Susan Lawrence posts on a study (Comparison of Behavior Modification With
and Without Swaddling as Interventions for Excessive Crying. Van Sleuwen BE,
L'Hoir MP, Engelberts AC, et al. *J Pediatr*. 2006;149:512-517) in which the
researchers compared two groups of babies who were cared for on a schedule
and left alone in bed to cry, half swaddled, and half unswaddled.  The
swaddling, or not, did not affect how long they cried.  The summary does not
say on what basis the researchers decided not to have a comparison group of
babies who were being held, cuddled and comforted and fed on cue, with or
without swaddling; they 'contend' that their cookbook-style behavior
modification program is better than an individual pattern of responding to
the baby's signals with typical caring behavior, such as touch or feeding. 
The definition of excessive crying according to the summary in Susan's post
was that old bugabear, over three hours a day.  Somehow, spending one minute
of every eight in such distress that you are wailing and in tears has been
accepted as NORMAL for humans of less than three months of age.  This chills
me to the core, because it implies we don't even need to worry about what is
bothering the person until they are spending more than the 'normal' three
hours a day crying.  

Susan quotes the summary as saying how many babies were available for
randomization to swaddling/no swaddling after those whose crying decreased
on an elimination diet for the mother were excluded; it does not say how
many babies were excluded.  Did they have to start with 450 babies, or 4000
babies, to end up with 398?  I'd want to know that.  I'd also want more than
the information that 'all infants experienced decreased crying and fussiness
over the 12 weeks of the study follow-up period'.  They were crying for more
than one sixth of every day, on average.  Were they down to 'normal' levels
at the end, that is, less than three hours?  Had they simply given up trying
to get someone to respond to them, and become apathetic and shut down?  Or
had they started feeling better?  

I found the abstract on PubMed but was unable to view the full article.  In
the abstract it says that the actual decrease in crying time was ten minutes
per day, but in another sentence it says crying was reduced in both groups
by forty-two percent in the first week of the interventions.  Nowhere in the
abstract is the number from the summary Susan read, four hours and
thirty-seven minutes, which if reduced by forty-two percent would be much
less than four hours and twenty-seven minutes.  

I've requested the full text from my hospital library so I hope to have
answers to some of the questions I have.  Will report to the list if and
when that happens.

Rachel Myr
Kristiansand, Norway

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