Cry Patterns Research Articles

Baby Business: a randomised controlled trial of a universal parenting program that aims to prevent early infant sleep and cry problems and associated parental depression.

BackgroundInfant crying and sleep problems (e.g. frequent night waking, difficulties settling to sleep) each affect up to 30% of infants and often co-exist. They are costly to manage and associated with adverse outcomes including postnatal depression symptoms, early weaning from breast milk, and later child behaviour problems. Preventing such problems could improve these adverse outcomes and reduce costs to families and the health care system. Anticipatory guidance-i.e. providing parents with information about normal infant sleep and cry patterns, ways to encourage self-settling in infants, and ways to develop feeding and settling routines before the onset of problems-could prevent such problems. This paper outlines the protocol for our study which aims to test an anticipatory guidance approach.Methods/Design750 families from four Local Government Areas in Melbourne, Australia have been randomised to receive the Baby Business program (intervention group) or usual care (control group) offered by health services. The Baby Business program provides parents with information about infant sleep and crying via a DVD and booklet (mailed soon after birth), telephone consultation (at infant age 6-8 weeks) and parent group session (at infant age 12 weeks). All English speaking parents of healthy newborn infants born at > 32 weeks gestation and referred by their maternal and child health nurse at their first post partum home visit (day 7-10 postpartum), are eligible. The primary outcome is parent report of infant night time sleep as a problem at four months of age and secondary outcomes include parent report of infant daytime sleep or crying as a problem, mean duration of infant sleep and crying/24 hours, parental depression symptoms, parent sleep quality and quantity and health service use. Data will be collected at two weeks (baseline), four months and six months of age. An economic evaluation using a cost-consequences approach will, from a societal perspective, compare costs and health outcomes between the intervention and control groups.DiscussionTo our knowledge this is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common, distressing problems.Trial registration numberISRCTN: ISRCTN63834603

Cry-Based Classification of Healthy and Sick Infants Using Adapted Boosting Mixture Learning Method for Gaussian Mixture Models

We make use of information inside infant’s cry signal in order to identify the infant’s psychological condition. Gaussian mixture models (GMMs) are applied to distinguish between healthy full-term and premature infants, and those with specific medical problems available in our cry database. Cry pattern for each pathological condition is created by using adapted boosting mixture learning (BML) method to estimate mixture model parameters. In the first experiment, test results demonstrate that the introduced adapted BML method for learning of GMMs has a better performance than conventional EM-based reestimation algorithm as a reference system in multipathological classification task. This newborn cry-based diagnostic system (NCDS) extracted Mel-frequency cepstral coefficients (MFCCs) as a feature vector for cry patterns of newborn infants. In binary classification experiment, the system discriminated a test infant’s cry signal into one of two groups, namely, healthy and pathological based on MFCCs. The binary classifier achieved a true positive rate of 80.77% and a true negative rate of 86.96% which show the ability of the system to correctly identify healthy and diseased infants, respectively.

Overcoming Barriers to Investigating Mother–Infant Interactions in the First Two Hours of Life

As a result of the unexpected delays experienced in a study designed to investigate mother-infant interactions and infant cry patterns in the first 2 hours following delivery, the study was assessed to identify the barriers that the investigators had encountered in its planning and conduct. These barriers can be categorized as issues with (1) institutional review board approval, (2) participant recruitment and retention, (3) requirements for study personnel, (4) instrumentation, (5) potential observer and participant bias, and (6) budgeting. Each barrier is detailed, along with suggested solutions. It is hoped that that these experiences will be of value to other researchers, particularly those working in non-research-intensive institutions, as they gather data to contribute to the understanding of mother-infant interactions in the immediate postpartum period.

