Infant crying

Last updated
Excessive crying
Baby yelling.jpg
An infant crying
Specialty Pediatrics
Symptoms crying for three or more hours per 24 hours [1]
Complications parental sleep deprivation
Usual onsetat birth
Durationdiffers due to cause
Diagnostic method report by caregivers and differential diagnosis
Differential diagnosis colic
Prognosis later developmental delays

Infant crying is the crying of infants as a response to an internal or external stimulus. Infants cry as a form of basic instinctive communication. [2] Essentially, newborns are transitioning from life in the womb to the external environment. [3] Up to 27% of parents describe problems with infant crying in the first four months. Up to 38% identify a problem with their infant crying within the first year. Parents can be concerned about the amount of time that their infant cries, how the infant can be consoled, and disrupted sleeping patterns. [4] [1] Colic is used as a synonym for excessive crying of infants, even though colic may not be the cause of excessive crying. [5] [6]

Contents

Physiology

Crying may elicit the Valsalva reflex. This reflex negatively impacts sucking pressures and results in poor feeding. The cortisol levels will rise along with blood pressure. Increased blood pressure will have an effect on cerebral blood flow, cerebral blood flow velocity and intracranial pressure. Increased pressures and velocity can lead to intracranial hemorrhage. Prolonged exhalation may also cause some adverse effects. Obstructed venous return and quick inspiratory gasp can occur. Foramen ovale shunting can occur. [3] Adults can often determine whether an infant's cries signify anger or pain. [7] Most parents can distinguish their own infant's cries from those of a different child. [8] Babies mimic their parents' pitch contour. French infants wail on a rising note while German infants favor a falling melody. [9] Overstimulation may be a contributing factor to infant crying and that periods of active crying might serve the purpose of discharging overstimulation and helping the baby's nervous system regain homeostasis. [10] [11]

Misconceptions

Misconceptions regarding the purpose of crying in the infant are common among caregivers and medical personnel. These are usually determined by cultural mores and not by evidence-based explanations. Infant crying is regarded by some to be normal. [12] [13] The belief that infants have a need to cry to expand or exercise their lungs is not supported by research. This is because a healthy newborn infant lung's are able to contain a sufficient amount of air plus a reserve. [3] Birth trauma is related to the amount of crying. Mothers who had experienced obstetrical interventions or who were made to feel powerless during birth had babies who cried more than other babies. [14] Babies who had experienced birth complications had longer crying spells at three months of age and awakened more frequently at night crying. [15] [16] [17] When infants cry for no obvious reason after all other causes (such as hunger or pain) are ruled out, the crying may signify a beneficial stress-release mechanism, although not all sources agree with this. The "crying-in-arms" approach is a way to comfort these infants. [18] [19] [20] Another way of comforting and calming the baby is to mimic the familiarity of the mother's womb. [21] Consistency and promptness of maternal response is associated with a decline in frequency and duration of crying by the end of the first year, and individual differences in crying reflect the history of maternal responsiveness rather than constitutional differences in infant irritability. [22]

Causes

Most infants cry in response to something, although it may be difficult to identify the cause. Sometimes there may be no apparent reason. [23]

Some possible reasons include: [24] [23]

Excessive crying in infants may indicate colic or another health problem. [24] Some health problems are listed below:

Colic

The term 'colic' was defined in 1954 as: "crying for more than three hours per day, for more than three days per week, and for more than three weeks in an infant that is well-fed and otherwise healthy." [12] Colic and excessive crying by infants is synonymous to some clinicians. [6] Colic is attributed to gastrointestinal discomfort like intestinal cramping. [25] Clinicians often admit that colic cannot be treated or that alternative treatments are ineffective. [26] The protocol followed by clinicians to treat colic is described as "treating the parents" with reassurance. [12]

Maternal responses

Crying in infants is associated with high stress levels and depression in mothers. [27] [28] [1] [4] Excessive crying has also been linked to maternal "physical aggression" and "angry speaking." Mothers without assistance in caring for the infant, are more prone to physical aggression. [1] During evaluations of maternal depression responses to infant crying, sleeping problems are closely associated with excessive crying. It is not always clear that when sleeping problems are associated with infant crying, whether the sleeping problems are descriptive of the mother or the infant or both. [28] Maternal stress is associated with excessive crying. [29]

Effects on young children

One definition used to study excessive crying in infants (colic) is crying for three or more hours per 24 hours. Excessive infant crying has been associated with a twofold increased risk of the overall problem behavior, conduct problems, hyperactivity, and mood problems at the age of 5–6. Excessive infant crying doubles the risk of behavioral, hyperactivity, and mood problems at the age of 5–6, as reported by their mother. Excessive crying is not the only factor in later childhood difficulties. Behavioral problems in childhood include the so-called regulatory problems, such as excessive crying, sleeping, and feeding problems, which occur in 20% of infants in multiproblem families. Excessive crying, whining and sleeping problems at 4–6 months are associated with decreased social development at 12 months. [1]

Several factors may contribute to, and partly explain, an association between excessive infant crying and later behavioral and emotional problems. During early infancy, the quality of the mother–child dyad can be considered to be a crucial vehicle for child's healthy mental development. Both early maternal and early paternal reciprocity in infancy are predictive of social competence and lower aggression in preschoolers. [1]

