoinvestigatetheeffectsofthenewbornsiblingandtheother
factors’contributiononprevioussibling’sbehaviors.
MaterialsandMethods:Inthiscross‐sectionalstudy,weinterviewedwith312motherswhohad
childrenundertheageofone,betweenFebruary‐July2012,inthewell‐childoutpatientclinicsofGazi
UniversityFacultyofMedicine,DepartmentofPediatrics.Astructuredquestionnairewasconducted,
interviewingfacetofacewiththemothers.Scoresofjealousybehaviorsquestionnairecouldrangefrom
0‐13.Thecut‐offscoreisacceptedas8pointsandscoresbetween0‐7pointswereevaluatedasnormalor
acceptable,whereasthescoresof8pointsormorewasevaluatedaspathologicaljealousybehaviors.The
numericalvaluesofdependentandindependentvariablesaskedinthequestionnairewereshownas
numberandpercentage.Chi‐squaretest,Fisher'sexacttestandLikelihoodtestwereusedtoexamine
theeffectofindependentvariablesonjealousybehavior.TheSpearmanRhocorrelationcoefficientwas
calculatedtoexaminethecorrelationbetweentheageofthefocuschildandthejealousyscore.
Variablesdeterminedtoaffectjealousybehaviorwereexaminedbylogisticregressionmodel(enter
method).Withthemodelestablished,itwastriedtodeterminetheriskfactorsthatcouldaffectthe
jealousyofthefirstbornchild.IntheEntermethod,theprobabilityofentryintothelogisticregression
modelateachstepwas0.05andtheprobabilityofbeingextractedfromthemodelwas0.10.Confidence
intervalsof95%weredeterminedfortheOddsRatio(OR)valueobtainedbylogisticregression.
Forstatisticalanalysis,SPSSforWin.Ver.15.0(SPSSInc.,Chicago,ILL,USA)andforjealousyscore
calculation,tablesandgraphsMS‐Excel2016programswereused.Significancelevelofp≤0.05was
acceptedinstatisticaldecisions.
Results:Motherswhoparticipatedinthestudywerefoundtohaveamedianageof30(min:20,max:
44,IQR:6).Ageofthepreviouschildrenwas48months(IQR:24months).Themostcommonnegative
behaviorsinthepreviousbrotherswereregression(77.74%),sleepchanges(47.76%),violentbehaviors
(46.28%),changesintoilethabits(32%)anddecreaseinappetite(%31).Children'sjealousybehaviors
decreasedasageincreased(Rho=‐0.302;p<0.001).Itwasseenthatthemostimportantriskfactorsfor
jealousywerehavinganon‐workermother(OR:0.19),decreaseintimethatisspentwithfather(OR:
4.43),andbeingattheriskyagegroup(2‐4years)ofthefirstbornchild(OR:8.16).
Conclusion:Anewlyjoinedbabycausessomenegativebehaviorpatternsontheprevioussibling.
Attitudesofparentstotheirchildrencanaffectthissituation.Itisimportantintermsofprimarycare
medicinetoquestionhowthepreviouschildrenofthefamilieswhohaveorhaveplanstohaveanew
babyrespondedtothissituationandhowtocontrolthechild'sjealousybehaviorbyresolvingthe
concernsofthefamily.
Keywords:Siblingjealousy,newbornbabyandjealousy,siblingrivalry

Öz
Amaç:Çalışmamızınamacı,aileyeyenikatılanbebeğin,biröncekikardeş üzerindekietkilerininve
kardeşkıskançlığınaetkiedenfaktörlerinbelirlenmesinekatkıdabulunabilmektir.
MateryalveMetot:Kesitseltiptekibuçalışmada,GaziÜniversitesiTıpFakültesiÇocukHastalıkları
AnabilimDalıSağlamÇocukPolikliniği’neŞubat2012‐Temmuz2012tarihleriarasındabaşvuran,son
çocuğu1yaşınıgeçmemiş olanvebiröncekiçocuğubiryaşındanbüyükolan312anneileyüzyüze
görüşülerek,yapılandırılmış biranketuygulandı.Anketteyeralanvekıskançlıkdavranışınıyansıtan
sorulardaverilebilecekherbircevappuanlanarak,toplamkıskançlıkpuanıbelirlendi.Puanlama0‐13
arasındadeğişebilmekteydi.Değerlendirmede0‐7puanalançocuklarnormalyadakabuledilebilir
tutumasahip,8vedahayüksekpuanalançocuklarisepatolojikkıskançlıkgösterenolarak
sınıflandırıldı.KategorikdeğişkenlerileçocuğunkıskançlıkdurumuarasındakiilişkilerKi‐karetestiile
araştırıldı.KıskançlıkpuanıileodakçocuğunyaşıarasındakiilişkiyibelirleyebilmekamacıileSpearman
Rhokorelasyonkatsayısıhesaplandı.Puanlamasonuçlarıilekıskançlıkdavranışınaetkiettiğisaptanan

