Infant Crying Patterns in the First Year: Normal Community and Clinical Findings

James‐Roberts, Ian St; Halil, Tony

doi:10.1111/j.1469-7610.1991.tb01922.x

Cited by 267 publications

(177 citation statements)

References 22 publications

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“…First, the pattern of increased, peaking, and decreased crying has been replicated in all Western societies studied with few variations (61,(68)(69)(70)(71)(77)(78)(79) and no secular trend over the past 30 y (69, 70, 77) (Fig. 2).…”

Section: Cryingmentioning

confidence: 77%

“…Six properties of crying, all described in infants with colic as well, have been shown to be typical and unique to the first months of life (63,(66)(67)(68). Overall crying per day (fussing, crying, and inconsolable crying combined) increases weekly, peaks in the second month, and recedes to stable lower levels by the fourth or fifth month (68)(69)(70), typically referred to as the "normal crying curve." (71) The number of hours of inconsolable crying is roughly proportional to the overall crying infants do (72).…”

Section: Cryingmentioning

confidence: 99%

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Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

Barr

2012

Proc. Natl. Acad. Sci. U.S.A.

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Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.infant development | colic | excessive crying | child maltreatment | parenting A busive head trauma (AHT), also known more commonly as shaken baby syndrome (SBS), is a devastating and potentially lethal form of infant physical abuse (1). The outcomes are grim. In recognized cases, AHT typically results in death or extremely damaging injuries. About 18-25% of babies who are shaken and hospitalized die (2-7). As many as 80% of survivors have significant lifelong brain injuries (3,8,9). Although currently under study, there are no published estimates of lifetime costs per victim specific to AHT. However, the conservative estimated lifetime costs per victim is $210,012 for nonfatal child maltreatment or $1,272,900 for a death from child maltreatment (in 2010 dollars) for a total estimated economic burdern in the US for one year of $124 billion (10). Given its relative severity compared to other forms of maltreatment, these per victim estimates are likely to underestimate the lifetime costs for AHT victims. Of course, the "costs" go far beyond financial considerations, and include the destruction of families and the failure of society's moral obligation to protect defenseless infants.Preventing child maltreatment of any kind is challenging (11) because of the lack of specific stimuli for abuse, the density and difficulties of modifying risk factors in which families of maltreated children are often embedded, and the challenges of getting appropriate supports to the families. However, the convergence of our increasing un...

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Section: Cryingmentioning

confidence: 77%

Section: Cryingmentioning

confidence: 99%

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

Barr

2012

Proc. Natl. Acad. Sci. U.S.A.

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“…Infant irritability and crying problems belong to the most common difficulties for which parents seek professional advice in the first year after birth (Forsyth & Canny, 1991;James-Roberts, & Halil, 1991). Crying problems are reported to peak around 6 weeks of age (Barr, Rotman, Yaremko, Leduc, & Francoeur, 1992) and decrease substantially after the first 3 to 4 months of life.…”

Section: Introductionmentioning

confidence: 99%

Infant irritability: The impact of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband

Lemola

Stadlmayr

Grob

2009

Infant Mental Health Journal

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Objectives: The aim of this study was to investigate the impact of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband on infant irritability in the first one and a half years of life. Four models describing the interplay of these factors were assessed: A direct effect model, an interaction or threshold model, a mediational model and a transactional model. Method: A sample of initially 458 women was assessed in a prospective 3-wave study across the first 17 months after childbirth. Fetal alcohol exposure was questioned retrospectively six weeks after birth. Infant irritability was reported by the mothers and fathers. Results: Support for the direct effect model and the interaction model could be found: Fetal alcohol exposure and low emotional support from the husband were associated with increased infant irritability at 5 months. The impact of fetal alcohol exposure was moderated by postnatal depressive symptoms. More irritability was reported if both risk factors, prenatal alcohol exposure and maternal depressive symptoms, were present. Infant irritability and maternal depressive symptoms were associated cross-sectionally. At the age of 17 months only a main effect of prenatal alcohol exposure on irritability could be found. Conclusion: Direct effects of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband on infant irritability as well as an interaction between fetal alcohol exposure and maternal depressive symptoms were revealed. The interaction can be understood in terms of a diathesisstress model. However, no longitudinal associations between maternal depressive symptoms and infant irritability could be found. Objetivos: La meta de este estudio fue investigar el impacto que el haber estado el feto expuesto al alcohol, los síntomas de la depresión maternal, y el bajo apoyo emocional de parte del esposo tienen sobre la irritabilidad del infante en el primer año y medio de vida. Se evaluaron cuatro modelos que describen el interjuego de estos factores: un modelo de efecto directo, un modelo de interacción o de entrada, un modelo de meditación y un modelo transaccional. Método: Un grupo muestra de 458 mujeres fue evaluado en un estudio de tres etapas futuras a través de los 17 meses después del nacimiento del niño. El haber estado el feto expuesto al alcohol fue investigado retrospectivamente seis semanas después del nacimiento. Las madres y los padres reportaron la irritabilidad del infante. Resultados: Se puede encontrar apoyo para el modelo directo y el modelo de interacción: se asociaron la exposición al alcohol del feto y el bajo apoyo emocional del esposo con el incremento de la irritabilidad del infante a los 5 meses. El impacto de la exposición del feto al alcohol fue moderada por los síntomas depresivos postnatales. Se reportó más irritabilidad si ambos factores de riesgo, la exposición del feto al alcohol y los síntomas de depresión maternal, se encontraban presentes. La irritabilidad del infante y los s...

