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Ohmura N, Okuma L, Truzzi A, Shinozuka K, Saito A, Yokota S, Bizzego A, Miyazawa E, Shimizu M, Esposito G, Kuroda KO. A method to soothe and promote sleep in crying infants utilizing the transport response. Curr Biol 2022; 32:4521-4529.e4. [PMID: 36103877 DOI: 10.1016/j.cub.2022.08.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/14/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022]
Abstract
Approximately 20%-30% of infants cry excessively and exhibit sleep difficulties for no apparent reason, causing parental stress and even triggering impulsive child maltreatment in a small number of cases.1-8 While several sleep training methods or parental education programs may provide long-term improvement of infant cry and sleep problems, there is yet to be a conclusive recommendation for on-site behavioral interventions.9-13 Previously we have reported that brief carrying of infants transiently reduces infant cry via the transport response, a coordinated set of vagal activation and behavioral calming conserved in altricial mammals.14-18 In this study, we disentangled complex infant responses to maternal holding and transport by combining subsecond-scale, event-locked physiological analyses with dynamic mother-infant interactions. Infant cry was attenuated either by maternal carrying or by reciprocal motion provided by a moving cot, but not by maternal holding. Five-minute carrying promoted sleep for crying infants even in the daytime when these infants were usually awake, but not for non-crying infants. Maternal laydown of sleeping infants into a cot exerted bimodal effects, either interrupting or deepening the infants' sleep. During laydown, sleeping infants were alerted most consistently by the initiation of maternal detachment, then calmed after the completion of maternal detachment in a successful laydown. Finally, the sleep outcome after laydown was associated with the sleep duration before the laydown onset. These data propose a "5-min carrying, 5- to 8- min sitting" scheme for attending to infant cry and sleep difficulties, which should be further substantiated in future studies. VIDEO ABSTRACT.
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Affiliation(s)
- Nami Ohmura
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan
| | - Lana Okuma
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan; Laboratory for Human Cognition and Learning, RIKEN Center for Brain Science, Saitama 351-0198, Japan
| | - Anna Truzzi
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan; Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Kazutaka Shinozuka
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan
| | - Atsuko Saito
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan; Department of Psychology, Sophia University, Tokyo 102-8554, Japan
| | - Susumu Yokota
- Department of Clinical Laboratory, Saitama Prefectural Cardiovascular and Respiratory Center, Saitama 360-0197, Japan
| | - Andrea Bizzego
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Eri Miyazawa
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan
| | - Masaki Shimizu
- Division of Neonatology, Saitama Prefectural Children's Medical Center, Saitama 330-8777, Japan
| | - Gianluca Esposito
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan; Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.
| | - Kumi O Kuroda
- Laboratory for Affiliative Social Behavior, RIKEN Center for Brain Science, Saitama 351-0198, Japan.
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The Effects of an Infant Calming Intervention on Mothers' Parenting Self-Efficacy and Satisfaction During the Postpartum Period: A Randomized Controlled Trial. J Perinat Neonatal Nurs 2020; 34:300-310. [PMID: 33079803 DOI: 10.1097/jpn.0000000000000510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this study was to evaluate the effects of a behavioral infant calming technique to support mothers' parenting self-efficacy and parenting satisfaction. The methods of this randomized controlled trial are based on the CONSORT guidelines. Data were collected during March 1 to May 20, 2019, from 3 postpartum units in 1 university-level hospital in Finland. A total of 250 mothers agreed to participate, of which 120 were randomly allocated to the intervention group and 130 to the control group. All mothers completed a baseline questionnaire before randomization. Mothers in the intervention group were taught the 5 S's infant calming technique. The control group received standard care. Follow-up data were collected 6 to 8 weeks postpartum. The primary outcome measure was the change in parenting self-efficacy and parenting satisfaction scores over the follow-up period. The intervention group showed significantly larger improvements in parenting self-efficacy scores. There were no statistically significant differences in median improvements in parenting satisfaction. The 5 S's infant calming technique is feasible. These study findings may assist midwifery and neonatal nursing staff to support mothers and families during the postpartum period, whether the infants are fussy or not.
