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A report published last month found that child abuse rates have increased in association with the economic hardships in the United States.1 Specifically, the rate of abusive head trauma increased significantly in 3 study locations during the economic recession compared with the rate in these areas before the recession. Economic hardship is felt to be a source of stress in many households, which then can serve as a trigger for child abuse. During the week in which this report surfaced, I coincidentally attended a Grand Rounds about head injury prevention. It was here that I first heard the term "period of PURPLE crying."
PURPLE crying is not something that Barney the Dinosaur does when he is sad. It is an acronym that describes normal crying that all infants do. It also is a potential trigger for parental stress. Each letter in PURPLE represents a characteristic of this familiar type of crying:
P = peak of crying.
U = unexpected.
R = resists soothing.
P = pain-like face.
L = long-lasting.
E = evening occurrence.2
PURPLE crying sounds a lot like colic—a frustrating condition for parents to experience and for pediatricians to explain or treat. In the children's hospital where I work, new parents are provided educational materials about PURPLE crying and how to deal with it. Providing parents with this information can help reassure them that PURPLE crying is normal for all babies. The coping mechanisms described for this extremely trying yet normal process may prevent child injury. I recommend that those who care for newborns provide this education to their patients' parents or caregivers, if a preventive measure like this is not already in place in one's practice.
