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Biomedical subjects

R G Barr

Publications and source records attributed to R G Barr.

At least 55 records · Page 3Linked to original sources
PubMed1993

Rhythmic organization of the sound of infant crying.

The purpose of the present study was to examine the temporal morphology and rhythmic structure underlying the repeated bursts of expiratory sounds in a sustained bout of crying of twenty-three 1-month-old infants. Durations of expiratory sounds and bursts were determined from a 90-s bout of naturally occurring cries recorded in the home before feeding. Results indicated wide individual differences in temporal morphology between infants and within infant cry sounds. Binary spectrum analysis of the presence of expiratory sounds in the cry sound detected rhythms in temporal organization at a wide range of dominant frequencies. Spectral complexity (higher numbers of peaks in the power spectrum) was related to a longer time since infants were last fed and shorter expiratory sounds. Results emphasize the importance of viewing cries of young infants as dynamic signals. An ontogenetic history of the rhythms of infant cry sounds may contribute to understanding organismic and environmental experiences which contribute to development.

Child Behavior↗
PubMed1993

Normality: a clinically useless concept. The case of infant crying and colic.

To summarize, it has been argued that: 1. The assessment of complaints about crying and colic present particular diagnostic problems. 2. The crying brought as a complaint seldom indicates disease. 3. Once clinical disease has been ruled out, the clinical meanings of normality and abnormality no longer apply. 4. At that point, one should not try to determine a "cut-off" point for abnormal crying, because (a) it is unhelpful clinically, (b) it is wrong in principle, and (c) it is not likely that any specific amount of crying is normal or abnormal, independent of context. 5. As a possible alternative, it is proposed that we should think of the behavior not a symptom of something the infant "has," but as something the infant "does." This behavior may have consequences that are functional or dysfunctional for the infant, the caregiver, or the infant-caregiver interaction. If this argument has merit, it may have some interesting and important implications for the way we think about, treat, and investigate developmental and behavioral problems including (but not limited to) infant crying and colic. First, what holds true for crying and colic may also hold for bedwetting and enuresis, overactivity and attention-deficit hyperactivity disorder, and abdominal pain and recurrent abdominal pain syndrome, to name just a few. As a brief test of their applicability, one might ask how often organic disease is found in these entities, or how often patients are investigated and treated because an arbitrary amount of these behaviors is taken to be "excessive" or abnormal.(ABSTRACT TRUNCATED AT 250 WORDS)

Colic↗
PubMed1993

Crying and motor behavior of six-week-old infants and postpartum maternal mood.

OBJECTIVE: To determine whether prepartum and postpartum emotional distress in first-time mothers is associated with crying and fussing behavior and activity level in 6-week-old infants, after eliminating potential biases. DESIGN: Observational study examining predictive and concurrent associations between maternal emotions and infant behaviors. SETTING: General community. PARTICIPANTS: Expectant primiparas attending obstetricians' offices for routine prenatal care were recruited in the third trimester. Mothers and babies were required to be free of medical complications to complete the study. Of 113 mothers who enrolled, complete crying/fussing data were obtained in 88 dyads. Activity data were obtained in a designated subgroup of 50 infants. MEASUREMENTS: Mothers completed a self-report scale of emotional distress, the 28-item General Health Questionnaire, at 34 weeks of gestation and at 6 weeks postpartum. Crying/fussing data were obtained using a previously validated parent diary of infant behavior during the sixth week of life. Motor activity was measured objectively in the home setting with actometers. RESULTS: Third-trimester distress was not related to either infant crying/fussing or activity. Postpartum distress was significantly related to crying/fussing duration and bout frequency (r[88] = .45 and .28, respectively; both P < .01). These relations were not diminished after controlling statistically for background and/or potential mediating variables, nor could they be accounted for by different diary-recording styles in the mothers. Postpartum distress was not, however, related to activity level (r[50] = -.09; not significant). Furthermore, the pattern of maternal distress was associated differentially with crying levels. Distress levels increased from prepartum to postpartum among mothers of infants who met predefined clinical criteria for "colic," while decreasing in the others ("colic" status x period interaction: F(1,86) = 8.2; P < .01). Also, infant crying varied among four groups of mothers who differed according to presence and timing of clinically significant emotional disturbance (one-way analysis of variance, F (3,86) = 9.4; P < .001). Infants of mothers who became significantly distressed postpartum ("reactive") cried more than those in the other groups, even mothers who had been distressed both prepartum and postpartum ("depressed") (3.7 vs 2.7 h/d; P = .05, post hoc Tukey). CONCLUSIONS: Maternal emotional distress and infant crying behavior are associated in the postpartum period independent of reporting or referral biases. Clinically significant levels of crying (or "colic") are differentially associated with different patterns of clinically significant maternal distress. Reported concern about either maternal mood or infant crying behavior should be taken seriously as a possible indicator of a stressed mother-infant relationship.