Influência do choro e de padrões respiratórios na deposição de medicação inalatória em crianças

OBJETIVO: Verificar a influência do choro e de padrões respiratórios na eficácia da terapia inalatória em crianças. FONTES DE DADOS: busca sistemática por artigos científicos referentes ao tema nas bases de dados Cochrane Controlled Trials Data Base, MedLine e Science Direct, publicadas no período de 1994 a 2009. Utilizaram-se os descritores: "choro", "inalação", "aerossol", "trabalho respiratório" e "criança", nos idiomas português e inglês. SÍNTESE DE DADOS: Foram selecionados 13 artigos, 12 em inglês e um em português. A maioria dos trabalhos apresenta os efeitos da terapia inalatória em crianças, sem discutir a influência do choro e de diferentes padrões respiratórios sobre a deposição da medicação. Estudos que fizeram essa relação verificaram que a respiração e, principalmente, o choro reduzem a quantidade de fármaco que chega às vias aéreas periféricas. Autores discutem as diferenças anatômicas e fisiológicas do sistema respiratório da criança que podem interferir na eficácia da terapia inalatória. Porém, a maioria deles não analisa a influência qualitativa e quantitativa dos padrões respiratórios e do choro sobre a mecânica pulmonar. CONCLUSÕES: O choro e os padrões respiratórios influenciam na terapia inalatória, sendo atribuída ao choro a redução significativa da deposição medicamentosa nas vias aéreas. Pouco se sabe sobre o princípio determinante para a alteração do potencial de deposição, pois são escassas as evidências sobre o tema, apesar de sua relevância no manejo de afecções pulmonares da população pediátrica.

Acoustical development of the human baby cry: Anatomical and social factors

We investigated the acoustical development of the human baby cry based on our two-stage hypothesis, which holds that two distinct factors affect the development of the baby cry. First, humans possess the cortico-bulbar pathway connecting the face motor cortex and the medullary respiratory and vocal centers. This pathway is absent in nonhuman primates and other mammals. We postulate that the myelinization of this pathway would change the acoustic characteristics of the baby cry. Second, after neuroanatomical maturation enabled variable cry patterns, the social relationships with caregivers should differentiate the acoustical patterns of the baby cry. This should lead to family-specific cry patterns. To test the two-stage hypothesis, we recorded ten newborn babies until they were 1 year old. In all babies, the cry pattern was very simple up to 2 weeks, while after 1 month, the pattern became temporally and spectrally complex, suggesting neuroanatomical changes. At three months, we asked the mothers to classify the cries of their own babies into three categories: sleepy, hungry, and wet diaper. There were no acoustic patterns common to their classifications, suggesting that baby cry semantics are family-specific. These results support our two-stage hypothesis of cry development. [Work supported by JST and JSPS.]

Maternal sensitivity behavior and infant crying, fussing and contented behavior: the effects of mother's experienced social support.

Maternal sensitivity behavior, mother's experienced difficulties, experienced social support, and the amount of infant's crying, fussing and contented behavior were studied when the infants were 3 and 12 months of age. Fifty-seven Finnish low-risk mothers' sensitivity behavior was assessed by the Parent-Child Early Relational Assessment method. Infant's crying behavior was assessed by the Baby's Day Record and by the Crying Patterns Questionnaire. The Social Support Questionnaires (SSQ 1 and 2) were used to evaluate mother's experienced difficulties and support. The infants of More Sensitive (MS) mothers were more contented than those with Less Sensitive (LS) mothers. The MS mothers experienced fewer difficulties with their infants and experienced more support from their best friend and their husband than LS mothers. In addition, some gender differences were found concerning infant behavior.

Crying in the first year of infancy: Patterns and prevalence

This study set out to discover whether the findings of St James-Roberts and Halil (1991), Infant crying patterns in the first year, Journal of Child Psychology and Psychiatry , and McGlaughlin and Grayson (1999) A prospective study of crying during the first year of infancy, Journal of Reproductive and Infant Psychology , could be replicated. Mothers who attended child health clinics with their infants were interviewed using a revised version of the Crying Patterns Questionnaire. This asks about mothers' perceptions of the amount their infant cries at six different periods of the day. The sample of 297 mothers was divided into four groups, according to the age of their infants (1-3 months, 4-6 months, 7-9 months, 10-12 months). In this way patterns of perceived daily crying across the first year of life were identified. The findings reported in this paper lend strong support to those of St James-Roberts and Halil and confirm the conclusion of McGlaughlin and Grayson that perceived time of day crying peaks are concentrated in the later part of the afternoon and early part of the evening.

