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Zeevenhooven J, de Bruin FE, Schappin R, Vlieger AM, van der Lee JH, Haverman L, van Sleuwen BE, L'Hoir MP, Benninga MA. Follow-up of infants with colic into childhood: Do they develop behavioural problems? J Paediatr Child Health 2022; 58:2076-2083. [PMID: 36054703 PMCID: PMC9804625 DOI: 10.1111/jpc.16174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/28/2022] [Accepted: 08/07/2022] [Indexed: 01/07/2023]
Abstract
AIM To assess whether infants with colic (IC) demonstrate persisting developmental dysregulation into childhood, manifested as behavioural problems, and to determine if these behavioural problems are associated with parenting factors. METHODS Preschool children with a history of IC at the age of 0-3 months, as defined by the Wessel criteria, were invited to participate in an observational follow-up study, in which their caregivers completed the Child Behaviour Checklist (CBCL). Raw scores and clinical-range scores on the internalising, externalising and total behavioural problems scales were compared with a Dutch normative sample using independent t-tests and Chi-square tests. For the clinical-range scores, multivariable logistic regressions (odds ratios [99% confidence interval, CI]) were used to adjust for confounders and to identify variables associated with behavioural problems. RESULTS Two hundred and fifty-eight children with a history of IC (median age 5.1 (interquartile range, IQR 4.6-5.5) years, 51.9% boys) were included. The cases had a significantly higher adjusted risk (adjusted odds ratios (aORs) [99% CI]) of scoring in the clinical range of the emotionally reactive, internalising and total problems scale (2.96 [1.24-7.06]; 2.50 [1.35-4.62]; 2.98 [1.46-6.07], respectively). Internalising (P < 0.001), externalising (P < 0.001) and total (P < 0.001) behavioural problems in children with a history of IC were associated with higher parenting stress scores. CONCLUSIONS Children with a history of IC demonstrated significantly more internalising behavioural problems at preschool age compared to the norm sample. Specific advice and support need to be available for parents to understand and regulate the behaviour of their child, from infancy to childhood.
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Affiliation(s)
- Judith Zeevenhooven
- Department of Medical Psychology and Social Work, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands,Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Françoise E de Bruin
- Faculty of Social and Behavioral SciencesUtrecht UniversityUtrechtthe Netherlands
| | - Renske Schappin
- Department of Medical Psychology and Social Work, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Arine M Vlieger
- Department of PediatricsSt. Antonius HospitalNieuwegeinthe Netherlands
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | | | - Monique P L'Hoir
- Nutrition and Health over the LifecourseWageningen University & ResearchWageningenthe Netherlands
| | - Marc A Benninga
- Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
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Abstract
Excessive crying, often described as infantile colic, is the cause of 10% to 20% of all early pediatrician visits of infants aged 2 weeks to 3 months. Although usually benign and self-limiting, excessive crying is associated with parental exhaustion and stress. However, an underlying organic cause is found in less than 5% of these infants. In the majority of cases, treatment consists not of "curing the colic," although usually it is possible to reduce crying, but of helping the parents to get through this challenging period in their baby's development. The aims of this review are to discuss definition, etiology, and evaluate different treatment regimes in infants who cry excessively.
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Liebrechts-Akkerman G, Lao O, Liu F, van Sleuwen BE, Engelberts AC, L’Hoir MP, Tiemeier HW, Kayser M. Postnatal parental smoking: an important risk factor for SIDS. Eur J Pediatr 2011; 170:1281-91. [PMID: 21404101 PMCID: PMC3175033 DOI: 10.1007/s00431-011-1433-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 02/15/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sudden infant death syndrome (SIDS) is the unexpected death of an infant that remains unexplained after a thorough investigation of the circumstances, family history, paediatric investigation and complete autopsy. In Western society, it is the leading cause of post-neonatal death below 1 year of age. In the Netherlands, the SIDS incidence is very low, which offers opportunities to assess the importance of old and new environmental risk factors. For this purpose, cases were collected through pathology departments and the working group on SIDS of the Dutch Paediatrician Foundation. A total of 142 cases were included; these occurred after the parental education on sleeping position (1987), restricted to the international age criteria and had no histological explanation. Age-matched healthy controls (N = 2,841) came from a survey of the Netherlands Paediatric Surveillance Unit, completed between November 2002 and April 2003. A multivariate analysis was performed to determine the risk factors for SIDS, including sleeping position, antenatal maternal smoking, postnatal parental smoking, premature birth, gender, lack of breastfeeding and socio-economic status. Postnatal smoking was identified as an important environmental risk factor for SIDS (OR one parent = 2.5 [1.2, 5.0]; both parents = 5.77 [2.2, 15.5]; maternal = 2.7 [1.0, 6.4]; paternal = 2.4 [1.3, 4.5] ) as was prone sleeping (OR put prone to sleep = 21.5 [10.6, 43.5]; turned prone during sleep = 100 [46, 219]). Premature birth was also significantly associated with SIDS (OR = 2.4 [1.2, 4.8]). CONCLUSION Postnatal parental smoking is currently a major environmental risk factor for SIDS in the Netherlands together with the long-established risk of prone sleeping.
