Tuesday, September 16, 2008

What I've learned about colic, and babies

I was never an "oh, let me hold the baby" kind of guy. I just wasn't. Frankly, I wasn't much interested in infants until language acquisition started, at which point I could at least get academically interested. Which ended up meaning that I pretty much knew bupkis about babies before Christie got pregnant, at which point I started reading everything I could get my hands on. How ignorant was I? Well, I changed my first diaper in the hospital.

I still wouldn't say I'm good with babies. But as the colic specialist said, I'm good with this one. As I've written about colic, I've noticed that I get a fair number of people coming to my blog from searches on "baby won't stop crying" or "baby cries when I lay her down" and so on. I've done a lot of those searches myself, and my heart goes out over the wires to anyone doing late night googling to find out if their baby is really okay.

For those people, here's a catalog of what I now know about colic:

What it is: I've already given the basic definition, which is uncontrollable crying in an otherwise healthy baby. Most doctor's seem to think it's a gut thing, but the specialist we went to is actually a gastroenterologist, and he thinks differently, based on something like 40 years of experience. His take is that these are babies with a fiery temperament who aren't good at self-calming, and don't deal well with the variety of experiences that the world outside the womb provides them with. They're particularly bad with transitions (awake to sleeping, daytime to nighttime, etc.). They tend to have a lot of gas because they swallow air when they're crying, but the gas isn't what causes the colic.

What about pain? He had me lay the baby down, at which point she would start crying, then pick her up, and she would calm. That kind of on/off crying, he said, is textbook colic, and he sees it as proof there's no pain. Heartburn is a frequent suspect thrown up for colic (I know we've pointed a finger in that direction many times), but think about when you have heartburn. Lying down makes it worse, but it doesn't just go away when you sit up. It hangs around for a while. But medicine makes it go away completely. The results we saw when we gave our baby Zantac (maybe less crying, but still some) vs. what we saw when we picked her up (able to completely calm her) were the exact opposite of what you'd expect if it were heartburn.

Why did it get better when we did _____? Babies mature out of colic. Sometimes that's all that happens. As more than one expert has pointed out, if you keep trying stuff, eventually the colic will go away on its own, and you'll think the last thing you tried is what worked. In our case, switching from breastmilk to hypoallergenic formula meant a lot less gas, and gas pain was one of the things that would trigger a hellacious crying jag. We weren't fixing the colic, really, just reducing one of her triggers, which left her free to be a happy baby every now and again. Christie kept pumping, and now she's reintroducing breast milk, with much better results.

Accept the fact that you're nuts: Your baby is screaming at you, and you're fantasizing about sleep, and thinking of new experiments to perform, trying to figure out what in the hell is wrong. That's normal. You will go a little crazy, people will say very not helpful things, and ideas will come to you at 2 in the morning that will not, thank god, survive the light of day. For instance, when Christie was first reintroducing breastmilk, we both had middle of the night moments when we were convinced the problem was her milk. Of course, I'd had the same thoughts about formula, just a few weeks before. You are sleep deprived and under enormous stress, so make allowances for your own emotional state.

Look her in the eye I lamented to Christie once that I spent so much time thinking of Spud as a problem to manage that I sometimes forgot that she was a person. It's easy to do that when all you see are gums and uvula. But one night, about two in the morning, I was staring at her in total bewilderment, wishing I knew what the problem was so I could fix it, and she stopped screaming, opened her eyes and looked at me with that same look of total confusion. Now, maybe she was just mirroring my expression, but it was my first person-to-person connection with my daughter, and it was over the fact that neither of us had the slightest idea why she was crying.

Pretend to be calm Everybody told us that we needed to be calm, because babies take their emotional cues from their care givers. That's so true, but telling the parent of a colicky baby to be calm is like telling a man falling out of an airplane to pop his chute. Believe me, if we could have been calm, we would already be calm. So I'm telling you to fake it. When she cries, smile. When she screams, smile. Don't oversmile, or you'll end up looking like the cryptkeeper. Just think of something that makes you happy. Like silence. And smile just enough that she'll know what one looks like when it's time to make one. Count your breaths. Think of what calm people look like, and try to make your outside look like that. Don't worry about what's going on inside, because you can't really do anything about it. Just let it go.

Expectations and aspirations: Speaking of letting go, you'll be doing a lot of that. You might have goals of sleep training. Or breastfeeding exclusively, or not exposing your baby to polka music. But you're not in charge anymore. You've got a little tyrant running things now, and if you're going to ever get any rest, you'd better learn to appease her needs. There's a reason why they play tapes of crying babies at Guantanamo. It. Is. Torture. You need to have compassion for yourself, or else you will break. Get help. Find a good babysitter and hire them for as much time as you can. We had a woman come in four hours a day, five days a week, for a month. If you can at all arrange it, go on a date. You'll feel guilty as hell, but you need to see the rest of the world every now and again. Set clear shifts with your partner. When you're on, you have two responsibilities: the baby and letting your partner rest. When you're off, you're off. Read a book, take a nap, whatever. It's your time. Be selfish. At shift change, do some prepwork, like cleaning bottles, picking up blankets, or whatever needs doing that takes two hands.

Tricks for Calming the Baby:

Colic hold: Billie calls it "monkey on a branch", and that's kind of what it looks like. The baby is lying on top of your forearm, limbs hanging on either side. You can do it like this, with the baby's head in your hands, or, when they're smaller, turned the other way, with her head in the crook of your elbow. Lately, Spud's gotten so big I can barely reach her head if I try to do it one handed, so I need to use my other hand to support her head. When she's really cranky, I do a move I call the "tommy gun", where I jiggle her and move her back and forth, like Al Capone strafing a room. Christie has her own techniques, and Spud seems to like different things from different people. She actually gets mad when I sing Christie's special calming song.

White Noise: Spud likes the vacuum so much we've considered changing her name to Dyson. It works when nothing else does. Rain sounds work pretty well, too. Another bright side is that white noice drowns out voices, which makes it harder for you to hear the baby, which helps with your nerves. And if your partner is trying to sleep, it'll help them as well.

Occam's Razor: I've been 45 minutes into a horrific crying jag before I realized she might need her diaper changed. Duh. And the clock can help guide you about hunger, but babies do go on growth spurts that leave them more or less constantly hungry. Do the same check for yourself. Are you hungry? Have you had anything to drink lately? Take care of your body as best you can. This time period is going to be hard on you, physically, but do what you can.

Music: Dancing with the baby is often very calming.

Boredom: Sometimes they want to see something new, look out the window, play on the playmat, etc. Try it and see.

Overstimulation: Sometimes the opposite is true.

Swinging: Get the baby in a good, firm hold, and yourself in a solid stance, and twist back and forth at the waist. It's good for your abs, and it's often very calming for the baby. Oddly enough, I found that if I positioned myself with a light behind me so that she was in light, then dark, then light as I swung with her, it sort of hypnotised her into calmness. I don't know why, but it worked. Sometimes.

Nothing works all the time and sometimes you're just in for a long ass night of screaming baby. They suck. I have no wisdom to offer on this point except to say that sometimes life sucks. Sorry about that. House rules, I guess.

2011 Update:

Kid #2 actually does have reflux, and it is so, so different from colic.  I mean, really.  If he hasn't had his Zantac, he fusses every time he spits up, and cries for almost half an hour after every feeding, but if he's had his Zantac, nothing.

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