Studies and scientific work
The influence of carrying on infant crying patterns
by Dr. Urs A. Hunziker, Kinderspital Zürich (Zurich Children’s Hospital)
Epidemiology of crying patterns
Crying patterns in the first three months of life are characterised by an increase in the total amount of crying per day up until the sixth week of life, which subsequently lessens up until the 12 week of life. (Brazelton; Emde, Gaensbauer, Harmon; Taubmann). The time of day when the crying takes place also changes during this period. While the crying is evenly spread out over 24 hours for the first two to three weeks, around the third month crying usually occurs more during the late afternoon and the early evening (Brazelton). In the industrialised world, this crying pattern has been observed in many studies as a typical trait of early childhood behaviour. In contrast, in third-world countries where children spend much more time strapped to their mothers or other adults, this phenomenon is much less common. (Konner).
234 mothers at two maternity wards in Montreal, Canada were asked to take part in a randomised controlled trial; 117 agreed. Via random selection, 59 mothers were selected for the study and 58 were placed in a control group. Parents in the study group were asked to carry their children more at the end of the baby’s third week of life while the children in the control group had an optical stimulus of a child’s face placed in their beds. This had no influence on the behaviour of the children. The mothers were asked to record their children’s behaviour daily and on a 24 hour basis during weeks 3, 4, 6, 7 and 12. The behaviour protocols included information about sleeping, happy awake times, crying, fussing and drinking as well as phases where nothing was recorded.
The crying patterns in the control group developed – as was expected – from a medium crying length of 1.6 hours per day in week three to 2.1 hours per day in week six. This then declined to 1.1 hours per day in week 12. This reproduces Brazelton’s crying curve with a peak at the age of six weeks. The crying patterns of the study group developed quite differently. Starting from 1.7 hours per day in week three, the daily length of crying went down to 1.3 hours per day in week six, 1.1 hours per day in week eight and 1 hour per day in week 12. There were significant differences between both groups during weeks six, eight and 12, thus completely bypassing the six-week crying peak. Carrying behaviour also varied according to our instructions. The study group carried their children between 4 and 4.5 hours a day and the control group carried their children for between 2.5 and 3 hours a day. The time of day when crying occurred was also significantly different between each group. While activities such as crying, happy awake times, drinking and sleeping occurred evenly throughout week three, the amount of crying experienced by the study group was reduced particularly between the hours of 16:00 and 24:00. During this eight hour period, crying was reduced by 40%. At the same time the study group experienced an increase in happy awake times that precisely corresponded to the reduction in crying. Sleeping behaviour was not at all affected. Similar observations were made in weeks eight and 12.
Behavioural changes due to increased carrying
In summary, our study demonstrated that children who are frequently carried modify their crying patterns as follows:
1. Daily crying periods are reduced
2. The increase in crying up to the sixth week of life is prevented
3. Evening crying is positively influenced
4. Less crying is associated with longer happy awake times
5. Sleeping behaviour remains unaffected
From this study we can deduce that increased carrying is able to influence the normal crying patterns of young infants. This study does not examine if carrying ‘colicky’ children can help alleviate this condition. We are currently carrying out a similar study with ‘colicky’ infants. Overall, increased carrying, as well as other behavioural measures, can be recommended as an intervention option as described by Taubmann (1984). Contingent parental behaviour that is tailored to the needs of the child could include the following scenarios: The child is tired and wants to lie down, the child is bored and wants to be entertained, the child is hungry and wants to be fed and the child is restless and wants to be soothed with non-nutritive sucking. All of these interventions, combined with increased carrying can lead to the child calming down and relaxing and helps the parents to better react to his needs.