All Babies Cry

About the program

All Babies Cry (ABC) is a video-based program designed to prevent abusive head trauma during the first year of a child’s life. It empowers new parents with practical demonstrations of infant soothing and clear strategies for managing normal stress in parenting.

It seeks to increase parents’ use of appropriate behaviours for calming a crying infant and maintaining one's own composure. It aims to:

• foster attachment and healthy infant development by bolstering family strengths known to reduce infant maltreatment
• to improve parent responses to infant crying by visually depicting a wide variety of care strategies
• normalise and mitigate parental stress by offering recommendations for identifying and reducing parental stress resulting from newborn care.

ABC employs a Strengthening Families Approach that promotes family protective factors known to decrease the likelihood of child abuse, including parenting knowledge, parental resilience and social connectedness.

The program was developed in collaboration with Massachusetts Department of Public Health.

Who does it work for?

The ABC program can be delivered to first-time parents aged 18 years and over. It was designed to engage both mothers and fathers.

The ACT program has only been evaluated in the USA.

A quasi-experimental design study was conducted with 326 people (154 in the intervention group and 172 in the control group) (Morill et al. 2015). On average, parents were 28 years old. Most of the parents were White. The program was delivered to first-time parents (i.e., with no previous children).

A randomised control trial was conducted with 115 people (53 in the intervention group and 62 in the control group) (Cala Cala et al. 2020). On average, parents were 27 years old and children were just under 2 days old (at enrolment). Most of the parents were Hispanic and low-income earners.

The program has not been evaluated in Australia or with Aboriginal Australians.

The program has not been evaluated with parents of children who (1) were preterm or weighed less than 5 pounds at birth, (2) had a congenital or sensory deficit, or (3) had spent more than 24hrs in the neonatal intensive care unit.

What outcomes does it contribute to?

The ABC program has mixed research evidence on two different outcomes: positive parenting behaviours and parenting knowledge. 

Positive parenting behaviours:

• Positive: parents who participated in the ABC program used a wider variety of strategies to manage parental stress, compared to parents who did not participate in the program (Morill et al. 2015).
• No effect: 
  • the program did not have an effect on the number of strategies parents used to manage parental stress when their baby cried (Morill et al. 2015; Cala Cala et al. 2020). 
  • the program did not have an effect on the number or variety of strategies parents used calm their babies crying (Morill et al. 2015; Cala Cala et al. 2020). 

Parenting knowledge:

• Positive: parents who participated in the ABC program were more likely to report improved knowledge of peak of crying (Cala Cala et al. 2020).
• No effect: the program did not have an effect on parents’ knowledge of shaken baby syndrome or that shaking a baby may lead to brain damage/death (Cala Cala et al. 2020).

Negative outcomes:

• No negative effects were found.

How effective is it?

Overall, the program had a mixed effect on client outcomes. 

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT) or quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT or QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT or QED studies show statistically significant adverse effects.

How is it implemented?

The ABC program consists of:

• An introductory video for parents to view in hospital
• A 55-minute video with skills-based modules:
  • What’s normal about crying
  • Comforting your baby
  • Self-care tips for parents
  • Colic and how to cope
• A booklet with checklists and activities reinforcing messages from the video

The program materials (video and booklet) include documentary footage, real parent testimonies, humorous animations and graphical information. 

How much does it cost?

Not reported.

What else should I consider?

Morill (2015) reports that the program was well received. The videos were rated an average of four out of five for helpfulness and 96% of parents would recommend All Babies Cry to other parents. 

Additional analysis conducted by Cala Cala et al. (2020) shows the program was more successful for mothers born outside the US. 

Where does the evidence come from?

1 QED conducted in the USA with a sample of 326 people (Morill et al. 2015).

1 RCT conducted in the USA with a sample of 115 people (Cala Cala et al. 2020). 

Further resources

For more information and resources about the All Babies Cry program see: https://www.allbabiescry.com/

Cala Cala et al. (2020), ‘Which mothers know that all babies cry? A randomized controlled trial of a child abuse prevention program for low-income new mothers’, Clinical Pediatrics, vol. 59, no. 9-10, pp. 865-873

Morill et al. (2015), ‘Evaluation of All Babies Cry, a second generation universal abusive head trauma prevention program’, Journal of Community Psychology, vol. 43, no. 3, pp. 296-314.