Infants' Transitions out of a Fussing/Crying State Are Modifiable and Are Related to Weight Status


  • [Correction added after online publication 11/21/12: In the original online publication, funding information was omitted. The authors would like to acknowledge that this work was supported by grant R56 DK72996 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and in part by a General Clinical Research Center grant from NIH (M01RR10732) and a GCRC Construction Grant (C06RR016499) awarded to the Pennsylvania State University College of Medicine. While it does not affect the content of the reported research, we regret that this information was not included in the original manuscript.]

Correspondence should be sent to Stephanie Anzman-Frasca, The Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802. E-mail:


Currently, about 10% of infants have a weight for length greater than the 95th percentile for their age and sex, which puts them at risk for obesity as they grow. In a pilot obesity prevention study, primiparous mothers and their newborn infants were randomly assigned to a control group or a Soothe/Sleep intervention. Previously, it has been demonstrated that this intervention contributed to lower weight-for-length percentiles at 1 year; the aim of the present study was to examine infant behavior diary data collected during the intervention. Markov modeling was used to characterize infants' patterns of behavioral transitions at ages 3 and 16 weeks. Results showed that heavier mothers were more likely to follow their infants' fussing/crying episodes with a feeding. The intervention increased infants' likelihood of transitioning from a fussing/crying state to an awake/calm state. A shorter latency to feed in response to fussing/crying was associated with a higher subsequent weight status. This study provides preliminary evidence that infants' transitions out of fussing/crying are characterized by inter-individual differences, are modifiable, and are linked to weight outcomes, suggesting that they may be promising targets for early behavioral obesity interventions, and highlighting the methodology used in this study as an appropriate and innovative tool to assess the impact of such interventions.