Viewpoint: Now there's an "app" for everything

February 1, 2010

One of the most common telephone calls pediatricians receive is the one concerning the crying infant.

One of the most common telephone calls pediatricians receive is the one concerning the crying infant. Often apologetic at the onset of our conversation, distressed parents want to know whether their crying infant is seriously ill. I explain, as many of you do, that crying is the baby's way of signaling to parents that they need attention. We discuss a variety of methods parents can use to investigate the "why" of the baby crying, and I provide suggestions for trying to soothe their infant. It is the ability of a parent to calm a crying infant that helps me distinguish a minor condition (eg, hunger, wet diaper) from one that is potentially more serious (eg, intussusception or meningitis). The "consolability" of a young patient plays a significant role in the advice I give to parents and how well I sleep at night after that phone call.

Times are indeed a-changing, and rather than contacting their pediatricians to seek advice about consoling fretful babies, parents have a new option. They can merely download a $30 application to their iPhone called CryTranslator from Biloop Industries, a Spanish bioengineering company. CryTranslator "listens" to a baby's cry for 5 seconds, analyzes the acoustics of the recording, and informs parents if the cry indicates that the baby is hungry, stressed, sleepy, bored, or uncomfortable. Once the application determines the nature of the cry, it provides advice on how to attend to the baby's needs. For example, if the baby is sleepy, they suggest half a dozen ways to soothe the baby to sleep. According to the CryTranslator Web site, the application can decipher the broad meaning of a baby's cry with 96% accuracy, based on clinical trials conducted by "impartial third parties" using a prototype device. The application has had mixed reviews from parents who have used the application, some saying it's worthless and others saying it's extremely accurate.

I was initially skeptical about the application's ability to correctly discern the difference between the cries of a hungry child versus one in "distress" (ie, pain), but being curious, I began to investigate the science behind baby cry analysis. I discovered that research that began more than 30 years ago demonstrated that there are unique acoustic characteristics of the cries of sick babies (ie, those with respiratory diseases, prematurity, asphyxia, malnutrition, and elevated bilirubin levels) compared to those without medical problems. Subsequent research showed that computer analysis of baby cries could identify babies at risk for sudden infant death syndrome as well as distinguish the cries of babies born to mothers addicted to variety of drugs compared to those born to mothers who did not use drugs during pregnancy. It appears that high-pitched infant cries above 1,000 Hz are more likely to indicate pain or distress compared to normal cries, which typically are in the 400 to 650 Hz range.

If it's possible to develop computer technology to accurately screen the cry of an infant as being related to nonmedical conditions, perhaps some day computer technology will be used to play soothing sounds, music, or use vibrations to help calm a fretful baby.