A prospective study of crying during the first year of infancy

Mothers of ‘crying’ infants, who reported excessive crying before 3 months of age, together with mothers of matched controls who did not, were interviewed using the Crying Patterns Questionnaire (CPQ) at infant ages 4 months, 8 months, and 12 months. By 4 months of age daily amounts of crying for both groups had fallen significantly. ‘Crying’ group infants were reported to cry significantly more than controls for the whole of their first year. Both groups cried somewhat less at 12 months than at 4 months, although these age differences were found to be statistically nonsignificant. The pattern of infant crying across the day was also analysed and found to be similar for both groups. Reported hourly crying rates increased during the afternoon and evening, with morning and night-time being the periods of least crying. Closer analysis of the pattern of crying across the day suggested that further investigation of crying peaks within the afternoon and evening may be worthwhile. Overall, the study suggests that after the first 3 months, the mean amount of infant crying tends to persist across the rest of the first year of life.

Relationships between infant crying, birth complications, and maternal variables.

The aim of the study is to identify factors influencing infants' crying behaviour (total crying duration, length of crying bouts, and frequency of crying). The searching for variables explaining inter-individual differences requires a sufficient stability of the cry parameters at least over short time intervals. Thus, a second aim is to assess the intra-individual stability of the crying behaviour in an age range from 3 to 12 months. Sixty-two mother-child dyads participated in the study. The results show substantial stabilities of the crying behaviour of infants between 3 and 12 months of age. This is related to the amount of crying as well as to the pattern of crying shown by the children over a 24 h interval. The typical cry pattern is characterized by peaks at 12.00 h and early in the evening, although there are large individual differences between the children with regard to cry durations at each hour of the day. Regarding the cry durations at 3 months of age, birth complications and the perceived emotional atmosphere in the mothers' family of origin are the major contributing factors.

Infant fussing and crying patterns in the first year in an urban community in Denmark.

Infant crying amounts and patterns in 590 1- to 12-month-old infants in an urban community in Denmark were studied using the Crying Patterns Questionnaire. The impact of the crying on parents and the primary health services was also assessed. The results showed that Danish mothers leave their infants to "cry out" substantially less than mothers in the UK and North America. Despite this difference, mean crying amounts, crying patterns and the incidence of persistent crying were similar to those reported in earlier western studies. The findings support the view that the infant crying peak in the first 3 months is due to normal maturational and developmental processes.

Pattern of Night Waking and Crying of Korean Infants from 3 Months to 2 Years Old and Its Relation with Various Factors

Night waking and crying are very common in infancy and can cause problems for parents and families. This study surveyed 218 healthy Korean infants from 3 months to 2 years old to determine their night waking and crying patterns. On average, 83% awoke and 28% cried more than once per night. Ninety-eight percent of the babies slept with a member of the family. Infants with transitional objects or nighttime habits (e.g., finger sucking, touching and/or playing with mother's or own hair, touching a part of mother's or own body) cried more frequently. In terms of the maternal response toward the crying babies, most of the mothers used traditional methods, such as patting/holding, feeding, changing diapers. Only one mother ignored the crying baby, and none used medication, delayed response, or white noise. Sixteen percent of the mothers indicated that their babies' crying constituted a problem for them.

Colic—A Pain Syndrome of Infancy?

A review of colic research supports the theory that colic may be caused by pain, particularly pain generated by gastrointestinal causes. At the same time, it also supports the view that disturbing crying in the first 3 months of life may be secondary to behavioral-interactive problems or simple parental misinterpretation of cry. In fact, a closer look at the methodology of colic studies along with our preliminary results suggest there may be at least two different patterns of disturbing infant crying. It is possible that one is associated with true pain and the other not. Dependence on retrospective parental reports alone to substantiate the presence of pain is only as reliable as parent interpretation of crying. Although specific cry patterns may represent specific infant conditions, parents may not be accurate interpreters of those patterns. In trying to determine the presence of gastrointestinal pain in colicky crying, close attention therefore should be given to the nature of the cry. Specific attention to qualitative and quantitative aspects of crying in colicky infants is identified as important by our pilot work. In the future this may help to explain the apparent discrepancies in the colic literature and to determine to what extent infant colic is a true pain syndrome.

