Background: Excessive crying, sleeping, and feeding problems in early childhood are major stressors that can result in parents feeling socially isolated and having low self-efficacy. Affected children are a risk group for being maltreated and developing emotional and behavioral problems. Thus, the development of an innovative and interactive psychoeducational app for parents of children with crying, sleeping, and feeding problems may provide low-threshold access to scientifically based information and reduce negative outcomes in parents and children. Objective: We aimed to investigate whether following the use of a newly developed psychoeducational app, the parents of children with crying, sleeping, or feeding problems experienced less parenting stress; gained more knowledge about crying, sleeping, and feeding problems; and perceived themselves as more self-effective and as better socially supported and whether their children’s symptoms decreased more than those of the parents who did not use the app. Methods: Our clinical sample consisted of 136 parents of children (aged 0-24 months) who contacted a cry baby outpatient clinic in Bavaria (Southern Germany) for an initial consultation. Using a randomized controlled design, families were randomly allocated to either an intervention group (IG; 73/136, 53.7%) or a waitlist control group (WCG; 63/136, 46.3%) during the usual waiting time until consultation. The IG was given a psychoeducational app that included evidence-based information via text and videos, a child behavior diary function, a parent chat forum and experience report, tips on relaxation, an emergency plan, and a regional directory of specialized counseling centers. Outcome variables were assessed using validated questionnaires at baseline test and posttest. Both groups were compared at posttest regarding changes in parenting stress (primary outcome) and secondary outcomes, namely knowledge about crying, sleeping, and feeding problems; perceived self-efficacy; perceived social support; and child symptoms. Results: The mean individual study duration was 23.41 (SD 10.42) days. The IG reported significantly lower levels of parenting stress (mean 83.18, SD 19.94) after app use compared with the WCG (mean 87.46, SD 16.67; P=.03; Cohen d=0.23). Furthermore, parents in the IG reported a higher level of knowledge about crying, sleeping, and feeding (mean 62.91, SD 4.30) than those in the WCG (mean 61.15, SD 4.46; P<.001; Cohen d=0.38). No differences at posttest were found between groups in terms of parental efficacy (P=.34; Cohen d=0.05), perceived social support (P=.66; Cohen d=0.04), and child symptoms (P=.35; Cohen d=0.10). Conclusions: This study provides initial evidence of the efficacy of a psychoeducational app for parents with child crying, sleeping, and feeding problems. By reducing parental stress and increasing knowledge of children’s symptoms, the app has the potential to serve as an effective secondary preventive measure. Additional large-scale studies are needed to investigate long-term benefits. Trial Registration: German Clinical Trials Register DRKS00019001; https://drks.de/search/en/trial/DRKS00019001

There is a lack of evidence-based app guidance for parents of children with crying, sleeping, and feeding problems who are often highly burdened and not likely to seek professional help. A new psychoeducational app for parents providing scientifically sound information via text and videos, a diary function, selfcare strategies, a chat forum and a regional directory of specialized counseling centers may serve as a low-threshold intervention for this target group. We investigated how parents perceived the app in terms of the following: (1) overall impression and usability, (2) feedback on specific app functions regarding usefulness and (3) possible future improvements. Our clinical sample of N = 137 parents of children aged from 0 to 24 months was recruited from a cry baby outpatient clinic in Southern Germany between 2019 and 2022. A convergent parallel mixed methods design was used to collect and analyse cross-sectional data on app evaluation. After app use within the framework of a clinical trial, parents filled in an app evaluation questionnaire. Most participants used the app at least once a week (86, 62.8 %) over an average period of 19.06 days (SD = 15.00). Participants rated overall impression and usability as good, and the informational texts, expert videos and regional register of counseling centers as appealing and useful. The diary function and chat forum were found to be helpful in theory, but improvements in implementation were requested, such as a timer function for the diary entry. Regarding future functionality, parents posed several suggestions such as the option to contact counseling centers directly via app, and the inclusion of the profile of their partners. Positive ratings of overall impression, usability, and specific app functions are important prerequisites for the app to be effective. App-based guidance for this target group should include easy-to-use information. The app is intended to serve as a secondary preventive low-threshold offer and to complement professional counseling.

Background: Child ADHD symptoms are highly prevalent in middle childhood, alongside impairment in social functioning. The parent–child relationship has been shown to play an important role; however, studies investigating specific facets of the parent–child relationship in ADHD symptomatology in middle childhood have been neglected. We assumed that higher ADHD symptoms were associated with both (1) lower maternal emotional availability (EA) and (2) lower child attachment security. Moreover, (3) we aimed to explore which specific EA dimensions were associated with ADHD symptoms. Methods: In a socio-pediatric clinic in Germany, 71 inpatient mother–child dyads (child age: M = 7.70, SD = 1.06; n = 54 boys) were assessed. Clinical data about child ADHD symptoms (Child Behavior Checklist 6–18 subscale “attention deficit/hyperactivity problems”), maternal EA (free play), and child attachment representation (Attachment Story Completion Task, GEV-B) were analyzed cross-sectionally. Results: Controlling for child oppositional behavior and sex, child ADHD symptoms were associated with overall maternal EA, and more specifically non-hostility, but not with child attachment representation. Conclusions: Our results imply that the role of parent–child interaction quality should be considered in the treatment of ADHD. Bidirectional effects cannot be ruled out.

