Cynthia Stifter - US grants

Infant colic or prolonged, inconsolable crying in an otherwise healthy infant has been a source of confusion for parents and pediatricians alike. Much of this confusion is due to the inconsistent criteria by which colic is identified and the lack of concrete evidence as to its origins. In addition, a small number of studies have revealed that colic may influence later infant behavior. The purpose of the proposed research is to address these issues by investigating the physiological and behavioral antecedents and correlates of infant colic and to examine the impact of colic on later behavior. Toward these ends, this research proposes to prospectively study a group of colic and non- colic infants from birth to five months of age. The emergence of colic will be identified at its onset and behaviors associated with colic obtained through the use of health diaries. Physiological activity during baseline and colic conditions will also be recorded. At five months of age, infant reactivity and responsivity will be measured through laboratory procedures and parental ratings of temperament. The results of this study will provide important information for the design and implementation of a large scale longitudinal study of the development and impact of colic.

Infant colic or prolonged, inconsolable crying in an otherwise healthy infant has been a source of confusion for parents and pediatricians alike. Much of this is due to the lack of concrete evidence as to its origins. Adding to the confusion is the finding that colic may have an impact on later infant behavior or parent perceptions of that behavior. The purpose of the proposed research is to address these issues by investigating the physiological and behavioral antecedents and correlates of infant colic and to examine its influences on later infant development. Toward these ends, two studies are proposed. One is a longitudinal study designed to prospectively identify and follow a group of colic and non-colic infants from birth to ten months of age. Two other groups, one an irritable group that cries frequently but does not meet colic criteria, and one that exhibits excessive gastrointestinal symptoms but not excessive crying will also be followed. The emergence of colic will be identified at its onset and behaviors associated with colic obtained through the use of diaries. Anecdotal reports and our preliminary study of behaviors exhibited during a colic bout suggest that infants are expressing gastrointestinal pain. Work with adults using the non-invasive electrogastrogram (EGG) has shown reports of gastrointestinal upset to be associated with dysrhythmia. We propose to record the EGGs of colic infants during a baseline and colic condition to determine whether changes in normal rhythms are associated with colic cry behavior. To determine the contribution of infant temperament to the emergence of colic and whether colic influences infant behavior once it has dissipated, we propose to measure infant reactivity and regulation at birth, five months, and 10 months of age through laboratory procedures and parental ratings. A second cross-sectional study is proposed to examine the development of gastric myoelectric activity within the first year of life using the EGG. To date, no developmental studies using this measure exist. This study will precede the longitudinal study as the results are essential to our understanding of the physiological changes associated with colic. Both studies will contribute important information to several areas of infant health and development.

DESCRIPTION (adapted from the investigator's abstract): High reactivity, uncooperativeness, and lack of impulse control are characteristics of behavior problems in early childhood. The inability to control or regulate emotions, particularly negative emotions, may be an important antecedent to these disorders. In the present study, we propose to follow a sample of 150 infants, recruited and tested since they were 2 weeks of age, and their parents through the preschool years until 6 moths into their first grade experience, a period when the social contexts of the child expand and study examining the development of emotion regulation and its relation to early behavior problems. This multilevel (infant physiology, infant temperament, parent behavior), multi-informant (mothers and fathers) study has provided a rich database from which continue investigation the developmental pathways toward behavior problems. In the present study we propose to expand our investigation of infant physiology by adding a measure of sympathetic activation (pre-ejection period), observing temperament behaviors, specifically anger reactivity, measuring child behavioral control and regulatory responses, and assessing parent behaviors when subjects are 4.5 and 5.5 yeas of age. Subjects will also participate in a peer interaction before entry into first grade and six months after school entry, teachers and parents will rate problem behavior. Finally, measures of depression, marital satisfaction, life stresses, child rearing disagreements, parent regulatory strategies and family structure will be obtained. By identifying the processes by which children develop problem behavior, preventions and interventions can be more effectively designed and implemented.

Obesity in childhood is increasing at an alarming rate. For children ages 2-5 years, the prevalence of overweight children has almost tripled over the last 30 years, from 5% to 13.9%, Obesity is a multifactorial condition with varying causes including genetic, social, cultural, and behavioral factors, all of which may interact. The aims of the present proposal are to examine a number of these factors and their role in rapid weight gain in infancy and overweight in early childhood. We propose to investigate the interaction between genetically-based child characteristics and early parent feeding practices as risk factors for childhood obesity. More specifically, the parent feeding practices of using food to soothe infant distress is explicitly to interact with the temperament trait of urgency, which is characterized by a sensitive reward system, to increase the risk of childhood obesity. This hypothesis is guided by the central principle of the proposed study;that temperament is linked to health and adjustment either indirectly by evoking parenting responses or through interactions with parenting behaviors that may either buffer the negative defects or increase the risk for poor outcome. Toward this goal infant/toddler temperament and parenting will be assessed throughout the first l8 months of life using multiple methods including diaries, laboratory visit" telephone surveys and parent reports. Rapid weight gain in infancy and toddler weight are the proposed outcomes. Identifying modifiable factors present early in a child's life will contribute to more successful interventions aimed at reducing childhood and adult obesity.

DESCRIPTION (provided by applicant): Obesity in childhood has been increasing at an alarming rate. For children ages 2-5 years, the prevalence of overweight children has almost tripled over the last three decades. Obesity is a multifactorial condition with varying causes including genetic, social, cultural, and behavioral factors, all of which may interact. The aims of the present proposal are to examine a number of these factors and their role in childhood obesity. The proposed study is a follow-up of an infant sample seen at 4, 6, 12 and 18 months of age when temperamental reactivity and parent use of food to soothe was assessed. In the present application we propose to investigate a core developmental construct, self- regulation, which demonstrates rapid growth during the preschool years. As young children develop the ability to regulate their behavior, parents begin to socialize children to rules and standards of behaving. In some instances, parents may turn to instrumental feeding, or the use of food to control or reward behavior. The health outcomes of this feeding practice is expected to be different based on the child's temperamental style and/or their self-regulatory ability. More specifically, instrumental feeding is expected to interact with the genetically-based temperament trait of surgency, which is characterized by a sensitive reward system, to increase the risk of childhood obesity. This hypothesis is guided by the central principle of the proposed study; that temperament is linked to health and adjustment either indirectly by evoking parenting responses or through interactions with parenting behaviors that may either buffer the negative effects or increase the risk for poor outcome. Toward this goal child temperamental reactivity, self-regulation and parenting will be assessed throughout the preschool years of life using multiple methods including laboratory visits, parent reports, and objective measurements. Childhood BMI and weight change are the proposed outcomes. Identifying modifiable factors present early in a child's life will contribute to more successful preventions aimed at reducing childhood and adult obesity.