Abstract
We present the hypothesis that subdural hemorrhages during childbirth might be associated with so-called three-month colic, whereby an infant cries intensively and repeatedly during its first three months. A traditional interpretation is that this infantile crying is associated with nutrition and is accordingly “a gut issue”, but this is probably not the whole explanation. It has also been suggested that infantile crying can trigger a caregiver to shake the baby to make it stop crying, thereby inflicting a subdural hemorrhage.A mechanism-based argument supporting our hypothesis would be that the bilateral film-thin subdural hemorrhage associated with a high percentage of deliveries might cause meningeal irritation and in some cases also symptoms as inconsolable crying. An epidemiological argument is that infantile crying is more frequent among first-born, male and premature babies; these categories have also an increased incidence of subdural hemorrhage. Moreover, preventive programs for managing infantile crying have had no effect on the incidence of alleged shaken baby cases.As infantile crying is currently considered unexplained, it is reasonable to explore the proposed hypothesis and strategies which refute or corroborate it. We suggest that a cohort study of premature, first born and male babies with and without infantile crying are examined with brain MRI scan soon after delivery with clinically and MRI follow up during 3–6 months.
Highlights
In 1954 Wessel defined infantile colic as a state in which an apparently healthy baby cries intensively and without explanation for more than three hours per day, and more than three days per week for more than three weeks [1]
We suggest that a cohort study of premature, first born and male babies with and without infantile crying are examined with brain MRI scan soon after delivery with clinically and MRI follow up during 3–6 months
A high rate of infantile crying has been found among first-born infants [2,3,8], preterm babies [4], and the infants of mothers who smoked during pregnancy [6]
Summary
In 1954 Wessel defined infantile colic as a state in which an apparently healthy baby cries intensively and without explanation for more than three hours per day, and more than three days per week for more than three weeks [1]. It seems reasonable to assume that a thin SDH might bring about clinical symptoms Another relevant mechanism theory might explain why male infants have a higher incidence of SDH, illustrated by allegedly shaken baby cases, i.e. AHT cases without external signs of trauma [27]. The presence of a SDH might increase the risk of delayed speech development and of autism 24 months after delivery, all study cases were considered asymptomatic when newborn [22,32] Both preterm and first-born infants seem to have a higher risk of infantile crying [2,3,4,5]. According to the Bradford Hill criteria, this finding indicates a lack of support for the claim that crying triggers shaking of an infant [33]
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