Research Article
Are babies sensitive to the context of acute pain episodes? Infant distress and maternal soothing during immunization routines at 3 and 5 months of age
Giovanna Axia,
Sabrina Bonichini,
Corresponding Author
Giovanna Axia
Department of Developmental and Social Psychology, University of Padova, Italy
Department of Developmental and Social Psychology, Via Venezia 8, 35131 Padova, Italia===Search for more papers by this authorSabrina Bonichini
Department of Developmental and Social Psychology, University of Padova, Italy
Search for more papers by this authorGiovanna Axia,
Sabrina Bonichini,
Corresponding Author
Giovanna Axia
Department of Developmental and Social Psychology, University of Padova, Italy
Department of Developmental and Social Psychology, Via Venezia 8, 35131 Padova, Italia===Search for more papers by this authorSabrina Bonichini
Department of Developmental and Social Psychology, University of Padova, Italy
Search for more papers by this authorAbstract
Ninety-three healthy full-term Italian infants were observed longitudinally at 3 and 5 months during routine vaccinations. Mothers' behaviour was also observed. Participants were divided into two cohorts depending on procedure of inoculation (the first cohort, n=44, showed more distress; the second cohort, n=49, showed less distress). Results indicate that babies' different levels of behavioural distress correspond to mothers' different soothing strategies. Maternal proximal soothing at 3 months predicts faster infant quieting at 5 months, but concurrent and predictive effects of maternal proximity are apparent only when level of baby distress is not too high. The study confirms the view that young babies are sensitive to the overall context of acute pain episodes, including medical procedure and maternal soothing. Copyright © 2005 John Wiley & Sons, Ltd.
REFERENCES
- Aisworth MD, Blehar MC, Waters E, Walls S. 1978. Patterns of Attachment. A Psychological Study of Strange Situation. Erlbaum: Hillsdate, NJ.
- Anand KJS, Hickey PR. 1987. Pain and its effects in the human neonate and fetus. New England Journal of Medicine 317: 1321–1328.
- Atkinson WL, Pickering LK, Schwartz B, Weniger BG, Iskander JK, Watson JC. 2002. General recommendations on immunization. Recommendation of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). Morbility and Mortality Weekly Report 51(RR02): 1–36.
- Axia G. 1998. Temperament and culture. Invited paper, presented at NIH Workshop on Culture, Health and Development, Mystic, May 10–20.
- Axia G. 2000. Culture and maternal soothing of infant pain. Invited lecture at the Evolution, Behavior and Culture Meetings, Department of Anthropology, UCLA, October 2, 2000.
- Axia G, Bonichini S. 1998. Regulation of emotion after acute pain from 3 to 18 months: A longitudinal study. Early Development and Parenting 7(4): 203–210.
- Axia G, Bonichini S. 2001. La regolazione del distress nella prima infanzia. Paper presented at Congresso AIP - Sezione di psicologia dello Sviluppo e Psicologia Clinica- 28–30 September, Palermo, Italy.
- Axia V, Weisner TS. 2002. Infant stress reactivity and home cultural ecology of Italian infants and families. Infant Behavior and Development 140: 1–14.
- Axia G, Bonichini S, Benini F. 1999. Attention and reaction to distress in infancy: A longitudinal study. Developmental Psychology 35: 500–504.
- Axia G, Sponchiado E, Bonichini S, Harkness S, Super CM. 1998. Cultural models for parenting in Italy: emotional closeness and the role of intergenerational transmission. Poster presented at the XV Biennal ISSBD Meeting, Berne, 1–4 July.
- Barr RG. 1989. Recasting a clinical enigma: The case of infant crying. In Challenges to Developmental Paradigms: Implications for Theory, Assessment and Treatment, PR Zelago, RG Barr (eds). Erlbaum: Hillsdate, NJ; 43–64.
- Barr R. 1990a. The colic enigma: Prolonged episodes of a normal disposition to cry. Infant Mental Health Journal 11: 340–348.
- Barr RG. 1990b. The normal crying curve: What do we really know? Developmental Medicine and Child Neurology 32: 356–362.
- Barr RG. 1998. Reflections on measuring pain in infants: dissociation in responsive systems and ‘honest signaling’. Archives of Disease in Childhood: Fetal Neonatal Edition 79: F152–F156.
- Bell SM, Ainsworth MD. 1972. Infant cry and maternal responsiveness. Child Development 43: 1171–1190.
- Bluaer T, Gerstmann D. 1998. A simultaneous comparison of three neonatal pain scales during common NICU procedures. Clinical Journal of Pain 14: 39–47.
- Bonichini S, Axia G. 2002. Effect of maternal soothing on infant stress reactivity with an Italian sample. Paper presented at the VIII International Workshop on Infant Cry Research, 27-29 June, Padova.
- Cassidy J. 1994. Emotion regulation: Influences of attachment relationships. Monograph of the Society for Research in Child Development 59: 228–283.
- Coates DL, Lewis M. 1984. Early mother-infant interaction and infant cognitive status as predictors of school performance and cognitive behavior in six year olds. Child Development 55: 1219–1230.
- Craig KD, Whitfield MF, Grunau RVE, Linton J, Hadiistavrospoulos HD. 1994. A comparison of two measures of facial activity during pain in the newborn child. Special section: assessment of pediatric settings. Journal of Pediatric Psychology 19(3): 305–318.
- de Woff MS, Van Ijzendoorn M. 1997. Sensitivity and attachment: a meta-analysis of parental antecedents of infant attachment. Child Development 68: 571–591.
