Why cry baby analyzer manual

History of present illness focuses on onset of crying, duration, response to attempts to console, and frequency or uniqueness of episodes. Parents should be asked about associated events or conditions, including recent immunizations, trauma eg, falls , interaction with a sibling, infections, drug use, and relationship of crying with feedings and bowel movements.

Review of systems focuses on symptoms of causative disorders, including constipation, diarrhea, vomiting, arching of back, explosive stools, and bloody stools gastrointestinal disorders ; fever, cough, wheezing, nasal congestion, and difficulty breathing respiratory infection ; and apparent pain during bathing or changing trauma.

Past medical history should note previous episodes of crying and conditions that can potentially predispose to crying eg, history of heart disease, developmental delay. Examination begins with a review of vital signs, particularly for fever and tachypnea. Initial observation assesses the infant or child for signs of lethargy or distress and notes how the parents are interacting with the child.

The infant or child is undressed and observed for signs of respiratory distress eg, superclavicular and subcostal retractions, cyanosis. The entire body surface is inspected for swelling, bruising, and abrasions. Auscultatory examination focuses on signs of respiratory infection eg, wheezing, crackles, decreased breath sounds and cardiac compromise eg, tachycardia, gallop, holosystolic murmur, systolic click. The abdomen is palpated for signs of tenderness.

The diaper is removed for examination of the genitals and anus to look for signs of testicular torsion Testicular Torsion Testicular torsion is an emergency condition due to rotation of the testis and consequent strangulation of its blood supply. Symptoms are acute scrotal pain and swelling, nausea, and vomiting Extremities are examined for signs of fracture eg, swelling, erythema, tenderness, pain with passive motion.

Fingers and toes are checked for hair tourniquets. The ears are examined for signs of trauma eg, blood in the canal or behind the tympanic membrane or infection eg, red, bulging tympanic membrane. The corneas are stained with fluorescein and examined with a blue light to rule out corneal abrasion, and the fundi are examined with an ophthalmoscope for signs of hemorrhage.

If retinal hemorrhages are suspected, examination by an ophthalmologist is advised. The oropharynx is examined for signs of thrush or oral abrasions. The skull is gently palpated for signs of fracture. A high index of suspicion is warranted when evaluating crying. Parental concern is an important variable. A majority of the time, the researchers don't listen to the cries- only our machines do!

We remove as much personal information as possible from audio files to better focus on the audio of the baby, and our algorithms- not humans- analyze the cries! See our FAQ page for more information. The app is now aimed at helping parents better understand their babies and in turn, to help researchers at UCLA understand how cries affect the babies themselves.

For more information about our researchers, meet the team! There are some concerns around the safety of manual techniques in the treatment of infants, but published data of cases of serious adverse events are rare. In this review, we aimed to update the Cochrane review 23 of RCTs for crying time and investigate non-RCT studies and outcomes that are important to parents, rather than biomedical markers alone that might be of more interest to primary researchers exploring aetiology as our selected population was infants that were considered healthy.

We included the following types of peer-reviewed studies in our search: RCTs, prospective cohort studies, observational studies, case—control studies, case series, questionnaire surveys and qualitative studies. Systematic reviews were identified to inform our research and for citation tracking. There were no language restrictions in our search criteria. Participants were aged between 0 months and 12 months infants when they received manual therapy treatment.

They were healthy, thriving and not receiving other medical interventions. We excluded studies that included infants requiring treatment for conditions that needed specialist or hospital-based clinical care for conditions such as: respiratory disorders, developmental disorders learning and motor , cystic fibrosis, cerebral palsy, otitis media, neuralgia, congenital torticolis or musculoskeletal trauma. We also excluded studies about plagiocephaly or brachycephaly.

We included studies where the manual therapy intervention was delivered in primary care by statutorily registered or regulated professional s. This included osteopaths, chiropractors, physiotherapists and any other discipline using manual contact as the primary therapeutic component.

Studies where the professional trained a non-professional to deliver the therapy or where parents delivered the therapy were excluded also. Unsettled behaviours included, for example, excessive crying, lack of sleep, displays of distress or discomfort back arching and drawing up of legs and difficulty feeding.

Adverse events data were also collected. We selected this timeframe because our scoping work revealed that most papers prior to January were theory-driven position papers on the manual therapy care of infants and for pragmatic reasons in terms of access to full-text original articles.

The main search string modified for the different engines is included in the electronic online supplementary appendices. It included the key terms: musculoskeletal, manipulation, manual and physical therapy, physiotherapy, osteopathy and chiropratic with infant baby and new borns. We also located articles through peer networks. Four reviewers the authors in two teams of two reviewed the titles and abstracts, then the full texts independently.

