Annotated abstracts

Abstract

Novosad, C., Thoman, E. B. (2003). The breathing bear: An intervention for crying babies and their mothers. Journal of Developmental and Behavioral Pediatrics, 24, 89-95. This article describes an exciting intervention study involving “fussy” infants and the mother-infant relationship. The authors created a “breathing bear,” which is a stuffed animal with an inflation/deflation device in the torso of the bear, controlled by a custom-designed pump that allows the bear to breathe with a very gentle body motion which mimics the breathing pattern of a healthy term infant. The “breathing bear” is placed in a crib and the infant can control when and how long the infant makes contact with the bear and its rhythmic body motion. The authors' initial study with the “breathing bear” involved premature infants who were exposed to the bear for two weeks. Their data revealed that premature infants, exposed to the “breathing bear” had more regular sleep patterns, and more positive and fewer negative facial expressions. The first study led the authors to believe that full term infants who were considered irritable during the first postnatal weeks could benefit from the “breathing bear” intervention. For this study, the researchers used two groups of healthy full term infants: 35 infants who received the “breathing bear” intervention, and 37 infants who received a non-breathing bear. At four weeks of age, mothers who gave birth at one of two participating hospitals were called and questioned about infant crying. If the mother reported the infant as fussy, the mother and infant were invited to participate in the study. The infants were exposed to the “breathing bear” from 4 weeks old to 6 months old. Each mother was given detailed instructions on how and when to use the “breathing bear.” Assessments were completed at 3, 7, and 9 months. The Infant Behavior Questionnaire, the Infant Characteristics Questionnaire, the Parenting Stress Index, and the Beck Depression Inventory were tools used in the study. The results showed that the “breathing bear” intervention was not associated with a report of less infant fussiness by the mother. However, at both 7 and 9 months, the infants of the “breathing bear” group had significantly lower Negativity scores than the infants in the non-breathing bear group. Additionally, the mothers of infants in the “breathing bear” group reported that their infant was comforted and slept through the night for the first time shortly after the “breathing bear” was placed in the crib. At the end of the study, the mothers of infants in the “breathing bear” group were significantly less depressed and less stressed than mothers of infants in the non-breathing bear group. The authors concluded that the intervention had positive effects on the mothers and most likely positive effects on the infants through the mother-infant interaction. Commentary: This interesting intervention study clearly showed benefit to the mother-infant relationship in the first few months of life. The authors plan a more intensive study of infant crying. The authors may not have had the result they had anticipated regarding infant fussiness via the mothers' reports of infant crying since the authors did not enlist infants who had a diagnosis of colicky behavior, just fussy by the mother's report in a telephone conversation. If the authors clearly defined “colic” and “fussy,” enrolled only those infants in the intervention group, and had an identified means of measuring the length of time infants cried during the study days, perhaps the “breathing bear” intervention would yield more positive results in relation to a reduction in overall crying and/or fussiness.