ZusammenfassungBis zu 20 % aller gesunden Säuglinge und Kleinkinder zeigen in den ersten Lebensjahren psychische Störungen im Sinne von untröstbarem Schreien (sog. Schreibabys), Schlaf- und Fütterstörungen. Nach Frühgeburt und bei Kindern mit neuropädiatrischen Erkrankungen finden sich noch deutlich häufiger vor allem langanhaltende Fütterstörungen und Schlafstörungen. Langfristig können sich daraus internalisierende und externalisierende Störungen im späteren Kindesalter entwickeln, häufig ist die Eltern-Kind-Beziehung belastet. Die Eltern schildern schwere Erschöpfung, extreme Verunsicherung und Hilflosigkeit.Kinderärztinnen und Hebammen sind die ersten Anlaufstellen für die Familien. Schreibabyambulanzen, wie die 1991 von Mechthild Papoušek gegründete „Münchner Sprechstunde für Schreibabys“ am kbo-Kinderzentrum-München, sind für die hochbelasteten Familien ein niederschwelliges Angebot und leisten einen wichtigen Beitrag zur Prävention von Vernachlässigungen, Misshandlungen und psychischen Folgeerkrankungen des Kindes. Behandlungskonzepte basieren auf der Eltern-Kleinkind- und Bindungsforschung und integrieren kind- und elternbezogene Therapieansätze.Während der COVID-19-Pandemie sind die psychosozialen Belastungen in den Familien gestiegen; dies war auch in den Schreibabyambulanzen deutlich spürbar.

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

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Die Eltern-Kind-Bindung und frühen Beziehungserfahrungen prägen entscheidend die frühkindliche psychische Entwicklung in allen Facetten, insbesondere das kindliche soziale Verhalten und die Entwicklung zur Empathie. Was braucht das Baby von seiner unmittelbaren Umgebung, von seinen primären Bezugspersonen? Was brauchen die Eltern für eine förderliche Entwicklung ihres Babys und Kleinkindes?