Newborns with shrill cries could indicate brain damage -


Newborns with shrill cries could indicate brain damage

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Newborns cry for everything they need, but researchers now say some of those wails may actually be a warning sign.

Cry studies have unearthed a wealth of new findings about prenatal care and the signals babies could be sending for help.

The cry of a newborn whose mother was pregnant and on cocaine, or the shrill screech of a baby who is still suffering the side effects of prenatal drinking are very different from healthy normal wails of babies whose mothers did not engage in these behaviors during pregnancy.

Studying the difference and clues between known brain damaged and healthy babies is the work of Dr. Sandy Zeskind, Director of Developmental Research at Carolinas Healthcare System in Charlotte, NC.

"Crying is the first language a baby has," and Zeskind added, "It's a way of communicating at a distance."

Listening to a baby's cry is essentially listening to a baby's brain stem, and a shrill cry could indicate brain damage.

"Even though the baby may look fine, it actually has a damaged nervous system," Zeskind said.

Computer analysis of a healthy, normal baby's cry is about 2.2 seconds long, and shows a smooth arch with evenly spaced lines or 'harmonics.'  

When you examine the cry of a baby who isn't healthy, the anomaly is obvious.

The lines are farther apart, disjointed and at a much higher frequency.

Zeskind played audio of a healthy baby crying.

"This is the cry sound of a full-birth weight baby, full-term, no physical anomalies, everybody would say this baby is perfectly healthy," Zeskind noted.

Next, he played audio of a baby whose cry was very different from the first.

"This mom drank alcohol during pregnancy," he commented.

What does this say about alcohol use during pregnancy?

Zeskind says it only confirms that there is still no known safe amount of drinking because even with no routine signs of alcohol exposure, cry analyses can show hidden damage that's been scarred across the newborn's nervous system and only signaled in their screech.

Booze and hard drugs are not the only culprits showing up in cry studies.

Poor diet and use of prescription drugs or depressants can also damage a baby's nervous system.

If a mother took prescription drugs during her pregnancy, this can cause her newborn to shake more because the infant is experiencing withdrawal.

"We would never just cut off the amount of anti-depressants she [mother] is taking," Zeskind said. "Instead, you taper it down over time, but babies basically have to go cold turkey."

One conclusion from the cry studies has become clear.

"The effects of being a good parent don't start when the baby is born, it starts at conception," Zeskind said. "So, what you eat, drink, smoke, how well you eat, makes a big difference in how the baby's nervous system develops."

While cry analyses may one day be a diagnostic tool for doctors and researchers dealing with undetectable conditions, for now, parents can use this information to guide how they respond to an ear-piercing wail.

Babies who have these disorders often suffer in other ways.

"It is so aversive and distressing, they [mothers] can't take it and they don't want to deal with this baby at all so the baby doesn't get loving stimulation," Zeskind said. 

The best remedy is the gold standard of parenting: tender love and care.

"That kind of stimulation actually makes the baby's nervous system get better," Zeskind said. "The cry sound goes away and the baby can develop in a healthy manner."

Zeskind says the shrill screams of a newborn aren't cries for attention, but rather a biological siren because its their only way to cry for help.  

Dr. Zeskind says there's also reason for concern if your newborn starts sleeping through the night during his first few days or weeks and doesn't wake up crying.

While this may seem like a luxury for a parent, babies actually need to eat every few hours. If a baby can't get itself aroused enough to actually start crying, they don't get fed when they need to.

If this occurs, you should consult with your doctor immediately.


Additional Information:

The following information is from Dr. Sandy Zeskind, Director of Developmental Research at Carolinas HealthCare System.

  • Crying in the first few months is a response to hunger, pain or overstimulation. At about 3-4 months the child beings to cry to elicit attention.
  • The cry tells us about the baby's individual nervous system. While there may be individual differences, they fall in a normal scope.
  • Cry analysis has long been used as part of the neurological examination, to support the diagnosis of brain damage.
  • The cry tells us how the brain stem of the baby is acting. The brain stem handles arousal, crying, sleeping, breathing. The Vagus nerve comes down from the brainstem, into the heart and up to the pharynx and controls the pitch of the cry.
  • Studies looked at babies who were healthy by all measures but suspected of having nervous system damage. Researchers took the measures of baby's who had known cases of brain damage and applied them to baby's who looked healthy but whose suspected problems could not be detected.
  • Hyperphonation (the shrill cry) shows up in cases of malnutrition, antidepressants, alcohol and drug use.
  • Other neurological aspects must be considered. Does the baby look at you? Does it look away? Does it push  you away? Does it snuggle?
  • With cocaine use, it's often used in conjunction with other drugs and/or alcohol, so it's hard for researchers to isolate the affect of just cocaine. But the cry pitch is there.
  • Cry analysis may predict future conditions (SIDS, autism) or act as a diagnostic tool.
  • Hyperphonation may not happen all the time. It may be spontaneous and can be hard to predict. Researchers used a specific stimulus on each baby to know they were eliciting an equal response.

