Evaluation of self-regulation (crying, sleeping and feeding) in premature and term infants

Self-regulation, in accordance with one's own purposes, targeting cognition, emotion, action and environmental characteristics; are multi-component, repetitive and self-managed transactions. The degree of development of self-regulation in childhood and adolescence greatly predicts success and happiness in life. The aim of this study was to determine the prevalence of self-regulation problems in premature and term infants at the 3rd, 6th and 12th months; to investigate the predictors which may be the signal of self-regulation problems before and after birth and to investigate the frequency of self-regulation problems of the infants who have self-regulation problem in the first 6 months of life. This study is a national single center prospective, descriptive research. The study was conducted between February 2018 and May 2019 at Hacettepe University İhsan Doğramacı Children's Hospital Developmental Pediatric Outpatient Clinic. A total of 174 infants which were very premature (VP, n=50), moderate premature (MP, n=26), late premature (LP, n=50) and control term (n= 48) were included in this study. Early self-regulation problems were defined as crying, sleep and feeding problems and multiple self-regulation problems which includes multiple problems at the same time. Maternal depression was screened, infant's developmental evaluations and neurological examinations were performed. There was a self-regulation problem in 83,3% infants at 3-month, 71,8% at 6-month, 67,2% at 12-month; crying problem in 8,6% at 3-month, 4,5% at 6-month, 5,2% at 12-month; sleep problem in 77,6% at 3-month, 69,0% at 6-month, 64,9% at 12-month; feeding problem in 24,1% at 3-month, 20,1% at 6-month, 10,6% at 12-month. No significant difference was found between the groups in crying and sleep problems at the third, 6th and 12th months. However, feeding problems were more frequent in term and late premature (LP) infants at 3 months, while feeding problems were more frequent in VP and MP infants at 12 months. Mother's stress, male gender, being young mother, being VP, neurodevelopmental disturbances, developmentalal delay increased the risk of crying problem. Mother's stress, neurodevelopmental disturbances, feeding problems, developmental delay of the baby increased the risk of sleep problems. Mother's stress, female gender, VP, neurodevelopmental disturbances, sleep problems, developmental delay of the baby increased the risk of feeding problems. Sleep problems at the third month were associated with sleep problems at 12 months. Feeding problems at the third and sixth months were associated with feeding problems at 12 months. The crying problem in the third month and sleep or feeding problem at the 6th month were associated with multiple regulatory problems at 12 months. As a result, early self-regulation problems are common in premature and term babies and the mother should be questioned about these self-regulatory problems in the baby as well as evaluated and screened for maternal stress score and depression.