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Affiliation(s)
- Germaine Liebrechts-Akkerman
- Department of Forensic Molecular Biology, Erasmus MC University Medical Center Rotterdam, 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Oscar Lao
- Department of Forensic Molecular Biology, Erasmus MC University Medical Center Rotterdam, 2040, 3000 CA Rotterdam, The Netherlands
| | - Fan Liu
- Department of Forensic Molecular Biology, Erasmus MC University Medical Center Rotterdam, 2040, 3000 CA Rotterdam, The Netherlands
| | - Bregje E. van Sleuwen
- Netherlands Paediatric Surveillance Unit, TNO Prevention and Health, 2215, 2301 CE Leiden, The Netherlands
| | - Adèle C. Engelberts
- Department of Paediatrics, Orbis Medical Center, 5500, 6130 MB Sittard, The Netherlands
| | - Monique P. L’Hoir
- Netherlands Paediatric Surveillance Unit, TNO Prevention and Health, 2215, 2301 CE Leiden, The Netherlands
| | - Henning W. Tiemeier
- Department of Epidemiology and Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, 2040, 3000 CA Rotterdam, The Netherlands
| | - Manfred Kayser
- Department of Forensic Molecular Biology, Erasmus MC University Medical Center Rotterdam, 2040, 3000 CA Rotterdam, The Netherlands
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Semmekrot BA, van Sleuwen BE, Engelberts AC, Joosten KFM, Mulder JC, Liem KD, Rodrigues Pereira R, Bijlmer RPGM, L’Hoir MP. Surveillance study of apparent life-threatening events (ALTE) in the Netherlands. Eur J Pediatr 2010; 169:229-36. [PMID: 19544071 PMCID: PMC2797405 DOI: 10.1007/s00431-009-1012-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Accepted: 06/08/2009] [Indexed: 11/24/2022]
Abstract
SIDS and ALTE are different entities that somehow show some similarities. Both constitute heterogeneous conditions. The Netherlands is a low-incidence country for SIDS. To study whether the same would hold for ALTE, we studied the incidence, etiology, and current treatment of ALTE in The Netherlands. Using the Dutch Pediatric Surveillance Unit, pediatricians working in second- and third-level hospitals in the Netherlands were asked to report any case of ALTE presented in their hospital from January 2002 to January 2003. A questionnaire was subsequently sent to collect personal data, data on pregnancy and birth, condition preceding the incident, the incident itself, condition after the incident, investigations performed, monitoring or treatment initiated during admission, any diagnosis made at discharge, and treatment or parental support offered after discharge. A total of 115 cases of ALTE were reported, of which 110 questionnaires were filled in and returned (response rate 97%). Based on the national birth rate of 200,000, the incidence of ALTE amounted 0.58/1,000 live born infants. No deaths occurred. Clinical diagnoses could be assessed in 58.2%. Most frequent diagnoses were (percentages of the total of 110 cases) gastro-esophageal reflux and respiratory tract infection (37.3% and 8.2%, respectively); main symptoms were change of color and muscle tone, choking, and gagging. The differences in diagnoses are heterogeneous. In 34%, parents shook their infants, which is alarmingly high. Pre- and postmature infants were overrepresented in this survey (29.5% and 8.2%, respectively). Ten percent had recurrent ALTE. In total, 15.5% of the infants were discharged with a home monitor. In conclusion, ALTE has a low incidence in second- and third-level hospitals in the Netherlands. Parents should be systematically informed about the possible devastating effects of shaking an infant. Careful history taking and targeted additional investigations are of utmost importance.
