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Background: An important developmental task for infants over their first few years of life is to learn to settle to sleep with a reasonably short latency, maintain sleep through the night and coordinate with family sleeping and waking schedules. A child who can reliably do this is exhibiting self-regulated sleep. Otherwise, children's sleep may have to be other (non-self) regulated to some degree and they may exhibit pediatric sleep disturbances (e.g., extended sleep latency, and/or frequent nightwaking); these are reported by 36-45% of parents of infants between ages four to 12 months., Purpose: To answer the question: Can infant and parent factors observed at 1 month of infant age predict which infants will have regulated sleep at 6- and 12-months of age? Prediction from 1 month has not previously been investigated., Methods: In a prospective longitudinal study, the mothers of 52 typically developing infants completed 6-day sleep diaries at 1, 3, 6, 9 and 12 months from which a composite sleep score (CSS) was derived for each child at each month. Diary reliability was assessed once (for 54% of families) using all-night videosomnography., Results: At 6 months, CSS scores were distributed bi-modally and thus differentiated into two groups by an empirically observed CSS cutoff score, with a majority (56%) of infants classified as self-sleep regulated (S-R) and the rest as non-self sleep-regulated (NS-R). At 12 months, 72% could similarly be classified as S-R, while 28% exhibited some continuing sleep disturbance. Discriminant function analysis investigated the predictors of S-R vs NS-R group membership at 6 and 12 months from parent and child variables recorded at 1 month. Parent presence at sleep onset and less total infant sleep time predicted group membership at 6 months with 94% classification accuracy, and parental presence at sleep onset and frequency of infant night wakings predicted group membership at 12 months with 85% accuracy. At 1 month, parents of infants later classified as NS-R at 6 and 12 months had higher frequencies of all settling activities than parents of those later classified as S-R., Conclusion: Variables measured at 1 month that predicted sleep status at 6 and 12 months were parental presence at sleep onset, frequency of infant night waking and total infant sleep time. The overall frequency of parent settling activities at 1 month also clearly differentiated the two sleep groups at the older ages. Parenting behaviours are modifiable factors and thus may have the potential for preventing pediatric sleep disturbances in children., Competing Interests: The authors have no financial relationships relevant to this article or conflicts of interest to disclose., (© 2020 Henderson et al.)

Background: Children born to opioid-dependent mothers are at risk of adverse neurodevelopment. The magnitude of this risk remains inconclusive., Objective: To conduct a meta-analysis of studies that assessed neurodevelopmental outcomes of children aged 0 to 12 years born to opioid-dependent mothers, compared with children born to nonopioid-dependent mothers, across general cognitive, language, motor, and social-emotional domains., Data Sources: PubMed, CINAHL, PsycINFO, and Google Scholar databases., Study Eligibility Criteria: English-language publications between January 1993 and November 2018, including prenatally opioid-exposed and nonopioid-exposed comparison children, reporting outcomes data on standardized assessments., Study Appraisal and Synthesis Methods: Two reviewers independently extracted data. Pooled standardized mean differences (SMDs) were analyzed using random effects models. Risk of bias was assessed with the Newcastle-Ottawa Quality Assessment Scale., Results: Across 16 studies, individual domain outcomes data were examined for between 93 to 430 opioid-exposed and 75 to 505 nonopioid-exposed infants/children. Opioid-exposed infants and children performed more poorly than their nonopioid-exposed peers across all outcomes examined, demonstrated by lower infant cognitive (SMD = 0.77) and psychomotor scores (SMD = 0.52), lower general cognition/IQ (SMD = 0.76) and language scores (SMD = 0.65-0.74), and higher parent-rated internalizing (SMD = 0.42), externalizing (SMD = 0.66), and attention problems (SMD = 0.72)., Limitations: Most studies examined early neurodevelopment; only 3 reported school-age outcomes thereby limiting the ability to assess longer-term impacts of prenatal opioid exposures., Conclusions and Implications of Findings: Children born to opioid-dependent mothers are at modest- to high-risk of adverse neurodevelopment at least to middle childhood. Future studies should identify specific clinical and social factors underlying these challenges to improve outcomes., (Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.)

This review investigates development in the durations of infants' capabilities for sustained sleep across their first year, a matter of interest to clinicians, parents and researchers. It describes three aspects of sleep development: longest sustained sleep period (sleep sustained without awakening), longest self-regulated sleep period (behavioural quietude including sleep and quiet awakenings), and sleeping through the night (a predetermined nocturnal period). Clear trends were evident despite methodological differences making comparison between studies difficult. The most marked changes were across the first 4 months, particularly ages 1 and 2 months. Minimal changes followed through to 9 months and a small increase in all but the longest sustained sleep period, until age 12 months. Moore and Ucko's early, yet influential definition for sleeping through the night (24:00-05:00 h) may have underestimated infants' capacities for uninterrupted sleep. Infants do meet more stringent criteria and most can sleep 8 h by age 6 months and 9 or more hours thereafter. These findings have implications for clinicians addressing parental concerns around developmentally appropriate expectations of infant sleep. Researchers now have sufficient evidence to identify developmentally sensitive timing for preventive interventions for infant sleep disturbance., (Copyright © 2010 Elsevier Ltd. All rights reserved.)