The result: women with an unwanted pregnancy have a 12-fold increased risk of ending up with a “cry baby”. Socially stressed pregnant women have a 5.5-fold increased risk. The first few weeks with a newborn at home are not just pure bliss. Many families suffer because their babies cry during the first months of life significantly more than other babies and are difficult to calm or cannot be calmed at all. According to “Wessel’s Criteria (of threes)”, a baby is a cry baby when it cries at least three hours a day, at least three days a week, over at least three consecutive weeks. Normally the screaming subsides from the fourth month on. With children who cry excessively, crying often persists beyond that. In Germany, an estimated 21% of newborn infants are “cry babies” – about 40% of these children cry even more after the age of three months.
Heidelberg Project intercepts families under stress
Assistance services are often quite difficult to obtain for the affected families. Things are different in Hesse, Baden-Württemberg and Saarland in Germany: there the project “Nobody falls through the net“, under the direction of Heidelberg psychoanalyst and psychiatrist Professor Manfred Cierpka, sees to it that families under stress during the child’s first year get support – parent training and regular visits from a family midwife, for instance, are part of it. In this project the scientists wanted to find out whether psychosocial stress of the mother might be linked to excessive crying of a baby in the fifth month of life. Mothers were visited at the start of the study by trained student team members – at this time the babies were on average 18.5 weeks old. As part of the survey of mothers, both personal interviews and questionnaires were carried out, which were to be filled out by the mothers. Mothers who were, according to the so-called Heidelberg Stress Scale (HBS), considered to be sufficiently highly stressed (HBS-value over 20) were enrolled in the study. These mothers were interviewed again when their babies were between four and five months old.
The researchers identified these parameters:
- Excessive crying on the basis of the “Questionnaire on crying, feeding and sleeping“
- The prenatal, perinatal and postnatal situation of the child using the socio-economic panel (SOEP mother-child)
- The overall stress of the family using the Heidelberger Stress Scale
- Postnatal depressive symptoms of mothers using the Edinburgh Postnatal Depression Scale (EPDS with a cut-off value of 13)
- The stress of the mother-child relationship using the “Parenting Stress Index” and the “Postpartum Bonding Questionnaire“
Relatively few cry babies in study – how come?
In this study, 4.2% of babies were affected by persistent crying – that is, they cried a great deal even in the fifth month of life. According to estimates by the authors, the prevalent level would have to be about 8%. The authors suggest that this finding could be connected with the relatively low sensitivity of affected mothers: Since socially stressed mothers are less sensitive to their babies, they could tend to ignore them and answered more questions about the screaming with a “no”. In addition, the Wessel-Criteria are a relatively tightly defined set of criteria for the excessive crying of the child.
Unwanted pregnancies – a link to cry babies?
Listed among the critical forms of social stress during pregnancy were: enduring maternal stress; initially unwanted pregnancy, depression; unresolved pair conflicts; conflicts with the biological family; critical life events and stress in the workplace. The risk that a baby cries excessively in the fifth month of life was for unwanted pregnancy 13-fold higher. While only two percent of women with desired pregnancy indicated that their child cries excessively, for those with an unwanted pregnancy the figure was 19.4% of women (χ ² (1, 284) = 22.40, p < 0.001). Social stresses of those pregnant women increased the risk 17-fold. It is hypothesised that the maternal stress hormone cortisol crosses the placenta and affects the brain of the unborn child – the autonomic nervous system is activated by this and affects the HPA axis (hypothalamic-pituitary-adrenal axis). In addition, the excessive crying can later transform into sleep disorders, or other behavioral disorders.
Consultation is important
The study thus shows how stress in pregnancy can already preprogram problems in the baby. Therefore the mothers should be already well advised during pregnancy on help services available. For example, birth attendants, so-called “Doulas“, can accompany a pregnant woman and help her to overcome fears and insecurities. Also programs for urgent emotional help or family midwives can help support stressed parents. It would be desirable, of course, that the project “Nobody falls through the net” be extended to all federal states in Germany.