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PubMed2004

Sleep of excessively crying infants: a 24-Hour Ambulatory Sleep Polygraphy study.

OBJECTIVE: Parents' reports suggest that excessively crying or colicky infants sleep less compared with control subjects. The aim of this study was to determine the sleep-wake structure of excessively crying infants throughout a 24-hour cycle. METHODS: A 24-hour sleep polygraphy study was conducted at home for 24 excessively crying infants and 23 control subjects at the age of 6 weeks. In addition, parental diaries were kept for 4 days. RESULTS: In sleep polygraphy recordings, no major differences between study groups were observed in either the duration or the structure of the 24-hour sleep. In the diaries, the parents overestimated the amount of sleep in both study groups. The parents of the control infants overestimated the amount of sleep more than the parents of excessively crying infants (69.8 minutes [standard deviation: 79.3] compared with 27.1 minutes [standard deviation: 65.4], respectively). In excessively crying infants, the proportion of rapid eye movement sleep was higher during the 3-hour period from the beginning of the first long sleep in the evening and lower during the preceding 3-hour period compared with the control group. CONCLUSIONS: The results of this study suggest that diary-based studies are prone to be biased as the parents of the control infants are more likely to overestimate the amount of infant's sleep and, therefore, report more sleep than the parents of the crying infants. Although no differences in the total amount of sleep or proportions of sleep stages were observed, excessively crying infants may be characterized by a disturbance that affects rapid eye movement and non-rapid eye movement sleep stage proportion during evening hours.

Case-Control Studies↗
PubMed2006

Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study.

OBJECTIVE: To report the prevalence and stability of cry-fuss problems during the first 4 months of life and sleep problems from 2 to 24 months and relationships between the persistence of cry-fuss and sleep problems and outcomes at 24 months. METHODS: The study was a prospective cohort study in maternal and child health centers in 3 local government areas in Melbourne, Australia. A total of 483 first-born infants were monitored prospectively from 2 weeks through 2, 4, 8, 12, 18, and 24 months. Child behavior, maternal depression, parenting stress, and marital quality were assessed. Predictor variables were parent reports of moderate or greater cry-fuss problems (2 and 4 months) and sleep problems (8, 12, 18, and 24 months) and parent-reported, 24-hour, sleep/cry-fuss diaries (2, 4, and 12 months). RESULTS: The response rate was 68% (483 of 710 infants); the attrition rate was <6%. The prevalence of cry-fuss problems decreased from 19.1% at 2 months to 12.8% at 4 months, with 5.6% of mothers reporting cry-fuss problems at both ages. Prevalence rates of sleep problems were 21.2%, 16.2%, 10.0%, and 12.1% at 8, 12, 18, and 24 months, respectively; 6.4% had a problem at > or =3 of these ages. In multivariate analyses, cry-fuss/sleep problems at > or =3 previous time points (but not 1 or 2 time points) contributed significantly to depression (2.8% of variance), total behavior (1.4% of variance), and total stress (4.6% of variance) scores. Repeated problems had a greater impact than a concurrent sleep problem on depression and stress scores, whereas the reverse was true for behavior scores. CONCLUSIONS: Most cry-fuss and sleep problems in the first 2 years of life are transient. Persistent, rather than transient, problems contribute to maternal depression, parenting stress, and subsequent child behavior problems.

Adult↗
PubMed2002

Infant crying: nature, physiologic consequences, and select interventions.

This article describes the nature of infant crying, the physiologic events and changes associated with it, and appropriate nursing interventions for infant crying. A cry is a series of four movements that basically resembles a Valsalva maneuver. Documented immediate and long-term sequelae of crying include increased heart rate and blood pressure, reduced oxygen level, elevated cerebral blood pressure, initiation of the stress response, depleted energy reserves and oxygen, interrupted mother-infant interaction, brain injury, and cardiac dysfunction. Caregivers are encouraged to answer infant cries swiftly, consistently, and comprehensively. Kangaroo care is an efficient method for preventing, minimizing, and halting crying. Other interventions for crying include swaddled holding, a pacifier, sugar water, a sweet-tasting nonsucrose solution, heartbeat sounds, distraction by lullabies or mother's voice, rhythmic movement, and reduction of external stimuli.

Crying↗
PubMed1992

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.

Circadian Rhythm↗
PubMed2004

[Excessive crying in infants: a problem for both parents and children (only rarely caused by milk allergy)].

