Infant regulatory problems, parenting quality and childhood attention problems

Background and aims: To determine the combined impact of infant multiple/persistent regulatory problems (RPs), parenting quality and maternal mental health on childhood attention problems. Study design: A prospective, population-based cohort study including 16 paediatric hospitals in Southern Bavaria (Germany). Subjects: 1459 infants were followed from birth to 8 years of age. Outcome measures: RPs were assessed at 5 and 20 months using interviews by trained paediatricians; parenting quality was assessed between birth and 5 months using parent interviews and nurses’ observations; maternal mental health was assessed at birth and 5 months using standardized parents’ interviews; childhood data on attention problems were collected at 8 years, using parent reports and expert behaviour observation ratings. Results: After correction for gestational age, sex, and socioeconomic status, early RPs (β = 0.079) and low parenting quality (β = 0.175) predicted later attention problems (R ² = 0.272). Their impact was additive, such that infants with both multiple/persistent RPs and poor parenting quality showed the highest attention problems 8 years later. However, the impact of RPs on attention was strongest for preterm children. Maternal mental health was a significant moderator of the relationship between parenting quality and attention problems. With adequate maternal mental health, good parenting quality was related to lower attention problems, yet with mental health problems present, the effect of good parenting on attention problems diminished. Conclusions: Guidance and support for parents of infants with multiple/persistent crying, sleeping or feeding problems may be essential to prevent the development of childhood attention problems, especially when maternal mental health problems are present.