Adult↗
PubMed1992

Short-term effects of feed composition on sleeping and crying in newborns.

To determine whether the composition of feedings would affect newborn behavior independently of the act of feeding itself, 53 two- to three-day-old normal newborns were randomly assigned to receive an extra feeding of water, carbohydrate (lactose), or balanced formula 3 hours after their usual early morning feeding. Previous studies in adult humans and animals, and a single study in human newborns, have indicated that more sleep might be expected following the carbohydrate feed compared with the water and balanced-formula feeds because of recruitment of centrally mediated serotonergic systems. Behavioral effects were assessed for 40 minutes postfeeding by direct observation of the newborn's states (quiet, active, and indeterminate sleep; drowsiness; non-cry wakefulness; and fret/cry). Feed composition did affect behavior, and the effects were fairly specific to particular newborn states. Non-cry wakefulness and drowsiness were unrelated to the presence or type of nutrients, but they tended to occur soon after the meal in all groups. Crying was increased in water-fed newborns relative to both carbohydrate- and formula-fed newborns. Sleeping showed specific patterns of change in all three groups. Sleep duration was increased in the balanced-formula group compared with the water group throughout the observation period. Contrary to the prediction, sleeping duration in carbohydrate-fed newborns never exceeded that of formula-fed newborns; rather, it resembled that of water-fed newborns early in the postprandial period, but formula-fed newborns later. These effects could not easily be explained by potential confounding factors such as handling, volume ingested, caloric intake, or plasma glucose concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Crying↗
PubMed1992

Pediatric pain: interacting behavioral and physical factors.

Pain in infants, children, and adolescents warrants study from a developmental, behavioral, and physiological perspective because maturation of physical, emotional, and cognitive systems influences the way in which pain is experienced and expressed. Pediatric pain is an underdeveloped area ripe for study within the realm of developmental and behavioral pediatrics, as noted by documentation of its undertreatment in children. The focus of this paper is to present issues relevant to the study of pain in children, using the example of the recurrent abdominal pain syndrome to illustrate points regarding epidemiology, assessment, and intervention. It is the opinion of these authors that pediatric pain must be understood from a developmental perspective in both clinical and nonclinical populations of children. Multidisciplinary approaches to research in pain aids in understanding the development of nociceptive transmission and inhibitory systems, the development of pain expression, and the influence of context on pain experience and behavior. The goal of research in pediatric pain is to understand these systems within a developmental context so that preventive and therapeutic intervention strategies can be developed to reduce children's distress and pain-related disability.

Abdominal Pain↗
PubMed1992

Temperament and the psychobiology of childhood stress.

This paper provides a conceptual overview of recent research on the developmental psychobiology of childhood stress. We propose that the construct of temperament can be regarded as an organizing principle in children's responses to environmental adversity, and we review three physiologic "windows" through which such responses can be usefully examined. It is concluded that individual differences between children in their psychobiologic reactivity to stressors may constitute an important and novel point of departure for future studies of stress and childhood morbidity.

Cardiovascular Physiological Phenomena↗
PubMed1992

The crying of infants with colic: a controlled empirical description.

