Something very unpleasant happens to one in five infants born every day; something that depresses some parents and may even cause an accelerated marital breakdown. It is sad and bad and there is nothing that even the best doctor on the planet can do to make the problem disappear.
This problem is colic. Aside from cancer, colic is another medical problem under the "C- word" category. It may not kill anybody the way cancer does, but the stresses and sleepless nights can take a big toll on families.
According to Dr. Weasel, an expert in the area, by definition colic describes a baby who follows the rules of threes: the infant is in the first three months of life; cries for three hours per day; does it for at least three days per week and perhaps as long as three weeks at a time. There is no specific reason, no specific cause.
However, there is no end to theories and speculation.
One popular theory – and perhaps the most researched – is the issue of a possible link with cow's milk allergy. This link has never been conclusively shown to be true, although some studies would suggest that in 10% of babies with inconsolable crying, a cow's milk reaction might be the reason. Yet, I often tell moms – especially those at their wits end and much more exhausted than any marathon runner can ever dream of – to try and use a soy formula or hypoallergenic formula such as Nestlé's Goodstart.
Another popular theory is gastroesohageal reflux as the cause of colic. This condition, often abbreviated as GER, involves the backflow of acid from the stomach into the esophagus, very much like a door left partially open and allowing cold air to leak into the house. The burning sensation in the lower esophagus can irritate the baby and lead to a grazer who is never full and always somewhat hungry. These babies sleep poorly and experience frequent interruptions in their feeding efforts.
And then there is one of the most unfortunate theories, attempting to explain the cause of colic: blaming an inexperienced mom for being depressed, uptight and anxious, thus causing her baby to be cranky and colicky. This theory is not only wrong; it is dead wrong and should have been buried long ago. Unfortunately though, some clinicians still resurrect it and allow it to have legs. At Brown University in Providence, Rhode Island, there is a fairly unique clinic specializing in helping babies and families who suffer through fatigue, depression, sleepless nights and facing a baby who is in pain daily for weeks on end.
At the clinic they utilize a team of experts – a multidisciplinary approach. Why? Because this is what it takes to help families well. First, a thorough history with the help of diaries and journals is recorded (I want to emphasize again, how vitally important it is to keep a diary of symptoms whenever a child suffers from something that is constant, such as headaches, tummy pain or joint pains for example.) Next, all other causes for sustained crying, fussiness and irritability are ruled out. Of particular importance are urinary tract infections, blood in the stool, meningitis and ear infections. Colic is, without a doubt, a diagnosis of exclusion. Far too many babies have been misdiagnosed as colic, when in fact they had a urinary or middle ear infection.
If the diagnosis is indeed colic, the next step is to teach more about what it is and specifically focus on establishing useful routines, feeding schedules and sleep patterns. Fathers should be involved during the psycho educational efforts. They are often given "a break" because the theory goes (a dead wrong theory I may add) that they need to sleep in order to go to work the next day to put food on the table for the family. Needless to say, colic can be one of the best forms of contraception. Few mothers are in any shape or form ready to nurture their husband-wife relationship when they are sleep deprived.
Exhaustion may lead to car accidents when a mom takes a whaling baby for a drive in the middle of the night – a common attempt to calm babies down and an alternative to placing the baby in a car seat on top of the clothes dryer or running the vacuum cleaner at midnight, creating white noise with the hope of calming down a desperate baby.
One of the cruellest "tricks" of nature has to be giving a colicky infant to a mother who already suffers from post-partum depression. It's like rubbing salt in a wound. The CPS is currently working on a paper that will hopefully raise the awareness of just how common and potentially dangerous maternal depression is.
Other ideas to help families may include: elimination of hidden sources of caffeine; elimination of diary products from a nursing mom's diet; and the use of medications such as simethidone drops, antacids and a product called ranitidine. Gas-relieving measures such as pumping the baby's legs are of some, but limited use.
The bottom line is that we do not have a clue why babies get colic; however, not all
babies who cry inconsolably should be labelled "colic.” Most importantly, it takes much time, energy and money to support these poor parents who, not infrequently, mourn the absence of bonding with a sweet, happy and cute young baby.
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