Main Points:
The sound of a crying baby is just about the most disturbing, demanding, shattering noise we can hear. In the baby’s crying there is no future or past, only now. There is no appeasement, no negotiations possible, no reasonableness.
Sheila Kitzinger, The Crying Baby
Waaaa … waaaa … waaaaaa … WAAAAAAAAAAAAAAAAAAA!!!!!!!! The word infant derives from Latin and means “without a voice.” However, many colicky babies wail so powerfully that their parents think a better name for them would be mega-fants or rant-fants!
There’s no doubt that colicky infants can cry louder and longer than any adult. We would drop from exhaustion after five minutes of full-out screaming, but these little cuties can go and go, with the tenacity of the Energizer bunny.
The word colic derives from the Greek word kolikos, meaning “large intestine or colon.” In ancient Greece, parents believed that intestinal pain caused their babies’ crying. (While a gas twinge may start a baby’s screaming fit, at other times these very same babies have gas and noisy stomachs yet they don’t even make a peep. More on this in Chapter 4.)
All babies have short periods of crying that usually last for a few minutes, totaling about a half hour a day. These babies settle quickly once fed, picked up, or carried. However, once colicky babies start their frantic screaming, they can yell, on and off, for hours.
In 1962, Dr. T. Berry Brazelton asked eighty-two new mothers to record how much their normal, healthy infants cried each day during their first three months of life.
The results of this study are shown in the figure below. When Dr. Brazelton did the math, he discovered that at two weeks of age, twenty-five percent of the babies cried for more than two hours each day. By six weeks, twenty-five percent cried for more than three hours each day. Reassuringly, he found that by three months almost all had recovered from their fussy period and few cried more than one hour a day. (Persistent crying tends to vanish after three months which is why some doctors refer to it as “three-month” colic.)
When a baby is brought to me because of crying fits, I first ask about the parents’ family history and the baby’s birth, feeding habits, and general behavior. Next I examine the baby to make sure she’s healthy and thriving. Once I’m sure that the baby is well, I consider if her crying pattern fits the “Rule of Threes,” the formal medical definition of colic first formulated by Dr. Morris Wessel, a private pediatrician from Connecticut.
The “Rule of Threes” states that a baby has colic if she cries at least: three hours a day … three days a week … three weeks in a row.
Some doctors call babies colicky even if they don’t fit the “Rule of Threes” but still frequently scream uncontrollably for no obvious reason.
Some parents in my practice also think that the “Rule of Threes” should be revised. They say the true definition of colic is when a baby cries so much her poor mom needs three nannies, three margaritas, and … six hands! (Okay, there’s an exception to every rule.)
Parents often ask me if there’s a way to predict which babies will have colic. While many doctors have tried to find a pattern to this problem, no consistent association has been found between colic and a baby’s gender, prematurity, birth order, or their parents’ age, income, or education. Colic can happen to anybody’s baby. It is truly an equal-opportunity parental nightmare!
Nine times out of ten, parents of colicky babies believe that their infants are suffering from some kind of pain. This would seem to be a reasonable guess, since colicky babies:
Pain was what was on Sherry’s mind when she brought her baby in to see me for a consultation about his incessant crying.
Charlie, a robust two-month-old, had a normal examination. This surprised his mother who was convinced that his daily frenzies must be the result of pain. When I asked her how she could be so sure, Sherry sheepishly admitted that she’d accidentally hit Charlie’s head with the telephone receiver. She said, “When that happened, I realized that his cry after getting whacked sounded exactly the same as his normal afternoon screamfest. I thought, That proves it, he’s been in pain this whole time.”
Was Sherry right? Was Charlie’s crying caused by pain? Or had she somehow misread the situation? As you can imagine, since time immemorial, parents of crying babies have been analyzing their child’s shrieks, trying to come up with an explanation for why their contented little infant at times suddenly “morphs” into one of the unhappiest babies on the block.
Before I got married I had six theories about bringing up children; now I have six children and no theories.
John Wilmot
It wasn’t so long ago that people believed leeches could cure diseases and babies were born blind. Likewise, our ancestors made many guesses about why some infants cried so much. Deciphering a Stone Age baby’s cry may well have been one of the first multiple-choice questions in history:
Your cave baby is crying because:
a. She’s hungry.
b. She’s cold.
c. She needs a fresh loincloth.
d. A witch cast a spell on her.