TheEffectsoftheNewBabyontheOlderSibling
DağcıoğluAnkaraMedJ,Vol.18,Num.3,2018
287

değişkenlerlojistikregresyonmodeliyleanalizedildi.İstatistikselanalizleriçinSPSSforWin.Ver.15.0
(SPSSInc.,Chicago,ILL,USA),kıskançlıkpuanhesabı,tablovegrafikleriçiniseMS‐Excel2016
programlarıkullanıldı.İstatistikselkararlardaanlamlılıkdüzeyip≤0,05olarakkabuledildi.
Bulgular:Çalışmayakatılanannelerinyaş ortancası30(min:20,maks:44;ÇAG:6)olarakbulundu.
Sondanbiröncekiçocuklarınyaşortancası48ay(ÇAG:24ay)idi.Yenikardeşindoğumuyla,birönceki
kardeşteensıkgörülenolumsuzdavranışlarınregresyon(%77,74),uykudeğişikliği(%47,76),şiddet
davranışları(%46,28),tuvaletalışkanlıklarındadeğişiklikler(%32)veiştahtaazalma(%31)olduğu
görüldü.Çocuklardakikıskançlıkdavranışlarıyaş arttıkçaazalmaktaydı(Rho=‐0,302;p<0,001).
Kıskançlıkiçinenönemliriskfaktörlerininanneninçalışmıyorolması(OR:0,19),babailegeçirilen
zamanınazalması(OR:4,43)vesondanbiröncekiçocuğun2‐4yaşaralığındaolması(OR:8,16)olduğu
görüldü.
Sonuç:Aileyeyenikatılanbebek,biröncekikardeşüzerindebazıolumsuzdavranışkalıplarınınortaya
çıkmasınayolaçmaktadır.Annevebabanın,çocuklarıileilgilitutumları,budurumu
etkileyebilmektedir.Yenibebeksahibiolanyadaolmayıplanlayanailelerinbiröncekiçocuklarınınbu
durumanasıltepkiverdiğininsorgulanmasıvebukonudaailelerinkaygılarınıngiderilerek,çocuktaki
kıskançlıkdavranışınınnasılkontrolaltındatutulabileceğihakkındayolgösterilmesi,birincibasamak
hekimliğiaçısındanönemarzetmektedir.
Anahtarkelimeler:Kardeşkıskançlığı,yenibebekvekıskançlık,kardeşrekabeti

Correspondence/YazışmaAdresi:
Dr.BasriFurkanDağcıoğlu
AnkaraYildirimBeyazitUniversity,FacultyofMedicine,DepartmentofFamilyMedicine,
Bilkent/Ankara
e‐mail:bfurkan@gmail.com
Dateofsubmission:27.07.2018
Dateofadmission:09.09.2018


