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BMJ Paediatrics Open Apr 2023Stimulating infants to elicit a cry at birth is common but could result in unnecessary handling. We evaluated heart rate in infants who were crying versus non-crying but... (Comparative Study)
Comparative Study Observational Study
BACKGROUND
Stimulating infants to elicit a cry at birth is common but could result in unnecessary handling. We evaluated heart rate in infants who were crying versus non-crying but breathing immediately after birth.
METHODS
This was single-centre observational study of singleton, vaginally born infants at ≥33 weeks of gestation. Infants who were or within 30 s after birth were included. Background demographic data and delivery room events were recorded using tablet-based applications and synchronised with continuous heart rate data recorded by a dry-electrode electrocardiographic monitor. Heart rate centile curves for the first 3 min of life were generated with piecewise regression analysis. Odds of bradycardia and tachycardia were compared using multiple logistic regression.
RESULTS
1155 crying and 54 non-crying but breathing neonates were included in the final analyses. There were no significant differences in the demographic and obstetric factors between the cohorts. Non-crying but breathing infants had higher rates of early cord clamping <60 s after birth (75.9% vs 46.5%) and admission to the neonatal intensive care unit (13.0% vs 4.3%). There were no significant differences in median heart rates between the cohorts. Non-crying but breathing infants had higher odds of bradycardia (heart rate <100 beats/min, adjusted OR 2.64, 95% CI 1.34 to 5.17) and tachycardia (heart rate ≥200 beats/min, adjusted OR 2.86, 95% CI 1.50 to 5.47).
CONCLUSION
Infants who are quietly breathing but do not cry after birth have an increased risk of both bradycardia and tachycardia, and admission to the neonatal intensive care unit.
TRIAL REGISTRATION NUMBER
ISRCTN18148368.
Topics: Humans; Male; Female; Infant, Newborn; Pregnancy; Adult; Crying; Heart Rate; Bradycardia; Tachycardia; Intensive Care Units, Neonatal; Respiration; Resuscitation; Parturition
PubMed: 37028906
DOI: 10.1136/bmjpo-2023-001886 -
American Family Physician Aug 2004Infantile colic can be distressing to parents whose infant is inconsolable during crying episodes. Colic is often defined by the "rule of three": crying for more than... (Review)
Review
Infantile colic can be distressing to parents whose infant is inconsolable during crying episodes. Colic is often defined by the "rule of three": crying for more than three hours per day, for more than three days per week, and for longer than three weeks in an infant who is well-fed and otherwise healthy. The physician's role is to ensure that there is no organic cause for the crying, offer balanced advice on treatments, and provide support to the family. Colic is a diagnosis of exclusion that is made after performing a careful history and physical examination to rule out less common organic causes. Treatment is limited. Feeding changes usually are not advised. Medications available in the United States have not been proved effective in the treatment of colic, and most behavior interventions have not been proved to be more effective than placebo. Families may turn to untested resources for help, and the physician should offer sound advice about these treatments. Above all, parents need reassurance that their baby is healthy and that colic is self-limited with no long-term adverse effects. Physicians should watch for signs of continuing distress in the child and family, particularly in families whose resources are strained already.
Topics: Colic; Crying; Humans; Infant; Infant Behavior; Infant, Newborn
PubMed: 15338787
DOI: No ID Found -
BMJ Clinical Evidence Feb 2010Colic in infants causes one in six families (17%) with children to consult a health professional. One systematic review of 15 community-based studies found a wide... (Review)
Review
INTRODUCTION
Colic in infants causes one in six families (17%) with children to consult a health professional. One systematic review of 15 community-based studies found a wide variation in prevalence, which depended on study design and method of recording.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for colic in infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: advice to increase carrying, advice to reduce stimulation, casein hydrolysate milk, cranial osteopathy, crib vibrator device, focused counselling, gripe water, infant massage, low-lactose milk, simethicone, soya-based infant feeds, spinal manipulation, and whey hydrolysate milk.
Topics: Animals; Colic; Crying; Double-Blind Method; Humans; Infant; Manipulation, Osteopathic; Milk; Research Design; Simethicone
PubMed: 21729336
DOI: No ID Found -
Current Treatment Options in Oncology Nov 2023Since total neoadjuvant treatment achieves almost 30% pathologic complete response, organ preservation has been increasingly debated for good responders after... (Review)
Review
Since total neoadjuvant treatment achieves almost 30% pathologic complete response, organ preservation has been increasingly debated for good responders after neoadjuvant treatment for patients diagnosed with rectal cancer. Two organ preservation strategies are available: a watch and wait strategy and a local excision strategy including patients with a near clinical complete response. A major issue is the selection of patients according to the initial tumor staging or the response assessment. Despite modern imaging improvement, identifying complete response remains challenging. A better selection could be possible by radiomics analyses, exploiting numerous image features to feed data characterization algorithms. The subsequent step is to include baseline and/or pre-therapeutic MRI, PET-CT, and CT radiomics added to the patients' clinicopathological data, inside machine learning (ML) prediction models, with predictive or prognostic purposes. These models could be further improved by the addition of new biomarkers such as circulating tumor biomarkers, molecular profiling, or pathological immune biomarkers.