According to a systematic review published in 1998, hypoallergenic formula can be useful in treating infants who cry excessively. For this reason it is normal practice in the Netherlands to prescribe hypoallergenic formula for these infants. However, two of the three studies on which this systematic review was based were carried out in specialist paediatric allergy centres where there is a higher chance of encountering food allergy than in normal well-baby clinics. The third study was carried out in a well-baby clinic but only included babies who cried for more than 3 hours a day on more than 3 days per week. Experience with crying diaries has shown that by no means all babies who cry excessively according to their parents satisfy these criteria. It is not known if prescribing hypoallergenic formula is a useful intervention in infants whose parents report that they cry excessively. The tension and distress felt by the parents of infants who cry excessively are also important factors. In our opinion, support and guidance for the parents is a more effective treatment for excessive crying in infants than intervention with hypoallergenic formula.

Adult↗
PubMed1992

When the nurse encounters crying.

1. Crying has therapeutic value. For the patient and family, crying can facilitate working through grief, promote emotional healing, and release emotions that might otherwise lead to crippling emotional or physical illness. 2. Crying may be precipitated by a variety of emotions and may be related to a variety of situations. When patients cry, the behavior may express sadness and grief, release emotion, manipulate others, be a means to cope with unresolved stress, reduce distance, and may represent emotional lability related to organic brain impairment. 3. When the patient is crying, the nurse's action should be based on an assessment of the crying and the nursing strategies appropriate for the patient's unique situation. Generally, crying should be accepted nonjudgmentally and emotional support should be provided.

Adaptation, Psychological↗
PubMed2006

The crying baby.

BACKGROUND: Up to 20% of parents report a problem with their infant crying in the first 3 months of life. The majority of babies have no organic cause of crying and most crying subsides by 3-4 months. OBJECTIVE: This article describes the management of persistent crying in the first 3 months of life. DISCUSSION: Management includes exclusion of medical causes and ensuring the baby is adequately rested and fed. Unexplained episodes of crying can be managed by: carrying the baby, going for a walk with baby in the pram, giving baby a deep, warm bath, or playing white noise or environmental sounds to distract the baby from crying. Postnatal depression is common in mothers of crying babies and should be actively screened for and appropriate clinical help offered if required. All families benefit from support including a review appointment and practical help around the home where possible.

Crying↗
PubMed1990

Adults' tolerance of cries: an experimental investigation of acoustic features.

Variations in the aversiveness of a newborn's distress cry were examined using experimental manipulation of 3 acoustic features of the cry (fundamental frequency, intonation, spectral complexity) and of the information given to subjects about the infant's health status. The subjects (N = 164 medical students) were allowed to control the sound pressure level (range: 50 dB [A]-105 dB[A]) of the different cry versions by repeatedly pressing a button (operant titration). For the nonmanipulated (original) cry version, the accepted sound pressure level decreased as fundamental frequency increased at above 610 Hz. This effect was modified by experimental manipulation of spectral complexity as well as intonation. A preference of intonated cries over monotonous cries was most pronounced between 534 and 686 Hz. Significant interactions of the information variable with the intonation and the complexity variables suggest that the listener's reaction to certain physical cry characteristics can be altered substantially by inducing different cognitive sets.

Adult↗
PubMed1986

Neonatal pain cries: effect of circumcision on acoustic features and perceived urgency.

The relation between neonatal cry features elicited by painful circumcision procedures and the perceived urgency of those cries was investigated. Vocalizations were recorded during circumcision of 30 normal newborn males, analyzed by spectrographic methods and validated with computer techniques. The most invasive procedures elicited significantly longer crying bouts; shorter quiet intervals; shorter, more frequent vocalizations; higher peak fundamental frequencies; fewer harmonics; and greater variability of the fundamental. Cries elicited by the most intrusive procedures were judged by adult listeners to be the most urgent, and cries from similarly invasive procedures were judged to be of the same degree of urgency. Cries appeared to be judged along 3 dimensions described by harmonic, temporal, and pitch characteristics. Subjective judgments and objective quantitative data converge to demonstrate that infants' cries are perceived as varying and, objectively, do systematically vary with respect to the intensity of painful stimuli.

Arousal↗
PubMed1982

Adult physiological response to infant cries: effects of temperament of infant, parental status, and gender.

