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PubMed1999

The response of crying newborns to sucrose: is it a "sweetness" effect?

Intraoral sucrose (and other sweet carbohydrates) induce rapid and sustained calming in crying newborns and transiently increase mouthing and hand-mouth contact ("sucrose effects"). To investigate whether these effects are due to the sweetness of sucrose, 60 crying newborns were randomized to receive 250 microL of 24% sucrose solution, 0.12% of aspartame solution of equivalent sweetness (to adults), or 24% polycose, a soluble carbohydrate that is only very slightly sweet (to adults), as well as water in a mixed parallel crossover design. Relative to water, sucrose persistently reduced crying, and transiently increased mouthing and hand-mouth contact, as previously demonstrated. Aspartame also reduced crying, and transiently increased mouthing and hand-mouth contact, virtually mimicking the time course and the magnitude of the effects obtained in response to sucrose. By contrast, polycose solution had no specific effects on crying, mouthing, or hand-mouth contact. The results imply that the responses of crying newborns to intraoral sucrose are neither specific to sucrose nor to the general class of carbohydrates, and that these effects are more appropriately understood as "sweetness" effects.

Administration, Oral↗
PubMed2000

Crying and behavior pattern in breast- and formula-fed infants.

Breast- and formula-fed infants were compared with regard to behavior patterns, especially crying behavior. A diary concerning seven behaviors was completed by 188 mothers of breast- and formula-fed infants at the well baby clinic. Breast-fed infants were fed more frequently with longer feeding duration. They slept more, but their long bouts were shorter than those of formula-fed infants. The crying pattern of formula-fed infants was different from that of breast-fed infants in that they displayed an evening cluster and a 7-week peak of crying. Since the educational level of the formula group mothers was higher and there are more later born babies in that group, it is speculated that these mothers have a Westernized tendency in their caretaking style and, as a result, the crying pattern of formula-fed infants are similar to that of Western babies. In multivariate analysis, contact, play, sleep durations and mothers' education contributed significantly to cry duration. These results imply that contact with the mother and other caretaking practices are closely associated with infants' crying.

Adult↗
PubMed1998

Persistent crying in early infancy: a non-trivial condition of risk for the developing mother-infant relationship.

Infants between 1 and 6 months of age (mean age 3.6 months) who were referred to the Munich Interdisciplinary Research and Intervention Programme because of persistent crying and their mothers were examined and compared with an age-matched community-based control sample with no current cry problem. Three groups, referred extreme criers, referred moderate criers, and controls, were compared with regard to measures of psychosocial and organic risks, the mothers' perception of her own psychological state and infant temperament, the quality of mother-infant relationship, and intuitive parenting in mother-infant face-to-face interactions. In comparison with general-community samples of infants with persistent crying, the present clinical sample represents a biased group with particularly high levels of infant distress for long periods of time, with problems of sleep-wake organization, neuromotor immaturity, and difficult temperament. Moreover, extreme crying was associated with a cumulation of organic and psychosocial risks, including high rates of prenatal stress and anxiety, maternal psychopathology and partnership conflicts. Mothers in both referred groups scored similarly low on feelings of self-efficacy, and high on depression, anxiety, exhaustion, anger, adverse childhood memories, and marital distress. Mother-infant relationships were more often distressed or disturbed among referred dyads than among controls, and 40% as compared with 19% showed dysregulatory patterns of interactional failures in face-to-face contexts. The findings suggest that factors related to parental care did not cause persistent crying, but functioned as maintaining or exacerbating factors. Dynamic interactions between persistent crying, difficult temperament, and parenting factors which compromise maternal resources and intuitive parenting may put such families at long-term risk for both relationship and behaviour problems.

Adult↗
PubMedDate not supplied

Crying migraine.

Eighty-five percent of migraineurs report triggers which include a diverse array of internal and external factors. Crying as a trigger has been reported in two women, without details, in only one prior study. In the present report, the clinical history of two women (aged 38 and 41 years, respectively) with migraines triggered by crying are detailed. In both women, the migraines were triggered by crying associated with sadness or emotional upset. Crying when happy or due to cutting onions was not a trigger. Only in the second patient was crying during a sad movie or theatrical production also a trigger. Crying may be a common underrecognized migraine trigger.

Adult↗
PubMed1996

Pathological laughter and crying in patients with closed traumatic brain injury.

We report on the clinical and radiological features in 16 adult patients who suffered a traumatic brain injury and subsequently developed pathological laughter and crying. Patients with pathological laughter and crying were identified from among 301 consecutive brain-injured admissions to a trauma centre and subsequently to a rehabilitation facility. Patients displaying pathological laughter and crying had a greater severity of injury than patients without the syndrome; they also had other associated neurological features compatible with pseudobulbar palsy. Pathological laughter alone, or combined with crying, was more frequent than crying alone. An attempt to correlate clinical features with focal lesions on neuroimaging studies yielded inconsistent results. The theoretical anatomical substrate for pathological laughter and crying in patients with traumatic brain injury is discussed.

