Interventions to Support Parents Whose Babies Cry Excessively: Systematic Review

Abstract

CONTEXT: Parents report that around 10% to 20% of babies cry a lot without an apparent reason during early infancy. This "excessive" infant crying can lead to adverse outcomes, including parental depression, breastfeeding cessation, impaired parent-child relationships, and, in extreme cases, infant abuse. Cost-effective parent-support services are needed. OBJECTIVE: To assess the effectiveness and cost-effectiveness of interventions designed to support parents of excessively crying babies. DATA SOURCES: MEDLINE, Embase, EconLit, Web of Science, Scopus, PsycINFO, CINAHL and CENTRAL were searched from inception to 8th April 2025. The NIHR CRN database and handsearching were used to identify further studies. STUDY SELECTION: Comparative studies reporting parental outcomes for any intervention supporting parents of excessively crying infants aged ≤1 year were included. DATA EXTRACTION: Two independent reviewers conducted data extraction and assessed risk of bias. Meta-analysis was performed when possible; otherwise, narrative synthesis was conducted. RESULTS: Meta-analysis found that educational interventions significantly reduced parental stress or anxiety. Narrative analyses produced mixed findings, but components common to successful educational interventions were indicated. Meta-analyses of studies administering probiotics to infants found significant improvements in parents' quality of life but not in parental depression. No safety data and limited economic evidence were found. LIMITATIONS: Few studies measured similar enough parental outcomes to be pooled in meta-analysis. Risk of bias ranged from unclear to high risk. CONCLUSIONS: Educational and probiotic interventions show promise for supporting parents of excessively crying babies. Additional controlled trials employing evidence-based interventions and outcome measures and cost-effectiveness analyses are needed to build on these findings.