Introduction
Althoughthefirststudiesabouttheeffectofsiblingsonchilddevelopmentwere
conductedaroundthebeginningofthe20thcentury,siblingresearchesjustrecently
hasbeguntoevaluatemanyoftheissueswhichconcernfamilies.1Havingasiblinghas
manydirectandindirectcontributionstodevelopment,suchascognitive,language
andpsychosocialaspects.1
Thequalityofsiblingrelationshipalsoplaysanimportantroleinchildren’s
adjustment.Siblingrivalryislinkedtodeviantandantisocialbehavior,aswellasto
depressionandotherinternalizingproblems.Lookingonthebrightside,warmand
positiverelationshipsofsiblingsinchildhoodcanhelpcopingwithadjustment
problems.2
Jealousyandsiblingrivalryarecommonconditionsinsociety,whichisasoldas
humanhistoryandoftenconsideredasnormal.3,4Accordingtosomeexperts,these
feelingsareamongthatapersonfirstexperiencesandthusliesinthedeepestplacesin
thesoul.5Thereisalmostnobodyintheworldwhohasasiblingandneverhada
problemwithit.
Althoughtheconceptsofrivalry,conflict,jealousyandenvyareusuallyconfusedand
usedinsteadofeachother,thesearedistinctemotions.6‐8Withatheoreticalapproach,
itcanbesaidthatthejealousindividual,belovedthingandrivalryexistinthecorners
ofthetriangleformingtheconceptofjealousy.9Theterm‘‘envy’’nearlyalwaysrefers
tothetwo‐personcaseinwhichaperson(havingsimilarorequivalentcharacteristics)
lacksadesiredthing.Intheconceptofrivalry,thereisacompetitionwithanother(e.g.

TheEffectsoftheNewBabyontheOlderSibling
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newbabysibling)fortheinterestandloveofthechild'slovedone.Conflictisa
conditionthatdependsentirelyoninterpersonaldynamicsandcanbeinfluencedby
jealousy,butitisaseparateconcept.9
Whenpeoplehavetoshareconceptssuchasinterest,compassion,loveortimethat
arepresentedtothemwithsomeonewithouttheirownwill,jealousyrises.According
toFreud,whostudiestheplaceofjealousyinhumannature,jealousyconsistsof:3,10
1)Grief,thepainofthinkingoflosingalovedone
2)Thepainthatwerealizethatwecannotgeteverythingwewant
3)Hostilityforasuccessfulrival
4)Selfcriticizeforourloss,moreorless
Themosteffectiveonesthatcausefeelingsofsiblingrivalryareemotionsofanger,self‐
pityandsadness.Itisarguedthattheinfantshavebeeninteractingwiththeirbrothers
after6monthsofage.11Thefirstprimitivejealousybehaviorsarebeginningtobe
observedaround9‐10months.12However,thecomplexfeelingofjealousybeginstobe
feltinfacialexpressionsaftertheindividualis18monthsold.12Fortheoldersibling,
thisinteractionstartswhenthenewbabyisborn.Newlyjoinedsiblingsoftencause
jealousyinthepreviouschild.Surprisingly,sometimesthiscanevenbeobservedin
elderlypeoplelikegrandparents.13
Thefearthat,bythearrivalofnewbaby,oldersiblingwillnotbelovedasmuchasold
timesmaystartduringthepregnancyofthemother.14Manyfamiliesbegintryingto
familiarizetheirchildrenfortheideaofhavingasiblingbeforebirth.Ithasalsobeen
mentionedinthegeneticbaseofjealousy.Someexpertshavearguedthatthis
sensationfirststartedaroundtheageoftwo.15
Decreaseinthetimethatspentforthepreviouschildbythebirthofthenewsibling;
canleadtothedevelopmentofemotionsinthechildsuchasangerand
disappointment,whichseemtobeagainstthebaby,butactuallyagainsttheparents.
Amongthemostcommonpresentationsofregressivebehaviors,hittingtobaby,
harmingtheobjects,bitingpeoplecanbeseenaswellastoavoidtoiletingforalong
time,speakinglikeababy,drinkingfromababy’sbottle,bedwetting,naileatingand
fingersucking.16,17
Whenparentsvisitdoctors,theyusuallydonottalkaboutjealousyamongtheir
children.However,whenthesubjectisbroughtintoquestionbythedoctor,itappears
thattheyarewillingtotalkaboutsomeofthedifficultiestheyencounterandtoseek
constructiveadvicefromthedoctor.Thisproblem,whichisoftennotaddressed
spontaneously,sometimesleavesfamilieshelpless,andevenmoreimportantly,itcan
leavepermanenttracesthatwilllastalifetimebyaffectingchildren'spsychological
developmentnegatively.
Consideringtheprinciplesofholisticandcomprehensiveapproachoffamilymedicine,
itisveryimportanttoquestionsuchproblemsthatfamiliesdonotexpressby
themselves.Forthisreason,knowingtheprevalenceofsiblingjealousy,determining
thefactorsthattriggerthiscondition,andexplaininghowfamiliescancopewiththis
problemshouldbeconsideredasanimportantcomponentofprimaryhealthcare.

