Parent characteristics and conceptualizations associated with the emergence of infant colic

The goal of the present study was to examine parental characteristics associated with the emergence of infant colic using a prospective longitudinal study. When infants were 2 weeks of age, parent measures of personality, marital satisfaction, parenting stress, and social support were obtained. In addition, parents were asked about their definition of colic. When infants were 6 weeks of age, parents completed a 4 day, 24 hour cry diary. Parents also completed a stress questionnaire. Based on the fussing/crying data derived from the diaries, 22 of the 128 infants were identified as having colic. Results showed colic infants to have distinctive crying and fussing patterns. Differences in parent conceptualizations of colic were also identified for colic and non-colic families. Results indicated that parental variables, particularly parenting stress and marital satisfaction, may have contributed to the parents’ report of excessive crying and fussing. Much of our current knowledge about crying in early infancy, particularly excessive crying, is based on parental report. Using either interviews, questionnaires, screening mechanisms, or cry diaries, the results have provided important evidence for a cry peak during the 6th to 8th week of life and confirmation of a more extreme condition of crying in an otherwise healthy infant, i.e. colic (Barr, 1990; Brazelton, 1963; St. James Roberts, 1989). Parental reports have been instrumental in colic research because of the intensive and temporal properties of this condition. The most widely used definition of colic, fussing or crying lasting for a total of more than 3 hours a day occurring on more than 3 days a week for at least 3 weeks in the infant’s first 3 months (Wessel et al., 1954), demands daily observations by necessity. Consequently, parents are regarded as the most logical and efficient observers of their infants’ cry behaviour. Address for correspondence: Cynthia A. Stifter, Department of Human Development and Family Studies, 105 White, Pennsylvania State University, University Park, PA 16802, USA. Received: 6 March 2002. Accepted: 17 January 2003. JOURNAL OF REPRODUCTIVE AND INFANT PSYCHOLOGY, VOL. 21, NO. 4, NOVEMBER 2003, pp. 309–322 ISSN 0264-6838/print/ISSN 1469-672X/online/03/040309-14 # 2003 Society for Reproductive and Infant Psychology DOI: 10.1080/02646830310001622123 While recognized as an important source of information, parental reports of infant behaviour have their limitations (Bates, 1989). Several studies have shown parental perceptions of their infants’ behaviour to be a function of the parents’ own personality (Bates & Bayles, 1984; Diener et al., 1995; Matheney et al., 1987). Parental reports of infant colic could be similarly affected. For example, a parent with a low threshold for crying may interpret fussing behaviour as excessive crying. Indeed, characteristics of the mother measured prenatally were found to be related to whether she reported retrospectively that her child had colic (Rautava et al., 1993) or to be more temperamentally difficult (Pedersen et al., 1996). Clinical studies in which parental complaints of problematic crying were used to recruit infants with colic also suggest that the source of excessiveness may be in the ‘eye of the beholder’ (Barr et al., 1992; Papousek & von Hofacker, 1995; Pauli-Pott et al., 2000). For example, Barr and colleagues (1992) found that 65% of the infants referred for problematic crying did not meet the Wessel criteria for colic based on information from diaries. The significant difference in overall total of crying/fussing between these two groups of referred infants led Barr to conclude that contextual factors may play a role in understanding parental assessments of excessive crying. It is important to note that parents of the non-Wessel and Wessel colic groups rated the after-feed cries of their infants as more ‘sick’ sounding (Barr et al., 1992). Moreover, a follow-up acoustical analysis demonstrated that the cries of both colic groups were more vociferous than the non-colic control group (Zeskind & Barr, 1997) suggesting that parents who refer their infants for problematic crying may not be entirely biased. In a series of studies which attempted to illuminate the bases for maternal perceptions of excessive crying or colic, St. James Roberts (St. James Roberts et al., 1995) screened infants for colic from a community sample and then verified this grouping with parental diaries. The results revealed that while colic infants were reported by parents to cry more than non-colic infants, the predominant distress type was not crying, as expected, but fussing. Colic infants were also found to be less soothable using an objective criteria. In a follow-up study (St. James Roberts et al., 1996) which used audio recordings to confirm the daily diaries, parents were found to be reliable in their assessments of long cry bouts as a characteristic of colic. However, the audio recordings did not verify parental reports that colic cries were distinct from other cries of distress. Finally, in a third cross-cultural study that compared the audio and diary recordings of infants of British and Manali mothers (St. James Roberts et al., 1994), St. James Roberts found that the Manali mothers reported up to 20% less crying in their infants compared to the British mothers while the audio recordings revealed they cried at similar rates. Thus, as St. James Roberts suggests, excessive crying or infant colic might best be regarded as social phenomenon involving the interaction between an inconsolable child and the expectations and experiences of the parents. Developmentally, infants begin to increase in the duration of their crying at approximately 2 weeks of age with a peak emerging at 6 weeks of age. While there is individual variation in the timing of the cry peak, this developmental cry curve has been consistently demonstrated in both Western and non-Western societies (see Barr, 2000; cf. St. James Roberts & Plewis, 1996). One way of determining what, if any, parental characteristics influence their assessments and/or complaints of colic is to examine these characteristics prior to the peak of excessive crying rather than during the colic period. Measuring parent characteristics during the time infants are crying and fussing excessively would likely be confounded by the stress of caring for an C. A. STIFTER ET AL. 310