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The devastating and for the most part irremediable consequences for an infant, his or her family, and society in cases of abusive head trauma have spurred research into ways of preventing it. In the last four or five decades, increasing interest in infant crying and its clinical manifestation of colic has led to a reconceptualization of crying in early infancy, such that most of the characteristics of colic can be understood as manifestations of the crying typical of normal infants. This includes an early increase and then decrease in the amount of crying, the unexpected and unpredictable appearance of prolonged crying bouts, and the presence of inconsolable crying that occurs in the early months of life. When these concepts are merged with anecdotal clinical experiences, perpetrator confessions and epidemiological evidence of abusive head trauma, it is clear that these crying characteristics - and caregiver responses - are the predominant, and potentially modifiable, risk factors for abusive head trauma. This unfortunate but understandable relationship between early crying, shaking and abuse has opened windows of opportunity for primary, universal prevention efforts that are appropriate for - and support - all parents and may be able to prevent at least some of these tragic cases. [ABSTRACT FROM AUTHOR]

Prolonged inconsolable crying bouts in the first months of life are frustrating to parents and may lead to abuse. There is no empirical description of frustration trajectories during prolonged crying, nor of their emotional predictors or emotional and behavioural sequelae. Frustration responses and their relationships were explored in an analogue cry listening paradigm. Without knowing how long it would last, 111 postpartum mothers were randomized to listen to a 10-min audiotape of infant crying or cooing while continuously recording frustration on a visual analogue ‘slider’ scale. The listening bout was preceded by questionnaires on negative mood, trait anger and empathy and followed by questionnaires on the reality of the cry sound, positive and negative emotions, soothing strategies, coping strategies and urges to comfort and flee. Individual frustration trajectories were modelled parametrically and characterized by frustration maximum, rate of rise, inflections and harmonicity parameters. As hypothesized, the modal response was of gradually increasing frustration throughout. However, there were marked individual differences in frustration trajectories. Negative mood, trait anger and empathy did not predict modal or modelled individual trajectories. However, frustration responses were significantly related to post-listening emotions and behavioural ratings. In particular, prolonged crying generated highly ambivalent positive and negative emotional responses. In summary, maternal frustration generally increased as the crying bout progressed; however, frustration trajectories were highly individual and emotional responses were highly ambivalent in terms of positive and negative emotions generated. Some emotional and behavioural responses were associated with specific trajectory parameters of frustration responses. [ABSTRACT FROM AUTHOR]

Abstract. To determine whether the composition of feedings would affect newborn behavior independently of the act of feeding itself, 53 two- to three-day-old normal newborns were randomly assigned to receive an extra feeding of water, carbohydrate (lactose), or balanced formula 3 hours after their usual early morning feeding. Previous studies in adult humans and animals, and a single study in human newborns, have indicated that more sleep might be expected following the carbohydrate feed compared with the water and balanced-formula feeds because of recruitment of centrally mediated serotonergic systems. Behavioral effects were assessed for 40 minutes postfeeding by direct observation of the newborn's states (quiet, active, and indeterminate sleep; drowsiness; non-cry wakefulness; and fret/cry). Feed composition did affect behavior, and the effects were fairly specific to particular newborn states. Non-cry wakefulness and drowsiness were unrelated to the presence or type of nutrients, but they tended to occur soon after the meal in all groups. Crying was increased in water-fed newborns relative to both carbohydrate- and formula-fed newborns. Sleeping showed specific patterns of change in all three groups. Sleep duration was increased in the balanced-formula group compared with the water group throughout the observation period. Contrary to the prediction, sleeping duration in carbohydrate-fed newborns never exceeded that of formula-fed newborns; rather, it resembled that of water-fed newborns early in the postprandial period, but formula-fed newborns later. These effects could not easily be explained by potential confounding factors such as handling, volume ingested, caloric intake, or plasma glucose concentration. The... INSET: JUNK MAIL, by Arthur A. Holbrook. [ABSTRACT FROM AUTHOR]

Abstract. To obtain a controlled empirical description of some of the measurable clinical features of colic in a naturalistic context, 38 infants whose mothers considered crying a problem ("colic") and 38 pair-matched control infants were observed and videotaped at home 10 minutes before and after an evening feed. The parents kept a diary of infant behaviors (including crying and fussing) for 7 days following the visit. Following Wessel et al (Pediatrics. 1954;14:421-434), each "colic" infant was classified according to the number of days per week that crying and fussing duration was greater than 3 h/d. The distribution of infants with colic suggested that there were two subgroups: Wessel's colic infants, with 3 days or more per week of more than 3 hours of crying and fussing per day; and non-Wessel's colic infants, with fewer such days. Maternal measures of total daily crying/fussing duration, crying/fussing bout length, and infant temperament and objective analyses of facial activity showed a consistent pattern of differences in which Wessel's colic infants differed from both non-Wessel's colic and control infants, who in turn did not differ from each other. Both colic groups differed from control infants only in the perception of postfeed cries as being more "sick sounding." The results imply that the complaint of colic represents two (or more) groups and that there may be meaningfully distinct colic syndromes. They also provide the first independent empirical support for Wessel and colleagues' clinical distinction between "fussy" and "contented" babies. [ABSTRACT FROM AUTHOR]

