ABSTRACT
An intervention for infant irritability or colic was evaluated in a randomized clinical trial. A total of 121 full-term irritable infants (2 to 6 weeks old) were randomized to routine care or the home-based intervention program. A third group (n=43) of irritable infants were entered into a post-test-only group. Following the 4-week intervention, the treatment group infants cried 1.7 hours less per day than the infants in the control group (p=0.02). The findings support the emerging view of infant colic as a behavioral pattern that is responsive to environmental modification and structured cue-based care.
Subject(s)
Colic/nursing , Crying , Home Nursing , Infant Care/methods , Irritable Mood , Adult , Female , Humans , Infant , Infant Behavior , Infant, Newborn/psychology , Male , Psychology, ChildABSTRACT
PURPOSE: To describe and evaluate a home-based nursing intervention program, the REST routine, which incorporates the use of infant behavior assessment, pattern recognition, individualized infant schedules, specific management strategies, and parent education and support. STUDY DESIGN AND METHOD: A two-site clinical trial was conducted on 164 healthy full-term infants with excessive unexplained irritability or colic. Infants between the ages of 2 to 6 weeks were randomized to routine care or a home-based intervention program (n = 121). A third group (n = 43) of infants too old at entry for randomization (mean age = 10.4 weeks) were entered into a posttest-only group. RESULTS: Infants in the REST routine treatment group cried 1.3 hours per day on average following the intervention program as compared to the control group crying 3 hours per day (p = .02). Infant irritability was resolved (< 1 hour) in 62% of the treatment group while only in 29% of the control group at the time of the 8-week follow-up visit (p = .04). CLINICAL IMPLICATIONS: Families in both the treatment and control groups reported benefiting from a nurse visiting in their home to inquire about their infant and their well-being. Options for individualizing the program for those most in need of intensive home visiting and other delivery modes for the intervention are areas for further investigation.
Subject(s)
Infant Behavior , Infant Care/methods , Irritable Mood , Parents/education , Pediatric Nursing/methods , Crying , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Patient Satisfaction , Qualitative Research , Social Support , Treatment OutcomeABSTRACT
INTRODUCTION: The purpose of this study was to describe the current beliefs about the etiology of colic as well as current management approaches used by pediatric health care providers. METHOD: An open-ended, short- answer survey concerning beliefs about the etiology and treatment of colic was conducted at major National Association of Pediatric Nurse Associates and Practitioners and American Academy of Pediatric meetings. The two groups of providers surveyed, pediatric nurse practitioners (PNPs) (n = 216) and pediatricians (n = 215), were similar in age and years of practice. RESULTS: PNPs were more likely to define colic as "excessive crying." No differences were found in the beliefs regarding etiology of colic. Pediatricians reported seeing more colicky infants per month. A strong relationship existed between etiology and primary treatment approach. Statistically significant differences were found between PNPs and pediatricians in approaches to management of colic. DISCUSSION: Colic remains a prevalent and mysterious malady, with a critical need for more evidence-based treatment protocols. Differences in approaches used by providers were found, with PNPs more likely to use behavioral and environmental approaches to treatment.