- Eisenberg N, Fabes RA. 1992. Emotion, regulation and the development of social psychology. In Review of Personality and Social Psychology: Emotion and Social Behaviour, MS Clark (ed.), vol. 14. Sage: Newbury Park, LA; 119–150.
- Fitzgerald M, Millard C, Mc Intossh M. 1989. Cutaneus hypersensitivity following peripheral tissue damage in newborn infants and its reversal with topical anesthesia. Pain 39: 31–36.
- Fox NA (ed.). 1994. The development of emotion regulation: biological and behavioural considerations. Monographs of the Society for Research in Child Development, vol. 59, Serial No 240.
- Gianino A, Tronick Z. 1988. The mutual regulation model: The infant self and interactive regulation and coping and defensive capacities. In Stress and Coping Across Development, TM Field, PM McCabe, N Schneiderman (eds). Erlbaum: Hillsdale, NJ; 47–68.
- Gray L, Miller L, Philipp BL, Blass E. 2002. Breastfeeding is analgesic in healthy newborns. Pediatrics 109: 590–593.
- Gray L, Watt L, Blass E. 2000. Skin to skin contact is analgesic in healthy newborns. Pediatrics 105(1): e14.
- Grunau RVE, Craig KD. 1987. Pain expression in neonates: facial action and cry. Pain 28: 395–410.
- Grunau RVE, Whitfield MF, Petrie JH, Fryer EL. 1994. Early pain experience, child and family factors, as precursor of somatization: a prospective study of extremely premature and full-term children. Pain 56(3): 353–359.
- Gunnar MR. 1992. Reactivity of the hypothalamic–pituitary–adrenocortical system to stressors in normal infants and children. Pediatrics 90: 491–497.
- Gunnar MR, Broderson L, Krueger K, Rigatuso J. 1996. Dampening of adrenocortical responses during infancy: normative changes and individual differences. Child Development 67: 877–889.
- Hadjiastavropulos HD, Craig KD, Grunau RVE, Johnston CC. 1994. Judging pain in newborns: facial and cry determinants. Journal of Pediatric Psychology 19(4): 485–491.
- Hadjiastavropulos HD, Grunau RE, Whitfield MF, Craig KD. 1997. Judging pain in infants: behavioural, contextual, and developmental determinants. Pain 73(3): 319–324.
- Hunziker UA, Barr RG. 1986. Increased carrying reduces infant crying: a randomized control trial. Pediatrics 77: 641–648.
- Izard CE. 1979. The Maximally Discriminative Facial Movement Coding System (MAX). Instructional Resources Center, University of Delaware: Newark.
- Johnston C, Stevens B, Yang F, Horton L. 1996. Developmental changes in response to heelstick in preterm infants: a prospective cohort study. Developmental Medicine and Child Neurology 38(5): 438–445.
- Lewis M, Coates DL. 1980. Mother-infant interaction and cognitive development in twelve-week-old infants. Infant Behavior and Development 3: 95–105.
- Lewis M, Goldberg S. 1969. Perceptual-cognitive development in infancy: a generalized expectancy model as a function of the mother-infant interaction. Merrill Palmerly Quarterly 15: 82–100.
- Lewis M, Ramsay DS. 1995a. Stability and change in cortisol and behavioural responses to stress during the first 18 months of life. Developmental Psychobiology 28: 419–428.
- Lewis M, Ramsay DS. 1995b. Developmental change in infants' responses to stress. Child Development 66: 657–670.
- Lewis M, Ramsay D. 1999a. Effect of maternal soothing on infant stress response. Child Development 70(1): 11–20.
- Lewis M, Ramsay D. 1999b. Environment and stress reduction. In Soothing and Stress, M Lewis, D Ramsay (eds). Lawrence Erlbaum Associates, Inc.: Mahwah, NJ, USA; 171–192.
- Lewis M, Thomas D. 1990. Cortisol release in infants in response to inoculation. Child Development 61: 50–59.
- McGrath PJ. 1989. Evaluating a child's pain. Journal of Pain and Symptom Management 4(4): 198–214.
- Moscovitc M. 1984. Infant Memory: Its Relation to Normal and Pathological Memory in Humans and Other Animals. Plenum Press: New York.
10.1007/978-1-4615-9364-5 Google Scholar
- Riese ML. 1999. Prenatal and perinatal stress: Implications for neonatal soothing and integrity. In Soothing and Stress, M Lewis, D Ramsay (eds). Lawrence Erlbaum Associates: NJ.
- Rothbart MK, Derryberry D. 1981. Development of individual differences in temperament. In Advances in Developmental Psychology, ME Lamb, AL Brown (eds). Erlbaum: Hillsdale, NJ.
- Shash VS, Taddio A, Bennett S, Speidel BD. 1997. Neonatal pain response to heel stick vs venepuncture for routine blood sampling. Archives of Disease in Childhood: Fetal Neonatal Edition 77(2): F143–F144.
- Sroufe LA. 1996. Emotional Development: The Organization of Emotional Life in the Early Years. Cambridge University Press: New York.
- Sweet SD, McGrath PJ. 1998. Relative importance of mothers' versus medical staff' behavior in the prediction of infant immunization pain behavior. Journal of Pediatric Psychology 23(4): 249–256.
- Sweet D, McGrath PJ, Symons D. 1999. The roles of child reactivity and parenting context in infant pain response. Pain 80: 655–661.
- Tronik E. 1989. Emotions and emotional communication in infants. American Psychologist 44: 112–119.
