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Updated: Jul 24, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Newborn predictors of infant irritability
M R Keefe1, A Froese-Fretz, A M Kotzer
1College of Nursing, Medical University of South Carolina, Charleston 29425, USA.
Objective:
To identify newborn infant behaviors that may predict infant irritability, commonly referred to as colic.
Design:
A prospective, correlational design, with data collection occurring the first 4 days of life and again at 1 month of age.
Setting:
This study was conducted in a private hospital in a large metropolitan city in the Midwest.
Participants:
Sixty infants who were at low risk and full term and whose weight was appropriate for gestational age were recruited during their postpartum hospital stay. Infants with congenital anomalies, signs of illness, or high-risk factors were excluded from the study.
Main Outcome Measures:
During infants' 1-4-day hospital stays, their crying was assessed and reported by the nurses, and a Neonatal Behavioral Assessment Scale was completed on each infant. At 1 month of age, irritability was measured using the Fussiness Rating Scale.
Results:
Only two components of the Neonatal Behavioral Assessment Scale were related to development of colic or infant irritability at 1 month of age. These were the cluster of variables representing motor activity and the Neonatal Behavioral Assessment Scale supplemental item measuring the persistence necessary on the part of the examiner to get the infant to attend to stimuli presented. The infants who were classified by parents as irritable at 1 month of age were more active and more attentive to stimuli in the first few days of life.
Conclusions:
Of interest was that the newborn nursery nurses cry ratings were not related to the later development of colic in these infants. Active infants who are sensitive to stimuli may be predisposed to infant irritability; however, further work is needed to understand the relationships of these infant characteristics to the human interactions and physical environments they encounter
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