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Affiliation(s)
- Ben A. Semmekrot
- Department of Pediatrics, Canisius-Wilhelmina Hospital, P. O. Box 9015, 6500 GS Nijmegen, The Netherlands
| | - Bregje E. van Sleuwen
- Netherlands Pediatric Surveillance Unit, TNO Quality of Life, Prevention and Health, P. O. Box 2215, 2301 CE Leiden, The Netherlands
| | - Adele C. Engelberts
- Department of Pediatrics, Orbis Medical Centre, P. O. Box 5500, 6130 MB Sittard, The Netherlands
| | - Koen F. M. Joosten
- Erasmus Medical Centre, Sophia Children’s Hospital, P. O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Jaap C. Mulder
- Rijnstate Hospital, P. O. Box 9555, 6800 TA Arnhem, The Netherlands
| | - K. Djien Liem
- Department of Neonatology, Radboud University Medical Centre, P. O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Rob Rodrigues Pereira
- Netherlands Pediatric Surveillance Unit, TNO Quality of Life, Prevention and Health, P. O. Box 2215, 2301 CE Leiden, The Netherlands
| | | | - Monique P. L’Hoir
- Netherlands Pediatric Surveillance Unit, TNO Quality of Life, Prevention and Health, P. O. Box 2215, 2301 CE Leiden, The Netherlands
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Blom MA, van Sleuwen BE, de Vries H, Engelberts AC, L'hoir MP. Health care interventions for excessive crying in infants: regularity with and without swaddling. J Child Health Care 2009; 13:161-76. [PMID: 19458170 DOI: 10.1177/1367493509102476] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article describes two health care interventions developed to support parents whose infant cries excessively. Intervention 1 consists of advice to caregivers to bring about regularity and uniformity in daily infant care and to reduce external stimuli. Intervention 2 is the same advice accompanied by instructions to swaddle during sleep. Nurses can teach parents these interventions easily. The goal is to help infants to establish a stable sleep-wake rhythm, for overtiredness to disappear and excessive crying to stop. The approach is based on offering predictability, which helps to develop infant self-regulating ability. If the intervention succeeds, which is often the case, the baby cries less, drinks adequately, is able to fall asleep on their own and to sleep sufficiently, and therefore is no longer overtired. Parental stress is reduced, which could translate into an improvement in family health and quality of interaction between the parents and the child.
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Affiliation(s)
- Maria A Blom
- Maternal and Child Health Care Nurse, Health Care Centre Therapeuticum Utrecht, Utrecht, the Netherlands.
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Abstract
Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and The Netherlands to curb excessive crying. We have systematically reviewed all articles on swaddling to evaluate its possible benefits and disadvantages. In general, swaddled infants arouse less and sleep longer. Preterm infants have shown improved neuromuscular development, less physiologic distress, better motor organization, and more self-regulatory ability when they are swaddled. When compared with massage, excessively crying infants cried less when swaddled, and swaddling can soothe pain in infants. It is supportive in cases of neonatal abstinence syndrome and infants with neonatal cerebral lesions. It can be helpful in regulating temperature but can also cause hyperthermia when misapplied. Another possible adverse effect is an increased risk of the development of hip dysplasia, which is related to swaddling with the legs in extension and adduction. Although swaddling promotes the favorable supine position, the combination of swaddling with prone position increases the risk of sudden infant death syndrome, which makes it necessary to warn parents to stop swaddling if infants attempt to turn. There is some evidence that there is a higher risk of respiratory infections related to the tightness of swaddling. Furthermore, swaddling does not influence rickets onset or bone properties. Swaddling immediately after birth can cause delayed postnatal weight gain under certain conditions, but does not seem to influence breastfeeding parameters.
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Affiliation(s)
- Bregje E van Sleuwen
- Department of Medical Psychology, Wilhelmina Children's Hospital, University Medical Center Utrecht, KA.00.004.0, PO Box 85090, 3508 AB Utrecht, The Netherlands.
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