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Gastrointestinal Symptoms in Infants of Mothers With a Psychiatric History and the Role of Depression and Bonding. J Pediatr Gastroenterol Nutr 2019; 69:662-667. [PMID: 31517718 DOI: 10.1097/mpg.0000000000002484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Gastroesophageal reflux (GER), excessive crying, and constipation are common gastrointestinal symptoms in infancy of multifactorial origin in which psychosocial stress factors play an important role. The aims of this observational study were to investigate the presence of gastrointestinal symptoms in infants of mothers with or without a history of a psychiatric disorder, their association with maternal depressive symptoms, and the possible mediating role of bonding. METHODS One hundred one mothers with a history of a psychiatric disorder and 60 control mothers were included. Infant gastrointestinal symptoms, maternal depressive symptoms, and mother-infant bonding were assessed using validated questionnaires and diagnostic criteria at 1.5 months postpartum. RESULTS The mean total score on the Infant Gastroesophageal Reflux Questionnaire Revised reported in infants of mothers with psychiatric disorder (13.4 standard deviation 5.4) was significantly higher than that in infants of control mothers (10.8 standard deviation 5.4; P = .003). No significant differences were found in the presence of excessive crying (modified Wessel criteria and subjective experience) and constipation (ROME IV criteria) between both groups. Infant GER was associated with maternal depressive symptoms (P = 0.027) and bonding problems (P = <0.001). Constipation was related to maternal depressive symptoms (P = 0.045), and excessive crying (Wessel and subjective criteria) was associated with bonding problems (P = 0.022 and P = 0.002, respectively). The effect of maternal depressive symptomatology on infant GER symptoms and excessive crying was mediated by bonding problems. CONCLUSION Maternal psychiatric history is associated with infant gastrointestinal symptoms, in which mother-infant bonding is a mediating factor.
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Bamber D, Powell C, Long J, Garratt R, Brown J, Rudge S, Morris T, Bhupendra Jaicim N, Plachcinski R, Dyson S, Boyle EM, Turney N, Chessman J, St James-Roberts I. Parental and health professional evaluations of a support service for parents of excessively crying infants. BMC Health Serv Res 2019; 19:592. [PMID: 31438940 PMCID: PMC6704568 DOI: 10.1186/s12913-019-4430-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 08/13/2019] [Indexed: 11/24/2022] Open
Abstract
Background The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents’ and NHS professionals’ evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use. Methods Participants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents’ and HVs’ ratings of the Surviving Crying materials were measured. Results Thirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package. Discussion and conclusions The findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research. Trial registration Study Registration no. ISRCTN84975637.
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Affiliation(s)
- Deborah Bamber
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - Charlotte Powell
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - Jaqui Long
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - Rosie Garratt
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - Jayne Brown
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - Sally Rudge
- Counseling Psychologist and CBT Practitioner, Leicester, UK
| | - Tom Morris
- Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
| | | | | | - Sue Dyson
- School of Health and Education, Middlesex University, London, UK
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | | | - Ian St James-Roberts
- Thomas Coram Research Unit, UCL Institute of Education, University College London, London, WC1H OAL, UK.
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Bailhache M, Doyle O, Salmi LR, McDonnell T. Does maternal attachment to her infant mediate the link between perceptions of infant crying at 6 months and parenting stress at 24 months? A structural equation modelling approach. Child Care Health Dev 2019; 45:540-550. [PMID: 31021419 DOI: 10.1111/cch.12676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/15/2019] [Accepted: 04/22/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Parenting stress is influenced by many factors including maternal attachment and excessive infant crying, yet the nature of these relationships is not well understood. For example, excessive infant crying despite maternal soothing may impact maternal attachment to the child, leading to higher stress. This paper explored whether maternal perception of excessive infant crying at 6 months was associated with higher maternal parenting stress at 24 months, and whether maternal attachment mediated this relationship. METHODS All families, present at 24 months in a randomized controlled trial of a 5-year early intervention programme targeting school readiness skills in disadvantaged area of Ireland, were included. At 6 months, infant crying was assessed using a maternal reported measure of duration of infant crying, and maternal attachment to the infant was assessed using the Condon Maternal Attachment Scale. Parenting stress was assessed at 24 months using the childrearing stress subscale from the Parenting Stress Index. Structural equation modelling was used to explore the direct and indirect effects of maternal perceptions of excessive infant crying on parenting stress, controlling for infant, maternal, and environmental characteristics, and focusing on the mediating role of maternal attachment. RESULTS Reporting excessive infant crying at 6 months was associated with lower maternal attachment at 6 months, which led to higher parenting stress at 24 months. In addition, vulnerable adult attachment style, previous maternal mental health difficulties, low paternal education, paternal involvement with the child, and not being married were associated with higher parenting stress. CONCLUSION Findings suggest that the association between maternal perceptions of excessive crying at 6 months and later parenting stress may be mediated through maternal attachment to the infant. Interventions based on improving maternal attachment could be investigated to determine the effectiveness of supporting mothers with low attachment.
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Affiliation(s)
- Marion Bailhache
- Pole de pediatrie, CHU de Bordeaux, Bordeaux, France.,ISPED, Centre INSERM U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
| | - Orla Doyle
- UCD Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.,UCD School of Economics, University College Dublin, Dublin, Ireland
| | - Louis-Rachid Salmi
- ISPED, Centre INSERM U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France.,Pole de Santé Publique, CHU de Bordeaux, Bordeaux, France
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