Multiples

Coping with persistent crying

Coping with persistent crying in an otherwise healthy newborn is extremely stressful for parents, even if it’s a common condition in babies. Caroline Allen asks two midwives for their insights into the unexplained excessive crying that is known as colic. 

When your new arrival is crying out for help – repeatedly crying excessively – it can cause a lot of distress and worry. Common misconceptions about what causes infant crying and a lack of information and support can leave sleep deprived parents feeling anxious and guilty.

Research has found that infants who have ‘colicky’ crying have unexplained and repeated bouts that are not alleviated by parents or trained experts, according to The National Childbirth Trust in its book ‘Your Baby’s First Year’ (Mitchell Beazley.)

One recent theory, it says, is that it could be babies’ brain development that causes incessant crying. Babies with colic may be experiencing disruption during the change from one area of brain control to the other – from crying being under the control of the mid-brain function to the cortex – particularly in their recovering response.

The thinking is that these babies are extremely sensitive to their environment, have intense emotions and reactions, and then have difficulty calming down. The evenings are particularly trying because  babies – not to mention their parents – are tired and more sensitive, with less control. This is also the time the household gets busier and noisier.

Other theories pinpoint excessive gas or wind or that the gut is sensitive to substances in formula or breast milk, causing pain. Nothing is set in stone when it comes to colic and there are no hard and fast rules or definite answers. The crying attributed to colic usually lasts at least for three hours per day, for at least three days a week for at least three weeks, with no other explanation for the crying.

Some studies show that it can affect up to 20 to 40 per cent of infants and affects boys and girls equally. It mostly kicks in between the ages of two to three weeks and three to four months. Although colic can be quite traumatic for all involved, the condition isn’t harmful, and passes with time.

Wexford-based midwife Ann Stenning who runs one-to-one ante natal and post natal classes, has personal experience of colic. “After a difficult birth, my son, who is now 25, never stopped crying, night and day. When you have a baby with colic, the devastation is horrendous if you haven’t got support, parents can become unwell themselves,” she says.

cry baby

With severe cases of colic, the ideal is to have someone come into your home, providing parents with much-needed rest, Ann says. The exhaustion caused by dealing with a colicky baby can lead to post natal depression; difficulties bonding with baby; and general family upset and other areas of the household are neglected.

“In my case, my friends came out, put me to bed and took the child. He slept much better and that night’s sleep was like gold dust to me,” Ann says. “In many cases, new mothers find their friends are out working, so they could possibly call on their mother or grandmother,” she suggests.

“Women are often not debriefed after a traumatic birth and they are left dealing with all that which can go deeper. Women nowadays are often not getting the nurturing they need. In the past there was a lying in period, where it was about being with baby, getting the sleep needed and not doing anything else. Now I find that women expect more of themselves and often don’t look for help.”

“The pressure of being the only one with a baby who cries non-stop can also be testing, Ann remarks. “If every other baby is quiet, and yours is the only one roaring, all that worry will come into your head. I’ve known of babies with colic that never settled until the end of their first year. The thing to bear in mind is that colic will go away, and a child with colic is as bright as any other child. Parents need to be reassured.”

Both Ann and Dan Oakes, a home birth midwife and director of Neighbourhood  Midwives, stress that all babies are individuals and there is no ‘one size fits all’ approach to dealing with colic. “I would be a proponent of lots of winding. Parents, especially first time parents, go home and often don’t have a lot of help so they miss out on the opportunity to do a lot of winding,” says Dan who also has personal experience of a colicky baby.

“I would say there are five things to look out for in a crying baby – hunger; dirty or wet nappies; the need to be winded; over-stimulation or over-tiredness; and the basic need for a hug,” Dan outlines. “Change the nappy before feeding so that the baby is comfortable while feeding. When changing them, see if you get get a burp. Make sure you’re feeding effectively and half-way through wind the baby. Feed them some more and just before you put them down, wind them again. Avoid over-stimulation such as handing around the baby to different people and having a noisy background.

The final check list is the need for a  hug. Some infants find the separation once outside the womb difficult and may need to be just held more,” he says.

Stripping the baby down to their nappy and putting them on your chest, maybe with the use of a sling, provides important skin-to-skin contact. It can also be facilitated as parents go about their daily tasks, Dan suggests. “The movement makes them feel like they are back in the womb,” he remarks.

Simply ensuring the baby is well winded has ensured a lot of success for Dan with clients, he says. “I previously worked in special care and we would have a line of babies and a time limit. If you fed one and put them down again without winding them, you could guarantee they would be back up in 15 minutes,” he says. Dan also suggests investigating cranial osteopathy for affected infants. Its theory is that birth is stressful. As the baby makes it way through the birth canal, its skull bones can mould to an unusual shape.

cry baby

Various other coping strategies have been suggested over the years. These range from keeping the baby upright after feeding; using special bottles; giving them a warm bath; taking them for a walk; offering a soother; trying some gentle massage and playing calming music. It has also been suggested that white noise such as a washing machine or radio static may help calm an infant. Over- the-counter medications are available and your local pharmacist will advise on the options to best soothe your child.

If the crying is accompanied by other symptoms such as high temperature, vomiting, diarrhoea, constipation, blood in their stools, a high pitched abnormal cry or feeding problems or symptoms other than just excessive crying, it’s always best to seek medical advice as soon as possible.

It’s also important to remember that this is an intense phase that will pass as your baby grows. Don’t blame yourself for being unable to stop the crying. Try to get regular breaks and to as calm as possible. Enlist help, whether it’s family or friends or the health professionals to get you through this demanding phase of your child’s life.

As Ann says: “Remember colic is a common problem and there is help out there. You don’t have to cope with it on your own.”

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Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.

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Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.