This article describes research on adult physiological and self-report response to audiotapes of infants' cries. 3 groups were studied: nonparents, primiparous parents, and multiparous parents. The tapes consisted of cries ordered (difficult, average, easy) according to sound spectrographic features and infant temperament ratings. While nonparents and multiparous parents showed the expected order in arousal levels (difficult infant cries highest, easy infant cries lowest), primiparous parents had highest levels to average infant cries. Overall, primiparous parents had highest levels of arousal, nonparents next, and multiparous parents least. There were no gender differences in arousal. Difficult infant cries received higher irritation and spoiled ratings; were rated as more grating, arousing, piercing, etc.; were less similar to own infants' cries; and were said to be caused more frequently by frustration, etc., rather than routine physical discomfort. Fathers had higher irritation and spoiled ratings, and lower care for ratings, than mothers. The relationship of these data to own infant temperament ratings was also assessed.

Adult↗
PubMed1981

Stability of individual differences of neonatal motor and crying patterns.

Longitudinal research suggests that characteristic levels of individual energy expenditure are enduring over time and influencing personality development. To measure characteristic levels of energy output at the very beginning of life, the activity and crying patterns of 72 normal neonates were monitored for 1-3 days by an electronic activity monitor. This monitor measures crying, noncrying, and total activity of various amplitudes and cry time. Day-to-day stability was highly significant in daytime crying, noncrying and crying activity, and median amplitude of noncrying movements. The amplitude of noncrying movements had the highest day-to-day stability, with correlations of .69-.80 This measure of the vigor of the infants' movements was not related to the infants' activity level as expressed in the frequency of movements and was not confounded by the infants' crying. The activity and crying measures were not significantly affected by the infants' sex or weight, length of labor, maternal parity, or by the analgesic drugs used during labor and delivery. Over the first 3 days of life, the amplitude or vigor of the infants' movements increased, while the frequency of motions did not change significantly.

Circadian Rhythm↗
PubMed1995

Evidence for a distinct region causing a cat-like cry in patients with 5p deletions.

The cri-du-chat syndrome is a contiguous gene syndrome that results from a deletion of the short arm of chromosome 5 (5p). Patients present with a cat-like cry at birth, which is usually considered diagnostic of this syndrome. Additional features of the syndrome include failure to thrive, microcephaly, hypertelorism, epicanthal folds, hypotonia, and severe mental retardation. We report on four families in which patients with 5p deletions have only the characteristic cat-like cry, with normal to mildly delayed development. The precise locations of the deletions in each family were determined by FISH using lambda phage and cosmid clones. All of the deletion breakpoints map distal to a chromosomal region that is implicated with the facial features and severe mental and developmental delay in the cri-du-chat syndrome. DNA clones mapping in the chromosomal region associated with the cat-like cry feature will be useful diagnostic tools. They will allow for the distinction between 5p deletions that will result in the severe delay observed in most cri-du-chat syndrome patients and those deletions that result in the isolated cat-like cry feature, which is associated with a better prognosis.

Adult↗
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↗
PubMed1976

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.

Acoustic Stimulation↗
PubMed2006

Role of receptor interaction in the mode of action of insecticidal Cry and Cyt toxins produced by Bacillus thuringiensis.

Cry toxins from Bacillus thuringiensis are used for insect control. Their primary action is to lyse midgut epithelial cells. In this review we will summarize recent findings on the Cry toxin-receptor interaction and the role of receptor recognition in their mode of action. Cry toxins interact sequentially with multiple receptors. In lepidopteran insects, Cry1A monomeric toxins interact with the first receptor and this interaction triggers oligomerization of the toxins. The oligomer then interacts with second receptor inducing insertion into membrane microdomains and larval death. In the case of mosquitocidal toxins, Cry and Cyt toxins play a part. These toxins have a synergistic effect and Cyt1Aa overcomes Cry toxin resistance. Recently, it was proposed that Cyt1Aa synergizes or suppresses resistance to Cry toxins by functioning as a membrane-bound receptor for Cry toxin.

Bacillus thuringiensis↗
PubMed2006

Mode of action of Bacillus thuringiensis Cry and Cyt toxins and their potential for insect control.

