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Colicky babies
Regard colicky baby at full throttle. Tiny arms and legs stiffen. Tummy goes hard. Face resembles a beet emitting paroxysmal shrieks. Unbelievably, the cry goes on for one, two, even three hours without pause. What's a parent to do?
Run a checklist. Is the baby hungry? Wet? Feeling gas pains? Allergic to something?
No, nothing is wrong. The baby appears healthy, even thriving. So, parents call the paediatrician who gives a diagnosis: colic. Then, reflecting the mystery that still surrounds unsoothable crying, the physician offers medical advice, which these days falls into these three camps:
— Colic is perfectly normal; learn to live with it. It is temporary.
— Colic indicates something is wrong with your baby; keep looking for the cause and treat it.
— Colic is inevitable; but you can try a new method that will stop the crying by turning on a baby's internal "calming instinct."
Not so long ago, the main explanation for colic was intestinal distress like gas or cramps, said Dr. Ronald G. Barr, a paediatrician and leading authority on colic at the University of British Columbia in Vancouver. That is no longer true, he said. A very few infants have gastric reflux or allergies to cow's milk or formula, but a vast majority is perfectly healthy.
Studies of infants around the world show that unsoothable colic is a natural phase of early infant development, Barr said. Babies typically begin crying at 2 weeks of age. Colicky crying peaks at 6 weeks and ends by 3 to 4 months. It is not related to weak parental skills, being a single parent, postpartum depression or anything done by adults. Infants in primitive tribes who are held 24 hours a day and breast-fed constantly show the same pattern in peak inconsolable crying.
Another paediatrician, Dr. Harvey Karp, who has a private practice in Santa Monica, California, claims that he has devised a method for calming screaming babies — in minutes.
Karp shows parents five steps that performed together set off what he calls an infant's innate calming instinct. He says the method can also help infants, who do not have colic, sleep an extra hour or two a night.
Karp said his technique involved helping the baby cope with what he calls the fourth trimester of life.
Human infants are born in an immature state because the birth canal cannot handle a larger head with a bigger brain. Thus humans are born with an apple-size brain, limited control of muscles and senses, and a small kit of survival tools. They can suck, swallow, sneeze and cry.
For the first two weeks of life, Karp said, newborns sleep and eat. Then, over the next 10 weeks or so, they enter a state of quiet alertness. Their brains increase in size by 20 per cent as circuits mature and make functional connections.
The infant's job is to cry when it needs help, stop crying, stay awake and stay asleep, Karp said. Infants must learn to turn their attention on, so as to watch and learn, and turn their attention off, to recover and sleep.
Eighty per cent of babies have no problem doing this, he said. They cry for a reason and then calm down.
But a subset of infants cannot stop crying. For them, the three months after birth is a tremendous challenge.
Karp's solution: recreate for infants sensations in the womb to help them stay calm.
To calm a baby, Karp sets out five manoeuvres that he says will touch off a calming reflex and put the infant to sleep. They must be carried out progressively, as a kind of dance, to work their magic, he said.
The first is swaddling or snug wrapping that imitates the restrictiveness of the womb for the last two months of pregnancy. But it is only the first step and will not by itself stop the crying.
The second step is to hold the swaddled infant in one's arms or on one's lap and roll the baby onto its side or stomach.
Third is a very loud shushing noise delivered directly into the baby's ear. The sound imitates what the foetus hears inside the womb as blood pulses through the placenta. The shushing must be as loud or louder than the infant's cries, Karp said.
Next comes the jiggling. A foetus is accustomed to certain motions that can be replicated for the crying infant. Karp recommends supporting the baby's head and neck while delivering tiny energetic movements, like shivering. The movements must be gentle, he said, to avoid shaking the baby's vulnerable head.
The last step is non-nutritive sucking. A baby will calm itself if it can suck on a finger.
(Courtesy: New York Times)
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