Adolescent↗
PubMedDate not supplied

Crying and infant abuse in rhesus monkeys.

This study investigated the relation between crying and infant abuse in group-living rhesus monkeys (Macaca mulatta). The subjects were 10 abusive mothers with their infants and 10 control mother-infant pairs. Abused infants cried more frequently than controls in the first 12 weeks of life, even when cries immediately following abuse were excluded from the analysis. The coos of 5 abused infants differed from those of 5 controls in several acoustic parameters, whereas their screams and geckers were acoustically similar, when recorded in the same context. Abusive mothers were less likely than control mothers to respond positively to the cries of their infants. Although infant cries may increase the probability of abuse being repeated, infant crying per se does not appear to be a major determinant of abuse.

Aggression↗
PubMed2006

Respiratory inhibition after crying in infants.

BACKGROUND: Among full-term neonates, the authors discovered infants who showed respiratory inhibition after crying which involved a marked decrease in SpO2. The infants were found to present increased echogenicity or a cyst in a cranial region termed the ganglionic eminence, or to have a subependymal cyst. The authors prospectively examined the relationship between respiratory inhibition after crying and these changes to examine the prevention and treatment of the episode. METHODS: The authors conducted cranial ultrasonography to screen 381 full-term neonates who showed no abnormalities at birth and whose parents requested ultrasonographic screening of the head, followed by polygraphy of infants who showed increased echogenicity or a cyst in ganglionic eminence, or had a subependymal cyst. The authors similarly conducted polygraphy for 50 neonates without cranial ultrasound abnormalities; the former constituted the control group. Respiratory inhibition was defined to be central apnea immediately after crying with a decrease in SpO2 to <60%. RESULTS: Among 381 neonates examined, 104 showed cranial ultrasound abnormalities; 60 of the 104 neonates indicated respiratory inhibition after crying. Oxygenation failed to improve the episode in 17 neonates with severe respiratory inhibition. However, theophylline alleviated the episode, and SpO2 no longer decreased to <60%. Theophylline was discontinued successfully by 6 months after birth, while 50 neonates in the control group showed no respiratory inhibition after crying. CONCLUSION: Respiratory inhibition after crying which involved a marked decrease in SpO2 was observed in full-term neonates who showed no abnormalities after birth. These neonates could be screened by cranial ultrasonography.

Apnea↗
PubMed1996

Crying patterns in preterm infants.

Healthy infants born at term cry most in the first three months of life, with a peak and increased crying in the evening during the second month. To determine whether the crying of preterm infants manifests similar features, the pattern of crying from 40 weeks gestational age through 24 weeks corrected age was described for 35 relatively healthy preterm infants born between 28 and 34 weeks gestational age. Despite their additional extra-uterine experience, they still cried significantly more after 40 weeks gestational age, with a peak and evening clustering at 6 weeks corrected age. The age of peak crying was not related to gestational age at birth, weight for gestational age, or a variety of perinatal and neurological indices. The results support the argument that the early-peak pattern is a robust maturational feature of early development and may be universal to human infancy.

Age Distribution↗
PubMed1989

Pathologic laughter and crying in ALS: a search for their origin.

Spells of laughter and crying are well known in patients with amyotrophic lateral sclerosis (ALS). Since ALS occurs mostly in older age groups, this brings up the possibility that aging changes in the brain could play a causative role in the origin of such spells. To rule out or at least reduce the complicating factor of aging, a study was made of the incidence of pathologic laughter and crying in patients whose motor neuron disease had started before the age of 45 years. The data were collected from 73 such individuals, all with confirmed ALS. All told, 36 had experienced episodes of pathologic laughter and/or crying. Of these, 20 had bouts of both laughter and crying. 9 bouts of crying alone and 7 spells of laughter alone. Nearly all with such emotional spells had developed bulbar involvement with the illness. The youngest patient with spells was 31 when his illness began and 35 when he started to have bouts of crying.

Adolescent↗
PubMed2004

Randomised controlled trial of swaddling versus massage in the management of excessive crying in infants with cerebral injuries.