Background: Families with child crying, sleeping, and feeding problems are a vulnerable group due to high levels of parenting stress and an increased risk for child abuse. However, little is known about their specific situation during the COVID-19 pandemic. The aim of our study was to assess parenting stress and pandemic burden / constraints in families with child crying, sleeping, and feeding problems (= clinical sample) compared to a non-clinical sample. First, we hypothesized that parenting stress during the pandemic would be higher in the clinical sample compared to the nonclinical sample. Moreover, we aimed to explore the extent to which pandemic-related burden / constraints were perceived as restrictive and whether they differed between the two groups. Last, we intended to explore which pandemic-related constraints were associated with parenting stress during the pandemic, controlled for demographic variables. Methods: Using a case-control matched design, standardized questionnaire data from N = 142 parents of children aged 0–24 months, drawn from two different studies (clinical sample: n = 71, nonclinical sample: n = 71) were analyzed. Groups were compared using paired sample t-tests and variables associated with parenting stress were analyzed using a multiple linear regression model. Results: Parenting stress (p <.001, d _z =0.64) and overall pandemic burden (p =.034, d _z =0.26) were higher in the clinical group compared to the nonclinical group, whereas groups did not differ significantly in terms of specific pandemic-related constraints. Both groups reported being burdened especially by restricted leisure activities (79.6%) and reduced family support services (74%). Parenting stress was associated with child age (β=-0.20, p =.024), the presence of siblings (β=-0.21, p =.034), overall pandemic burden (β = 0.25, p =.009), increased childcare responsibilities (β = 0.19, p =.046), and increased family conflicts (β = 0.29, p <.001). Conclusions: Families with crying, sleeping, and feeding problems experienced high levels of parenting stress and were significantly burdened by the pandemic itself. Thus, as a double-risk group during the pandemic, they require targeted attention in prevention and intervention efforts, including access to professional support and opportunities for safe social connection and leisure activities. Trial registration: Clinical group: German Register of Clinical Studies DRKS00019001, registration date: 2020-01-28, nonclinical group: OSF, https://osf.io/tksh5, registration date: 2021-01-15.

Background/Objectives: Infant regulatory problems (RPs), i.e., crying, sleeping, and feeding problems, are associated with unfavorable outcomes in later childhood. RPs increased during the pandemic; however, their occurrence in the face of today’s societal challenges remains unclear. RPs are strongly linked to parenting stress and less positive parenting behaviors, but their interplay is less investigated. Methods: In this cross-sectional, questionnaire-based study (ntotal = 7039), we compared the incidences of crying, sleeping, and feeding problems in infants (0–2 years) in pandemic (npandemic = 1391) versus post-pandemic (npost-pandemic = 5648) samples in Germany. We also investigated the relationship between post-pandemic infant RPs and parenting behaviors with parenting stress as a potential mediator for fathers and mothers. Results: Crying/whining/sleeping problems (34.8%) and excessive crying (6.3%) were significantly more prevalent in the post-pandemic sample. In both mothers and fathers, infant RPs were significantly associated with less positive parenting behaviors. Parenting stress partially mediated this relationship. Conclusions: RPs in the post-pandemic era are even more prevalent than during the pandemic, highlighting the imperative for health care professionals to focus on infant mental health. Parenting stress emerges as an entry point for addressing the cycle of infant RPs and maladaptive behaviors in both fathers and mothers.

Background/Objectives: Infant regulatory problems (RP), i.e. crying, sleeping, and feeding problems, are associated with unfavourable outcomes in later childhood. RP increased during the pandemic, however their occurence in the face of today’s societal challenges remains unclear. RP are strongly linked to parenting stress and less positive parenting behaviors but their interplay is less investigated. Methods: In this cross-sectional questionnaire-based study (ntotal =7,039), we compared incidences of crying, sleeping, and feeding problems in infants (0-2 years) in a pandemic (npandemic= 1,391) versus a post-pandemic (npost-pandemic= 5,648) sample in Germany. We also investigated the relationship between post-pandemic infant RP and parenting behaviors with parenting stress as a potential mediator for fathers and mothers. Results: Crying/ Sleeping problems (34.8%) and excessive crying (6.3%) were significantly higher pronounced in the post-pandemic sample. In both mothers and fathers, infant RP were significantly associated with less positive parenting behaviors. Parenting stress partially mediated this rela-tionship. Conclusions: RP in the post-pandemic era are even higher pronounced than during the pandemic, highlighting the imperative for health care professionals to focus on infant mental health. Par-enting stress emerges as an entry point for addressing the cycle of infant RP and maladaptive behaviors in both fathers and mothers.