Research shows efficacy of treatment model developed at Women & Infants

Having a new baby brings much joy to a new family. But for a family whose baby cries for hours on end, fusses through feedings, or has difficulty sleeping, the joy may be overshadowed by feelings of helplessness and frustration. The treatment of that infant – and that family – will impact the parent-child relationship for years to come.

Research has recently been published in the Infant Mental Health Journal that supports an integrated model of care that is found at the Infant Behavior, Cry and Sleep Clinic at the Brown Center for the Study of Children at Risk at Women & Infants Hospital of Rhode Island. Lead author on the research is Amy Salisbury, PhD.

Over a two-year period, Dr. Salisbury and her colleagues at Women & Infants studied 61 families who were dealing with infant cry and sleep issues, most often colic. The infants treated with the Infant Behavior, Cry and Sleep Clinic's model of integrated care vs. those infants who had standard pediatric care had fewer contacts with community medical care providers in all weeks following the first treatment session and experienced a more rapid decline in the amount of crying per day.

"More than 70% of the families in the integrated care group reported that participation in the study helped their family and their infant, compared to less than 30% of the families in the standard care group," said Dr. Salisbury.

According to Dr. Salisbury, integrated care is a family-based intervention provided by two clinicians, a developmental pediatrician and a mental health clinician, that treats the infant's symptoms as well as the impact that colic has on the larger family system and the infant-parent relationship. The families received individualized treatment plans addressing problems in the areas of sleep, feeding, routine, and family mental health.

Infants in the integrated care group were seen for three sessions over a 10-week period. Infants in the standard pediatric group were seen at home for measurement of infant behaviors only and continued with routine pediatric care with their physician.

Women & Infants' Infant Behavior, Cry and Sleep Clinic has provides clinical services for infants with crying, colic, sleep, or feeding concerns. The staff helps parents understand and manage their infant's behavior concerns.

"We can help families adjust to the disruption caused by having an infant who is difficult to manage in the first few months and/or years of life," said Barry Lester, PhD, director of Women & Infants' Brown Center for the Study of Children at Risk. "Our goal is to treat the infant's difficulties with crying, sleeping and feeding. By doing this, we are able to help parents deal with possible disruptions in the parent-infant relationship."

In the clinic, behavioral pediatricians, clinical social workers, and clinical and developmental psychologists work together to develop treatment plans for families whose infants are having early behavioral concerns. Occupational therapy is also available.

For information about the Infant Behavior, Cry and Sleep Clinic and the other services of the Brown Center for Children, call (401) 274-1122, extension 8935 or visit womenandinfants.org.

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A U.S.News Best Hospital in Gynecology and Best Children's Hospital in Neonatology, Women & Infants was ranked number one in the Providence metro area and a top-performer in cancer, and has achieved a 5-star rating in Maternity Care for 2011 from HealthGrades. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. In 2009, Women & Infants opened the country's largest, single-family room neonatal intensive care unit.

New England's premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the National Institutes of Health's Pelvic Floor Disorders Network.