Over the centuries, wild theories have abounded about the cause of prolonged crying. Here are a few:
The Top Ten Ancient Theories of the Cause of Colicky Crying
1. Someone who dislikes the mother gave the baby the “evil eye.”
2. The baby caught a draft.
3. The baby’s spirit is unhappy because her father denied the baby was his.
4. The baby is possessed by the devil.
5. The baby is communicating with the spirits of unborn babies.
6. The daytime is for adults to make noise, and at night it’s the baby’s turn.
7. The baby’s crying is a punishment for Adam and Eve’s original sin.
8. The mother’s milk is too thin.
9. The mother’s milk is too rich.
10. A trauma during pregnancy made the baby fearful.
Even Shakespeare tossed in his two cents about why babies cry. In King Lear he guessed: When we are born, we cry that we are come to this great stage of fools. Babies are amazing, but I’m afraid Shakespeare was giving them more credit than they deserve.
Crying is good for the lungs the way bleeding is good for the veins!
Lee Salk
Parents have long noticed that fussy infants eventually cry themselves to sleep. Some experts have guessed that these babies need to scream to exercise their lungs or unwind from the day’s thrills before they surrender to sleep.
I strongly disagree. The idea that screaming is good for babies is illogical from both a biological and evolutionary point of view. First, the lungs of calm babies are as healthy and strong as the lungs of colicky babies. Second, colicky prehistoric infants might well have put themselves in danger. Their screaming could have attracted enemies to their family’s hiding place. And it might have enraged their Neanderthal parents, leading to abandonment, abuse, and even infanticide.
Now, I freely admit …
Yes … babies can get wound up by a full day’s excitement.
Yes … some babies ignore their parents’ best attempts to calm them.
Yes … screaming babies eventually conk out from sheer exhaustion.
But your baby is not a little pressure cooker that needs to “blow off steam” before cooling down. Letting your baby cry it out makes as little sense as closing your ears to your screeching car alarm while you wait for the battery to die.
At this point, you may be thinking, “But I often feel better after I have a good cry.” Of course that’s true; however, while adults may sob for minutes, colicky babies can wail for hours!
I believe that most parents who let their babies shriek until they collapse do this only because they feel desperate and exhausted. It’s a last resort that goes against every parental instinct. Can it stop the crying? Yes. However, the real question is whether or not this climate of inconsistency—sometimes you answer her cry and sometimes you don’t—is what you want to teach your baby to expect from you. Most parents answer that question with a resounding no.
All baby experts agree that our children do best when we are consistent in our responses. You know how frustrating it can be when some days you can calm your baby yet other days nothing works. Well, that’s how your baby feels when her cry in the morning brings a prompt reward of touching and warm milk yet in the afternoon it’s ignored.
Is it ever okay to let your baby yell? I don’t believe it’s a tragedy if your little one cries for ten minutes while you are in the bathroom or preparing dinner. The loving and cuddling you’ve been giving her all day easily outweighs that short-lived frustration. But fussy infants are not like toddlers. If your two-year-old screams because she wants to yank your earrings, you may have to let her cry so she can learn that when you say, “No!” you mean it. The time will come when lessons of discipline will become important, even lifesaving. But you’re jumping the gun if you think you need to teach discipline to your two-month-old!
For the first few months, you should soothe your baby whenever she yells. Infants rarely cry unless they’re upset about something, and it’s our challenge and duty to figure out what they need and how to give it to them.
In order to understand what causes colic, we first must agree on what it is. Researchers analyzing babies from all around the world have discovered ten fundamental traits of colic and colicky babies:
1. Colicky crying usually starts at two weeks, peaks at six weeks, and ends by three to four months of age.
2. Preemies are no more likely to have colic than full-term babies. (And their colic doesn’t start until they are about two weeks past their due date.)
3. Colicky babies have twisted faces and piercing wails, like a person in pain. Often, their cries come in waves (like cramps) and stop abruptly.
4. Their screams frequently begin during or just after a feeding.
5. They often double up, grunt, strain, and seem relieved by passing gas or pooping.
6. Colic is often much worse in the evening (the “witching hour”).
7. Colic is as likely to occur with a couple’s fifth baby as with their first.
8. Colicky crying often improves with rocking, holding, shhhhing, and gentle abdominal pressure.
9. Babies are healthy and happy between crying bouts.
10. In many cultures around the world, babies never get colic.
Once scientists determined the colic clues, they compared them to the popular colic theories to determine which, if any, explained them best. The researchers immediately excluded many of the crazy old ideas and what remained are today’s top five colic theories:
1. Tiny Tummy Troubles—babies suffer from severe discomfort caused by simple digestive problems (such as gas, constipation, cramps).
2. Big Tummy Troubles—babies suffer severe pain from true intestinal illness (such as food intolerance or stomach acid reflux).
3. Maternal Anxiety—babies wail because of anxiety they pick up from their mothers.
4. Brain Immaturity—immaturity of a baby’s nervous system causes her to get overwhelmed and scream.
5. Challenging Temperament—a baby’s intense or sensitive temperament makes her shriek even in response to minor upsets.
Each of these theories has its group of followers, but is any one of them the true cause of colic? Can any one of these theories explain all ten of the universal characteristics of colic?