Sunday, July 12, 2009

What’s the Difference Between Crying and Colic?

Last week, I promised that I would talk about “colic” in more detail. I'm the team "expert" on this topic since I've had the most experience with dealing with a fussy baby. I can still remember the long nights pacing like a zombie up and down the narrow hallway in our apartment holding my screaming baby girl. For nearly 4 months, she did little but eat, sleep, and cry. If I only knew then…

What is “Colic?”
Surprisingly, “colic” doesn’t have a single definition. Instead, colic is used as a “catch-all” term for babies who cry a lot every day. While some doctors call babies “colicky” only if they cry for more than 3 hours a day, 3 days per week for at least 3 weeks, others don’t follow these guidelines. These days, experts call excessive infant crying “persistent” or “unexplained” crying rather than colic.

How long does “persistent crying” last?
For most babies, crying peaks in the first 6 to 8 weeks. Typical newborns cry a little more than 2 hours per day, fussing frequently in relatively short spurts. Babies with "persistent crying" cry more than 2 to 3 hours per day, for longer periods, and they don’t respond to their parents’ efforts to soothe them. The good news is that nearly all babies (even the persistent criers) will cry a lot less by the time they are 3 or 4 months of age. Of course to parents dealing with these challenging babies, 12 weeks of persistent crying can drag on like 12 years.

What are the causes of “persistent crying?”
Many parents of persistent criers are convinced that there must be something physically wrong with their newborns. Concerns that their babies might be sick only add to parents' stress. But 95% of persistent criers are healthy and growing well, many grow very well. It is always a good idea to check with your pediatrician about your baby’s persistent crying, especially if it is a big change in your baby’s behavior or related to any signs of illness. Given that most fussy babies are healthy, here are 4 reasons why persistent criers may cry a lot more than other infants.

1. They are not able to provide readable cues to the adults around them. Without clear signals, it is hard for parents to know what their babies' need. As they get older and better at using readable cues, these babies will cry less and less. For more about cues see our earlier post (http://www.secretsofbabybehavior.com/2009/06/baby-behavior-basics-part-3-learning.html).

2. They need more time than other babies to learn how to control their moods and to move predictably from one mood to another. We talked about babies moods in an earlier post (see: http://www.secretsofbabybehavior.com/2009/06/baby-behavior-basics-part-2-many-moods.html). While most drowsy babies fall asleep, persistent criers may bounce from drowsy to crying to sleeping to crying again. As their nervous systems mature, these babies will start to behave more predictably.

3. They can’t calm themselves when they are upset and they are not responsive to parents' frantic efforts to make them feel better. When these babies start crying, they spiral out of control. Even small distractions and irritations such as changes in routine, loud noises, or bright lights can send persistent criers into hysterical fits. These babies respond well to very little stimulation or to a lot of sustained repetitive stimulation, like white noise.

4. While most people think “colicky” babies have digestive problems, I’m listing stomach problems last because only about 1/3 of babies with persistent crying have indigestion. Babies with food allergies or intolerance have obvious signs. They have lots of gas, loose stools with mucus or specks of blood, and they may not be growing well. If your baby shows any of these signs, your pediatrician can help you determine the cause.

As a parent of a persistent crier, you may be blaming yourself and worrying that all the crying is somehow damaging to your baby. Fortunately, nearly all of these fussy babies are strong and thriving. Eventually, they settle down to become happy, social babies. Given the extraordinary stress that comes with caring for persistent criers, it is important that you reach out for help. You thought childbirth was tough! Dealing with a screaming baby while you're sleep deprived is even tougher. Call on family and friends to help with chores or to watch the baby so you can get a well deserved break. You may not want to ask for help because you worry that your baby's crying will upset others but experienced friends and family will tell you, it is not the same for them. Sometimes it might be necessary for you to put the baby down in a safe place and step away for a little break. Most parents of persistent criers have to do this at some point.

One point worth repeating, if you start to feel angry at your baby, can't control your emotions, or you don't feel interested in what's going on around you, it is time to call your doctor. Stress can do nasty things to people. Very soon, we'll share some well-researched tips for making this challenging time just a bit easier.

Next Time: Tips for Coping with Persistent Infant Crying

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