EFFECT OF MODERATE HYPERBILIRUBINEMIA ON ORIENTING RESPONSES & CRY IN TERM INFANTS

Brazelton auditory orienting responses and acoustic cry patterns were evaluated in 10 moderately jaundiced term infants, (BR-15.2±2.5 mg/dl, Mean±S.D.) and 11 non-jaundiced infants (BR-4.1±1.1 mg/dl). The groups did not differ in birthweight, gestational or postnatal age, or 5 min. Apgar score. Jaundiced infants scored lower on auditory orienting items, (4.7±1.25 vs 5.64±0.55, p<0.02) and on the global orientation cluster (4.96±0.92 vs 5.9±0.53, p<0.01). Cries were recorded during blood sampling, and analyzed by computing the log magnitude spectrum in 25 msec blocks for each cry unit; summary measures were computed across the 25 msec blocks of each cry unit. In jaundiced infants, the first cry utterance showed an increase in average first formant during dysphonation (AvDF1-1876±376 Hz vs 1434±470 Hz, p<0.05), and in the summation of first formant during dysphonation (SumDF1-2102±324 Hz vs 1192±786 Hz, p<0.005). 9 of 10 jaundiced and 4 of 11 non-jaundiced infants had episodes of hyperphonation, and jaundiced infants had greater variability (S.D.) in the maximum fundamental frequency of hyperphonation (Max HFo) for the entire cry (p=0.03 for S.D. Max HFo vs non-jaundiced infants). In summary, moderate hyperbilirubinemia decreases the global capability for orienting responses, and increases the frequencies and variability of some acoustic cry characteristics in term newborns.

The Effects of Within-Group and between-Group Methodologies in the Study of Perceptions of Infant Crying

Recent studies have indicated that various infant cry patterns can be reliably distinguished when directly compared with other infant cry patterns. The purpose of this study was to compare the effects of this within-group method of cry presentation (in which listeners are exposed to 2 types of cry patterns) with the effects of a between-group methodology (in which listeners are exposed to only 1 type of infant cry pattern). 4 groups of adult listeners rated the tape-recorded cries of low- and high-risk infants on 4 Likert-type scale items during experimental phases. In phase 1, subjects were exposed to either the cries of low-risk or high-risk infants but not both. In phase 2, subjects were exposed to both low-risk and high-risk infant cries. In phase 3, subjects were exposed to the cries they heard in phase 1. Whereas all scale items differentiated the low- and high-risk infant cries during the within-group analyses of phase 2, all scale items did not differentiate low- and high-risk infant cries during the between-group phase of the experiment. The specific pattern of results indicate that within-group methods of cry presentation accentuate the perceptual distance among cry types and may actually create many reliable differences that would not be found in between-group comparisons.

Sound spectrographic analysis of pain cry in preterm infants.

Sound spectrographic cry analysis was performed on 302 cries of 48 preterm infants born at 30-37 gestational weeks. The cries were recorded during the first week of life and thereafter weekly until the infants were discharged. The control series comprised 54 cries from 27 fullterm healthy infants. The results showed that the cries of the smallest prematures compared with the controls were shorter, more high-pitched, and included bi-phonation and glide more often. The cry characteristics changed with increasing conceptual age and the older the child the more the cry pattern resembled that of the fullterm. The cries of the preterm infants when they had reached 38 conceptual weeks were similar to those of newly born fullterm infants. The results indicate that the gestational age should be taken into consideration in cry analysis.

