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Using a nonconcurrent multiple baseline design, we evaluated the effects of extinction and stimulus control on nighttime sleep disturbances exhibited by 7 infants. Results showed that frequency and duration of night wakings decreased for all subjects, with corresponding improvements reflected through changes in responses to the sleep behavior scale. Observed improvements maintained at 3 and 24 months posttreatment.
Two-week-old infant rats were treated with intranasal ZnSO4 and compared with littlemate controls 24 hr later. When infants were returned to their mother and littermates, those with olfactory deficits lost weight, had reduced cardiac and respiratory rates and lower body temperatures, and showed increased locomotor behavior in an unfamiliar test area. Subsequent experiments showed that in the absence of the mother and also in isolation, differences between ZnSO4-treated and control infants involved fewer systems were less marked, and presented different patterns. Isolated infants given oral ZnSO4 did not differ from controls on any measures. Olfactory denervation appears to produce these effects by disrupting nursing, by altering littermate interaction, and by other central nervous system effects that are independent of social interaction.
The effects of obstetrical medication on neonatal behavior were studied using a sample of Israeli infants from medicated and nonmedicated mothers. Few significant behavioral differences were detected in the first month of life, and there was no difference in Bayley Infant Scale performance at 3 months of age. Comparative analyses using samples of American and Uruguayan infants and additional data from other studies of American newborns led to the conclusion that light levels of obstetrical medication do not appear to have significant effects on neonatal behavior. However, this may well be qualified by some initial population differences, by the measurements commonly used in the studies reviewed, and possibly by critical cutoff points dividing the levels of medication that will and will not affect neonatal behavior.
In Experiment 1, Sprague-Dawley rat pups at postnatal days 3-4, 7-8, 10-11, 15-16, and 23-24 were tested for suckling behavior on their anesthesized multiparous dams following administration of metergoline or scopolamine. The serotonergic antagonist, metergoline, inhibited suckling in 3- to 4- and 7- to 8-day-old rat pups, but was not found to influence suckling in older pups. Scopolamine, a cholinergic antagonist, reduced suckling primarily in 3- to 4-day-old pups. In Experiment 2, parity of the maternal female was manipulated to assess whether this variable would influence suckling behavior and the effects of metergoline on suckling of weanlings. Baseline levels of suckling were reduced in 23- to 24-day-old pups of primiparous dams when compared with multiparous-derived offspring. Administration of metergoline increased the amount of time that these primiparous-derived pups spent attached to nipples, but did not influence suckling of offspring of multiparous dams, perhaps as a result of a ceiling effect on suckling behavior in these animals.
The sucking behavior of infants was analyzed by taking pictures using a fiberscope. The pictures were taken from inside an artificial nipple when a baby was sucking. The recording was carried out on babies of between 38 and 40 weeks gestational age. The subjects were 20 normal full term infants and 20 low-risk preterm infants. Individual differences were found, but it was possible to abstract the common components of the sucking behavior. The main components studied were the degree of adhesiveness of the lips to the breast for forming an airtight closure, the degree to which the tongue wraps the nipple, the width of the peristaltic tongue movements, and 6 other components. Each component was measured on a 3 point scale, where 1 is poor, 2 is good and 3 is excellent. The total score for each subject was determined by adding the scores for all nine components. The overall score for each infant indicates a level of individual sucking behavior. After the scale was compiled, the level of the sucking behavior of normal full term infants and that of low-risk preterm infants were assessed. The result showed significant discrepancies between the two groups. Low-risk preterm infants had lower overall scores than normal full term infants, and this difference was seen in all nine components.
Drug-exposed infants did not differ from nonexposed infants on Neonatal Behavioral Assessment Scale (NBAS) clusters or on birth characteristics. Infants (n = 137) born to three groups of low-income mothers--cocaine and poly-drug-using mothers in a drug user treatment group (n = 76) and in a treatment rejecter group (n = 18), and to a nonuser group (n = 43)--were examined at 2 days and 2-4 weeks. The motor cluster improved and regulation of state worsened from time 1 to 2. There were no interactions of group by time. Regression analyses were conducted to see whether group differences might either emerge or disappear after removing effects of competing variables, but they did not. Power analysis showed that sample size was sufficient to have detected group differences.
