It’s 6:00 p.m. and the wailing begins. You’re holding your two-week-old baby – the model of a thriving infant, apparently without a care in the world. Suddenly and unexpectedly he stiffens his limbs, arches his back, clenches his fists, draws up his flailing limbs against a bloated, tense abdomen, and lets out ear-piercing shrieks. If he could speak, he would yell, “I hurt and I’m mad!” As the intensity of baby’s cries mount, your frustration escalates, and you feel helpless in determining the cause of his distress and alleviating your baby’s pain. He’s inconsolable, and you’re both in tears. You hurt together.
You try to cuddle, but baby stiffens in protest. You try to nurse, but baby arches and pulls away. You rock, sing, and ride. The soothing techniques that worked yesterday aren’t working today. And inside your head the familiar refrain, “What’s wrong with my baby? What’s wrong with me?” plays over and over again.
By the time you go through all of Aunt Nancy’s herbal teas, the doctor- advised feeding changes, and every conceivable holding pattern, as mysteriously as the fight began, around three to four months of age, it stops, and life goes on. Your baby seems none the worse for wear, and you close one of the most difficult chapters in life with your new baby. That’s colic.
Even though no one completely understands colic, let’s make two assumptions: First, the baby has pain in the gut. (The term “colic” comes from the Greek kolikos, meaning “suffering in the colon.”) Secondly, the whole baby is upset as a result. My perspective on colic changed years ago when a mother brought her baby in and wanted me to find out why he was crying so much. After I diagnosed her baby with colic, she challenged me. “Do pediatricians call it colic when they don’t know why a baby is hurting?” she asked bluntly. She was right. A gastroenterologist I often work with once confided to me: “Colic is a five-letter word for ‘I don’t know’.”
When an adult hurts, the doctor and patient do some detective work to track down the cause of the pain, so they can fix it. So, I started approaching my evaluation of colicky babies with this in mind. First, I dropped the term “colic” from my diagnosis list and adopted the term “the hurting baby.” Besides being more accurate, this motivated both the parents and myself to keep searching for a cause, and a way to fix it. Labels can be therapeutic. By viewing your baby as “hurting” instead of “crying,” you’re more likely to be empathetic, like you would a baby who was hurting because of an ear infection, rather than viewing crying as an annoying tool babies use to manipulate their parents into holding them a lot, which tops the list of colic myths.
DR. BILL’S COLIC TIPS:
- Don’t call it colic. Call it “the hurting baby.”
- In partnership with your doctor, keep searching for a cause.
DOES YOUR BABY HAVE COLIC? HOW TO TELL
If you wonder whether or not you have a colicky baby – you don’t. The agonizing outbursts of inconsolable crying leave no doubt that your baby hurts. While no one knows the cause, or even the exact definition of colic, pediatricians tag an apparently healthy, thriving infant with “colic” if the baby follows what is called the “Rule of Threes.” The episodes of inconsolable crying:
- Begin within the first three weeks of life
- Last at least three hours a day
- Occur at least three days a week
- Continue for at least three weeks
- Seldom last longer than three months
Sometimes when parents think that they have a colicky baby, I’ll send them to visit some members of the “colic club” – parents in our practice who truly do have colicky babies. They often return relieved, saying, “We don’t have a colicky baby after all.”
COLICKY VS. HIGH-NEED BABIES
The point at which a fussy baby (one who cries a lot) or a “high-need baby” (one who fusses unless he’s held a lot) becomes a colicky baby (one who hurts a lot) is often a matter of interpretation. What you call your baby’s behavior isn’t as important as what you do about it. In my pediatric practice, I’ve found it helpful to use the term “high-need baby” when I suspect it’s the baby’s temperament that’s causing his behavior, and “hurting baby” when I suspect a medical reason for it. Colicky babies don’t just fuss; they hurt. They shriek in agonizing discomfort. Colic calls for a more intensive approach. As one mother in our practice said, “Our daughter, now thirteen months, was the queen of colic. She’d start at three o’clock and cry non-stop until about midnight. When she wasn’t colicky, she was just plain high-need. There IS a difference. “High-need” responds to lots of holding and comforting; almost nothing works for colic.”