Descriptive figures for differences in parenting and infant night-time distress in the first three months of age

AIM: To provide descriptive figures for infant distress and associated parenting at night in normal London home environments during the first three months of age. BACKGROUND: Most western infants develop long night-time sleep periods by 4 months of age. However, 30% of infants in many countries sleep for short periods and cry out on waking in the night: the most common type of infant sleep behaviour problem. Preventive interventions may help families and improve services. There is evidence that 'limit-setting' parenting, which is common in western cultures, supports the development of settled infant night-time behaviour. However, a recent review has challenged this and argued that this form of parenting risks distressing infants. This study describes limit-setting parenting as practiced in London, compares it with ‘infant-cued’ parenting, and measures the associated infant distress. METHODS: Longitudinal infra-red video, diary and questionnaire observations comparing a General-Community (n=101) group and subgroups with a Bed-Sharing (n=19) group on measures of infant and parenting behaviours at night. FINDINGS: General-Community parents took longer to detect and respond to infant waking and signalling, and to begin feeding, compared with the highly infant-cued care provided by Bed-Sharing parents. The average latency in General-Community parents' responding to infant night-time waking was 3.5 minutes, during which infants fuss/cried for around one minute. Compared with Bed-Sharing parenting, General-Community parenting was associated with increased infant distress of around 30 minutes per night at 2 weeks, reducing to 12 minutes per night by three months of age. However, differences in infant distress between General-Community subgroups adopting limit-setting versus infant-cued parenting were not large or statistically significant at any age. The figures provide descriptive evidence about limit-setting parenting which may counter some doubts about this form of parenting and help parents and professionals to make choices.