Severely unsettled one-year-olds risk poor mental health, experts caution

Severely unsettled babies with sleeping, crying and feeding problems at the age of one are ten times more likely to have mental health problems during childhood, a new Murdoch Children's Research Institute (MCRI) study has found.

Presenting her work at the Sleep DownUnder Conference in Brisbane today, project lead Dr. Fallon Cook said the findings provide strong evidence that poor mental health begins in infancy for some children.

"We found that babies with severely unsettled sleep, excessive crying, feeding difficulties, mood swings and tantrums at the age of one are ten times more likely to have mental health difficulties during childhood," Dr. Cook said.

"These babies are also more likely to have delayed language development and reduced academic achievement."

However she was quick to reassure families where the babies have sleep issues in isolation.

"Parents with a baby who has sleep problems but no other difficult behaviours can be reassured that their baby is no more likely to experience mental health difficulties during childhood than babies who sleep well," Dr. Cook said.

"It is the combination of multiple severe problems that can indicate the beginning of difficulties for the child."

Such difficulties may include emotional symptoms, conduct problems and hyperactivity.

The MCRI researchers analysed data collected from 1759 children at age 1, 5 and 11, looking for links between severely unsettled behaviour in infancy and learning and behavioural issues in the years that follow.

Previous research has shown disturbed infant sleep and persistent crying are associated with poor child outcomes. However, multiple regulatory behaviors, and their combined impact on child mental health, have not been examined.

The MCRI study found that infants with multiple moderate to severe regulatory problems – about 3.4 per cent of all 1-year-olds—have more than 10 times greater odds of experiencing significant mental health concerns during childhood, compared to infants who are settled.

Dr. Cook said babies with sleep problems but no other regulatory difficulties—about one quarter of infants—have similar mental health outcomes to 'easy' or more settled babies.

She said at-risk infants could easily be identified if GPs or maternal child health nurses asked about the presence and severity of a range of behavioural difficulties at the 12 month checkup.

"We hope that by identifying infants at risk for poor mental health during childhood, we may be able to develop new interventions to help these children on to a pathway toward good mental health," Dr. Cook said.

The findings, which have been accepted for publication in Pediatrics, suggest that treating unsettled behaviour in the early years and increasing support for these families, may help avoid mental health and learning difficulties in childhood.

"We have a unique opportunity here to begin trialling targeted interventions and increase family support, to see if we can help improve outcomes for these kids and their families."