TheEffectsoftheNewBabyontheOlderSibling
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Inthisstudy,itisaimedtomakeanassessmentofsiblingjealousyonachosen
populationaswellastoattracttheattentionofourcolleaguestothissubjectwhichis
underestimatedindailypractice.
MaterialsandMethods
Inthiscross‐sectionalstudy,weinterviewedwith312motherswhohadchildrenunder
theageofoneandhadasecondchildolderthanoneyear,betweenFebruary‐July2012,
inthewell‐childoutpatientclinicsofGaziUniversityFacultyofMedicine,department
ofPediatrics.Choosingthenewbabiesunderage1ispreferredtominimizethe
memoryfactoronrememberingthebehaviorsofprevious(focused)child.Astructured
questionnairewasconducted,whichisformedbysearchingrelevantliteratureabout
thebehaviorsthatmaybeassociatedwithsiblingjealousy,interviewingfacetoface
withthemothers.
Variables
Asindependentvariables,thesociodemographicandeconomiccharacteristicsofthe
families(parents’ages,parents’educationalstatus,mothers’workingstatus,families’
totalmonthlyincome,familytype,children'sages,children'sgender)andfactorsthat
couldaffectsiblingjealousy(thetimewhenthechildwastold,thepersonwhogave
thenewsofthenewbaby,wherethefirstbornchildbegantospendtimeafterthenew
sibling,thechangeofthetimethatfirstbornchildspentwiththeparents)wereasked
inthequestionnaire.
Asdependentvariables,thebehaviorsofthefirstbornchildthatcouldbeattributedto
jealousywereaskedtomothersandtotaljealousybehaviorscorewascalculatedby
scoringeachquestion.Inthiscontext,somequestionswereaskedaboutchangesin
sleepingpatterns,deteriorationineatinghabits,clingingbehaviors,regressive
behaviorssuchasspeakinglikeababyordesireforbreastfeeding,avoidinggoingto
toilet,urinaryincontinence,violencetoparents,toobjectsortonewsibling,refusing
tohelpbabycare,whichcanallbeconsideredasjealousyassociatedbehaviors.
Scoring
Scoresofjealousybehaviorsquestionnaire,whichisformedbyscanningrelevantdata
intheliterature,couldrangefrom0‐13.Thedistributionofthescoreswasexamined
andthecut‐offscoreisacceptedas8points,whichwasunder2standarddeviations
(90thpercentile)frommaximumscore,andscoresbetween0‐7pointswereevaluated
asnormaloracceptable,whereasthescoresof8pointsormorewasevaluatedas
pathologicaljealousybehaviors.
Statisticalanalysis
Thenumericalvaluesofdependentandindependentvariablesaskedinthe
questionnairewereshownasnumberandpercentage.Chi‐squaretest,Fisher'sexact
testandLikelihoodtestwereusedtoexaminetheeffectofindependentvariableson
jealousybehavior.TheSpearmanRhocorrelationcoefficientwascalculatedtoexamine
thecorrelationbetweentheageofthefocuschildandthejealousyscore.Variables
determinedtoaffectjealousybehaviorwereexaminedbylogisticregressionmodel
(entermethod).Withthemodelestablished,itwastriedtodeterminetheriskfactors
thatcouldaffectthejealousyofthefirstbornchild.IntheEntermethod,the
probabilityofentryintothelogisticregressionmodelateachstepwas0.05andthe

