The enigma of infant colic results, clinical experiences and therapeutic approaches from the Munich Interdisciplinary Research and Intervention Program (MIRIP)

Aim of the study: The etiology of persistent crying during early infancy ha s been only insufficiently elucidated. Based upon recent data from the,Muni ch Interdisciplinary Research and intervention Program (MIRIP)", this paper shall discuss and challenge well known explanatory moctels. In addition,no vel approaches of intervention shall be presented. Methods: The sample consists of 63 1-6 months old infants, as well as 49 ag e-matched controls. Using a structured clinical interview, behavioral proto cols, questionnaires and videotaped samples of mother-infant interaction th e following aspects have been evaluated: Mean daily cry/fuss-duration of th e infant, organic and psychosocial risk factors of the infant and its famil y, infant temperament as perceived by the parents, marital satisfaction, ma ternal depression, maternal child care attitudes, social support of the fam ily, quality of mother-infant interaction and relationship in age relevant contexts, Finally, all infants underwent a thorough, standardized pediatric , neuropediatric and developmental examination. Results: Persistently crying infants and their families from the MIRIP were significantly different from control infants in the following aspects: hig her cumulative organic, and even more pronounced, psychosocial and psychic risk factors of the child and its family. A specific organic etiology of pe rsistent crying, such as cow's milk intolerance, could be demonstrated only in a minority. However, more than half of the crying infants (51%) as oppo sed to only 22% of control infants showed minor to moderate neurological ab normalities. Immaturity of the infants regulation of arousal and sleep-wake -cycles as well as dysfunctional parent-infant-interactions are among the s pecific maintaining conditions of excessive crying. Conclusions: The current sample exhibits a surprisingly high cumulation of organic and psychosocial risk factors. Pediatric diagnostic and therapeutic approaches, focussing on identifying and diminishing specific risks might prevent more severe infant developmental and relationship problems.