Abstract
Parents report that around 20% of infants in Western countries cry excessively without an apparent reason during the first four months of age. Traditionally, research has focused on the crying and its causes. However, evidence is growing that how parents evaluate and respond to the crying needs to receive equal attention. This focus encompasses parental resources, vulnerabilities, well-being and mental health. At present, the UK NHS lacks a set of routine provisions to support parents who are concerned about their baby's excessive crying. The rationales, methods and findings from a study developing materials for this purpose are reported. Following a literature review, 20 parents whose babies previously cried excessively took part in focus groups or interviews. They provided reports on their experiences and the supports they would have liked when their baby was crying excessively. In addition, they identified their preferred delivery methods and devices for accessing information and rated four example support packages identified by the literature review.FindingsDuring the period their baby cried excessively, most parents visited a health service professional and most considered these direct contacts to have provided helpful information and support. Websites were similarly popular. Telephones and tablets were the preferred means of accessing online information. Groups to meet other parents were considered an important additional resource by all the parents. Three package elements - a Surviving Crying website, a printed version of the website and a programme of Cognitive Behaviour Therapy-based support sessions delivered to parents by a qualified practitioner, were developed for further evaluation.
Highlights
Parents report that around 20% of infants in western countries cry a lot without an apparent reason during the first four months of age (Alvarez, 2004; Douglas and Hill, 2011; Wolke et al, 2017)
The term ‘infant colic’ has been criticised for failing to distinguish adequately between ‘prolonged’ infant crying and a parent’s evaluation that their baby is crying too much and may be a sign that something is wrong with this baby (‘excessive infant crying’) (St James-Roberts, 2012)
The study was regulated by a National Institute for Health Research (NIHR)-appointed Steering Committee and coordinated by a Management Group, including the research team, Senior Leicestershire Partnership NHS Trust (LPT) Health Visitors (HVs), a paediatrician, General Practitioner, health economist, members of Leicester Clinical Trials Unit and National Childbirth Trust (NCT), Cry-Sis and parent representatives
Summary
Parents report that around 20% of infants in western countries cry a lot without an apparent reason during the first four months of age (Alvarez, 2004; Douglas and Hill, 2011; Wolke et al, 2017). Evidence has accumulated that most such infants are healthy and grow and develop normally (Stifter and Braungart, 1992; Lehtonen, 2001), that many normal infants have a crying ‘peak’ in the first three months of age (Barr, 1990; St James-Roberts and Halil, 1991; Wolke et al, 2017), and that this crying peak and the ‘unsoothable’ crying bouts which alarm parents usually resolve spontaneously by five months of age (Barr et al, 2005) This has led some reviews to conclude that the crying is usually due to normal developmental processes (Barr and Gunnar, 2000; St James-Roberts et al, 2013). Parents turn to popular books, magazines or websites, which give conflicting advice (Catherine et al, 2008), or take babies to clinicians or hospital Accident & Emergency departments, only around 5% of such infants have an organic disturbance (Freedman et al, 2009)
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