Crying is one of the strongest signals a baby uses to get the attention of a caregiver, or parent, that something is bothering the baby. Through evolution, mothers are primed to respond to the cry signal and to attempt to soothe the baby as best possible.
It is thus no surprise that bouts of inconsolable crying will stress most parents, as with babies suffering from what is commonly known as colic. Here the baby is clearly signaling that something is bothering her or him, yet the parent or caregiver is not able to find the root cause of the incessant crying and help the baby calm down.
In this article, we will learn about crying and colic in babies and examine some of the hypotheses, and the resultant interventions offered for its resolution. We will scrutinize the scientific studies on how carrying may or may not affect crying and colic.
Interested parents will thereby become able to interpret their children’s cry signals in an appropriate manner. Such an understanding will moderate the parents’ perception of what is taking place in the baby and also lead to a more informed reflection of their own caregiving capabilities, in the face of an incessantly crying and inconsolable baby.
Basic definitions and patterns
Let us begin with making sure that we have the basic understanding in place. Researchers studying crying operate with different basic concepts. The baby’s “cry pattern” denotes the timing of the crying over a 24-hour cycle. The baby’s “cry quantity” describes the amount of crying over a 24-hour cycle.
Colic is defined by “the rule of three” as 3 hours of crying and fussing for a minimum of 3 days a week (and some researchers add: for a minimum of 3 weeks).
Amongst 0 to 12-week-old Western babies, recent research into crying has established the following general patterns:
- Babies cry the most in their first three months. The average cry quantity, including fussing, amounts to an average of approximately two hours per day.
- Babies’ cry quantity will increase from birth until it peaks at the age of six weeks, whereafter it tapers off until twelve weeks, when it is halved relative to the peak.
- There is a great variety in the cry quantity amongst babies. Some babies (approximately 5-19%) will cry and fuss for three hours or more per day and will thus be considered “colicky babies.” Others will cry very little.
- Babies’ crying pattern follows a diurnal rhythm. Babies will cry the most in the evenings, which also goes for the babies who cry very little.
- Child number two will cry as much as the firstborn. Not surprisingly, parents of firstborns tend to seek assistance from the child health care system more frequently.
- There is no difference in the amount of crying between girls and boys.
- Approximately 40% of all babies will experience inconsolable bouts of crying and fussing at age ten days old. The same percentage applies at age five weeks. This however, does not mean that they are colicky, which requires that they meet the criteria of “the rule of three.”
Given the intensity of parental concern and the economic costs associated with worried parents seeking help from the child health care system, the scientific interest in the causes of “colic” has been quite strong and several hypotheses have been put forth. Hypotheses for colic include: lack of sensitive care, lack of physical contact, baby’s difficult temperament, lack of alignment in the skeletal system, digestion difficulties and normal development processes.
Carrying and crying
Some of these hypotheses have also been tested in rigorous scientific experiments with a view to prevent colic from arising. Among the hypotheses tested is the concept that supplementary carrying leads to greater amounts of baby/parent physical contact, instant attention to cry signals and feeding on demand (a practice dubbed as “natural parenting,” or “proximal care”), and, so, may reduce the amount of hours babies cry per 24 hours, as well as reduce the number of babies who suffer from bouts of inconsolable crying.
This hypothesis has in part been inspired by anecdotal reports from cross-cultural studies of little or no prolonged fussiness and crying in societies in which infant care differs significantly from that of the Western countries. In such societies, infant caregiving is associated with constant close mother-baby proximity and extended carrying. Regrettably, the often quoted study on !Kung babies sampled cry behavior briefly and infrequently, using different methods from those employed in Western studies, which make the reported effects less scientifically reliable. The same goes for the study regarding Aka and Ngandu tribes.
When examining the scientific findings, it is important that we understand the distinction between cry quantity and the occurrence of the phenomenon of bouts of inconsolable crying.
As regards bouts of inconsolable crying, the scientific findings are mixed. The first study, conducted by Hunziker & Barr in 1985, found that supplementary carrying initiated prior to the expected peak of crying at 6 weeks eliminated the peak and reduced the amount of crying significantly and steadily from three weeks of age. Two subsequent studies sought to replicate these findings in similar trial designs, but were unable to demonstrate the same effects of supplementary carrying as an effective means to prevent inconsolable crying.
A later study, also conducted by Barr and colleagues, examined the effects of supplementary baby carrying on colic. The participants in this study were recruited when parents came to their family pediatrician with a baby who, in the view of the parents, cried more than normally, and were thus considered to suffer from colic. Again, carrying failed to demonstrate a significant effect.
The most recent large scale study included an investigation into the care patterns of “London parents,” “Copenhagen parents,” and parents practicing “Proximal Care” (“natural parenting”). Parents in London and Copenhagen had in previous studies been found to differ in the amount of hours engaged in physical contact with the baby, with London parents spending considerably less time in contact with their babies, relative to Copenhagen parents. London parents also delayed responding to their baby’s crying on 40-70% of the occasions, and tend to feed according to a schedule, where Copenhagen parents tend to feed on demand.