TheEffectsoftheNewBabyontheOlderSibling
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probabilityofbeingextractedfromthemodelwas0.10.Confidenceintervalsof95%
weredeterminedfortheOddsRatio(OR)valueobtainedbylogisticregression.
Forstatisticalanalysis,SPSSforWin.Ver.15.0(SPSSInc.,Chicago,ILL,USA)andfor
jealousyscorecalculation,tablesandgraphsMS‐Excel2016programswereused.
Significancelevelofp≤0.05wasacceptedinstatisticaldecisions.
Ethicalconsiderations
Forthestudy,ethicalapprovalwasobtainedbythedecisionoftheethicsBoardofthe
non‐interventionalclinicalresearchesEthicalCommitteeofGaziUniversityon
18.01.2012withthedecisionnumberof013.
Results
Thestudywasconductedwith312motherswhoappliedtoSocialPediatricsPoliclinic
ofGaziUniversityMedicalFacultyandagreedtoparticipateinthestudy.Theagesof
theparticipatedmotherswerebetween20‐44yearsandmedianagewas30year
(IQR=6).Oftheindividualsparticipatinginthestudy,131(41.98%)wereyoung
mothers,while178(57.05%)weremiddle‐agedmothers.Themedianageoffirstborn
childrenwasfoundtobe48(IQR=24)months.InTable1,somedescriptive
characteristicsaboutthefamiliesparticipatinginthestudy,andinTable2,descriptive
characteristicsaboutthefactorsthatcouldaffectthesiblingjealousyweregiven.
Thedistributionoftheanswersgiventothequestionsaboutthebehaviorthatmaybe
relatedtothejealousyoffirstbornchildrenisgiveninTable3.
Statisticalanalyzesshowingtherelationshipofthequestionedvariableswiththe
jealousystatusofthefirstbornchildrenaregiveninTable4.
Asignificantnegativecorrelationwasfoundbetweentheageofthefirstbornchildand
thetotaljealousyscore,despitethecorrelationwaslow(Rho=‐0.302;p<0.001).Itwas
seenthatasthechild'sageincreased,thejealousyscoredecreased.Figure1showsthe
distributionofjealousyscorewiththeageoffirstbornchildren.
Logisticregressionanalysiswasperformedforvariablesthatinfluencedjealousy.The
pathologicaljealousybehaviorgroupwasselectedasdependentvariable,maternal
workingstatus,timespentwithfather,andagegroupoffirstbornchildrenas
independentvariables.Logisticregressionmodelwascompletedwith306subjects
(98.1%)as6deficiencieswerefoundinthedata.Thelogisticregressionmodel
establishedwasstatisticallysignificant(NagelkerkeR2=0.190)inordertodetermine
thesignificantfactorsonthefirstbornchild'spathologicaljealousyscore.
Itisfoundthat,havinganon‐workermother(OR:0.19),decreaseoftimespentwith
father(OR:4.43)andbeingattheriskyagegroupofthefirstbornchild(OR=8.16)
increasedtheriskofhavingpathologicalattitudeofthefirstbornchild.
Theriskeffects(OR)resultingfromtheindependentvariablesinthemodelresulting
fromthelogisticregressionandtheconfidenceintervalsofthiseffectareshownin
Table5.




TheEffectsoftheNewBabyontheOlderSibling
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Table1.Somedescriptivecharacteristicsaboutthefamiliesincludedinthestudy
Theageofthefirstbornn=310
24monthsoryounger24(7.74%)
25‐59months175(56.45%)
60‐83months94(30.32%)
84monthsorolder17(5.48%)
Firstbornchild’sgendern=309
Girl155(50.16%)
Boy154(49.84%)
Newbaby’sgendern=280
Girl142(50.71%)
Boy138(49.29%)
Educationalstatusofmothersn=312
None‐primaryschool62(19.87%)
Middleschool‐highschool128(41.03%)
University‐postdoc.122(39.10%)
Mothers'workstatusn=310
Working70(22.58%)
Notworkingoroffduty240(77.42%)
Familyincomen=303
Lessthan1500₺67(22.11%)
1500‐3500161(53.14%)
3501₺andabove75(24.75%)
Familytypen=312
Core229(73.40%)
Extended83(26.60%)
Theplacethatfirstbornspendstimen=309
Home187(60.51%)
Nursery109(35.28%)
Withrelatives13(%4.21)


TheEffectsoftheNewBabyontheOlderSibling
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Table2.Descriptivecharacteristicsaboutthefactorsthatcouldaffectthesibling
jealousy
Whenwasthenewsiblingtoldn=312
Beforepregnancy20(6.41%)
Duringpregnancy279(89.42%)
Afterbirth13(4.16%)
Whogavethenewsofnewsiblingn=292
Mother177(60.61%)
Father7(2.39%)
Parentstogether108(36.99%)
Firstreactiontosiblingnewsn=302
Rejoicing192(63.57%)
Anger/Sorrow24(7.95%)
Surprised/Non‐reacting86(28.48%)
Thetimethatfirstbornspentwithmothern=309
Increased28(9.06%)
Decreased198(64.07%)
Hasnotchanged83(26.86%)
Thetimethatfirstbornspentwithfathern=310
Increased112(36.12%)
Decreased28(9.03%)
Hasnotchanged170(54.84%)