Where there was disagreement between the reviewers, a third reviewer from the other team arbitrated the final decision to select reject. Review articles retrieved in the search were citation tracked to identify additional studies. Covidence software was used to organise and classify the articles. Flow chart of search process for the review. RCTs, randomised controlled trials. We used the appropriate quality appraisal tools for each type of study design. All low quality cohort and case series studies were regarded as severely methodologically flawed and were not included in the final analyses.

One reviewer extracted the data and another checked the data extractions all authors. We aimed to meta-analyse data for RCTs and matched or paired cohort studies. For RCTs, we planned to extract final value scores for each group and convert them to standardised mean differences and weighted mean differences for comparison using a random effects model due to the expected differences in treatment protocols and effects between studies. We planned to extract risk ratios RR for comparison of adverse events between treatment and control groups.

I 2 was used to calculate heterogeneity. RevMan software V. For non-RCT studies, analyses proposed were descriptive and narrative, but change scores and RRs were extracted where possible.

If there were a sufficient number of qualitative studies, we proposed to organise and synthesise findings from the qualitative data, by identifying emergent themes and subthemes. We rated the strength of evidence across studies for each outcome, as either high, moderate or low, taking note of the quality and overall direction of results inconclusive, favourable or unfavourable. Consistent results from at least two high-quality RCTs, or other well-designed studies, conducted in representative populations where the conclusion is unlikely to be strongly affected by future studies.

Available evidence from at least one higher quality RCT or two or more lower quality RCTs but constrained by: number, size, quality, inconsistency in findings and limited generalisability to clinical practice. The conclusions are likely to be affected by future studies.

Evidence was insufficient with limitations in data provision, number, power, quality, inconsistency in results and findings not generalisable to clinical practice. All studies that were rated as low quality were treated as inconclusive regardless of author findings. Two reviewers rated the quality and strength of evidence, and a consensus vote was used in cases of disagreement. After duplicate removal, studies remained. We acquired full text for references and 19 of these fulfilled our inclusion criteria.

Reasons for exclusion are listed in figure 1. There were 19 primary studies included: seven RCTs, 32—38 seven case series, 39—45 three cohort studies, 46—48 one service evaluation survey 49 and one qualitative study.

The other four studies used massage therapy 35 and osteopathic intervention. In the few cases where there was uncertainty with selection choice, these were all resolved after discussion with a third reviewer.

The methodological quality of the studies varied table 2. Five studies were rated as high quality: four RCTs low risk of bias 32 34 35 38 and a qualitative study. The non-RCT studies rated as low quality were excluded from further analyses. Green indicates a positive quality attribute; Amber indicates unclear quality; Red indicates low or negative quality. Table 3 shows the results from studies reporting similar outcomes.

Six studies reported outcomes related to improvement in feeding, 38 42 44 48—50 seven reported a reduction in crying time, 32—34 36 37 45 46 five reported global improvement in symptoms, 32 34 36 39 40 four reported sleep outcomes 32 33 38 46 and three reported outcomes about parent—child relations. A meta-analysis was only possible for the RCTs with outcomes measuring reduction in crying time and for adverse events.

Seven studies reported data on crying time. This replicated a previous meta-analysis. The difference is due to apportioned weighting given by the different versions of RevMan. We classified dimethicone as a placebo control see figure 2. Reduction in crying: RCTs mean difference. The Dobson review assigned the SD of change scores based on the correlation coefficient of other, similar studies, because personal correspondence was not successful with the author.

We used the data from the Dobson et al review. We were able to extract dichotomous data for adverse events and calculate RRs for meta-analysis figure 3. Of the eight studies that reported presence or absence of adverse events, 33 34 37—39 42 43 45 three studies reported there were no adverse events, 38 42 45 two reported adverse events after manual therapy 39 43 and three reported adverse events worsening symptoms in the control group. Adverse events meta-analysis: RCTs relative risk.

RCTs, randomised conrolled trials. Using data from all the studies reporting adverse events, there were infants exposed to manual therapy and nine non-serious adverse events recorded, giving an incidence rate of seven non-serious events per infants. Figure 3 shows the meta-analysis for the RCTs, which was possible for four studies.

We found seven RCTs and 12 non-RCTs investigating the effects of manual therapy on healthy but unsettled, distressed and excessively crying infants treated in primary care. Previous systematic reviews from and 23 52 concluded there was favourable but inconclusive and weak evidence for manual therapy for infantile colic.

These two new RCTs blinded the parents to treatment, but they reported outcomes on feeding and global improvement and parent—child relations, respectively. This meant we were unable to update the meta-analyses conducted by Dobson et al. We considered all methodological study types narratively and looked at: direction of effect, quality of the study and results presented table 3.

