Early regulatory disorders are understood as difficulties infants have in adjusting to the environment, regulating their behavior and arousal and in self-calming. These difficulties reveal themselves in symptoms characteristic of age and developmental stages, such as crying or sleeping and feeding problems. Crying in the first three months is regarded as the expression of the usual difficulty experienced in initial adjustment to childhood development. However, according to the guidelines of the German Association for Child and Youth Psychiatry excessive crying/whining beyond the first 3 to 4 months of life is seen as a regulatory problem in early infancy, pertaining to interaction and regulatory contexts, such as self-calming, sleeping and feeding. In such a case, the infant would fuss or cry inconsolably and to an excessive degree. The symptoms typically appear two weeks postnatal, peaking in the sixth week and generally decreasing at the end of the third month. As for the prevalence of excessive crying in the first three months, frequencies between 5 and 19% were determined. Persistence of crying beyond the third month was reported in 5.8% of the cases and beyond the sixth month in 2.5% of them. An estimated 5% of all excessive crying cases have organic causes, such as gastrointestinal problems (gastrointestinal reflux, colic), atopy or neuro pediatric disorders.
According to the guidelines for the diagnosis of regulatory disorders, non-organic sleep disorders are only diagnosed from the 6th month, since the day-night and sleep-wake cycles are still establishing themselves in the first half of the first year of life. In the second half of the first year (between the 7th and the 9th months), the so-called reorganization processes set in, which lead to an accumulation of sleep problems involving waking and crying at night. Characteristic problems include falling and/or staying asleep (generally accompanied by crying). Sleeping problems are seen as being related to parental support for falling (and re-falling) asleep: the children are unable to fall asleep on their own.
Early Regulatory Problems in Infancy and Psychopathological Symptoms at 24 Months: A Longitudinal Study in a High-risk Sample
Last date updated on December, 2020