Comparison of behavior modification with and without swaddling as interventions for excessive crying

  • B.E. van Sleuwen
    Correspondence
    Reprint requests: B. E. van Sleuwen, Wilhelmina Children’s Hospital, University Medical Center Utrecht, KA.00.004.0, P.O. Box 85090, 3508 AB Utrecht.
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • M.P. L’Hoir
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • A.C. Engelberts
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • W.B. Busschers
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • P. Westers
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • M.A. Blom
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • T.W.J. Schulpen
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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  • W. Kuis
    Affiliations
    Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands; Maaslandziekenhuis, Sittard, The Netherlands; Center for Biostatistics, Utrecht University, The Netherlands; Therapeuticum Utrecht, The Netherlands; Paediatric Association of the Netherlands, Utrecht, The Netherlands.
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      Objective

      To test the hypothesis that swaddling is an effective method to reduce crying, we compared a standardized approach of regularity and stimulus reduction with the same approach supplemented with swaddling.

      Study design

      Healthcare nurses coached 398 excessively crying infants up to 12 weeks of age for 3 months. Outcome measurements were crying as measured by Barr’s 24-hour diary and parental perception of crying.

      Results

      Crying decreased by 42% in both groups after the first intervention week. Swaddling had no added benefit in the total group. Young infants (1-7 weeks of age at randomization) benefited significantly more from swaddling as shown by a larger decrease of crying over the total intervention period. Older infants (8-13 weeks of age at randomization) showed a significantly greater decrease in crying when offered the standardized approach without swaddling. The actual difference in crying time was 10 minutes.

      Conclusion

      For older babies, swaddling did not bring any benefit when added to regularity and stimuli reduction in baby care, although swaddling was a beneficial supplementation in excessively crying infants <8 weeks of age.

      Abbreviations:

      R ( Regularity), RS ( Regularity and swaddling), (t0) ( One of two interventions)
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