Abstract. In healthy infants, crying behavior is reduced significantly by "supplemental" carrying; that is, increased carrying throughout the day in addition to that which occurs during feeding and in response to crying. To determine whether the recommendation to increase carrying would be effective as a therapy for colic, 66 mothers of infants 4 weeks of age or less who came to their pediatricians with complaints of crying problems ("colic") were randomized to receive standard pediatric advice (standard group) or standard advice plus the recommendation to increase supplemental carrying by 50% (supplemental group). Overall, the supplemental group carried their infants 6.1 hours/d throughout the intervention period, an increase of 2.2 hours/d (56%) more than that provided by the standard group. Despite this significant increase in carrying, there was no difference between groups in the duration or frequency of crying, fussing, or cry/fuss at any time throughout the intervention period. When the greatest treatment effect was expected at 6 weeks, the supplemental group infants cried only 3 minutes less per day (95% confidence interval: 37 minutes less to 32 minutes more per day). We conclude that, compared with standard pediatric advice to be "responsive," supplemental carrying does not reduce crying and fussing behavior further in infants who have colic. In marked contrast to healthy infants, this apparent resistance to increased carrying may indicate an important difference in state regulation and control in infants with colic. [ABSTRACT FROM AUTHOR]

ABSTRACT. In the first 3 months of life, crying and fussing in normal infants tend to increase until 6 weeks of age and decrease progressively thereafter. To determine whether feeding choice and early infant temperament are predictors of early crying, 374 healthy, full-term infants were observed prospectively from birth to 6 weeks of age. Feeding choice and sociodemographic characteristics were ascertained in the first few days postpartum. Parents completed a 17-item early infant temperament questionnaire at 2 weeks of age and a 24-hour behavior diary for 8 days at 6 weeks of age. Initially breast-fed infants cried and fussed more frequently throughout 24 hours compared with those who were formula fed, and increased frequency and duration of crying and fussing were predicted by "more difficult" temperament. Furthermore, a different pattern of crying and fussing within the day was found for infants who were changed from breast- to formula feeding. However, according to stepwise multiple regression models, daily duration of crying/ fussing was significantly predicted only by the temperament score (but not initial feeding choice), which accounted for 7% of the variance. Frequency of crying/ fussing were predicted only by socioeconomic status, temperament, and feeding frequency, which accounted for 12% of the variance. Breast- or formula feeding at 6 weeks of age was independently associated with crying/ fussing only during the evening. It was concluded that early infant temperament predisposes to early crying and fussing but is of limited use as a clinical predictor. Later crying/fussing behavior is not predicted by initial feeding. However, the pattern of duration of crying/fussing appears to change following a change from breast to formula, which may account for the presumed effectiveness of this maneuver. Pediatrics 1989;84:514-521; crying, fussing, breast-feeding, formula feeding, temperament. [ABSTRACT FROM AUTHOR]

Abstract. In industrialized societies, the unique pattern of crying in the first three months is "unexplained" but thought to be due to different biobehavioral factors from later crying behavior. To increase the range of the feeding and caretaking behaviors hypothesized to be relevant determinants of early crying? home observations and diary records were analyzed from samples of two subcultures of American middle-class women (La Leche League and "standard care" mothers; each n = 16) differing primarily in such practices. Both during and after the early crying stage, frequently fed infants cried or fretted less often (8.1 v 15.8 episodes per hour at 2 months of age; 10.7 v 16.6 episodes per hour at 4 months of age), and fewer of them exhibited rhythmic crying behavior (four v 11 at 2 months; eight v 13 at 4 months) during observations. However, only during the early crying period at 2 months were interval between feedings and maternal response latency shown to be independent determinants of cry/fret frequency (overall r[sup 2] = .35, P = .01), each factor accounting for approximately half of the explained individual variance. Furthermore, feeding interval was the only variable associated with rhythmic crying behavior at 2 months of age (r[sup 2] = .20; P = .01). In similar analyses at 4 months, there were no significant relationships with later crying or fretting. The results suggest that, in the presence of variation in feeding practice greater than that which is typical for our society, feeding interval may be a significant factor in early (but not later) crying behavior; furthermore, this effect is independent of and additive to the soothing effect of short response latency. Pediatrics 1988;81:529-536; cry, infant, feeding. [ABSTRACT FROM AUTHOR]

ABSTRACT. The crying pattern of normal infants in industrialized societies is characterized by an overall increase until 6 weeks of age followed by a decline until 4 months of age with a preponderance of evening cubing. We hypothesized that this "normal" crying could be reduced by supplemental carrying, that is, increased crying throughout the day in addition to that which occurs during feeding and in response to crying. In a randomized controlled trial, 99 mother-infant pairs were assigned to an increased carrying or control group. At the time of peak crying (6 weeks of age), infants who received supplemental carrying cried and fussed 43% less (1.23 v 2.16 h/d) overall, and 51% less (0.63 v 1.28 hours) during the evening hours (4 PM to midnight). Similar but smaller decreases occurred at 4, 8, and 12 weeks of age. Decreased crying and fussing were associated with increased contentment and feeding frequency but no change in feeding duration or sleep. We conclude that supplemental carrying modifies "normal" crying by reducing the duration and altering the typical pattern of crying and fussing in the first 3 months of life. The relative lack of carrying in our society may predispose to crying and colic in normal infants. [ABSTRACT FROM AUTHOR]

