Parental Responses to Infant Crying and Colic: The Effect on Breastfeeding Duration

Abstract

Breastfeeding to comfort a crying infant is a strong predictor of partial (overall) duration and is rated as a highly effective calming method by parents. These data suggest that parents may benefit from education about normal infant crying patterns and effective methods of infant comforting, including breastfeeding. However, mothers of infants diagnosed with colic are at risk for shortened duration of full breastfeeding. Although the reasons for this are unclear, it may be helpful to specifically address the subject of colic and infant feeding and encourage mothers to fully breastfeed for the recommended 6 months.

A neurobiological model for cry-fuss problems in the first three to four months of life

“…A large multi-centre trial demonstrates that cry-fuss problems predispose mothers to postnatal depression [10]; another large-scale study demonstrates that crying babies are at risk of physically abusive behaviours from caregivers [11]. Breastmilk substitution, a common response to unsettled infant behaviour, is associated with health risks and substantial health system costs [9,23].…”

“…First, unidentified feeding difficulties commonly result in breastmilk substitution, which delays maturation of the intestinal epithelial barrier and increases permeability, alters intestinal motility, alters intestinal microbiota composition and diversity, and predisposes to allergy [9,62]. Second, unidentified feeding difficulties may result in functional lactose overload, which results in increased intestinal contractility, large volumes of gas, explosive, frothy, acidic stools, crying, and altered intestinal microbiota composition [49].…”

“…Although most infant cry-fuss problems resolve without long-term effects, excessive crying is a marker of risk and is not a trivial condition. It is associated with an increased risk of postnatal depression, child abuse, premature breastfeeding cessation, and an increased risk of feeding and behavioural problems including Attention Deficit and Hyperactivity Disorder later in childhood, particularly if the crying persists beyond the first few months [9][10][11][12]. Intervention as early as possible is important, yet health professionals give parents conflicting advice.…”

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

“…FGID symptoms vary from mild to extremely distressing for the infant and parents and may lead to parental anxiety, poor quality of life, short‐ and long‐term health consequences, shortened duration of full breastfeeding, numerous formula changes and medical consultations and high associated healthcare costs 1, 2, 6, 7, 8, 9, 10, 11 (Table 2). …”

The crying baby

“…Persistent problems at 5 months have been estimated to occur in perhaps 5% of crying babies and may also be associated with a small but significant adverse effect on cognitive development [7 ,8 ,9]. Crying babies are also at increased risk of premature breast-feeding cessation and child abuse [10,11]. Their mothers are at increased risk of postnatal depression [12].…”