Midwives' perspectives on assessing and managing mothers' distress related to excessive infant crying in Japan: a...

Excessive infant crying poses significant challenges to maternal well-being, often leading to parenting stress and postpartum depression. Midwifery assessment and support for mothers experiencing this distress remain inconsistent, emphasizing the need for evidence-based interventions in postpartum care.

This qualitative descriptive study recruited five midwives in Japan using a combination of purposive and snowball sampling. Semi-structured interviews were conducted between August and November 2023 to explore their perspectives on assessing and managing maternal distress related to excessive infant crying. Interview transcripts were analyzed using inductive content analysis to identify key assessment categories and nursing care approaches.

Seven assessment categories emerged: (1) Maternal psychological burden, (2) Maternal physical burden, (3) Maternal engagement with excessive crying, (4) Infant physical factors related to excessive crying, (5) Infant sleep disturbances related to irregular routines, (6) Characteristics of crying, and (7) Breastfeeding-related issues. The findings illustrate that midwives provided holistic support by addressing both maternal and infant needs. Midwives offered psychological support to alleviate mothers' self-blame, promoted family involvement, and provided practical guidance on infant care, such as touch-based interventions and regulating sleep-wake cycles. While all participants acknowledged the necessity of a comprehensive approach, the primary focus of their interventions varied.

This study highlights the role of midwives in identifying and addressing maternal distress during the postpartum period. The findings suggest that excessive crying often stems from an intricate interplay between maternal psychological burdens and infant-specific factors. However, the varied emphasis of interventions underscores the need for structured, evidence-informed midwifery practices to ensure consistent care. Furthermore, this study suggests that many mothers in Japan tend to blame themselves when their infant cries, a reaction that may arise in other cultural contexts. Greater insight into how maternal self-perceptions shape coping strategies across cultures could help develop more effective postpartum care worldwide.