Parental stress in the NICU has at least a short-term impact on the establishment of the parent-child relationship and potential repercussions on long-term child development outcomes. One way to help parents mitigate stress is to help them learn what they need to know about their infant's condition and care. In this article, we examine how learning to read the infant's physiologic and behavioral cues helps parents cope with stress. We view parental learning as a process in which parents target specific domains of information for learning according to the temporal relevance of the domain to their concerns. It is important that we recognize the fluidity of the process and anticipate what parents need to learn at different times during hospitalization. The NICU staff assumes a crucial role in reducing parental stress by delivering information that is relevant to the parents' needs and by helping parents understand this information.
Newborn infants who showed anthropometric signs of atypical patterns of fetal growth were compared with infants of appropriate growth on the Neonatal Behavioral Assessment Scale (NBAS) and on recently developed supplementary items. The sample consisted of lower-socioeconomic-status families in San Juan, Puerto Rico, and included teenage and older mothers. Infants with atypical patterns of fetal growth showed lower scores than did infants of appropriate growth on the NBAS orientation, motor, and reflex clusters and on 15 of the 18 supplementary scores. Gestational age was covaried and showed independent effects on 6 items. Differential effects on measures of state and autonomic function were also found when the effects of the ponderal index were held constant. The results suggested that neonatal behavior is related to multiple indices of fetal growth patterns that may indicate early versus late nutritional insult. Supplementary NBAS items do not improve the discriminability of the NBAS but may help explain the basis for observed group differences.
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OBJECTIVE: Western parents are given conflicting advice about whether to introduce a "scheduled" approach to infant care or to follow their infants' demands. Attempts to address this issue using randomized, controlled trials have been unsuccessful. This comparative study collected evidence about methods of parenting and associated infant crying and sleeping in 2 communities with substantially different approaches to infant care (London, United Kingdom, and Copenhagen, Denmark) and in a "proximal care" group, where parents planned to hold their infants > or =80% of the time between 8 am and 8 pm, breastfeed frequently, and respond rapidly to infant cries. METHODS: Validated behavior diaries were used to measure parental behavior and infant crying and night waking longitudinally at 8 to 14 days, 5 to 6 weeks, and 10 to 14 weeks of age. Feeding and sleeping practices were measured by questionnaire. RESULTS: Proximal care parents held infants for 15 to 16 hours per 24 hours and coslept with them through the night more often than other groups. London parents had 50% less physical contact with their infants than proximal care parents, including less contact when the infants were crying and when awake and settled. London parents also abandoned breastfeeding earlier than other groups. Copenhagen parents fell in between the other groups in measures of contact and care. These differences in caregiving were associated with substantial differences in several aspects of infant crying and settled behavior at night. London infants cried 50% more overall than infants in both other groups at 2 and 5 weeks of age. However, bouts of unsoothable crying occurred in all 3 of the groups, and the groups did not differ in unsoothable bouts or in colicky crying at 5 weeks of age. Proximal care infants woke and cried at night most often at 12 weeks. Compared with proximal care infants, Copenhagen infants cried as little per 24 hours, but woke and cried at night less often at 12 weeks of age. CONCLUSIONS: "Infant-demand" care and conventional Western care, as practiced by London parents, are associated with different benefits and costs. As used by proximal care and Copenhagen parents, infant demand parenting is associated with less overall crying per 24 hours. However, the proximal form of infant-demand parenting is associated with more frequent night waking and crying at 12 weeks of age. Copenhagen infants cry as little per 24 hours as proximal care infants but are settled at night like London infants at 12 weeks of age. Colicky crying bouts at 5 weeks of age are unaffected by care. The findings have implications for public health care policy. First, they add to evidence that bouts of unsoothable crying, which are common in early infancy, are not much affected by variations in parenting, providing reassurance that this aspect of infant crying is not parents' fault. Second, the findings provide information that professionals can give to parents to help them to make choices about infant care. Third, the findings support some experts' concerns that many English parents are adopting methods of care that lead to increased crying in their infants. There is a need for informed debate among professionals, policy makers, and parents about the social and cultural bases for the marked differences between London and Copenhagen parents' approach to care.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Early childhood regulatory disorders account for the most common behavioral abnormalities of the infant and young child that result from regulatory problems associated with age-specific adaptational and developmental tasks. Increasing empirical evidence indicates that these problems need to receive full attention. If left to themselves, such disorders impair the early parent-child relationship, and increase the risk for disturbances later on in life. In most cases, the family doctor is the first person to be consulted by the infant's parents who are unable to cope with excessive crying, sleeping or feeding disorders. A range of proven methods are available to support counseling on child development in the physician's office.
