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Open Access Highly Accessed Study protocol

Baby Business: a randomised controlled trial of a universal parenting program that aims to prevent early infant sleep and cry problems and associated parental depression

Fallon Cook1*, Jordana Bayer2, Ha ND Le3, Fiona Mensah4, Warren Cann1 and Harriet Hiscock2

Author affiliations

1 Parenting Research Centre 5/232 Victoria Parade East Melbourne, Victoria 3002 Australia

2 Centre for Community Child Health, Murdoch Childrens Research Institute The Royal Children's Hospital Melbourne 50 Flemington Road Parkville, Victoria 3052 Australia

3 Deakin Health Economics Deakin University 221 Burwood Hwy Burwood, Victoria 3125 Australia

4 Clinical Epidemiology and Biostatistics Unit Murdoch Childrens Research Institute The Royal Children's Hospital Melbourne 50 Flemington Road Parkville, Victoria 3052 Australia

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Citation and License

BMC Pediatrics 2012, 12:13  doi:10.1186/1471-2431-12-13

Published: 6 February 2012

Abstract

Background

Infant crying and sleep problems (e.g. frequent night waking, difficulties settling to sleep) each affect up to 30% of infants and often co-exist. They are costly to manage and associated with adverse outcomes including postnatal depression symptoms, early weaning from breast milk, and later child behaviour problems. Preventing such problems could improve these adverse outcomes and reduce costs to families and the health care system. Anticipatory guidance-i.e. providing parents with information about normal infant sleep and cry patterns, ways to encourage self-settling in infants, and ways to develop feeding and settling routines before the onset of problems-could prevent such problems. This paper outlines the protocol for our study which aims to test an anticipatory guidance approach.

Methods/Design

750 families from four Local Government Areas in Melbourne, Australia have been randomised to receive the Baby Business program (intervention group) or usual care (control group) offered by health services. The Baby Business program provides parents with information about infant sleep and crying via a DVD and booklet (mailed soon after birth), telephone consultation (at infant age 6-8 weeks) and parent group session (at infant age 12 weeks). All English speaking parents of healthy newborn infants born at > 32 weeks gestation and referred by their maternal and child health nurse at their first post partum home visit (day 7-10 postpartum), are eligible. The primary outcome is parent report of infant night time sleep as a problem at four months of age and secondary outcomes include parent report of infant daytime sleep or crying as a problem, mean duration of infant sleep and crying/24 hours, parental depression symptoms, parent sleep quality and quantity and health service use. Data will be collected at two weeks (baseline), four months and six months of age. An economic evaluation using a cost-consequences approach will, from a societal perspective, compare costs and health outcomes between the intervention and control groups.

Discussion

To our knowledge this is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common, distressing problems.

Trial registration number

ISRCTN: ISRCTN63834603