Discussion
Interestingresultshavebeenachievedinthisstudy,inwhichweareinvestigatingthe
effectofthenewbornbabyonthebehavioroftheoldersibling.
Itwasseenthatmostofthefamiliesgavethenewsofthenewsiblingthatwilljointhe
familytothepreviouschildduringthepregnancyandespeciallyinthefirsttrimester.
Manymotherssharedthiswiththeirchildrenshortlyafterlearningthattheywere
pregnant.Insomestudies,itisassertedthatfamiliarizationoftheoldersiblingtothis
situationbeforethebirthofthenewbabymakesapositivecontributiontothe
behaviorofthechild.18Oneofthecommonpracticesinourcountryisthatafterthe
birthofthenewbaby,parentsgiveagifttoolderchildandtellhimthatthebabyhas
broughtittohim.However,suchapproachesarenotrecommendedbysomeexperts,
foritmaycausechildrenfeeldeceived.

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Table3.Thedistributionoftheanswersgiventothequestionsaboutthebehaviorthat
mayberelatedtothejealousyoffirstbornchildren
Sleepingpatternofthefirstbornafternewbabyn=312
Hasnotchanged163(52.24)
Negativelyaffected149(47.76%)
Eatingappetiteofthefirstbornafternewbabyn=310
Increased18(5.81%)
Decreased97(31.29%)
Hasnotchanged195(62.90%)
Regressivebehaviorsofthefirstbornafternew
babyn=310
Regressionpresent241(77.74%)
Regressionabsent69(22.26%)
Toiletbehaviorsofthefirstbornafternewbabyn=309
Negativelychanged100(32.36%)
Hasnotchanged209(67.64%)
Violencebehaviorsofthefirstbornafternew
babyn=309*
None166(53.72%)
Toparents83(26.86%)
Tosibling128(41.42%)
Toobjects55(17.80%)
Firstbornchild’swillingnesstohelpbabycaren=308
Yes235(76.30%)
No22(7.14%)
Sometimes51(16.56%)
*Morethanoneanswerswerepossible

Thebirthofanewbabyoftencauseslessormorechangesinthepreviouschild.19Only
25(8.01%)ofthechildrenwhodidnotshowanyjealousybehaviorwerefoundinour
study.Ontheotherhand,theenvyofthenewbabybytheoldersiblingisoftena
concernforthefamily.However,only9.90%(n=31)ofchildrenshowedpathologically
negativebehaviorstowardsnewsiblingandbehaviorsofmorethan90%ofthe
childrencouldbeconsideredasnormal.AccordingtoastudyintheUnitedStates,the

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concernsofparentsaboutthejealousyofthepreviouschildagainstthenewbabywere
foundtobegreaterthanthebehaviorthatcouldberelatedtojealousyinthechild.20
Thismayindicatethatfamiliesareworryingmorethannecessaryonthesubjectof
siblingjealousy.

Table4.Relationshipofthequestionedvariableswiththejealousystatusofthe
firstbornchildren

Totaljealousyscore
Normalor
acceptable
attitude
(0‐7points)
n(%)
Pathological
attitude
(8pointsor
over)
n(%)
2p
Mother’seducationalstatus
Compulsoryeducationor
below85(90.43)9(9.57)
0.0400.980

Highschool86(89.58)10(10.42)
Universityorpost‐doc110(90.16)12(9.84)
Father’seducationalstatus
Compulsoryeducationor
below51(92.73)4(7.27)
2.1060.349
Highschool70(85.37)12(14.63)
Universityorpost‐doc111(90.24)12(9.76)
Mother’sworkingstatus
Working68(97.14)2(2.86)5.1260.024
Notworkingoroffduty211(87.92)29(12.08)
Familyincome
Lessthan1500₺63(94.03)4(5.97)
2.2320.3281500‐3500141(87.58)20(12.42)
3501₺andabove68(90.67)7(9.33)
Familytype
Core209(91.27)20(8.73)1.3900.238
Extended72(86.75)11(13.25)
Gender
Firstborn
child’s
gender
Newbaby’s
gender
GirlGirl67(87.01)10(12.99)0.054