Bacillus thuringiensis Crystal (Cry) and Cytolitic (Cyt) protein families are a diverse group of proteins with activity against insects of different orders--Lepidoptera, Coleoptera, Diptera and also against other invertebrates such as nematodes. Their primary action is to lyse midgut epithelial cells by inserting into the target membrane and forming pores. Among this group of proteins, members of the 3-Domain Cry family are used worldwide for insect control, and their mode of action has been characterized in some detail. Phylogenetic analyses established that the diversity of the 3-Domain Cry family evolved by the independent evolution of the three domains and by swapping of domain III among toxins. Like other pore-forming toxins (PFT) that affect mammals, Cry toxins interact with specific receptors located on the host cell surface and are activated by host proteases following receptor binding resulting in the formation of a pre-pore oligomeric structure that is insertion competent. In contrast, Cyt toxins directly interact with membrane lipids and insert into the membrane. Recent evidence suggests that Cyt synergize or overcome resistance to mosquitocidal-Cry proteins by functioning as a Cry-membrane bound receptor. In this review we summarize recent findings on the mode of action of Cry and Cyt toxins, and compare them to the mode of action of other bacterial PFT. Also, we discuss their use in the control of agricultural insect pests and insect vectors of human diseases.

Bacillus thuringiensis↗
PubMed1996

Single amino acid substitutions on a Japanese cedar pollen allergen (Cry j 1)-derived peptide induced alterations in human T cell responses and T cell receptor antagonism.

We generated T cell clones specific to a Japanese cedar pollen allergen (Cry j 1) and investigated effects of altered T cell receptor (TCR) ligand on changes of T cell responses. One of these Cry j 1-specific T cell clones established from patients with Japanese cedar pollinosis, ST1.9, recognized an antigenic peptide Cry j 1 p335-346 in the context of HLA-DRA+DRB3*0301 molecules and secreted interleukin-4 dominantly, with a smaller amount of interferon-gamma. ST1.9 represented one of the major T cell clones specific to Cry j 1 in the donor, because a short-term cultured polyclonal T cell line specific to Cry j 1 exhibited the same character as the ST1.9. We synthesized various analog peptides derived from Cry j 1 p335-346 with single amino acid substitutions and determined key residues for interactions between TCR of ST1.9 and HLA-DR molecules. We also analyzed changes in the responses of ST1.9 to Cry j 1 p335-346-derived analog peptides. Of interest was that the substitution of 339threonine to valine resulted in a significant increase in interferon-gamma production, with no remarkable changes either in proliferative response or interleukin-4 production. Analog peptides carrying the substitutions of 339threonine to glycine or glutamine revealed TCR antagonism, without changes in their binding affinities to the DR molecule. Therefore single amino acid substitutions on an allergen peptide carrying the T cell epitope may suppress helper-T-dependent class switch pressure to IgE in B cells either by inducing increased interferon-gamma production or by inhibiting proliferative responses in helper-T cells.

Allergens↗
PubMed2000

Identification and characterization of a group 2 conifer pollen allergen from Chamaecyparis obtusa, a homologue of Cry j 2 from Cryptomeria japonica.

BACKGROUND: Not only Cryptomeria japonica (Japanese cedar) pollen but also that of Chamaecyparis obtusa (Japanese cypress) induces the allergic symptoms of Japanese cedar pollinosis. However, allergens from C. obtusa pollen have not been as well characterized as those from C. japonica pollen. OBJECTIVE: We sought to identify and characterize a homologue of the second major allergen of C. japonica pollen, Cry j 2, from the pollen of C. obtusa. METHODS: An allergen homologous to Cry j 2 was identified in C. obtusa pollen extract by immunoblot analysis, probed with anti-Cry j 2 monoclonal antibodies and purified by a series of column chromatographic steps. RESULTS: The allergen isolated from the extract showed a slightly diffuse band of 45 kDa and closely spaced double-bands of 42 and 45 kDa on SDS-PAGE, under reducing and non-reducing conditions, respectively; the bands were approximately 5-7 kDa larger than those of Cry j 2. In 24 of 30 residues, the N-terminal amino acid sequence of the allergen was identical with corresponding sequence in Cry j 2. Most patients with pollinosis who were IgE antibody-positive to Cry j 2 were shown to be IgE antibody-positive to this allergen, and the IgE antibody levels to both allergens were highly correlated. CONCLUSION: The results indicate that the allergen isolated from C. obtusa pollen in this study is a homologue of Cry j 2. The allergen was designated as Cha o 2 according to the WHO/IUIS Allergen Nomenclature Subcommittee recommendation.

Allergens↗