The role of attachment security, temperament, maternal perception, and care‐giving behavior in persistent infant sleeping problems

This study investigates the relationship of etiological factors to infant sleeping problems during the first year, and at follow-up during the second year of life. The relevant factors for concurrent sleeping problems (in order of importance) were problematic maternal cognition concerning setting limits on the infant, fussy–difficult infant temperament, maternal anxiety–depression, ambivalent attachment, and certain maternal care-giving behaviors involving the use of active physical comforting (cuddling to sleep, settling on sofa or in parental bed, and giving a feed). High initial levels of sleeping problems largely explained the continuity in infant sleeping problems over time. However, this continuity was significantly mediated by the influence of both problematic maternal cognition and infant temperament on the parental use of active physical comforting to settle infants to sleep. In addition, ambivalent attachment had a small but significant independent contribution to persistent problems. Regarding discontinuity in infant sleeping problems over time, infants who developed sleeping problems were those whose parents used high levels of active physical comforting, whereas those infants whose sleeping problems recovered were more likely to have mothers with low depression–anxiety. The significance of these results is discussed with respect to developmental models of infant sleeping problems, and the assessment and treatment of infant sleeping problems. ©2003 Michigan Association for Infant Mental Health.