0.816
Boy53(88.33)7(11.67)
BoyGirl59(90.77)6(9.23)0.003

0.958
Boy71(91.03)7(8.97)

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Firstborn’sgender
Girl138(89.03)17(10.97)0.3010.583
Boy140(90.91)14(9.09)
Totalchildnumberofthefamily
2238(90.49)25(9.51)0.3460.556
3ormore43(87.76)6(12.24)
Whenwasthenewsiblingtold
Beforepregnancy20(100.00)0(0.00)
7.3500.025
*
Duringpregnancy247(88.85)31(11.15)
Afterbirth13(100.00)0(0.00)
Firstreactiontosiblingnews
Rejoicing177(92.19)15(7.81)
3.5920.166Surprised/Non‐reacting74(86.05)12(13.95)
Anger/Sorrow20(83.33)4(16.67)
Theplacethatfirstbornspendstime
Home164(85.42)28(14.58)
3.9530.139Withrelatives11(84.62)2(15.38)
Nursery103(94.50)6(5.50)
Thetimethatfirstbornspentwithmother
Increasedorhasnot
changed104(92.04)9(7.96)0.8440.358
Decreased174(88.78)22(11.22)
Thetimethatfirstbornspentwithfather
Increasedorhasnot
changed257(91.46)24(8.54)p=0.016
(Fischer’s
exacttest)
Decreased22(75.86)7(24.14)
Firstbornchild’sage(twogroups)
Under2yearsorover4
years120(97.56)3(2.44)12.95
2
<0.00
1
2–4years159(85.03)28(14.97)
*Clinicallynotsignificant,duetolackofenoughdatainsomeboxes

Themostcommonnegativeattitudewasregressivebehaviorswitharateof77.7%.
Amongthem,therewerebehaviorslikedemandinghelpfrommotherwhileeating,
demandingbreastfeeding,speakinglikeababyandclingingtomother.Accordingto
Volling,theregressionsignsmaydependonwhetheraskillisnewlyacquiredorfirmly
established,andmostofthetasksofself‐helpintoilet,weaninganddressingdepend
onthecomplexityofthechild'smaturationprocess.4Therefore,encouragingthechild
togainindependencemaybeaneffectivewaytopreparefirstbornsandparentsforthe
arrivalofanewbaby.4


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Table5.Logisticregressionmodel


Figure1.Thedistributionofjealousyscorewiththeageoffirstbornchildren.

Inourstudy,withthearrivalofanewbaby,itisseenthatthetimethatthefather
usuallyspentwiththepreviouschildrenusuallyincreased.Thismaybeanattitude
towardsclosingtheinterestdeficiencyofthemother,whonowhastodealwiththe
newbaby.Ithasalsobeenobservedthatthedecreaseinthetimespentbythefather
withthechild,increasestheriskofthechildshowingjealousyattitudes.Ithasbeen
reportedthatthepositiverelationshipbetweentheparentsandtherelationshipbased
pOdds
Ratio(OR)

95%C.I.forOR
LowerUpper
Havinganon‐workermother0.0270.1860.0420.829
Decreaseoftimespentwithfather0.0054.4271.55312.620
Beingattheriskyagegroup(2‐4
years)ofthefirstbornchild0.0018.1602.35728.251