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“…It has been suggested that an infant' s crying pattern is biologically based but may be modified by environmental factors, such as caregiving styles and physical holding. [5][6][7][8] In test situations in previous studies, preterm infants exhibited more irritability and difficulties in negative affect and state regulation. 9,10 However, in the home environment, preterm infants have been shown to be comparable to full-term infants in the duration and the frequency of crying during the first months of life.…”

mentioning

confidence: 99%

Preterm Infant’s Early Crying Associated With Child’s Behavioral Problems and Parents’ Stress

Korja¹,

Huhtala

Maunu³

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Preterm infants are at an increased risk of regulatory difficulties during infancy and of behavioral problems in childhood. In the full-term population, persistent crying problems that last beyond 3 months of age have been related to later behavioral problems. WHAT THIS STUDY ADDS:Excessive crying by a preterm infant may reflect an increased risk for later behavioral problems and higher parenting stress even years later. Therefore, it is clinically relevant to assess systematically the crying behavior of preterm infants.abstract OBJECTIVE: To study how the early crying behavior of preterm infants at term, 6 weeks, and 5 months of corrected age is related to later behavioral problems at age 3 and 4 years and parenting stress at 2 and 4 years. METHODS:The study group included 202 live-born, low birth weight infants (birth weight #1500 g) born from January 2001 through December 2006 at the Turku University Hospital, Finland. A Baby Day Diary was used to assess the preterm infants' crying behavior at term, 6 weeks, and 5 months of corrected age. The children' s behavior was assessed using the Child Behavior Check List at 3 and 4 years old, and parenting stress was assessed by using the Parenting Stress Index when the child was 2 and 4 years old. RESULTS:The duration and frequency of crying bouts in infancy was associated with Child Behavior Check List scores at 4 years old and to both mothers' and fathers' stress when the child was 2 and 4 years old.CONCLUSIONS: Early excessive crying, especially if lasting up to 5 months of corrected age, is a clinically relevant signal in preterm infants because it may reflect infants' regulatory problems and/or parenting stress. The crying behavior of preterm infants should be systematically inquired about at well-baby clinics. Copyright © 2014 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING:Funding for the full-time research work was received from the Emil Aaltonen Foundation and by the Hospital District of South-West Finland. The funding sources had no role in the study design; in the collection, analysis, or interpretation of data; in the writing of the article; or in the decision to submit it for publication. POTENTIAL CONFLICT OF INTEREST:The authors have indicated they have no potential conflicts of interest to disclose. Preterm infants are at a higher risk than term-born infants for regulatory difficulties during infancy and for behavioral problems in childhood. [1][2][3][4] During infancy, 1 sign of regulatory problems is excessive crying and fussing. It has been suggested that an infant' s crying pattern is biologically based but may be modified by environmental factors, such as caregiving styles and physical holding. [5][6][7][8] In test situations in previous studies, preterm infants exhibited more irritability and difficulties in negative affect and state regulation. 9,10 However, in the home environment, preterm infa...

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Infant Crying Patterns in the First Year: Normal Community and Clinical Findings

Cited by 267 publications

References 22 publications

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

Infant irritability: The impact of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband

Preterm Infant’s Early Crying Associated With Child’s Behavioral Problems and Parents’ Stress

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