Spectrum Analysis of the Cry Sounds of Well-nourished and Malnourished Infants

The cry sounds of 12 well-nourished and 12 malnourished male infants were compared using behavioral and acoustic measures. The cry of the malnourished infant had an initial longer sound, higher pitch, lower amplitude, more arrhythmia, and a longer latency to the next cry sound than the cry of the well-nourished infant. The similarity betweenthe cry of the malnourished infant and the cry of the brain-damaged infant suggested tha malnutrition may affect the regulatory function of the central nervous system. This hypothesis was supported by additional findings which showed that the abnormal cry patterns in the malnourished infants were associated with a low-level orienting response to a pure tone stimulus as measured by the magnitude of heart-rate deceleration.

Acoustical Analysis of the Consistency of Baby Cry Patterns

Research studies have been conducted in the past concerning different aspects of baby cries, but a perusal of the literature failed to reveal evidence showing extensive research done with consistency of baby cry patterns. In the present investigation, magnetic tapes were utilized to record cries of babies. The original tapes were played back utilizing a Sony, Model TC-530, tape recorded and simultaneously monitored utilizing a Tektronix Oscilosocope, model 545, and a Brüel &amp; Kjaer Graphic Level Recorder, type 2305. The purpose for monitoring the various tapes was to eliminate any cries that had been clipped by the recording procedures or system and those cries during which a baby coughed or seemingly became strangled. Once these cries had been identified, then in a random manner two cries were selected from each subject and recorded utilizing a general Radio Data Recorder, model 1525-A. Tape loops were then formed in order to be able to conduct a 1-oct and a 113-oct analysis of the cries. A statistical analysis was conducted and the results of the study are reviewed.

A statistical analysis of cry patterns in normal and abnormal newborn infants.

SUMMARYThe statistical properties of crying bouts have been studied in newborn infants during their first nine days of life. The crying was elicited by mild discomfort and by pinching the skin.Twenty‐one newborns were neurologically examined daily and, according to the diagnosis, divided into three groups: (1) normal; (2) transiently abnormal and (3) consistently abnormal.In the normals the duration of individual cries in a crying bout and the intervals between them are characteristic for the individual. There is an overall tendency for cry duration and interval to become shorter and less variable during the first nine days of life. In contrast to the normal babies, infants from groups 2 and 3 showed a large variation in the crying parameters, especially in the cry duration.The significance of these findings is discussed.RÉSUMÉAnalyse statistique des crises de pleurs chez le nouveau‐né normal et anormalLes propriétés statistiques des crises de pleurs ont étéétudiées chez des nouveaux‐nes durant les 9 premiers jours de la vie. Les pleurs étaient provoqués par un inconfort léger ou par pincements de la peau.21 nouveaux‐nés ont été examinés neurologiquement tous les jours et selon le diagnostic, divisés en trois groupes:(1) normaux; (2) transitoirement anormaux; (3) anormaux en permanence.Chez l'enfant normal, la durée de chaque pleur individuel dans une crise de pleurs ainsi que l'intervalle entre les pleurs est spécifique pour un individu.II y a une tendance générate à ce que la durée des pleurs et les intervalles deviennent plus courts et moins variables durant les neuf premiers jours de la vie. A l'opposé du nouveau‐né normal, les enfants des groupes 2 et 3 présentaient une grande variation dans les parametres de pleurs, specialement dans la durée des pleurs.La signification de ces faits est discutée.ZUSAMMENFASSUNGDie statischen Eigenschaften des akustischen Signals des Weinens wurden bei Neugebornnen in den ersten neun Lebenstagen untersucht. Ausgelöst wurde das Weinen dadurch, dass das Kind kurz vor der Fütterung aus der Wiege genommen wurde, sovvie durch leichtes Kneifen der Haut.21 Neugeborene wurden täglich neurologisch untersucht und je nach der Diagnose in drei Gruppen eingeteilt: (1) normale Kinder; (2) Kinder mit vorübergehend abnormen Zeichen; (3) konsistent abnormale Kinder.Bei den Normalen war die Dauer der einzelnen Schreie, sowie die Intervalle zwischen den einzelnen Schreien charakteristisch für das Individuum. Im allgemeinen werden die Schreidauer und die Intervalle während der ersten neun Lebenstage kürzer und regelmässiger. Im Gegensatz zu den normalen Kindern zeigten die Kinder der Gruppe 2 und 3 eine grössere Varianz der Schreiparameter. Dies gilt besonders für die Schreidauer.Die Bedeutung dieser Befunde wird diskutiert.RESUMEN Un análisis estadistico de tipos de llanto en recién nacidos normales y anormales Se ha estudiado la estadística de accesos de llanto en recién nacidos durante los nueve primeros días de la vida. Se incitó el llanto por condiciones de incomodidad moderada y por pellizcar la piel del lactante.Se realizaron tests neurológicos diarios en 21 recién nacidos, que se repartieron según el diagnóstico en tres grupos: (1) normales; (2) anormales transitorios; (3) anormales consistentes.En los lactantes normales, la duración de los gritos individuos y los intervalos éntre estos en un acceso de llanto son típicos para el individuo. En el grupo entero, se ve una tendencia hasta duracion e intervalos más cortos y menos variables durante los nueve primeros dias de la vida. En cambio, lactantes de los grupos 2 y 3 mostraban una gran variatión de los parámetros del llanto, especialmente de la duración de los gritos.Se discute la significancia de estos hallazgos.

