Infant Behavioral Problems in the First Year of Life and Maternal Stress During the COVID-19 Pandemic: Results from the "CoviFam" Online Survey

Theoretical background: The COVID-19 pandemic placed a burden on families in several respects, particularly because of the severe confinement imposed at its beginning. The confinement in spring 2020 led to social disruption and a reduction of supportive structures. In the first year of an infant's life, the psychological well-being of a mother-child dyad is particularly susceptible to external stressful changes. Research question: How did the restrictions from the pandemic affect families with children in the first year of the infant's life, particularly infant regulatory problems and related maternal stress? Methods: In an online survey, N = 577 mothers reported on their infants' behavior (0-12 months of age, M = 7.3 months, SD = 3.3) regarding their crying, sleeping, and feeding/eating behavior as well as the respective distress experienced during the restrictions. Measures of current maternal well-being included overall perceived stress, depressivity, relationship satisfaction, and maternal bonding. Frequency/duration of infantile crying, sleep latency as well as night awakenings and feeding/eating problems were surveyed following clinical criteria (DC: 0-5) and percentile scores, respectively. The association of infant behavior and maternal distress was examined using linear regression and MANOVA. Results: Overall, at least one in five mothers felt burdened by her child's regulatory problems during the time of severe restrictions. More than one in four mothers reported being highly or very highly distressed by her child's crying. Sleeping problems, such as prolonged steep latency (> 90th percentile) or several nightly awakenings, were reported for 21.7% of the children. Difficulty to console and frequent crying were reported for 12.3% and excessive crying for 1.6% of the children. Higher levels of stress as well as increased impairment in maternal bonding and less relationship satisfaction explained 17- 21% of the variance of maternal distress from crying and sleeping problems. Significantly more distress was evident in the group of mothers who reported increased crying and prolonged latency to fall asleep (> 45 min) and with more than one child in the household during the period of most severe restrictions (MANOVA). A lack of medical, psychotherapeutic, and other means of care was reported by nearly a quarter of the respondents and was the only restriction that was significantly related to the perception of more stressful child behavior. Discussion and conclusion: Pandemic-related stressors for first-year mothers appear to be enhanced by limited access to the care system, caring for more than one child, the increasing age of the child, while a good relationship with the child (bonding) and/or partner (relationship) satisfaction provide buffers.