Crying and Colic

From Dr. Laura MarkHam: http://ahaparenting.com/ages-stages/newborns/crying-colic

Crying and Colic

All babies cry. Most babies cry a lot. Some babies are more easily comforted, others can routinely work themselves into a frenzy. Of course it sends your heart racing. That's Mother Nature's way of insuring that the human race survives.

"She cries a lot. How do I know if this is colic?"

Colic is simply crying that goes on and on and does not seem to have a cause. Colic is traditionally defined as 3 hours or more of daily crying, at least three times a week. 20% of babies are diagnosed with colic.

But it probably doesn't matter if it's actually colic, unless when your baby's crying gets almost unbearable, it helps you to remember that there's nothing wrong with you or him; it's just colic. Whether it's actually colic, or just lots of crying, it is always stressful, and it helps to know that it's normal, it won't last more than 3 months, and you will eventually have a perfectly cheerful baby.

"What causes all this crying?"

I'm assuming you've eliminated the obvious causes -- i.e., the baby has been fed and burped and changed, and you've picked her up and moved around jiggling her, but the crying has continued. If you haven't tried all this, start there.

The truth is that we don't know what causes colic. There may be differing contributing causes for different babies, such as sensitivity to formula, food allergies, or gastrointestinal upset. In one study of colicky babies, when the moms stopped drinking cow's milk, half the babies' colic vanished. The other half, unfortunately, kept crying.

A study reported in the January 2007 issue of Pediatrics however, had 95% success rate by giving babies probiotics AND eliminating cow's milk. They gave colicy babies who were breastfeeding 5 drops daily of beneficial gut bacteria (the probiotic L. reuteri). All the moms were asked to eliminate cows milk from their diet. 95% of the probiotic babies improved, as opposed to only 7 percent of the control babies, with crying improving somewhat in the first week and dramatically within a month. If this study is repeated with the same results by other researchers, probiotics will soon be prescribed as the cure for colic. In the meantime, any parent with a colicky baby will probably want to conduct their own private experiment to see if it works on their baby.

The other recent theory that’s popular with doctors is that colic results from an immature brain and nervous system and is the baby’s way of releasing tension.

Newborns are used to being tightly held in a dark, muffled, soothing environment which often lulls them with Photo: Ben McLeodrhythmic motion as their mother walks. They must be dazzled and overwhelmed by the feast for the senses that greets them with every new day in the world. Their brains and nervous systems need time to mature so they can handle all the stimulation we take for granted.

"He didn't cry much for the first couple of weeks, but now he cries every evening for a few hours!"

This is very common. As babies become more aware of their surroundings, and stay awake for longer periods during the day, they cry more. It may be that the beneficial bacteria that was in her gut from your body is now gone, or that as babies get more and more stimulated all day, and by evening, have no other way to relieve their anxiety. In any case, the result is the behavior we call colic: crying for many hours, often late into the night.

"But I don't know how to comfort her and I feel so inept!"

After attending to your infant's physical health and safety, learning to comfort her is one of the most important tasks you face. That's not because crying is so terrible for infants, but because your feeling like a competent parent is a crucial building block in your relationship with her. The most effective way to reduce crying is to recreate a womb-like environment for your baby. Below, I tell you how to do that.

But while you can probably reduce your baby's crying, I urge you to let yourself off the hook here. There may be absolutely nothing you can do except hold her. Haven't you had times when what you needed was just to cry and to have someone there so you wouldn't feel so alone?

"But I worry that there might be something wrong with him!"

Every parent worries when their baby cries and they don't know why. But if you've looked for obvious causes (did you eat spicy food before you nursed him? Have you eliminated milk from your diet if you're nursing? Changed his formula?) and his doctor sees him regularly and has pronounced him thriving, you can rest assured that crying -- even long periods of incessant crying -- is considered normal for infants in our society, and there is nothing wrong with your baby.

"Why do you say it's normal in our society? Don't babies cry everywhere?"

Actually, no. In cultures where the infant is held or worn fairly constantly, colic is virtually unknown and babies rarely cry for long. We don't know if that's the baby wearing or the diet in those cultures, or something else entirely.

"Is there a reason to think that baby-wearing helps?"

Research shows that babies who are held or carried more (both during the colic spells and at other times) are definitely less susceptible to colic. It is possible that wearing babies is so soothing that they are less overwhelmed throughout the day and build up less tension. I used to think of myself as the lightning rod for my infants.

But another way to interpret this data is just that some babies need to be held virtually all the time. When they are put down, they cry. When they are picked up, they often stop.

"I do hold and carry my baby a lot. But in the evening, it seems that isn't enough, and he just cries and cries."

