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

Abstract

AbstractAimsTo explore parents' experiences of unsettled babies and medical labels.DesignQualitative systematic review, thematic synthesis and development of a conceptual model.Review MethodsSystematic 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 SourcesStructured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023.ResultsTen 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.ConclusionParents 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 CareInsight 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 MethodENTREQ guidelines were adhered to in the reporting of this review.Patient or Public ContributionParent input was crucial in the design phase; shaping the language used (e.g., ‘unsettled babies’) and in the analysis sense‐checking findings.