BACKGROUND: Infants with neonatal cerebral insults are susceptible to excessive crying as a result of difficulties with self-regulation. AIMS: To compare the effectiveness of swaddling versus massage therapy in the management of excessive crying of infants with cerebral insults. METHODS: Randomised three-week parallel comparison of the efficacy of two intervention methods. Infants with symptoms of troublesome crying and their parents were randomly assigned to a swaddling intervention group (n = 13) or a massage intervention group (n = 12). RESULTS: The amount of total daily crying decreased significantly in the swaddling group, but did not decrease significantly in the massage group. Infant behavioural profiles and maternal anxiety levels improved significantly in the swaddling group post-intervention. Parents in the swaddling group were more satisfied with the effectiveness of the intervention in reducing crying than parents in the massage group. CONCLUSION: Results indicate that swaddling may be more effective than massage intervention in reducing crying in infants with cerebral injuries.

Attitude to Health↗
PubMed2001

Economic evaluation of strategies for managing crying and sleeping problems.

AIMS: To estimate the financial cost to the NHS of infant crying and sleeping problems in the first 12 weeks of age and to assess the cost effectiveness of behavioural and educational interventions aimed at reducing infant crying and sleeping problems relative to usual services. METHODS: A cost burden analysis and cost effectiveness analysis were conducted using data from the Crying Or Sleeping Infants (COSI) Study, a three armed prospective randomised controlled trial that randomly allocated 610 mothers to a behavioural intervention (n = 205), an educational intervention (n = 202), or existing services (control, n = 203). Main outcome measures were annual total cost to the NHS of infant crying and sleeping problems in the first 12 weeks, and incremental cost per interruption free night gained for behavioural and educational interventions relative to control. RESULTS: The annual total cost to the NHS of infant crying and sleeping problems in the first 12 weeks was 65 pound sterling million (US$104 million). Incremental costs per interruption free night gained for the behavioural intervention relative to control were 0.56 pound sterling (US$0.92). For the educational intervention relative to control they were 4.13 pound sterling (US$6.80). CONCLUSIONS: The annual total cost to the NHS of infant crying and sleeping problems is substantial. In the cost effectiveness analysis, the behavioural intervention incurred a small additional cost and produced a small significant benefit at 11 and 12 weeks of age. The educational intervention incurred a small additional cost without producing a significant benefit.

Behavior Therapy↗
PubMed2004

Pseudobulbar crying induced by stimulation in the region of the subthalamic nucleus.

We describe a case of pseudobulbar crying associated with deep brain stimulation (DBS) in the region of the subthalamic nucleus (STN). Patients with pseudobulbar crying show no other evidence of subjective feelings of depression such as dysphoria, anhedonia, or vegetative signs. This may be accompanied by other symptoms of pseudobulbar palsy and has been reported to occur with ischaemic or structural lesions in both cortical and subcortical regions of the brain. Although depression has been observed to result from DBS in the region of the STN, pseudobulbar crying has not been reported. A single patient who reported the symptoms of pseudobulbar crying after placement of an STN DBS was tested in the off DBS and on DBS conditions. The patient was tested using all four DBS lead contacts and the observations and results of the examiners were recorded. The Geriatric Depression Scale was used to evaluate for depression in all of the conditions. The patient exhibited pseudobulbar crying when on monopolar stimulation at all four lead contacts. The pseudobulbar crying resolved off stimulation. This case describes another type of affective change that may be associated with stimulation in the region of or within the STN. Clinicians should be aware of this potential complication, the importance of differentiating it from stimulation induced depression, and its response to a serotonin reuptake inhibitor, such as sertraline.

Crying↗
PubMed2006

Hemifacial motor and crying seizures of temporal lobe onset: case report and review of electro-clinical localisation.

OBJECTIVE: To report a case of temporal lobe epilepsy with clinical presentation of paroxysmal episodes of "tightness" over the right hemiface, and ictal crying, and review electroclinical localisation of this phenomenon. METHODS: Clinical semiology, neurophysiological localising tests, and epilepsy surgery outcome are reported in a subject presenting with paroxysmal right hemifacial movements and ictal crying. Pertinent past reports of somato-motor signs and ictal crying in temporal lobe epilepsy are reviewed and the findings correlated with proposed human facial cortical representation. RESULTS: Simple partial seizures caused by temporal lobe epilepsy presented with right sided tonic facial movements and ictal crying. Intracranial EEG monitoring documented a left medial temporal onset of seizures that remained asymptomatic until they propagated to the left cingulate region. Anterior temporal lobectomy with resection of the amygdala and anterior hippocampus resulted in cessation of seizures. CONCLUSIONS: This is a rare example of epileptic seizures of medial temporal onset presenting with isolated somato-motor manifestations and ictal crying. Anatomical-electrical-clinical correlations with cortical regions controlling facial movements were highly suggestive that this case represents secondary activation of "emotional" motor cortex M3 and M4 (rostral and caudal cingulate motor cortex), giving rise to focal hemifacial movements and ictal crying.

