Overview of BC Period of PURPLE Crying Program

 

Implementation

Crying education and program materials are delivered to parents of BC’s nearly 43,000 annual births via three doses or exposures:

  1. Maternity Nurses and Midwives;
  2. Public Health Nurses; and a
  3. Public Education Campaign. 

Period of PURPLE Crying

The Period of PURPLE Crying provides educational information about the properties of normal infant crying that are uniformly frustrating to caregivers, and appropriate action steps that caregivers need to know. Inconsolable infant crying is the number one trigger that precedes a shaking event.

The letters in the word PURPLE describe the properties of normal infant crying that are frustrating:

P

PEAK OF CRYING

Your baby may cry more each week, the most in month 2, then less in months 3-5.

U

UNEXPECTED

Crying can come and go and you don’t know why.

R

RESISTS SOOTHING

Your baby may not stop crying no matter what you try.

P

PAIN-LIKE FACE

A crying baby may look like they are in pain, even when they are not.

L

LONG LASTING

Crying can last as much as 5 hours a day, or more.

E

EVENING

Your baby may cry more in the late afternoon and evening.

Action Steps

The behavioural component, “three action steps” guides caregivers on how to respond to crying in order to reduce crying as much as possible and to prevent shaking and abuse. These action steps are:

Carry, comfort, walk and talk with the infant

This encourages caregivers to increase contact with their infant, reduce some of the fussing and attend to their infant’s needs.

If the crying is too frustrating, it is okay to walk away

The infant may be put in a safe place so that the caregiver can take a few minutes to calm down and then go back and check on the infant again.

Never shake or hurt an infant

There is never a circumstance when it is okay to shake or hurt an infant, no matter how much they’re crying.

The program materials include either:

DVD + Booklet Package

  1. Available in 11 languages: English, French (Quebecois), Punjabi, Cantonese, Korean, Japanese, Vietnamese, Spanish (Mexican), Portuguese (Brazilian), Somali and Arabic (soon to be in Hebrew)
  2. Full colour 10-page booklet
  3. Parent Reminder Card
  4. DVD including:
    • 10-minute PURPLE Crying video
    • 17-minute Crying, Soothing, Coping: Doing What Comes Naturallyvideo

Web and Mobile Application + Booklet Package

  1. Available in 3 languages: English, Spanish and French (Quebecois)
  2. Full colour 10-page booklet
  3. Parent Reminder Card
  4. Web and mobile application including:
    • 10-minute PURPLE Crying video
    • 17-minute Crying, Soothing, Coping: Doing What Comes Naturallyvideo
    • 10-page e-booklet
Prior to discharge from the hospital, families receive crying education from a maternity nurse and resources to take home (DVD/booklet package or App/booklet package).  Within two weeks of being at home, families receive reinforcement of the program messages from a public health nurse during the new baby follow-up phone call or home visit.  Several midwifery clinics and Aboriginal health centres also provide crying education and materials to families.

Evaluation

The BC Period of PURPLE Crying program is currently being evaluated through quality improvement process measures as well as active and passive surveillance.

Quality improvement measures include:

  • public health nurse administrative forms (February 2009 to September 2011);
  • maternity nurse surveys (September 2009 to March 2014);
  • parent surveys when their infants are 2-4 months of age (January 2010 and ongoing);
  • public health nurse surveys (October 2012 and ongoing)

For active and passive surveillance, incidence rates of SBS and other forms of physical abuse in 0-2 year-olds are collected from the Neurosurgery Department at BC Children’s Hospital (completed), Child Protective Services, the BC Coroners Office, and Canadian Institute for Health Information.  The SBS and physical abuse rates are compared pre-/post- PURPLE program implementation. 

For more information, visit purplecrying.info.