A new European Union study suggests that a significant percentage of pediatric visits for physical complaints may be related to issues during infancy including child regulation or maternal psychiatric problems.

Researchers say that symptoms such as headaches, pain, fatigue, and dizziness, termed Functional Somatic Symptoms (FSS), affect 10 to 30 percent of children and adolescents and account for 2 to 4 percent of pediatric physician visits. The source of the symptoms cannot be explained medically.

In the study, scheduled for publication in The Journal of Pediatrics, researchers determined that infants with regulatory problems (i.e., feeding, sleeping, and tactile reactivity) and/or maternal psychiatric problems may have an increased risk of FSS in later childhood.

Experts believe that maternal anxiety and depression can influence the child’s capacity to self-regulate, but infant problems can also exaggerate parental problems.

Charlotte Ulrikka Rask, M.D., Ph.D., Child and Adolescent Psychiatrist at Aarhus University Hospital in Denmark, said, “Parents of infants with regulatory problems could be taught to help their infants regulate their behavioral and physiological state, which potentially could reduce the risk of later development of impairing FSS.”

Rask and colleagues prospectively assessed 1,327 5- to 7-year-old children who are part of the Copenhagen Child Cohort (6,090 children born around Copenhagen in 2000).

Home health nurses assessed infants four times before they were 10 months of age. Maternal mental health was assessed by self-report 1 to 5 weeks after childbirth, and researchers checked whether mothers had been diagnosed with a mental disorder during the infant’s first year of life.

Researchers looked at three major factors: (1) infant regulatory factor; (2) maternal postnatal psychiatric illness; and (3) annual household income.

At 5 to 7 years of age, 23.2 percent of the children had FSS, with an increased prevalence in girls (27.6 percent versus 18.8 percent).

Arm or leg pain, headaches, and stomach aches were the most frequent FSS reported. Severe FSS was seen in 4.4 percent of the children.

Thirteen mothers were diagnosed with depression, bipolar disorder, or anxiety during their infants’ first year of life; the infants of these mothers were seven times more likely to develop FSS at 5 to 7 years of age. Infants with 2 or more regulating issues had a nearly threefold increased risk of FSS at 5 to 7 years of age.

There was no association between impairing FSS and household income early in life.

Some emerging studies have suggested that eating and sleeping problems during early childhood may be risk factors for mood and anxiety disorders and FSS (e.g., recurrent abdominal pain) later in life.

Because of this, researchers say early intervention is important for both parents and infants.

“Interventions should include strategies to improve maternal mental health and parents’ ability to handle the infant’s regulatory problems, as well as strategies that focus on infants who have multiple regulatory problems,” Rask said.

Source: Elsevier Health Sciences