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 crying. We hypothesized that this "normal" crying could be reduced by supplemental carrying, that is, increased carrying 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.
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"On average, women who received PREPP reported over two fewer bouts of fuss/cry per day. These results add support to previous findings that demonstrated that the use of specific infant care techniques is effective at reducing infant fuss/cry behavior (Hunziker and Barr 1986; Hiscock et al. 2014). Unlike Hiscock et al. (2014), who found that their intervention reduced crying problems only in babies classified as Bfrequent feeders,^ the current study found that the effects on maternal report of cry behavior were not limited to a subset of infants. "
[Show abstract][Hide abstract] ABSTRACT: Most interventions to prevent postpartum depression (PPD) focus on the mother rather than the mother-infant dyad. As strong relationships between infant sleep and cry behavior and maternal postpartum mood have been demonstrated by previous research, interventions targeted at the dyad may reduce symptoms of PPD. The goal of the current study was to examine the effectiveness of Practical Resources for Effective Postpartum Parenting (PREPP). PREPP is a new PPD prevention protocol that aims to treat women at risk for PPD by promoting maternally mediated behavioral changes in their infants, while also including mother-focused skills. Results of this randomized control trial (RCT) (n = 54) indicate that this novel, brief intervention was well tolerated and effective in reducing maternal symptoms of anxiety and depression, particularly at 6 weeks postpartum. Additionally, this study found that infants of mothers enrolled in PREPP had fewer bouts of fussing and crying at 6 weeks postpartum than those infants whose mothers were in the Enhanced TAU group. These preliminary results indicate that PREPP has the potential to reduce the incidence of PPD in women at risk and to directly impact the developing mother-child relationship, the mother's view of her child, and child outcomes.
Archives of Women s Mental Health 08/2015; DOI:10.1007/s00737-015-0549-5 · 2.16 Impact Factor
"Our laboratory hopes to address the dyadic contribution to PPD with a novel protocol for the prevention of PPD . Practical Resources for Effective Postpartum Parenting ( PREPP ) , cur - rently under study , comprises unique targeted psychotherapy techniques along with the established infant behavioral inter - ventions ( Pinilla and Birch 1993 ; Hunziker and Barr 1986 ) . We hypothesize that women ' s elicitation of behavioral change from their infants may be protective against PPD through several possible mediating pathways : ( 1 ) an increase in par - enting efficacy and resulting diminishment of negative self attributions ; ( 2 ) an improved sense of social support from coaching sessions by the clinician ; ( 3 ) better maternal sleep ; ( 4 ) more effective parenting skills leading to a more respon - sive and rewarding baby ; and ( 5 ) increased attachment to infant . "
[Show abstract][Hide abstract] ABSTRACT: There is considerable public debate over the use of antidepressants in pregnancy. In this article, we offer a commentary on Gail Robinson's important overview of the current controversies. Dr Ronbinson gives a thorough review of the literature, including the risks posed by both antidepressants and depression itself. We summarize her arguments and point out that, in the public conversation, the risks posed to a fetus from antidepressants are consistently overestimated while the risks of untreated depression are consistently underestimated because of the pervasive stigma against mental health. We review recent lay media analyses and urge our fellow physicians to make decisions about prescribing in pregnancy on the basis of evidence and individual patient needs rather than media and stigma.
"Most have involved changes to diet or use of medication, with results mostly suggesting no effect over and above placebo and additionally, the methodological rigor of these trials has been questioned . Increased carrying of the infant has been shown in one trial to prevent crying  but did not reduce established crying in another trial . Keefe  has proposed a model to explain infant colic as a psychobiological disturbance in infant behaviour regulation due to increased sensitivity to the environment. "
[Show abstract][Hide abstract] ABSTRACT: Infant crying and sleep problems (e.g. frequent night waking, difficulties settling to sleep) each affect up to 30% of infants and often co-exist. They are costly to manage and associated with adverse outcomes including postnatal depression symptoms, early weaning from breast milk, and later child behaviour problems. Preventing such problems could improve these adverse outcomes and reduce costs to families and the health care system. Anticipatory guidance-i.e. providing parents with information about normal infant sleep and cry patterns, ways to encourage self-settling in infants, and ways to develop feeding and settling routines before the onset of problems-could prevent such problems. This paper outlines the protocol for our study which aims to test an anticipatory guidance approach.
750 families from four Local Government Areas in Melbourne, Australia have been randomised to receive the Baby Business program (intervention group) or usual care (control group) offered by health services. The Baby Business program provides parents with information about infant sleep and crying via a DVD and booklet (mailed soon after birth), telephone consultation (at infant age 6-8 weeks) and parent group session (at infant age 12 weeks). All English speaking parents of healthy newborn infants born at > 32 weeks gestation and referred by their maternal and child health nurse at their first post partum home visit (day 7-10 postpartum), are eligible. The primary outcome is parent report of infant night time sleep as a problem at four months of age and secondary outcomes include parent report of infant daytime sleep or crying as a problem, mean duration of infant sleep and crying/24 hours, parental depression symptoms, parent sleep quality and quantity and health service use. Data will be collected at two weeks (baseline), four months and six months of age. An economic evaluation using a cost-consequences approach will, from a societal perspective, compare costs and health outcomes between the intervention and control groups.
To our knowledge this is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common, distressing problems.