Sometimes holding is not enough, and babies don’t stop crying unless they are walked, jostled, danced, bounced, rocked or subjected to some other rhythmic motion, which seems to dissipate their tension. I ruined a mattress with each of our babies, because I found that holding them while jumping on the bed soothed them better than anything during that first three months, and wearing out the mattress seemed a small price to pay for a happy baby.

Whatever movement your baby responds to, it takes a lot of energy. But it is infinitely better than listening to a baby cry. And the gift to your baby is enormous, as he gets the message that you can be depended on when he’s miserable.

"I’ve tried everything: wearing her much of the day in a snuggly, holding, soothing, swaddling, rhythmic motion, adding probiotics to her diet, giving up milk in mine. She's still crying! What do I do?"

You witness. Sometimes people, especially babies, just need to cry. You override any needling suspicion in your mind that there is anything wrong with your parenting by reminding yourself that “Sometimes people just need to cry” and you hold your child, and she cries, and you do whatever you need to do to stay sane.

If you can pay attention to her, sing to her, empathize, that’s great. If not, then put on headphones and listen to music that blocks out her crying. Don’t be surprised if holding her, in your new calm state, helps her to stop crying, especially if you start dancing or singing to the music on your headphones.

"I just can't calm down when he cries like this. Even when I put the headphones on, the crying seems to reverberate in my head. It's driving me crazy!"

If you can’t calm yourself, put the baby down. It helps babies to be held while they cry (true for most of us) but not if the adult is experiencing extreme anger or anxiety.

If you think you might lose control and shake the baby, it simply isn’t worth taking that chance. Put the baby in a safe place (crib, car seat, strapped in a baby seat or swing) and shut the door to that room. Put on headphones so that you can’t hear the crying through the door. Now do whatever you need to do to calm yourself down. Step outside for a moment or open the window, and breath in some fresh air. Feel your tension draining out through your feet. Call another adult to come over. Remind yourself not to take the crying personally, and that this too shall pass.

It also might help you to remember the old proverb about children each offering a finite amount of grief to their parents, just so you know that you’re getting it over with up front and the teenage years will be easy!

"I buy the idea that babies need another month or two in a womb-like environment to mature. But what do I do to create a womb-like environment for my baby?"

These are techniques to use when your baby cries, but they are also preventive tools to keep your infant from getting over-stimulated all day long:

1. Hold or wear your baby as much as you can. As Dr. Sears says: “In counseling parents of fussy babies, we strive for two goals: to mellow the temperament of the baby and to increase the sensitivity of the parents. Babywearing helps foster both of these goals. By creating an organized, womblike, environment, wearing lessens a baby’s need to cry." An ounce of prevention is worth a pound of cure.

2. Swaddle your baby. Most babies like to be wrapped securely. It reminds them of their snug womb. And of course they love slings.

3. Rhythmic motion: Again, reminiscent of the womb. Rocking works for some babies, but most of the time when they're upset, more intense motion is called for. Some parents swear by baby swings or baby hammocks, others by putting the baby in a car seat and driving. But these techniques have their limits, usually the infant needs to be held at the same time that they're moving. Some parents dance, some go up and down steps, some jump on mattresses, many develop the bobbing, swaying motion I call the Mom's dance. Experiment to see what works for your baby.

4. White Noise: Soothing sounds can muffle or block out the jarring traffic horns or even voices that can jangle and over-stimulate baby nerves. I found new age chanting to be effective, some people swear by their vacuum cleaner or white noise machine, others just whisper repetitive shushing noises.

5. Nurse your baby. For some babies, nursing is a guaranteed instant soother. Why work any harder than that if you don't have to? And, for the record, babies fed on a schedule are more likely to have colic. Feed your baby whenever he or she asks, and colic is less likely.

6. Explore other "cures." Some babies have food allergies, and if you change the formula, or if the breastfeeding mother changes her diet, the crying stops. Often a diet free of cows milk, wheat, or other common allergens is a miracle cure. Every parent of a colicky baby should try probiotics, as mentioned above. Some moms swear by infant massage. If you try all these suggestions and your baby keeps crying, by all means talk to your doctor, and keep asking the parents you know what worked for them. And hang in there. Sooner or later, your little screamer will be a perfectly charming baby.

More Resources:
A great book for ideas on calming your baby is Harvey's Karp's The Happiest Baby on the Block. Karp goes into detail on what he calls the five S's: Swaddling, Side or Stomach position, Shhh (sound), Swinging (or motion), and Sucking. Another good resource is Linda Baby Matters, which presents all the latest research on probiotics and other effective treatments.