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ontheloveandcompassionhelpsthechildtocopewithnegativefeelings
significantly.21Inthisrespect,itcanbesaidthatparentswhohaveanewbabywill
benefitfromhavingmorequalitytimewiththeirpreviouschildren.
Oneoftheremarkablefindingsinourstudyisthatsiblingjealousyismorecommonin
childrenofmotherswhodonotworkandspendtimeathome.Thisinteresting
conclusioncanbeinterpretedasthemother,whoisapopularandcompetingentityin
therivalrytriadisoutallday,andthismaydecreasethejealousyinstinct.Thus,the
elementsofjealousyisdefinedbyKolakandVolling,asthejealousindividual,the
thingthatislovedandtherivalry.9Ontheotherhand,consideringthattheinterviews
aremadewithmothers,itmayalsohavebeencausedbythefactthatthemotherswho
spendmoretimeathomecouldhavewatchedmorejealousybehavior.Thisdistinction
wasnotpossibleduetothedesignofourstudy.
Anegativecorrelationbetweentheageofthefirstbornchildandthejealousyscore
wasfound,andfurtheranalysisshowedthatchildrenaged2‐4years(24‐59months)
weresignificantlymorejealousthanchildrenaged5years(60months)andolder.This
resultsupportstheresultsofmanyotherworkonthesubject,22despitesomestudies
advocatingthatjealousymayincreaseinlaterages.23Because,accordingtoexperts,
peoplearemorelikelytoenvyotherswhoaresimilartothemselvesinattributessuch
asgender,age,experience,andbackground.8Whatismore,accordingtoBowlby’s
attachmenttheory,theearlybondbetweeninfantsandtheirparentsiscriticalforthe
infant’ssurvival.However,withage,childrendependlessonparent’sphysical
proximityandmoreonasenseofconfidencethattheywillbeaccessibleintimesof
need.24Fromthisresult,itcanbesaidthatparentsandphysiciansshouldbemore
carefulaboutpossiblejealousbehaviorswhenthereisalittleagedifferencebetween
thetwosiblings.Insomestudiesithasbeenarguedthatthegenderfactormayalso
haveaneffectonjealousbehaviors.25,26Therearevariousassertionsintheliterature
thatsiblingswiththesamesextendtobemorejealouseachother,asgirlsshowmore
jealousy.27‐30However,inourdetailedanalysisofourstudy,itwasseenthatneitherthe
genderofthenewbornbabyandnorthefirstborn,hadanyeffectonjealousbehavior.
Inseveralstudies,itwasdefinedthat,therearethreemainsiblingrelationship
patterns:aconflictualcluster(lowonwarmth,highonconflict),anaffect‐intense
cluster(aboveaverageonwarmthandconflict),andaharmoniouscluster(highon
warmth,lowonconflict).31Theserelationalclustersmayhelpustocomprehendthe
natureofsiblingdynamics.
Arecentresearchsuggeststhat,someyoungpeoplewithobsessivecompulsive
disorder(OCD),canpresentwithanacutefearofasiblingasaritualofOCD.32In
thesecases,itcaneasilybemisdiagnosedasasiblingrivalrywhichleadstoadelayon
appropriatetreatment.
Toourknowledge,thereisnotanycommonusedinventoryinTurkishlanguageto
measuresiblingjealousyinearlychildhood.Developinganinventoryfromthe
questionslikeinourquestionnaire,withitsvalidityandreliabilitystudies,may
contributetoliterature.
Approximately80%ofchildrenintheUnitedStateshaveatleastonesibling,which
indicatesthatthebirthofababysiblingisanormativeecologicaltransitionformost
children.4Forrecentdecadesnow,siblingrelationshipsandtheirimpactonfamilylife

TheEffectsoftheNewBabyontheOlderSibling
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andindividualdevelopmenthaveattractedtheinterestofscientists,resultinginahuge
evidence‐basedliteratureaboutsiblingrelationships.2Jealousy,whichisunlikebasic
feelingssuchasanger,fear,sadnessandjoy,definedasacomplexsocialfeelingby
Volling,hasbecomeatopicthathasbeenincreasinglyaddressedinthelastcenturyto
reachasocietywithmoretrouble‐freeandconflict‐freepersonalities.21,33Further
researchesaboutthissubject,especiallyfromtheperspectiveofsearchinga
relationshipbetweenthejealousyofadulthood,wouldrevealthemysteriesofsibling
interactionswhichisalreadyunderstoodtobesubstantial.Apathologicjealousyof
siblingsmaybeanearlyindicatorofanarcissisticpersonality,whichneedstobe
investigatedaswell.Afamilyphysicianwhocansufficientlyunderstandthedynamics
ofsiblingrivalrywillbeabletohelpparentsforthemanifestationofthis
developmentalperiodonthechild.34Theexplanationoftheappropriateparenting
approach,whichstartsbeforethechild'sbirthandcontinuesintheprocessof
cohabitationwiththechild,shouldbeacceptedamongthemainpurposesoffamily
medicine.
Acknowledgements
IwouldliketoappreciateProf.Dr.UfukBeyazovaforhervaluablesupportandthanktoDr.Ebru
Yurdakul,Dr.ZahideErdemandallmyfriendswhomadeeffortandremarkablecontributionstothis
research.
Disclosurestatement
Nopotentialconflictofinterestwasreportedbytheauthor.

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