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Shedding light on excessive crying in babies

Abstract

Background

Excessive and inconsolable crying behavior in otherwise healthy infants (a condition called infant colic (IC)) is very distressing to parents, may lead to maternal depression, and in extreme cases, may result in shaken baby syndrome. Despite the high prevalence of this condition (20% of healthy infants), the underlying neural mechanisms of IC are still unknown.

Methods

By employing the latest magnetic resonance imaging (MRI) techniques in newborns, we prospectively investigated whether newborns’ early brain responses to a sensory stimulus (smell) is associated with a subsequent crying behavior.

Results

In our sample population of 21 healthy breastfed newborns, those who developed IC at 6 weeks exhibited brain activation and functional connectivity in primary and secondary olfactory brain areas that were distinct from those in babies that did not develop IC. Different activation in brain regions known to be involved in sensory integration was also observed in colicky babies. These responses measured shortly after birth were highly correlated with the mean crying time at 6 weeks of age.

Conclusions

Our results offer novel insights into IC pathophysiology by demonstrating that, shortly after birth, the central nervous system of babies developing IC has already greater reactivity to sensory stimuli than that of their noncolicky peers.

Impact

  • Shortly after birth, the central nervous system of colicky infants has a greater sensitivity to olfactory stimuli than that of their noncolicky peers. This early sensitivity explains as much as 48% of their subsequent crying behavior at 6 weeks of life.

  • Brain activation patterns to olfactory stimuli in colicky infants include not only primary olfactory areas but also brain regions involved in pain processing, emotional valence attribution, and self-regulation.

  • This study links earlier findings in fields as diverse as gastroenterology and behavioral psychology and has the potential of helping healthcare professionals to define strategies to advise families.

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Fig. 1: Comparison of the activated areas in response to the cabbage-like odor stimulus between the colicky and noncolicky groups.
Fig. 2: Linear regression of the activated areas in response to a cabbage-like odor stimulus.
Fig. 3: Functional connectivity.

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Acknowledgements

The authors thank all parents and babies and the Plateforme de Recherche de Pédiatrie, the Centre for Biomedical Imaging (CIBM) of the University Hospital of Geneva, and the Clinical Development Unit of Nestlé Research for their support. We thank N. Gons for her editorial help. This project was partly funded by Nestlé Research, Lausanne, Switzerland (Société des Produits Nestlé SA). R.H.-V.L. was supported by the Swiss National Science Fundation (SNF) grant numbers: 33CM30–124101 (P.I.: P.S.H.) and 33CM30_140334 (P.I.: P.S.H.). A.A.-D. was supported by the SNF grant numbers: 33CM30–124101 and 33CM30_140334 and by Nestlé Research (Société des Produits Nestlé SA), Lausanne, Switzerland. L.F. was supported by the SNF grant number 324730_163084 (P.I.: P.S.H.).

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Authors

Contributions

R.H.-V.L. and P.S.H. conceived the study. G.B. and C.L.G.-R. participated to the conceptualization of the study. P.S.H., R.H.-V.L., A.A.-D., F.L., F.G., P.P., G.B., and C.L.G.-R. contributed to the experimental design. A.A.-D. was in charge of the recruitment, the MRI data collection, and the main MRI analyses. A.A.-D., L.F., and J.S. did the data analysis, supported by F.G., and D.V.D.V., R.H.-V.L., P.S.H., A.A.-D., and F.G. contributed to the interpretation of data. A.A.-D. and R.H.-V.L. wrote the first draft of the manuscript. R.H.-V.L., P.S.H., A.A.-D., F.G., L.F., C.L.G.-R., and G.B. critically revised the manuscript. P.S.H. supervised the study. All authors had full access to all the data in the study.

Corresponding author

Correspondence to Alexandra Adam-Darque.

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Competing interests

P.P., J.S., C.L.G.-R., and G.B. are employed by Nestlé Research (Société des Produits Nestlé). No other disclosures are reported.

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All parents provided written informed consent before enrollment.

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Adam-Darque, A., Freitas, L., Grouiller, F. et al. Shedding light on excessive crying in babies. Pediatr Res 89, 1239–1244 (2021). https://doi.org/10.1038/s41390-020-1048-6

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