However, because the low quality studies were so methodologically flawed, we did not include their results in the final analyses this indicates a need for more scientific rigour in this field of research.

We were still able to review the effects of manual therapy on multiple outcomes in 12 of our 19 selected studies. We anticipated that there would be more measurement of outcomes related to parent satisfaction and confidence or parent—child relations, but only five studies reported these outcomes.

This was not unexpected due to the potential variation in treatments and hence effects , loose diagnostic criteria and the power of the samples for the RCTs. Therefore, the results have to be considered with caution and are likely to change with further research.

The meta-analysis helps illustrate and indicate that future research in this field requires well-powered studies, flexible but protocolised treatment and parental blinding. Our searches also revealed 19 references to other systematic reviews of manual therapy paediatric care for conditions that were not the focus of our review, for example, otitis media, asthma, cerebral palsy and motor development. Our review draws similar conclusions to these other reviews; that is, more high-quality RCTs are needed, but methodological problems with research in this field might preclude researchers taking on this challenge.

The gold standard to test effectiveness is the RCT, but double-blinding is not possible one cannot blind the treating therapist and some parents are reluctant to blinding and being separated from their child.

These problems are further compounded by the self-limiting nature of many childhood conditions. These methodological issues may help explain the equivocal findings, small numbers recruited and low-quality assessments presented in systematic reviews. Data about non-specific effects of treatment, such as the impact of care on parental confidence, and clinician reassurance were not found, possibly because these are difficult to assess as direct, indirect or independent of the study intervention.

In one study we reviewed, 36 all infants and parents received the same support, advice and non-manual therapy care. They found no difference in outcomes between the group who had manual therapy in addition, and both groups improved over time.

The authors of this study suggested that the counselling, support and natural progression of the condition played a more powerful role than the manual therapy. It remains unclear what the active components of a manual therapy consultation are, but we suggest that it would be valuable to understand why parents seek manual therapy care, despite the presence of other healthcare providers.

The safety data we extracted regarding adverse events indicated that manual therapy is a relatively low risk intervention, reflecting similar findings in other studies. This was a comprehensive and rigorously conducted review that included studies in all languages, including a growing number of articles published from China titles and abstracts were in English for indexing. There was one Chinese paper that was selected for full paper review. We translated this article, but we were unable to fully interpret and understand the treatment given and the outcomes that related to Chinese Traditional Medicine energy points.

Inclusion criteria were specific to our population of interest, that is, thriving infants who were inexplicably unsettled, distressed and excessively crying who were treated in primary care.

This symptom-based approach to selection permitted the inclusion of studies relating to various diagnoses, for example, breastfeeding, gastric and behavioural problems. However, this latitude could also be interpreted as a weakness, since definitions of unsettledness, distress and excessive crying and otherwise healthy were not always clear.

Outcomes for parental satisfaction and confidence were under-researched, and we did not find much data about these. Collecting parent outcomes may provide more informative data about the active components of care. A well-powered RCT with parental blinding, blinded assessment of reported outcomes, testing both non-specific and manual therapy effects of manual therapist care is needed to supplement research in this area.

Top reviews from the United States. There was a problem filtering reviews right now. Please try again later. Verified Purchase. The "Why Cry" I received wasn't the one in the picture, it is actually better - it has a LCD screen with baby faces on it, indicating the baby mood; plus it measures the room temperature and humidity - which is nice. However, it takes too long to "read" the baby, not only ten or twenty seconds.

So I often soothe the baby before I find out what he is crying about. But it's interesting to "play" with. This is a wonderful product.

I am a deaf parent of a 6 month old son. I have been using this since he was 4 months old. This has helped eliminate the guess work using his body language to determine what he wants. This is a helpful product even if you are not deaf.

I gave this a four stars instead of five because the batteries drain pretty fast. If I purchased the DC adapter it would be more reliable in terms of constant power source. Forget the Baby Registry! Get this instead. It's a funny gift- everyone will have a laugh- but it actually works.

This is the second one I've bought and both of the couples said it actually worked. I used this when my daughter was about It was surprisingly accurate but slow and bright. She would usually stop crying because I was holding this thing close to her and trying to get an accurate reading. She would pause and look at me like I was a crazy person.

You have to hold it pretty close to their little face to get a reading, and for about a minute, which is an eternity when your child is crying. When it did finally get a reading it was right about 4 out of 5 times. I would definitely buy it again, because any clue into why your child is in distress is helpful, especially when they can't communicate and you feel like you've exhausted all options.

This is an alright item. The cry analyzer is something neat. You have to get it real close to the baby and it takes a while for it to respond, and while pretty accurate, I can't stand to let the baby sit there and cry without trying to console her in the meantime.