To obtain a controlled empirical description of some of the measurable clinical features of colic in a naturalistic context, 38 infants whose mothers considered crying a problem ("colic") and 38 pair-matched control infants were observed and videotaped at home 10 minutes before and after an evening feed. The parents kept a diary of infant behaviors (including crying and fussing) for 7 days following the visit. Following Wessel et al (Pediatrics. 1954;14:421-434), each "colic" infant was classified according to the number of days per week that crying and fussing duration was greater than 3 h/d. The distribution of infants with colic suggested that there were two subgroups: Wessel's colic infants, with 3 days or more per week of more than 3 hours of crying and fussing per day; and non-Wessel's colic infants, with fewer such days. Maternal measures of total daily crying/fussing duration, crying/fussing bout length, and infant temperament and objective analyses of facial activity showed a consistent pattern of differences in which Wessel's colic infants differed from both non-Wessel's colic and control infants, who in turn did not differ from each other. Both colic groups differed from control infants only in the perception of postfeed cries as being more "sick sounding." The results imply that the complaint of colic represents two (or more) groups and that there may be meaningfully distinct colic syndromes. They also provide the first independent empirical support for Wessel and colleagues' clinical distinction between "fussy" and "contented" babies.

Colic↗
PubMed1991

Proton NMR imaging of cerebral blood flow using H2(17)O.

Cerebral blood flow was quantitatively mapped by monitoring the cerebral washout of H2(17)O using rapid, single-shot proton NMR imaging. H2(17)O acts as a freely diffusible contrast agent for proton imaging via its scalar-coupled term, enhancing T2 relaxation. Measured values for CBF ranged from 29 to 106 ml/min/100 g over a range of arterial pCO2 between 23 and 81 Torr.

Animals↗
PubMed1991

The stability of proton T2 effects of oxygen-17 water in experimental cerebral ischemia.

The gerbil model of unilateral cerebral ischemia has been used to test the temporal and spatial stability of the MRI T2 effects of oxygen-17 water. Following unilateral carotid ligation, symptomatic animals were given a single large intraperitoneal injection of H2(17)O and the distribution and stability of the brain T2 effects were followed with a spin-echo sequence. In contrast to the ischemic areas, the perfused tissue shows a marked and prolonged loss in intensity with little evidence of diffusion of the T2 effect of 17O into the ischemic tissue.

Animals↗
PubMed1991

Infantile colic. Is it a gut issue?

Despite its salience in terms of both prevalence and distress occasioned in parents, the nature and causes of infantile colic remain poorly understood. Causes in the gut (abnormal sensitivity to dietary components, excessive gas, intestinal hypermotility, hormonal factors) and alternative explanations (variant of normal crying behavior, effect of atypical parenting, manifestation of problems in parent-infant interaction) are critically reviewed. Gut pathology may, at best, explain a minority of cases. Although evidence in support of both sets of causes exists, it is frequently undermined by methodologic limitations, notably inadequate definition of the subjects studied. Conceptual issues have also constrained progress in resolving some of the dilemmas, specifically the assumption that gut and non-gut causes are mutually exclusive, and that presence of symptoms necessarily implies abnormalities of function. It is proposed that (1) colic may not be a homogeneous group, but a loose description for the crying of various clinical and etiological subgroups; and (2) that most cases may be conceptualized as resulting from behavioral and biologic interactions in which both the behavioral and biologic factors are functioning normally rather than pathologically.

Colic↗
PubMed1991

Crying in !Kung San infants: a test of the cultural specificity hypothesis.

The pattern of crying and fretting behavior during the first two years is described for 46 !Kung San infants from a hunter-gatherer society in northwestern Botswana. Despite markedly different caretaking practices predisposing to quieter infants, crying and fretting were significantly greater during the first three months, and a peak pattern was present. Measurement of crying 'intensity' indicated that it was predominantly short and fretful. The results support the concept that the early peak pattern is not specific to infants in western industrialized societies, and may represent a behavior universal to the human species. The caretaking differences between societies primarily appear to affect crying duration rather than its frequency and pattern in early infancy.

Arousal↗
PubMed1991

Reversible lactose malabsorption and intolerance in Graves' disease.