The following information is from (Source:

  • Subtle differences in infant cries can provide important clues to later developmental and neurological conditions, such as poor language acquisition.
  • Cry characteristics may give hospitals a way to assess pain when treating babies and eventually may help detect conditions and start treatment earlier.
  • Researchers at Brown University and Women & Infants Hospital in Providence have devised a computer program to analyze cries.
  • The program breaks down cries into 12.5-miliisecond frames and measures the pitch and volume, among other parameters (about 80) which could help detect risk for conditions affecting baby's health.
  • Cries are controlled by cranial nerves, which can act as a window into the brain.
  • Researchers have not yet linked cry characteristics with specific conditions. They have found that on a group level, an infant's nervous system/cry can be affected by prenatal exposure to alcohol, birth injuries and may be related to later diagnoses of autism.
  • Researchers have not yet been able to pinpoint specific illness but it is the goal.
  • Researchers began evaluating cries in the 1960s in relation to the disorder Cri du chat ("cry of the cat" in French) as babies with this rare genetic disorder have a very distinct, high –pitched cry.
  • Pitch is the number of times the vocal chords vibrate per second. A normal baby's cry pitch is about 400 hertz where a baby with Cri du chat would have a cry of 1,000 hertz or higher.
  • A computer program devised by researchers in Providence, RI breaks down a cry by pitch or frequency, additional characteristics called formats and shows how clear the cry sound (called "voicing" or "phonation." Finally, the program measures the energy or loudness of the cry.
  • Dr. Philip Sanford Zeskind, director of neurodevelopmental research at Carolinas HealthCare System's Levine Children's Hospital says analyzing cries during the first 2-3 months before baby picks up social cues (cry causes mommy to come) is crucial.
  • Tells if there is something wrong with the baby's nervous system even in the absence of routine signs on physical and neurological exams.
  • Healthy babies born full-term and with normal neurological exams can have cries indicating something is wrong with the nervous system due to prenatal alcohol exposure. This was found in a small study published in a 1996 article in the journal "Infant behavior and Development."
  • A cry's pitch is controlled by the brain stem and cranial nerves that goes out of the brain stem and to the muscles associated with the larynx.        
  • Listening to the cry is like listening to the brain stem.
  • Cries showing pain usually have a longer pause between the first and second utterance.
  • The first utterance is also usually louder and longer because the baby has to let out so much air, so it can last four to five seconds or more, as opposed to two or three.

The following information is from a (Source:

  • Doctors and engineers from Brown University and Women & Infants Hospital in Rhode Island have designed a "cry analyzer" computer program that evaluates audio recordings of an infant's wails for their frequency components. The program can pick out differences that are not perceptible to the human ear.
  • It's a non-invasive way to possibly understand whether an infant is at-risk for later developmental problems.
  • The tool helps measure the health status of babies in the newborn period by, for example, examining pain-related cry sounds compared to non-pain cries to determine whether or not certain procedures cause pain.
  • Several of the same researchers compared the cries of 21 different 6-month-old babies who were considered at higher risk for autism (had siblings with autism) with the cries of low-risk babies. The infants with a family history of the disorder had higher-pitched cries than those who did not.
  • The effort is to identify potential signals for risk of autism in early infancy but it is still a long way off.
  • The tool may be most helpful in determining if babies are in pain to adapt clinical practices.
  • The tool is not for parents and parents should not try to analyze cries. Parents should relay on intuition.

The following information is from a report (Source:

  • Severely depressed women face a dilemma: take antidepressants or not? Is it risky not only for her but also her unborn child?
  • Dr. Philip Sanford Zeskind, director of neurodevelopmental research at the Carolinas Medical Center in Charlotte, N.C. believes antidepressants can affect a baby.
  • His research has found that infants whose moms took antidepressants spent most of their time sleeping, were less rhythmic and less regular in their heart rates than babies of mothers who did not take antidepressants.
  • The Food and Drug Administration has strengthened its warnings to pregnant women about certain antidepressants.
  • Many experts believe untreated maternal depression can also be bad for the baby.
  • Patients who are not sleeping, not eating, not gaining enough weight for pregnancy are also at risk.
  • Women should consult with their doctor before getting pregnant and come up with a plan that hinges on the degree of depression.
  • There may be alternatives to medication like yoga, acupuncture, relaxation or exercise. These may not always work in cases of severe depression.
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