Research
Predictors of Crying Problems in the Early Postpartum Period

https://doi.org/10.1111/j.1552-6909.2010.01141.xGet rights and content

ABSTRACT

Objective

To investigate maternal and infant factors associated with midwife-reported crying problems in the early postpartum period.

Design

Case control study.

Setting

Postnatal home care in Switzerland.

Participants

Seven thousand seven hundred and sixty-five mother/child dyads who received postnatal homecare by midwives (n=1,636 cases of midwife-reported crying problems, n=6,129 controls).

Methods

We investigated factors associated with infant crying problems during the postpartum period as documented in the Statistical Database of Independent Midwives' Services in Switzerland (2007). Using case control methodology, we matched all identified cases of crying problems with controls who had been cared for by the same midwife. A conditional logistic regression model was used to analyze the associations of reported crying problems with maternal and infant factors.

Results

Maternal health and mood problems in the immediate postpartum period were significantly associated with reported crying problems. Maternal health and mood problems included physical complications after birth, psychological decompensation, and depression. Further risk factors for infant crying problems were planned resumption of paid work directly after paid maternity leave (at 15–16 weeks postpartum) and immigrant status. A protective effect was observed for higher parity.

Conclusions

Crying problems in the early postpartum period are associated with mothers' physical, psychological, and social conditions. Care practices that promote new mothers' physical and psychological recovery after birth could be a promising strategy to prevent early crying problems. Specific support is important for mothers with early signs of depression or decompensation, intention to return early to paid work, immigrant background, and for first-time mothers.

Section snippets

Background

Current pediatric theories regard infant crying as a normal part of a child's neuro-behavioral development with large interindividual variation. Infant crying follows a typical curve that peaks during the 6th week postpartum at nearly 3 hours crying per day and declines to below 1 hour/day by 12 weeks of age (Barr 2002, Brazelton 1962, Von Hofacker and Papousek 1998). Existing literature concentrates on the upper end of the crying continuum—infantile colic, also called excessive crying—which

Methods

Based on previous literature we hypothesized that the risk of early crying problems would be associated with sociodemographic factors (maternal age; maternal education, and work load; single parenthood), reproductive-maternal factors (parity, mode of delivery, prenatal, intrapartum, or postpartum disorders, including psychological decompensation and/or depression of the mother), and neonatal health factors (gestational age, birth weight, neonatal disorders). We also investigated women's plans

Results

The source population for the study was women that received postnatal home care by independent midwives in Switzerland in 2007. Characteristics of the source population were compared with the overall childbearing population in Switzerland for the same year (2007) (Table 1). The women in the source population were slightly older, and there was a higher percentage of non-Swiss mothers compared to the overall childbearing population in Switzerland in 2007. Family structure and the number of

Discussion

Our analysis identified significant associations between midwife-reported crying problems in the early postpartum period and sociodemographic, reproductive-maternal, and neonatal factors. A novel finding is that the relationship between maternal conditions and infant crying was already evident in the immediate postpartum period. Maternal depression and psychic decompensation during the first 10 days were the major risk factors associated with reported crying problems, followed by non-Swiss

Acknowledgments

The authors thank the Swiss Federation of Midwives who provided the data set for this study and Stephan Meyer and Sandra Engberg for final editing.

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