Newborn Infant Cry (Supplement 163).

Certain advances in physiology influence psychiatric progress. Dr. Lind's monograph reports the finding of acoustically distinctive cry patterns associated with arousal states in infancy. This has great relevance for human behavior research. Newborn Infant Cry , contains four papers about the study of cry and related upper respiratory actions conducted at the Karolinska Children's Hospital in Stockholm. The investigators treated cry as a specific performance of the newborn and correlated its audible, kinetic, and respiratory features. The first paper, written by Henry M. Truby, PhD, describes the acoustic analysis of rousal cries produced by 30 newborns after being pinched. Cries were collected with a laryngeal contact microphone and then analyzed sonagraphically and with a directwriting oscillograph. Simultaneous x-ray movies provided data about the motor activity of valved respiration. Three primary sorts of cry-sound were identified: (1) phonation , a simple, symmetrical, tonal basic cry which registers mild

Instantaneous heart rate patterns in newborn infants

The instantaneous heart rate, i.e., the reciprocal of the time interval between successive heart beats was measured and recorded over long periods in newborn, fullterm, and premature children.The following patterns predominated in normal children: 1.1. Phasic variation. A slightly irregular sinoatrial node (normal sinus) rhythm.2.2. Cry pattern. A smooth parabolic rise in pulse rate interrupting phasic variation, associated with crying and the Valsalva maneuver in general.3.3. Respiratory pulse rate variation. A slight rise in the pulse rate line with inspiration and slight fall with expiration.4.4. V shape falls. Sharp, steep, short rate falls, most frequently seen in the first 3 hours, infrequently after the twelfth hour of life.The following patterns were associated predominately with illness, at times leading to death: 1.1. Flat rate line. Thirteen of the 21 subjects demonstrating this pattern died; survivors were ill or exposed to maternal noxious factors. A “smooth mound” shaped rate line pattern was seen in patients with a flat rate line when artificial or assisted respiration was administered.2.2. Bradycardia. Periods of marked (60 to 80 beats per minute) sinoatrial (normal sinus) bradycardia lasting 30 seconds or longer. Ten of the 18 subjects demonstrating this pattern died; survivors were ill.3.3. Moderate and marked respiratory rate variation. Marked rise in pulse rate with inspiration and fall with expiration, most frequently associated with respiratory distress.Only minor changes in the instantaneous heart rate pattern appeared during the exchange transfusions monitored in this series. Alterations in the rate patterns were reversed by calcium administration.All children who died (Table II) had flat line and/or bradycardia patterns for hours or days before death, and frequently when clinical examination gave no indication of impending tragedy. Instantaneous heart rate monitoring is a valuable adjunct in the care of newborn infants.