Troublesome crying in infants: the effect of advice to reduce stimulation

Abstract

The observation that babies with troublesome crying improve quickly during hospital admission suggested that, if true, a common, quickly reversible, factor may operate. Histories from the parents of such babies suggest that much work goes into trying to console them. It is hypothesised that this may lead to excessive/inappropriate stimulation and the improvement seen in hospital reflects a reduction/change in stimulation.

Two studies were undertaken: 1) To validate the first observation subjects would have to be randomised to home or hospital management. Study 1 was a pilot study which indicated that too few carers were willing to be randomised but there was strong indication of improvement in mothers' distress and in crying in hospital. In a group advised to reduce stimulation at home similar improvement justified the second study. The subjects enrolled for Study 1 were paired with age-matched controls. Biographical data and a measure of carers' distress in the two groups was compared. In this way, a description of the cohort was obtained. 2) Study 2 was a randomised controlled study of the effect of advice to reduce stimulation in addition to an empathic interview. Non-parametric statistical methods, which described qualitative change, were used to measure change in crying and in carers' distress. The results indicated that the advice was helpful.

Whether this advice is any better than any other advice and whether stimulation is reduced is not known. In any event these studies suggest that most infants with troublesome crying are unlikely to have an underlying organic disorder

Previous research into the effect of interventions in infant colic have examined the effect of the intervention on crying and fussing times. The subject is difficult to study because of difficulties with the definition of 'colic' and crying and fussing. This is the first undertaking of a systematic study of the effect of an intervention to treat troublesome crying in infants and the first time non-parametric statistical methods have been used.