Crying babies, tired mothers: what do we know? A systematic review

Objective: to synthesise the evidence on the interconnectedness of infant crying and maternal tiredness in the postpartum period, from both quantitative and qualitative studies. Methods: a systematic review was conducted including studies in English, French and German published from 1980 to 2007. Studies were included in the systematic review if they had extractable data on infant crying as well as maternal tiredness in the first three months post partum. Of 100 retrieved publications, 10 met these criteria. Findings: evidence from this review indicated that the amount of infant crying during the first three months post partum is associated with the experience of tiredness and fatigue in new mothers. Significant associations were found in five of six quantitative studies. The four identified qualitative studies described how infant crying disrupts new mothers' circadian rhythms, reducing opportunities to rest and exacerbating tiredness. Incremental exhaustion diminished parents' ability to concentrate, raising the fear of harming their children, triggering depressive symptoms and burdening parent-child interaction. Key conclusions and implications for practice: if health-care professionals are to address the prominent concerns of parents caring for a neonate, it is essential to review current care practices and tailor them to maternal and infant needs. A care strategy alleviating the burden of infant crying and maternal fatigue has the potential to strengthen family health from the earliest stage. (C) 2009 Elsevier Ltd. All rights reserved.