Topics: Humans; Treatment Outcome; Positron Emission Tomography Computed Tomography; Crying; Chemoradiotherapy; Rectal Neoplasms; Neoadjuvant Therapy; Watchful Waiting; Biomarkers; Retrospective Studies
PubMed: 37702885
DOI: 10.1007/s11864-023-01125-9 -
Journal of the American Academy of... Jun 2023Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to...
OBJECTIVE
Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to understand the mechanisms underlying excessive crying and irritability in infancy, research into the neurobiology of excessive crying is needed. We examined whether excessive crying and irritability in infancy are associated with behavioral problems and amygdala volume among children and adolescents.
METHOD
This study included 4,751 singleton children from the prospective population-based Generation R Study cohort, born in the Netherlands in 2002 to 2006. Excessive crying (>3 hours on at least 1 day/wk) and irritability (Mother and Baby Scales questionnaire) were parent-rated at 3 months. Amygdala volume was measured at 10 years using magnetic resonance imaging, and internalizing and externalizing were parent-rated at 1.5, 3, 6, 10, and 14 years and self-rated at 14 years. Covariates included child age, sex, national origin, gestational age, and maternal age, psychopathology score, parity, education, relationship status, and family income.
RESULTS
Children who cried excessively in infancy had higher parent-rated internalizing (effect estimate = 0.20 SD-units, 95% CI = 0.14, 0.27) and externalizing (0.17 SD-units, 95% CI = 0.10, 0.24) throughout childhood (linear mixed models), and smaller amygdala volume at 10 years (-0.19 SD-units, 95% CI = -0.32, -0.06) (linear regression model). The pattern of associations for both behavioral problems and amygdala volume was similar for irritability.
CONCLUSION
Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and may be linked with neurobiological differences in the development of the amygdala.
Topics: Child; Female; Pregnancy; Humans; Infant; Adolescent; Prospective Studies; Problem Behavior; Crying; Mothers; Amygdala
PubMed: 36758936
DOI: 10.1016/j.jaac.2023.01.014 -
Journal of Clinical Psychology in... Dec 2019We examined several aspects of the crying experiences of physicians and medical interns, including the most common reasons to cry in the workplace, and their perceptions...
We examined several aspects of the crying experiences of physicians and medical interns, including the most common reasons to cry in the workplace, and their perceptions of and attitudes towards crying in the workplace and in the presence of a patient. A sample of Dutch physicians and medical interns (N = 1068 and N = 302 and for the full version N = 776 and N = 181) completed an especially designed anonymous online questionnaire about experiences with crying in the workplace, and perceptions of and attitudes towards crying in the workplace and in the presence of patients. Crying is a rather frequent behavior among physicians, in particular when they have to deal with the severe suffering of patients and their relatives. We found a considerable variety in the attitudes and perception of crying in the work setting, although there was also much agreement that crying in the presence of a patient is only appropriate if it is over the condition of the patient. Physicians reported a slightly more positive attitude and a stronger need for more attention to this topic in training and education than medical interns. Crying in the medical setting is a common, though understudied phenomenon. There is a strong need for further research on this topic in order to understand it better and how and when it might interfere with or facilitate with the therapeutic process. We strongly feel that currently the time is ripe for this topic because in particular the physicians expressed a greater need for more attention to this topic in training and the medical interns showed signs of, perhaps unhealthy, suppression of their emotions.
Topics: Adult; Attitude of Health Personnel; Crying; Emotions; Female; Humans; Internship and Residency; Male; Netherlands; Physicians; Psychotherapy; Surveys and Questionnaires; Workplace; Young Adult
PubMed: 30783989
DOI: 10.1007/s10880-019-09611-9 -
F1000Research 2018A newborn brings joy to the family. Crying belongs to the spectrum of normal behaviour of young infants. However, although it occurs in about 20% of all infants,... (Review)
Review
A newborn brings joy to the family. Crying belongs to the spectrum of normal behaviour of young infants. However, although it occurs in about 20% of all infants, unsoothable and persistent crying in young infants distresses the family, although it is usually benign. The aetiology of infantile colic remains unknown, although an unbalanced gastro-intestinal microbiome, increased intestinal permeability, and chronic inflammation are involved, as well as behavioural factors, including over- and under-stimulation. It is a challenge for healthcare professionals to decide when organic disease needs to be excluded. Parental stress is a reason for babies to cry more, inducing a vicious cycle. Therefore, parental reassurance with explanatory guidance is the cornerstone of management. The placebo effect is estimated to be as high as 50%. If an intervention is felt to be necessary to offer further support to the baby and family, it is important to choose the options for which there is some efficacy without adverse effects. There is evidence that some specific probiotic strains such as DSM 19378, especially in breastfed infants, are effective. However, there are also promising data for some synbiotics and/or killed or tyndallized bacteria, as well as substances decreasing intestinal permeability. Formula management with extensive and/or partial hydrolysates may also bring relief. But, above all, offering parental support remains imperative.
