Mental health and well‐being in parents of excessively crying infants: Prospective evaluation of a support package

Powell, Charlotte; Bamber, Deborah; Long, Jaqui; Garratt, R.; Brown, Jayne; Rudge, S.; Morris, Tom; Jaicim, Nishal Bhupendra; Plachcinski, Rachel; Dyson, Sue; Boyle, Elaine M.; James‐Roberts, Ian St

doi:10.1111/cch.12566

Cited by 13 publications

(28 citation statements)

References 32 publications

(45 reference statements)

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“…Parental recruitment lasted May–November 2016. Detailed recruitment and descriptive figures for participants are included in Powell et al [23] In total, 57 parents provided data. The majority (94%) were mothers and married or co-habiting (92%).…”

Section: Resultsmentioning

confidence: 99%

“…Their mean (SD) age at study entry (baseline) was 9.6 (5.6) weeks, range 3–24 weeks. At outcome assessment, their mean (SD) age was 15.3 (5.6) weeks, range 9–30 weeks [23]. Overall, 55 parents requested access to the website, 27 the printed booklet and 32 the CBT sessions (they could request all three elements).…”

Section: Resultsmentioning

confidence: 99%

“…In particular, specialist community nurse Health Visitors (HVs) and their teams, who provide health services for all UK parents with infants, were closely involved. The resulting materials, comprising a website, a printed booklet, and a programme of Cognitive Behaviour Therapy (CBT)- based support sessions delivered to parents by a qualified practitioner, have been described [21, 22] and provisional evidence that they are associated with reductions in parental frustration, anxiety and depression has been reported [23]. Since their use in the NHS depends on whether parents and NHS professionals find them suitable, this study aimed to measure parents’ use of the materials and parental and HV evaluations of whether they are fit for purpose.…”

Section: Introductionmentioning

confidence: 99%

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Parental and health professional evaluations of a support service for parents of excessively crying infants

Bamber

Powell

Long

et al. 2019

BMC Health Serv Res

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Background The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents’ and NHS professionals’ evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use. Methods Participants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents’ and HVs’ ratings of the Surviving Crying materials were measured. Results Thirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package. Discussion and conclusions The findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research. Trial registration Study Registration no. ISRCTN84975637 .

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Parental and health professional evaluations of a support service for parents of excessively crying infants

Bamber

Powell

Long

et al. 2019

BMC Health Serv Res

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“…For example, manual therapies may provide small positive benefits in reducing the duration of crying (Carnes, Plunkett, Ellwood, & Miles, ), and interventions focusing on strategies to prevent parents from harming their baby have also been proposed (Barr et al, ). Some interventions, for example, behavioural therapy (Powell et al, ), have been developed to support parental sensitivity in dealing with excessive crying or to improve interactions and communication between parents and infants (Akhnikh et al, ; Blom, van Sleuwen, de Vries, Engelberts, & L'hoir, ).…”

Section: Discussionmentioning

confidence: 99%

Does maternal attachment to her infant mediate the link between perceptions of infant crying at 6 months and parenting stress at 24 months? A structural equation modelling approach

Bailhache

Doyle

Salmi

et al. 2019

Child

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Background: Parenting stress is influenced by many factors including maternal attachment and excessive infant crying, yet the nature of these relationships is not well understood. For example, excessive infant crying despite maternal soothing may impact maternal attachment to the child, leading to higher stress. This paper explored whether maternal perception of excessive infant crying at 6 months was associated with higher maternal parenting stress at 24 months, and whether maternal attachment mediated this relationship.Methods: All families, present at 24 months in a randomized controlled trial of a 5year early intervention programme targeting school readiness skills in disadvantaged area of Ireland, were included. At 6 months, infant crying was assessed using a maternal reported measure of duration of infant crying, and maternal attachment to the infant was assessed using the Condon Maternal Attachment Scale. Parenting stress was assessed at 24 months using the childrearing stress subscale from the Parenting Stress Index. Structural equation modelling was used to explore the direct and indirect effects of maternal perceptions of excessive infant crying on parenting stress, controlling for infant, maternal, and environmental characteristics, and focusing on the mediating role of maternal attachment.Results: Reporting excessive infant crying at 6 months was associated with lower maternal attachment at 6 months, which led to higher parenting stress at 24 months.In addition, vulnerable adult attachment style, previous maternal mental health difficulties, low paternal education, paternal involvement with the child, and not being married were associated with higher parenting stress.Conclusion: Findings suggest that the association between maternal perceptions of excessive crying at 6 months and later parenting stress may be mediated through maternal attachment to the infant. Interventions based on improving maternal attachment could be investigated to determine the effectiveness of supporting mothers with low attachment.

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“…The findings in our study have several implications for clinical practice. First, obstetricians should consider offering pregnant women with a (history of) psychiatric disorder preventive strategies, like a "surviving crying" package which has been shown to significantly reduce depression and anxiety in parents and reduce crying of the baby by increasing parental confidence and parental sleep (39). Moreover, it is important that physicians are aware of the mental wellbeing of mothers who visit their practice with an infant with gastrointestinal symptoms.…”

Section: Several Hypotheses Exist Concerning the Association Between mentioning

confidence: 99%

Gastrointestinal Symptoms in Infants of Mothers With a Psychiatric History and the Role of Depression and Bonding

Kruijff

Choenni

Groeneweg

et al. 2019

J. pediatr. gastroenterol. nutr.

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Objectives: Gastroesophageal reflux (GER), excessive crying, and constipation are common gastrointestinal symptoms in infancy of multifactorial origin in which psychosocial stress factors play an important role. The aims of this observational study were to investigate the presence of gastrointestinal symptoms in infants of mothers with or without a history of a psychiatric disorder, their association with maternal depressive symptoms, and the possible mediating role of bonding. Methods: 101 mothers with a history of a psychiatric disorder ("PD mothers") and 60 control mothers were included. Infant gastrointestinal symptoms, maternal depressive symptoms, and mother-infant bonding were assessed using validated questionnaires and diagnostic criteria at 1.5 month postpartum. Results: The mean total score on the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) reported in infants of PD mothers (13.4 SD 5.4) was significantly higher than in infants of control mothers (10.8 SD 5.4; P =.003). No significant differences were found in the presence of excessive crying (modified Wessel's criteria and subjective experience) and constipation (ROME IV criteria) between both groups. Infant GER was associated with maternal depressive symptoms (P = 0.027) and bonding problems (P = <0.001). Constipation was related to maternal depressive symptoms (P = 0.045), and excessive crying (Wessel and subjective criteria) was associated with bonding problems (respectively P = 0.022 and P = 0.002). The effect of maternal depressive symptomatology on infant GER symptoms and excessive crying was mediated by bonding problems. Conclusion: Maternal psychiatric history is associated with infant gastrointestinal symptoms, in which mother-infant bonding is a mediating factor.

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Mental health and well‐being in parents of excessively crying infants: Prospective evaluation of a support package

Abstract: The findings suggest that the Surviving Crying package may be effective in supporting the well-being and mental health of parents of excessively crying babies. Further, large-scale controlled trials of the package in NHS settings are warranted.

Cited by 13 publications

References 32 publications

Parental and health professional evaluations of a support service for parents of excessively crying infants

Parental and health professional evaluations of a support service for parents of excessively crying infants

Does maternal attachment to her infant mediate the link between perceptions of infant crying at 6 months and parenting stress at 24 months? A structural equation modelling approach

Gastrointestinal Symptoms in Infants of Mothers With a Psychiatric History and the Role of Depression and Bonding

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