Adult↗
PubMed1999

Do cry features reflect pain intensity in preterm neonates? A preliminary study.

The purpose of this study was to investigate if cries from preterm neonates would reflect changes in pain intensity following interventions. The cries from 25 preterm neonates from an original sample of 122 were audiorecorded while the infant was undergoing heelstick during a randomized crossover design testing the efficacy of: pacifier with sucrose or water, or prone position as compared to standard care. Both pacifier conditions reduced procedural pain according to a validated composite pain measure (the Premature Infant Pain Profile). There were proportionately fewer cries in the two pacifier groups compared to the prone positioning and standard care groups, and cry duration was positively correlated with PIPP scores. However, neither cry duration nor fundamental frequency reflected group differences. Further research is needed to determine if cry is a sensitive and valid indicator of pain in preterm infants.

Blood Specimen Collection↗
PubMedDate not supplied

Cry characteristics of 172 healthy 1-to 7-day-old infants.

A total of 1,836 cry signals from 172 healthy babies, 1-7 days old, were analysed with sound spectrography. The mean values for the 8-15 cries from each infant were calculated and used for the statistical analyses. The mean duration of the cry signals was 1.4 +/- 0.6 s. The mean fundamental frequency was 496 +/- 95 cps (Hz). Fifty percent of the mean fundamental frequencies in the 8-15 cries analysed from each baby varied between 450 and 520 Hz. Of the children, 93% had cries with a mean fundamental frequency below 600 Hz. The mean value of the highest point of the fundamental frequency was 583 +/- 151 Hz and of the lowest point 398 +/- 75 Hz. The melody type had mainly a rising-falling contour, though the difference between the highest and the lowest point was often rather small. There were no significant differences noted in the cry characteristics according to gender, the age of the infants or the gestational age when they were born.

Age Factors↗
PubMed1997

Application of an acoustic cry template to evaluate at-risk newborns: preliminary findings.

The durational characteristics of crying episodes produced among two groups of at-risk newborn infants are reported. The groups included preterm infants with diagnosed respiratory problems and preterm infants with diagnosed neurological problems. Each infant's complete crying episode was audio-recorded and acoustically analyzed for overall occurrence of expiratory cry segments, inspiratory cry segments, and nonphonatory 'pause' segments. Remarkable similarity was found across risk groups with regard to the distributional occurrence of the cry features. Results obtained for the at-risk infants were highly similar to those observed for normal full-term newborns. These preliminary findings are taken to suggest that temporal features of newborn crying activity reflect a basic organizational response of the nervous system which is common to both normal and at-risk infants.

Acoustics↗
PubMed1996

Subjective appraisal of infant crying.

How families appraise difficult situations contributes to later adaptive functioning. We have observed in both research and practice that when appraising their infants' crying, mothers often compared their own infants' crying to actual or supposed much worse infants. They typically appraised their infants to be crying less than average infants. This phenomenon, defined in the social psychology literature, is called downward comparison. Secondary analysis of an established data set was used to assess the extent of downward comparison and the identification of excessive crying among a sample of 193 primiparous mothers. Mothers appraised their own infants' crying to be less than that of the expected average infant. Mothers who identified their infants as excessive criers made less robust downward comparisons than did mothers who did not identify their infants as excessive criers. Nursing interventions that focus on supporting mothers' positive appraisal and promoting knowledge of infant behaviors, particularly infant crying, are proposed.

Adult↗
PubMed2003

Crying as a precipitating factor for migraine and tension-type headache.

CONTEXT: Scarcely reported in the literature, crying seems to be an important precipitating factor for both migraine and tension-type headache in daily practice. OBJECTIVE: To evaluate the role of crying as a precipitating factor for migraine and tension-type headache. TYPE OF STUDY: Prospective evaluation. PARTICIPANTS: 163 workers or students from the Universidade Metropolitana de Santos, who presented at least one attack a month, for at least one year, of either migraine or tension-type headache. PROCEDURES: Interview by means of questionnaires and personal evaluations. Details of precipitating factors for the attacks were assessed. RESULTS: From the total group of 163 individuals, 90 (55.2%) considered crying to be a potential factor for triggering headache attacks. Of this group of 90 persons, 62 presented migraine (6 males, 56 females) and 28 presented tension-type headache (5 males, 23 females). Only stress, anxiety and menstrual periods rated higher or equal to crying as triggering factors for both types of headache. CONCLUSIONS: The physiology of crying is not well documented or understood. The act of crying seems to be an important precipitating factor for primary headaches and it should be studied further. The authors welcome comments on the matter and would like to work in collaboration with other groups interested in this subject.

Adolescent↗