Topics: Colic; Crying; Disease Management; Gastrointestinal Microbiome; Humans; Infant, Newborn; Limosilactobacillus reuteri; Probiotics
PubMed: 30271572
DOI: 10.12688/f1000research.14940.1 -
Journal of Neuroendocrinology Nov 2011This overview attempts to synthesise current understandings of the neuroendocrine basis of parenting. The parent-infant bond is central to the human condition,... (Review)
Review
This overview attempts to synthesise current understandings of the neuroendocrine basis of parenting. The parent-infant bond is central to the human condition, contributes to risks for mood and anxiety disorders, and provides the potential for resiliency and protection against the development of psychopathology. Animal models of parenting provide compelling evidence that biological mechanisms may be studied in humans. This has led to brain imaging and endocrine system studies of human parents using baby stimuli and concerted psychological and behavioural measures. Certain brain circuits and related hormonal systems, including subcortical regions for motivation (striatum, amygdala, hypothalamus and hippocampus) and cortical regions for social cognition (anterior cingulate, insula, medial frontal and orbitofrontal cortices), appear to be involved. These brain circuits work with a range of endocrine systems to manage stress and motivate appropriate parental caring behaviour with a flexibility appropriate to the environment. Work in this field promises to link evolving models of parental brain performance with resilience, risk and treatment toward mother-infant mental health.
Topics: Adult; Crying; Humans; Infant, Newborn; Neuroendocrinology; Parents
PubMed: 21848646
DOI: 10.1111/j.1365-2826.2011.02212.x -
Pediatric Research Dec 2023Maternal stress has negative consequences on infant behavioral development, and COVID-19 presented uniquely stressful situations to mothers of infants born during the...
BACKGROUND
Maternal stress has negative consequences on infant behavioral development, and COVID-19 presented uniquely stressful situations to mothers of infants born during the pandemic. We hypothesized that mothers with higher levels of perceived stress during the pandemic would report higher levels of infant regulatory problems including crying and interrupted sleep patterns.
METHODS
As part 6 sites of a longitudinal study, mothers of infants born during the pandemic completed the Perceived Stress Scale, the Brief Infant Sleep Questionnaire, and an Infant Crying survey at 6 (n = 433) and 12 (n = 344) months of infant age.
RESULTS
Maternal perceived stress, which remained consistent at 6 and 12 months of infant age, was significantly positively correlated with time taken to settle infants. Although maternal perceived stress was not correlated with uninterrupted sleep length, time taken to put the infant to sleep was correlated. Perceived stress was also correlated with the amount of infant crying and fussiness reported at 6 months.
CONCLUSIONS
Mothers who reported higher levels of perceived stress during the pandemic reported higher levels of regulatory problems, specifically at 6 months. Examining how varying levels of maternal stress and infant behaviors relate to overall infant developmental status over time is an important next step.
IMPACT
Women giving birth during the COVID-19 pandemic who reported higher levels of stress on the Perceived Stress Scale also reported higher levels of infant fussiness and crying at 6 months old, and more disruptive sleep patterns in their infants at 6 months and 12 months old. Sleeping problems and excessive crying in infancy are two regulatory problems that are known risk factors for emotional and behavioral issues in later childhood. This paper is one of the first studies highlighting the associations between maternal stress and infant behaviors during the COVID-19 pandemic.
Topics: Infant; Humans; Female; Pregnancy; Child; Pandemics; Longitudinal Studies; Infant Behavior; COVID-19; Mothers; Crying; Stress, Psychological
PubMed: 37500757
DOI: 10.1038/s41390-023-02748-2 -
Lancet (London, England)Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants...
Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants aged 1-6 months, in the Netherlands. In infants aged 6 months, 5.6% (95% CI 4.2-7.0) of parents reported having smothered, slapped, or shaken their baby at least once because of its crying. The risks of detrimental actions were highest for parents from non-industrialised countries, those with either no job or a job with short working hours, and those who judged their infant's crying to be excessive. Clinicians should be aware of the risks of abuse in children known to cry a lot and should target interventions at parents to help them cope with this crying.
Topics: Child Abuse; Crying; Female; Humans; Infant; Infant Behavior; Infant, Newborn; Male; Netherlands; Parents; Prevalence; Socioeconomic Factors; Surveys and Questionnaires
PubMed: 15474137
DOI: 10.1016/S0140-6736(04)17191-2