Compared to other infants, excessive crying infants had a slightly lower birth weight and a slightly younger gestational age. Excessive crying infants more often had a single, lower educated mother, originating from a non-industrialized country, who reported more depression, a higher burden of infant care, and more aggressive behavior and had an authoritarian parenting style. Excessive crying was associated with a higher risk for hyperactivity/inattention problems, emotional symptoms, conduct problems, peer relationship problems, and overall problem behavior at the age of 5–6, as well as a higher risk for decreased pro-social behavior as reported by the mother. Excessive crying was also associated with mood problems as well as generalized anxiety problems at the age of 5–6. [1]

Abuse

Shaken baby syndrome

A common type of physical abuse in infants, shaken baby syndrome, is often a reaction to infant crying. [30] Infant crying is a leading risk factor for shaken baby syndrome and other infant abuse. [31] [32]

Related Research Articles

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A time-out is a form of behavioral modification that involves temporarily separating a person from an environment where an unacceptable behavior has occurred. The goal is to remove that person from an enriched, enjoyable environment, and therefore lead to extinction of the offending behavior. It is an educational and parenting technique recommended by most pediatricians and developmental psychologists as an effective form of discipline. During time-outs, a corner or a similar space is designated, where the person is to sit or stand. This form of discipline is especially popular in Western cultures.

<span class="mw-page-title-main">Infant</span> Very young offspring of humans

An infant or baby is the very young offspring of human beings. Infant is a formal or specialised synonym for the common term baby. The terms may also be used to refer to juveniles of other organisms. A newborn is, in colloquial use, an infant who is only hours, days, or up to one month old. In medical contexts, a newborn or neonate is an infant in the first 28 days after birth; the term applies to premature, full term, and postmature infants.

<span class="mw-page-title-main">Physical abuse</span> Medical condition

Physical abuse is any intentional act causing injury or trauma to another person or animal by way of bodily contact. In most cases, children are the victims of physical abuse, but adults can also be victims, as in cases of domestic violence or workplace aggression. Alternative terms sometimes used include physical assault or physical violence, and may also include sexual abuse. Physical abuse may involve more than one abuser, and more than one victim.

<span class="mw-page-title-main">Attachment parenting</span> Parenting philosophy

Attachment parenting (AP) is a parenting philosophy that proposes methods aiming to promote the attachment of parent and infant not only by maximal parental empathy and responsiveness but also by continuous bodily closeness and touch. The term attachment parenting was coined by the American pediatrician William Sears. There is no conclusive body of research that shows Sears' approach to be superior to "mainstream parenting".

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<span class="mw-page-title-main">Baby colic</span> Medical condition

Baby colic, also known as infantile colic, is defined as episodes of crying for more than three hours a day, for more than three days a week, for three weeks in an otherwise healthy child. Often crying occurs in the evening. It typically does not result in long-term problems. The crying can result in frustration of the parents, depression following delivery, excess visits to the doctor, and child abuse.

<span class="mw-page-title-main">Swaddling</span> Practice of wrapping infants so as to restrict movement

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<span class="mw-page-title-main">Birth weight</span> Weight of a human baby at birth

Birth weight is the body weight of a baby at their birth. The average birth weight in babies of European and African descent is 3.5 kilograms (7.7 lb), with the normative range between 2.5 and 4.0 kilograms. On average, babies of Asian descent weigh about 3.25 kilograms (7.2 lb). The prevalence of low birth weight has changed over time. Trends show a slight decrease from 7.9% (1970) to 6.8% (1980), then a slight increase to 8.3% (2006), to the current levels of 8.2% (2016). The prevalence of low birth weights has trended slightly upward from 2012 to the present.

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<span class="mw-page-title-main">Crying</span> Shedding tears in response to emotional stimuli, pain, or irritation of eye

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Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment. Separation anxiety is a natural part of the developmental process. It is most common in infants and little children, typically between the ages of six to seven months to three years, although it may pathologically manifest itself in older children, adolescents and adults. Unlike SAD, normal separation anxiety indicates healthy advancements in a child's cognitive maturation and should not be considered a developing behavioral problem.

Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.

<span class="mw-page-title-main">Breastfeeding and mental health</span>

Breastfeeding and mental health is the relationship between postpartum breastfeeding and the mother's and child's mental health. Research indicates breastfeeding may have positive effects on the mother's and child's mental health, though there have been conflicting studies that question the correlation and causation of breastfeeding and maternal mental health. Possible benefits include improved mood and stress levels in the mother, lower risk of postpartum depression, enhanced social emotional development in the child, stronger mother-child bonding and more. Given the benefits of breastfeeding, the World Health Organization (WHO), the European Commission for Public Health (ECPH) and the American Academy of Pediatrics (AAP) suggest exclusive breastfeeding for the first six months of life. Despite these suggestions, estimates indicate 70% of mothers breastfeed their child after birth and 13.5% of infants in the United States are exclusively breastfed. Breastfeeding promotion and support for mothers who are experiencing difficulties or early cessation in breastfeeding is considered a health priority.

References

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Bibliography

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