Crying and colic. A healthy baby is a crying baby...

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Healthy babies cry. A lot. Sometimes for hours and hours every day. At times, a healthy baby will be so upset that you’re sure something is seriously wrong.

Key Points:

  • Colic is the medical term for inconsolable 'crying'
  • Colic is, unfortunately, a normal part of infant development
  • Most babies with colic are completely healthy

There’s a medical name for this inconsolable crying: colic. Although your friends (or even your family doctor) may treat it as an illness, colic is actually a normal thing - a hallmark of a growing brain.

For reasons that aren’t completely clear, the developing baby’s brain does two things to produce these inconsolable attacks: it over-reacts to normal sensations the baby feels (like a stomach digesting food, or a light breeze) and it produces enormous ‘positive feedback’ when a baby gets a little upset. This means reflexes in the baby’s brain automatically cause her sadness to worsen, which triggers further worsening, and so on (physicists ironically name this process a ‘well-behaved,’ non-linear phase transition).

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No matter what parents do to calm their baby - rock it furiously, hush their hardest, collectively freak out - it just doesn’t register against the tsunami of positive feedback. A colourful boss once described it as ‘Pissing in the ocean - all you’ll get is dehydrated.’

Eventually, after several minutes to hours, the brain resets and the baby settles. This occasionally times nicely with the ‘my baby never did this’ mother-in-law sweeping in to save the day. But don’t let her take the credit – tell her the positive feedback loop from hell just ended, and she got lucky (and that her Alzheimer’s is setting in).

Many parents turn to medication to relieve colic. Big trials show most are safe, but probably not effective.

The ‘normal’ way colic behaves in a baby varies widely. Some babies are angelic colickers (I’m sorry, was that a cry? Or bird song?). Others are nightmare children from the seventh circle of baby brain hell. But rest assured, although they may look like they’re in pain imaging studies convince us they’re just crackin’ it.

In general, colic starts between 2-6 weeks of age, peaks at 3-4 months and is gone by 4-5 months (mic check, yeah sorry – months). It tends to rear its ugly head in the early evening – the ‘witching hour’ – although some parents dream of it lasting that long. The average peak cry lasts around 15-20 minutes, but it would be completely normal to last much longer

There’s some overlap between colic and reflux in most parents’ minds. In truth, they are two distinct entities.

Reflux will be the topic of another post, but suffice it to say your baby probably does have reflux because almost all babies do. Yep, another normal part of development and again, it’s their brains’ fault.

Whether ‘silent’ (without vomiting) or vanilla reflux (shameless vomiting), baby isn’t bothered. What? A light breeze has you screaming for hours but tasting your own vomit - you’re cool with that. Unless your baby has choking-like episodes (where their face turns red and they struggle to breath for several seconds) it’s likely nothing needs to be done and they will grow out of it. More on that in a later post.

Many parents worry about colic and reflux. It can be hard to know the difference.

But how can I be sure it’s colic and not Ebola? There are a few ‘red flags’ that are really simple to spot. These won’t happen, but if they do pop into your local emergency department to get them checked out:

  • They spend the day alternating between sleep and inconsolable crying (that is, no moments of being awake and comfortable).
  • They suddenly turn very pale (you’ll be sure if you see this)
  • They are under 4 weeks old with a fever (38 degrees and over - don’t measure unless you’re otherwise worried)
  • They are having less than 3 wet nappies a day (as in 24 hours) – I find this more reliable, and easier to measure then how much milk goes in (and stays in)

If colic is occurring in isolation, there is very rarely a disease process at play. If you are concerned about more than periods of inconsolable crying, or you’re not coping, why not have a chat with Dr Ben, or see your family doctor.

So my child isn’t dying – but I am. What can I do?

Know that you are far from alone. Suffering through endless screaming, harbouring serious doubts about your parental instincts and just not liking your baby - is universal. Equally universal is that things will get better.

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In the meantime, you need to look out for number one, because you are the one at greatest risk.

If you have a tough bub in the colic/crying department, you are at higher risk of postnatal depression (both parents) and your baby is at greater risk of shaken baby syndrome (from either parent). I know that sounds unthinkable, but the fact is most people who shake their babies are not monsters, but completely exhausted, sleep-deprived, desperate parents.

How do you avoid this? Have a tag-team system in place for the hours that your baby is bonkers. One parent leaves (out of earshot – has a shower, starts the dinner with earphones on) then the other, in ten minute cycles (or whatever works).

Or if your it, when you feel the anger rising or deep anxiety setting in, it is perfectly safe (I would argue safest) to put baby in her bassinet or cot. Close the door (pop earphones on if you need to) and make a cup of tea. Know that you have five minutes, and make sure that deeper anger or anxiety has gone before you venture back in. Rinse and repeat.

The hardest time is the first. But once you do it, you’ll know for next time that nothing bad will happen to them. They won’t die from SIDS, stop breathing or choke. All they’ll do is scream.

Parents are often at greater risk of illness than their colicky companion. Regular, predictable breaks are essential.

But won’t I make my baby an intractable sociopath?

Seriously doubt it. Because it’s so hard to study there is limited evidence on the subtlest of psychological effects. But there is certainly no severe, long-lasting problems. Consider this: in the grips of colic, what you do to comfort your baby doesn’t register. For the brief moments that you’re not comforting them, it probably doesn’t register either.

Of course, not all crying is colic. I could give you a motherhood checklist to work through: offer food, check the nappy, settle to sleep, etc. But to be honest, with a little time you will learn your baby and know them better than me or anyone else. (It may not feel like that, because they keep changing - especially in the first 6 months - but you do know them best).

All in all, suffering through colic is a tough gig. Know you are not alone and it will get better. In the meantime, take solace in the truism that you can’t choose your family.

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