In a study on the psychological development of children born at biological and psychosocial risk adverse temperamental characteristics and psychopathological symptoms of 362 children were determined at the ages of 3 and 24 months. Adverse temperamental characteristics were measured with the help of behavioral observations in standardized situations. Symptoms were assessed in a highly structured parent interview. The results showed a higher-than-average rate of disturbed children, which increased from 15.5% at the age of 3 months to 19.5% at two years. Hyperkinesis was the most prevalent disturbance. Whereas no sex effect was found among infants, the 2-year-old boys manifested more symptoms and had more adverse temperamental characteristics than the 2-year-old girl. Sex differences in symptom patterns were similar to those seen in later childhood. The course of early disturbances was characterized by low persistence and stability. Four fifths of all infant disturbances had remitted by the age of two years. A small number of early problems (i.e. eating disorders) turned out to be predictive of later disorders.
The objective was to compare the behavior of full-term infants small-for-gestational age (SGA) with full-term appropriate-for-gestational age (AGA). The sample considered 20 infants in the 1st, 2nd and in the 3rd months of life. The Bayley Scales of Infant Development-II were used, with attention to items related to Behavior Rate Scale (BRS). It was found that SGA infants showed lower average values in the BRS in the 2nd month. The Motor Quality Factor displayed significantly lower average values in SGA group, in the items Gross-motor Movement Required by Tasks, Control of Movements and Hypertonicity. The Attention/Arousal Factor in the items Exploration of Objects/Surroundings and Orientation to Examiner displayed significantly lower average values in the SGA group.
This report concerns a four-month-old white female infant who exhibited abnormal feeding behavior and EKG irregularities during a newborn sucking behavior study. The immediate post-birth history showed an irregular heart rate on two occasions, but a cardiac consultation elicited no unusual findings. During sucrose sucking conditions, the heart rate increased with a beat-to-beat variation of 50 beats per minute, noted to be due to premature atrial beats. At 39 days, an EKG showed a marked sinus tachycardia of 156, a PR interval of 0.08, QRS of 0.05 and a QT of 0.26. The infant was diagnosed as a sudden infant death syndrome (SIDS) following an unexpected death at home. Subsequent cardiac pathology revealed an anomalous tract between the right atrium and the atrioventricular (AV) bundle which formed an extensive bypass of the AV node (atrio-His tract), and two accessory AV connections between the left atrium and posterior left ventricle. These findings are consistent with the Wolff-Parkinson-White syndrome type A. Only further studies can determine whether such abnormal feeding behavior with EKG irregularities can be used to identify infants who are at high risk for sudden death.
Promotion of oral rehydration therapy (ORT) for the treatment of diarrheal diseases and the WHO case management strategy for acute respiratory infections (ARI) have contributed to significant reductions in infant mortality, but these two conditions remain the leading causes of infant deaths in most developing countries. Identification of the factors contributing to these deaths may contribute to reduce infant mortality from preventable causes. To gain insight into the circumstances and maternal and health services factors that may contribute to infant deaths we used a verbal autopsy method to interview mothers of all infants who died during the previous 12 months (June 1995-May 1996) in 11 municipalities in the State of Ceara, Northeast Brazil. Our results revealed that one-third of the deaths occurred in a hospital and two-thirds at home. Almost all the infants who died at home, however, had been examined one or more times by a doctor, and 36% of them had been hospitalized during the disease episode that resulted in death. For most (85%) of these children the causes of death were diarrhea or acute respiratory infection, and it is likely that death could have been averted if appropriate treatment had been initiated promptly. Three major groups of factors that alone or in combination appeared to contribute to most deaths were delays in seeking medical care on behalf of the parents, medical interventions reported as ineffective by mothers and delays in providing medical care to children who arrived at the hospital too late in the day to be scheduled for consultation. Our findings suggest that government efforts to further reduce infant mortality in Ceara should focus on health education interventions that address quality of home care, recognition of signs of severity and danger and importance of seeking timely medical care: and on improving the quality of care provided at community health centers and hospitals. Measures likely to improve infants' chance of survival include: ensuring prompt access to medical consultation for young children brought to health centers or hospitals with potentially life-threatening symptoms related to infections, health education to mothers on the need for continued home care after discharge and to return to the medical care facility if the child does not recover, and that they have access to medicine prescribed by hospital physicians. Further benefits could be obtained by using community health workers, now integrated into the Family Medicine Program (PSF) health teams, to provide health education, supervise home care, refer mothers to health centers and facilitate their access to hospitals.