Supposedly the London caregiving parents reflect a widespread and common practice on most of continental Europe and in the USA. Parents practicing “Proximal Care” would, however, offer even more physical contact than the Copenhagen parents, so the study in essence examined the effects of three different levels of physical contact.
The researchers found no significant difference in the number of babies who would suffer from occasional bouts of inconsolable crying (which does not mean colic, remember “the rule of three”) across the three different caregiving practices.
As regards colic, a significant difference was found at 10 days of age. In the London group, 17% of the babies had colic, whereas only 1-2% of the Copenhagen and Proximal Care babies experienced this. At 5 and 12 weeks, the differences were found to be not statistically significant.
As regards fussing and cry quantity, a significantly different pattern emerged. The babies of London parents were found to fuss and cry 50% more, compared to the Copenhagen or Proximal Care babies.
And what is more, the Copenhagen or Proximal Care babies would express their distress with fussing rather than with crying. And fussing is a less drastic distress signal than crying.
Therefore, the current scientific view on the effects of carrying on crying and colic is that carrying will not reduce the amount of babies affected by colic. Carrying will, however, reduce the amount of crying significantly.
Other hypotheses and treatments for colic
What then are the other hypothesized reasons for colic? So far, only interventions involving reflexology and acupuncture, recently investigated in either randomized, blinded and controlled studies, or in an acupuncture case study involving a relatively large number of babies (approximately 900) have demonstrated an effect in reducing colic. Interestingly, the point used in the acupuncture trials is what is known as the “Large Intestine 4,” pointing to an association between digestive disorders and colic.
The acupuncture case study asked parents to rate, amongst other things, frequency of drooling, being inflated in the stomach, and frequency of defecation, fecal color and consistency. For a week, the babies received daily short acupuncture sessions, with needle insertion lasting for about 10-20 seconds. No infants had an overt reaction to the needle insertion. The parents reported a significant change in drooling, which reflects an increased saliva production. This is likely to improve digestion and reduce stress on the infant, thereby leading to reduced crying. Certainly, the reported frequency of being inflated in the stomach and of defecation were markedly reduced, paired with a change in the consistency and color of the feces, which went from water-thin to mucous/gruel/toothpaste-like and changed color from green to more yellow shades. The parents also rated their impression of the infants’ general colic symptoms, including crying behavior as much ameliorated in 76% of the cases.
None of the other presented hypotheses have, to our knowledge, been successfully proven in scientific studies.
Parents with colicky babies will often worry over the long-term implications of their baby’s bouts of inconsolable crying. However, various studies indicate that prolonged crying in the first three months is not associated with increased rates of sleeping and feeding disorders. For allergic (atopic) disturbances, the recent evidence suggests a weak relationship, but the evidence is equivocal, with several studies finding no such relationship.
In summary, the available evidence indicates that some children will suffer from resistant colic. At the moment, only interventions, including acupuncture or reflexology have demonstrated an effect, and notably, not in all the children participating in the studies. Provided that the baby is thriving in other respects, showing appetite, gaining weight and gradually adapting to the day/night rhythm and presenting no medical conditions, colic need not be a cause of concern.
Carrying and crying – what science may have overlooked
One likely significant difference between Western parents adopting “proximal care” patterns (“natural parenting”) and the indigenous people who served as a source of inspiration to the researchers to investigate the effects of carrying could be the practice of skin-to-skin contact. Given the climatic conditions in the tropics and subtropics, and a different attitude towards nudity, it is very likely that the babies of indigenous people, apart from being carried, are also in direct skin-to-skin contact with the caregiver.
The extraordinarily strong effect on babies’ social-emotional development of providing skin-to-skin contact to babies in the first month has been demonstrated in a Canadian study. The results suggest that these babies, among other capabilities, developed an unusually strong stress resilience which was demonstrated when the three-month-old skin-to-skin babies were exposed to a situation which would normally elicit strong stress signals. Improved stress regulation could well be linked to more effective cry regulation as well.
For Western parents wanting to mirror this approach, using a good ergonomic carrier, dressing down the baby to only wearing a diaper, and simply putting on an oversized shirt or sweater, for discretion purposes, should do the trick.
So, does baby wearing help with colic? While conventional baby carrying may not reduce the risk that your baby develops colic, it will reduce the amount of crying, especially if you wear your baby in a wrap or sling for several hours a day. If your baby has colic or you would like to preempt the onset of colic, you could practice babywearing in the same manner as many indigenous people, with skin-to-skin contact, and see if this hitherto not investigated practice will help in your case. Acupuncture seems to be another viable option.
If nothing relieves your baby’s crying and the necessary medical check-ups have been done, just make sure that you are there for your baby, and that you have someone who is there for you as well, so you can go through this challenging phase with a strengthened love for your baby and for one another. Colic will pass.
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