‘Colic’ is an ill-defined but common complaint typically thought to be a sign of an underlying disease process or a clinical entity distinct from the crying t hat characterizes normal in rants. In this paper, an alternative hypothesis is suggested. The general argument is that colic represents the upper end of the spectrum of the crying activity of normal infants. However, it is not the case that all aspects of crying will be increased: rather, that the ‘excessive’ crying in colic is due specifically to prolonged bouts of otherwise normal crying. The results of three studies in normal infants are presented to support this argument. Together, the results support the concept that the crying typical of normal infants reflects a biological predisposition to cry, which is nevertheless affected by sufficiently large changes in the caretaking environment, and that these caretaking changes preferentially affect bout length. If so, then the key to ‘colic’ may be in understanding how biology and behavior interact to produce, not just crying, but prolonged crying bouts. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the temporal morphology and rhythmic structure underlying the repeated bursts of expiratory sounds in a sustained bout of crying of twenty-three 1-month-old infants. Durations of expiratory sounds and bursts were determined from a 90-s bout of naturally occurring cries recorded in the home before feeding. Results indicated wide individual differences in temporal morphology between infants and within infant cry sounds. Binary spectrum analysis of the presence of expiratory sounds in the cry sound detected rhythms in temporal organization at a wide range of dominant frequencies. Spectral complexity (higher numbers of peaks in the power spectrum) was related to a longer time since infants were last fed and shorter expiratory sounds. Results emphasize the importance of viewing cries of young infants as dynamic signals. An ontogenetic history of the rhythms of infant cry sounds may contribute to understanding organismic and environmental experiences which contribute to development. [ABSTRACT FROM AUTHOR]

Recent research concerning the phenomenology of crying in normal and clinical contexts has clarified a number of defining dimensions of the behaviour. Four of the most prominent are developmental changes in both form and function of crying, especially those which take place between two and four months of age; categorical as compared to non-categorical descriptions of crying phenomenology; crying as a behavioural state and its relationships to other state behaviours of infants; and the differential impact of crying in clinical and non-clinical settings. These dimensions are recurrent themes in current research on crying as a signal and must be considered In any comprehensive account of the role and meaning of early infant crying. [ABSTRACT FROM AUTHOR]

Comments on infant crying and infantile colic in the context of a family affair. Predisposition for otherwise normal infants to increase the amount of crying; Mystery and phenomenon of infantile colic; Difficulty of getting a clean definitional handle on the elusive phenomenon.

Introduces articles related to infant crying published in the November 1995 issue of the journal "Early Development and Parenting."

Presents an abstract of the study `Differential Calming Responses to Sucrose Taste in Crying Infants With and Without Colic,' by Ronald G. Barr, Simon N. Young, et al., published in the electronic pages of the `Pediatrics' journal.

Objectives: Infant crying is particularly frustrating to caregivers in the first few months of life and the most common trigger for shaking and abuse. The effectiveness of the Period of PURPLE Crying prevention materials (DVD and booklet) designed to increase knowledge and change behaviors related to crying and the dangers of shaking was reported in North America. The aim of this study was to replicate the effectiveness of the PURPLE materials with mothers of newborns in Japan. Methods: In a randomized controlled trial, 201 parents received either PURPLE materials or analogous control materials on infant safety via mail within 2 weeks of birth. At 6 weeks, mothers completed a 4-day behavioral diary. At 2 months, participants completed a predefined 20-min structured telephone survey by an independent firm to assess knowledge and behavior. Results: Scores on crying knowledge scales (out of 100) were significantly higher in the intervention than control groups (56.1 vs. 53.1; difference=3.0, 95% confidence interval [CI]: 1.0–4.9, p <0.005). Percentage of sharing of advice to walk away if frustrated by crying was significantly higher in the intervention than control groups (22.4% vs. 4.1%; difference=18%, 95% CI: 7.4–29.1). Walking away during unsoothable crying was significantly higher in the intervention group than controls (0.085 vs. 0.017 events per day, rate ratio=4.8, 95% CI: 1.1–21.2) by diary. Self-talk behavior scale (out of 100) tended to significance in the intervention group (16.6 vs. 8.9, difference=7.7, 95% CI: −1.0 to 16.4, p <0.1). Conclusions: Crying knowledge, sharing of walk away information with others and walk away behavior when crying was unsoothable were higher for those who received intervention than control materials. The Period of PURPLE Crying materials may be useful in Japan as well as in North America for informing caregivers about the properties of infant crying and changing some behaviors related to infant crying and shaking. (UMIN Clinical Trials Registry register no. UMIN000001711.) [Copyright &y& Elsevier]