Infant Crying Behaviors Interventions Crying cycle strain phase
Infant Crying Behaviors & Interventions
Crying cycle strain phase - inspiration sigh phase - exhalation pause infant cry 1 (click on icon and left arrow) quick gasp
Physiological effects BABY ↑ HR & BP ↓ O₂ ↑ stress response ↓ energy reserves ↑wbc association
CAREGIVER Cry = natural irritant, designed for quick response ↑ BP Quality of response influenced by: stress coping mechanisms post partum depression mental illness fatigue degree of social support
Why? Baby is upset Cues and reasons not always clear Problem-solving/strategies may not be successful
Early Infant Crying Patterns 1 st 3 days - 6. 7 hrs/day 6 wks - Mean duration of crying/day = 43 -120 min 13 wks- ↓ mean duration of 29 min Crying mainly in late afternoon/early evening Innate maturation - similar among many cultures
Normal crying behaviors Source: Brazelton T. Crying in Infancy. Pediatrics. 1962; 29: 582.
Up to 3 months of age: ► 25% of infants will cry for > 3 ½ hours day. ► 10 -20% of infants may be what is termed “excessive” or “colicky” criers. - Colic due to GERD estimated at only 5% for infants <3 mos ► Rule of 3’s: crying >3 continuous hours/day @ least 3 days/wk ► Possible symptoms for advised prompt contact with healthcare provider: • weight loss • blood in vomit or stools • fever • persistent diarrhea
Association of infant crying behaviors and abusive head trauma (AHT) Source: Barr R, Trent R, Cross J. Age-related incidence curve of hospitalized Shaken Baby Syndrome cases: Convergent evidence for crying as a trigger to shaking. Child Abuse & Neglect. 2006; 30: 11.
Education & Intervention Period of Purple Crying® Early Infant Crying: A Guide for Parents & Caregivers Johnson & Johnson Pediatric Institute REST routine
Period of Purple Crying® Sources: http: //purplecrying. info & www. dontshake. org ®
Johnson & Johnson Pediatric Institute Source: Barr R, James-Roberts I, Keefe M. Early Infant Crying: A Guide for Parents and Caregivers. Johnson & Johnson Pediatric Institute. 2007. http: //www. baby. com/jjpi/baby-care/Early. Infant-Crying-A-Guide-to-Parents-and-Caregivers. pdf
The REST Routine Source: Keefe M, Barbosa G, Froese-Fretz A, Kotzer A, Lobo M. An Intervention Program for Families with Irritable Infants. The American Journal of Maternal/Child. 2005; 30(4): 232.
Crying and Disabilities persistent crying associated w/ sleeping & feeding problems >4 mos of age may be associated with multiple parental psychosocial risk factors & can be a predictor of poor infant social & emotional development exposure to neurotoxic substances in utero may increase hyperirritability, particularly when undergoing withdrawal postnatally delay of communication skills may prolong use of crying behaviors as means of functional communication. signs of crying may or may not be typical due to disability
ATYPICAL CRYING EXAMPLE View videoclip of: Matthew* ► Tracheostomy ► Mobius syndrome * Name changed
References 1. Crying sounds audioclip. Audio Productions You. Tube. http: //www. youtube. com/watch? v=Njk. NNDu. Ab 9 A. Accessed December 10, 2013. 2. Ludington-Hoe S, Cong X, Hashemi. Infant Crying: Nature, Physiologic Consequences, and Select Interventions. Neonatal Network. 2002, ; 21(2): 29 -36. 3. Synthesis on crying behavior. Encyclopedia on Early Childhood Development. http: //www. childencyclopedia. com/pages/PDF/Crying_behaviour. pdf. Updated November 4, 2008. Accessed online July 21, 2013. 4. Brazelton T. Crying in Infancy. Pediatrics. 1962; 29: 579 -588. 5. Barr R, Trent R, Cross J. Age-related incidence curve of hospitalized Shaken Baby Syndrome cases: Convergent evidence for crying as a trigger to shaking. Child Abuse & Neglect. 2006; 30: 7 -16. 6. Treem W. Assessing Crying Complaints: The interactions with Gastroesophageal Reflux and Cow’s Milk Protein Intolerance. In: Barr R, James-Roberts I, Keefe M. New Evidence on Unexplained Early Infant Crying: Its Origins, Nature, and Management. Johnson & Johnson Pediatric Institute. 2001: 165 -176. http: //www. baby. com/jjpi/forprofessionals/New-Evidence-on-Unexplained-Early-Infant-Crying-Its-Origins-Nature-and-Management. pdf. 7. National Center on Shaken Baby Syndrome. The Period of Purple Crying. Accessed Online July 22, 2013. http: //purplecrying. info/sub-pages/what-is-the-period-of-purple-crying/components-of-the-program. php. 8. Barr R, James-Roberts I, Keefe M. Early Infant Crying: A Guide for Parents and Caregivers. Johnson & Johnson Pediatric Institute. 2007. Accessed Online July 22, 2013. http: //www. baby. com/jjpi/baby-care/Early-Infant-Crying-AGuide-to-Parents-and-Caregivers. pdf. 9. Keefe M, Barbosa G, Froese-Fretz A, Kotzer A, Lobo M. An Intervention Program for Families with Irritable Infants. The American Journal of Maternal/Child. 2005; 30(4): 230 -237. 10. Douglas P, Hill P. The crying baby: what approach? Current Opinion in Pediatrics. 2001; 23: 523 -529. 11. Hemmi M, Wolke D, Schneider S. Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioral outcomes in childhood: a meta-analysis. Arch Dis Child. 2011; 96: 622 -629.
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