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‘Either something's wrong, or I'm a terrible parent’: a systematic review of parent experiences of illness-related interpretations for unsettled babies

‘Either something's wrong, or I'm a terrible parent’: a systematic review of parent experiences of illness-related interpretations for unsettled babies
‘Either something's wrong, or I'm a terrible parent’: a systematic review of parent experiences of illness-related interpretations for unsettled babies

Aims: To explore parents' experiences of unsettled babies and medical labels. Design: Qualitative systematic review, thematic synthesis and development of a conceptual model. Review Methods: Systematic review and thematic synthesis of primary, qualitative research into parents' experiences of unsettled babies <12 months of age. ‘Unsettled’ was defined as perception of excessive crying with additional feature(s) such as vomiting, skin or stool problems. The Critical Appraisal Skills Programme (CASP) checklist was used to assess trustworthiness. Data Sources: Structured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023. Results: Ten eligible studies were included across eight countries contributing data from 103 mothers and 24 fathers. Two analytical themes and eight descriptive themes were developed. Firstly, parents expressed fearing judgement, feeling guilty and out of control as a result of babies' unsettled symptoms and seeking strategies to construct an ‘Identity as a “Good Parent”’. This desire for positive parenting identity underpinned the second analytical theme ‘Searching for an explanation’ which included seeking external (medical) causes for babies' unsettled behaviours. Conclusion: Parents can become trapped in a cycle of ‘searching for an explanation’ for their baby's unsettled behaviours, experiencing considerable distress which is exacerbated by feelings of guilt and failure. Impact and Implications for Patient Care: Insight gained from this review could inform interventions to support parents, reducing inaccurate medicalization. Health visiting teams supporting parents with unsettled baby behaviour could focus on supporting a positive parenting identity by managing expectations, normalizing the continuum of infant behaviours, reducing feelings of guilt or uncertainty and helping parents regain a feeling of control. Reporting Method: ENTREQ guidelines were adhered to in the reporting of this review. Patient or Public Contribution: Parent input was crucial in the design phase; shaping the language used (e.g., ‘unsettled babies’) and in the analysis sense-checking findings.

crying, infant, parenting, qualitative research, systematic review, unsettled babies
0309-2402
Dobson, Amy
8c9ce4e3-124a-445a-aaaa-601043e3cc50
Hornsey, Samantha
ae4537b0-04fd-4c1a-a859-e7863fab5055
Ghio, Daniela
96351cac-877b-4010-80f0-e88dcf92dc29
Latter, Susan
83f100a4-95ec-4f2e-99a5-186095de2f3b
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Dobson, Amy
8c9ce4e3-124a-445a-aaaa-601043e3cc50
Hornsey, Samantha
ae4537b0-04fd-4c1a-a859-e7863fab5055
Ghio, Daniela
96351cac-877b-4010-80f0-e88dcf92dc29
Latter, Susan
83f100a4-95ec-4f2e-99a5-186095de2f3b
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad

Dobson, Amy, Hornsey, Samantha, Ghio, Daniela, Latter, Susan, Santer, Miriam and Muller, Ingrid (2024) ‘Either something's wrong, or I'm a terrible parent’: a systematic review of parent experiences of illness-related interpretations for unsettled babies. Journal of Advanced Nursing. (doi:10.1111/jan.16166).

Record type: Review

Abstract

Aims: To explore parents' experiences of unsettled babies and medical labels. Design: Qualitative systematic review, thematic synthesis and development of a conceptual model. Review Methods: Systematic review and thematic synthesis of primary, qualitative research into parents' experiences of unsettled babies <12 months of age. ‘Unsettled’ was defined as perception of excessive crying with additional feature(s) such as vomiting, skin or stool problems. The Critical Appraisal Skills Programme (CASP) checklist was used to assess trustworthiness. Data Sources: Structured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023. Results: Ten eligible studies were included across eight countries contributing data from 103 mothers and 24 fathers. Two analytical themes and eight descriptive themes were developed. Firstly, parents expressed fearing judgement, feeling guilty and out of control as a result of babies' unsettled symptoms and seeking strategies to construct an ‘Identity as a “Good Parent”’. This desire for positive parenting identity underpinned the second analytical theme ‘Searching for an explanation’ which included seeking external (medical) causes for babies' unsettled behaviours. Conclusion: Parents can become trapped in a cycle of ‘searching for an explanation’ for their baby's unsettled behaviours, experiencing considerable distress which is exacerbated by feelings of guilt and failure. Impact and Implications for Patient Care: Insight gained from this review could inform interventions to support parents, reducing inaccurate medicalization. Health visiting teams supporting parents with unsettled baby behaviour could focus on supporting a positive parenting identity by managing expectations, normalizing the continuum of infant behaviours, reducing feelings of guilt or uncertainty and helping parents regain a feeling of control. Reporting Method: ENTREQ guidelines were adhered to in the reporting of this review. Patient or Public Contribution: Parent input was crucial in the design phase; shaping the language used (e.g., ‘unsettled babies’) and in the analysis sense-checking findings.

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Accepted/In Press date: 11 March 2024
e-pub ahead of print date: 25 March 2024
Published date: 25 March 2024
Additional Information: For the purpose of open access, the author has applied a Creative Commons attribution licence (CC-BY) to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
Keywords: crying, infant, parenting, qualitative research, systematic review, unsettled babies

Identifiers

Local EPrints ID: 488978
URI: http://eprints.soton.ac.uk/id/eprint/488978
ISSN: 0309-2402
PURE UUID: 2038e64e-c70b-4228-85e8-d5a8e8ed349f
ORCID for Amy Dobson: ORCID iD orcid.org/0000-0002-7795-2232
ORCID for Samantha Hornsey: ORCID iD orcid.org/0000-0003-1521-248X
ORCID for Susan Latter: ORCID iD orcid.org/0000-0003-0973-0512
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133

Catalogue record

Date deposited: 10 Apr 2024 16:36
Last modified: 05 Oct 2024 02:10

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Contributors

Author: Amy Dobson ORCID iD
Author: Samantha Hornsey ORCID iD
Author: Daniela Ghio
Author: Susan Latter ORCID iD
Author: Miriam Santer ORCID iD
Author: Ingrid Muller ORCID iD

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