Ten patients with untreated Graves' disease underwent tests to determine lactose absorption, liquid gastric emptying, and oral cecal transit time. To determine the influence of thyroid hormone status on lactose absorption, eight of these same patients had repeat studies when rendered euthyroid. Two of these eight patients also underwent studies while transiently hypothyroid. Motility studies were also evaluated in a group of 11 control subjects. Lactose malabsorption occurred in nine patients with Graves' disease. In seven patients who repeated these studies, lactose malabsorption normalized in three, symptoms induced by lactose improved in two and were unchanged in two. However, these latter two patients appeared to have improved symptoms in the transient hypothyroid state. Liquid gastric emptying was significantly faster in untreated patients than controls and treated self-same patients. Transit time was significantly faster in untreated patients than when they were rendered euthyroid. There may be a relationship between altered lactose absorption states and changes in intestinal motility in patients with Graves' disease.

Adult↗
PubMed1991

Effects of formula change on intestinal hydrogen production and crying and fussing behavior.

To determine whether incomplete carbohydrate absorption plays a role in mediating the effects of formula change on babies' crying, breath hydrogen excretion and behavior were measured in 17 normal formula-fed infants who entered a feeding trial at 28 days of life. The trial permitted two comparisons between (1) lactose and reduced lactose soy-based formulae, and (2) the infant's usual pretrial formula and the subsequent soy-based variable-carbohydrate formulae. Reduced lactose formula was associated with a small reduction in H2 excretion (from a mean of 15 to 7 ppm, p = .07) but no difference in crying or fussing. However, compared with their usual pretrial formula, the change to soy-based variable-carbohydrate formulae was associated with a substantial and sustained reduction in H2 excretion (mean 32 to 11 ppm, p less than .03) and a modest 21% decline in fussing (90.4 to 71.5 min/24 hr, p less than .08). By 8 days after the formula change, there was a 40% decline (90.4 to 53.9 min/24 hr) in fussing. These results suggest that, although behavioral changes due to differences in carbohydrate content are unlikely in normal infants, formula changes involving protein and carbohydrate can reduce colonic gas production and may have some effect on crying. Such effects may be implicated when feeding changes occur in normal infants, but their potential role in treatment of crying problems (colic) is yet to be demonstrated.

Bottle Feeding↗
PubMed1991

Carrying as colic "therapy": a randomized controlled trial.

In healthy infants, crying behavior is reduced significantly by "supplemental" carrying; that is, increased carrying throughout the day in addition to that which occurs during feeding and in response to crying. To determine whether the recommendation to increase carrying would be effective as a therapy for colic, 66 mothers of infants 4 weeks of age or less who came to their pediatricians with complaints of crying problems ("colic") were randomized to receive standard pediatric advice (standard group) or standard advice plus the recommendation to increase supplemental carrying by 50% (supplemental group). Overall, the supplemental group carried their infants 6.1 hours/d throughout the intervention period, an increase of 2.2 hours/d (56%) more than that provided by the standard group. Despite this significant increase in carrying, there was no difference between groups in the duration or frequency of crying, fussing, or cry/fuss at any time throughout the intervention period. When the greatest treatment effect was expected at 6 weeks, the supplemental group infants cried only 3 minutes less per day (95% confidence interval: 37 minutes less to 32 minutes more per day). We conclude that, compared with standard pediatric advice to be "responsive," supplemental carrying does not reduce crying and fussing behavior further in infants who have colic. In marked contrast to healthy infants, this apparent resistance to increased carrying may indicate an important difference in state regulation and control in infants with colic.

Colic↗
PubMed1990

Kung infancy: the social context of object exploration.

The present study consists of new analyses of systematic observations of Kung infants made by Konner during the late 1960s and early 1970s. Our intent was to examine claims about the role of object sharing in development by describing how Kung infants develop interest in objects and how their caregivers act toward them when they are engaged in object-related acts. Results indicated that infants first displayed sustained interest in objects beginning at 4 months of age and that, beginning at about 8 months, they also began to engage in relational play and to give objects to others. Others tended to ignore infants during episodes of object manipulation and play, but moments of object offering were often socially embedded. These findings provide support for claims that there are universal changes in infants' involvement with objects and that their involvement is channeled in a culturally relevant manner by their caregivers.

Affect↗