Читать книгу The Fourth Trimester - Susan Brink - Страница 11

CHAPTER TWO

Crying

The Wakeup Call That Says Everything Has Changed

“I have never hurt him and don't believe I will, but I have had to leave the room he was in, go somewhere else and just breathe for a while, clenching and unclenching my fists,” author Anne Lamott writes of her son's crying.¹

When a baby screws up his face, squeezes his eyes shut, and throws his head back for a full-throttled wail, it's normal. Healthy newborns cry an average of one to three hours a day, though to any parent it seems like a lot more. Even a colicky baby, who cries more than three hours a day, will usually outgrow it in three to four months.

Small comfort.

The sound itself is so jarring, so unsettling, that it has qualified as torture, according to Dr. Jerome Groopman, author and chair of medicine at Harvard Medical School.² Quoting British social anthropologist Sheila Kitzinger, he says in his New Yorker article: “The sound of a crying baby . . . is just about the most disturbing, demanding, shattering noise we can hear.”

But we now know that every newborn cry of life ushers in a human being who isn't quite ready to be separated from his mother's womb. It is his first and, for a while, only tool of communication to signal hunger, fear, or discomfort—needs that were effortlessly met in the three trimesters that preceded birth. His very survival during the transition that is the fourth trimester depends on this signaling cry.

THE BABY'S POINT OF VIEW

Think for a few moments about what birth is like for a newborn. If parents are overwhelmed at this time, we can only imagine the surprise of their infant. Emerging from a snug, temperature-controlled, and highly customized personal sac, she is suddenly in an alien environment. All she knows and craves—food, warmth, and security—has been left behind. In the uterus, she didn't have to ask for a thing. Now, during this phase of development that is so closely linked to her fetal life, her only way of asking is to cry. She's been a contented parasite for forty weeks, and though she's ready for life, she can handle it only with lots of help and definitely on her own demanding terms. It's up to parents and caregivers to quickly figure out what those terms are.

Her lungs fill with air for the first time, taking over respiratory function from the placenta. The amniotic fluid and mucous in the respiratory tract may not have been fully cleared by the forceful compression of the chest during birth—an even greater likelihood if the birth is cesarean—so her nose has to be cleared. Eyedrops make it hard for her immature visual system to see even the outline of her mother's face. The delivery room is filled with light, brighter than anything she's experienced before, and with sounds louder than anything she's heard before.

And yet, despite all the fussing that goes on immediately after delivery, some things are familiar to the baby. Colostrum, the first breast secretion before milk comes in, and the scent of her mother's nipples, both influenced by the food a mother eats, remind the newborn of the smells and tastes of amniotic fluid, also influenced by diet. That smell represents a sturdy bridge between fetal life and this new phase of development.

He hears mom coo, “Welcome, my boy,” and the singsong, high-low pitch of the words is familiar. The sound is clearer now, without the muffling effect of amniotic fluid and layers of uterus and skin, and it's yet another bridge between “then” and “now.” He understands nothing, but he's getting his first crude lesson in the yearslong effort to learn a language—that sounds make words. But for now the sounds are all strung together, and, like his mother, the baby is so exhausted from his birth adventure that he will probably fall sleep.

When he wakes, he feels something damp, but it's unlike the constant and soothing wetness of his nine-month amniotic-fluid bath. This is a wet, soggy, and perhaps chilly diaper, and he cries for help. His cries release cortisol, and his heart rate and temperature rise. He's picked up and cuddled within the warm circle of loving arms, and this feels vaguely familiar. His cries lessen. Then he is on a changing table, his clothes changed, and a dry diaper fastened around him. At the same time, he feels hunger pangs. His cries increase.

From the newborn's point of view, there's a lot to complain about. It's little wonder that, almost immediately, newborn infants add their own sounds to the mix of worldly noise around them—their cry of life. They are in an alien world and need help adjusting to it. Their cry is their first insistent request that attention must be paid, that care must be taken.

WHY NEWBORNS CRY

Babies are supposed to cry. It's the primary tool they have with which to communicate about a messy diaper, an empty stomach, and a need for reassurance or human connection. A baby's health is initially measured, in part, by a strong, lusty cry. Her cries communicate—loudly—her feelings, her needs, and her wants. Adults can't help but sit up and pay attention.

Research shows that normal, healthy infants have two cries.³ They have a basic cry and a pain cry. The two are distinct enough to show up differently on printouts of acoustical analyses of infants’ cries. The pain cry is urgent—usually high-pitched and loud. It comes on suddenly and includes long periods of breath holding. It's that pause between one loud, high-pitched waaah and the second outburst that puts parents on edge. They most likely are running to the infant's side as the next waaah comes through, signaling that the infant is still breathing. That's an instinct worth trusting. When the cry sounds like the baby is signaling pain, a physician should check to see if there's a physical cause. But an urgent cry of pain is also the cry of colic—signaling that parents might be in for a short-term, bumpy ride.

The other cry, the basic cry, is for everything else—hunger, discomfort, a need to be held. It is somewhat lower in pitch with a more gradual buildup in intensity. There are no interminable periods of breath holding, and overall, there's a less frantic sound to it.

By about six weeks, the infant has gained enough control of his vocal cords that he makes the amazing discovery that he can cry at will. Imagine the power! He is learning that this vocal tool brings someone to his side. At this point, he may not be crying for a basic need like food or a clean diaper. He may be crying because he needs attention, something he received twenty-four hours a day in the uterus.

Attention is a serious need for infants. They may need a burp, they might have gas or indigestion, or they may be getting tired. They may be too warm. They may want to move—in someone's arms, a rocking chair, a stroller, or a car seat gliding down the highway. They may simply be lonely and want the sound of a human voice or a cuddle. Or maybe it's just that fussy time of the day, and all a parent can do is try to provide comfort as the crying runs its course. That kind of attention teaches him that a caring adult is still there for him, just as his mother was always there for him during the first three trimesters, in the happy times and through the inconsolable times.

EVOLUTION HAS MADE NEWBORNS ADORABLE FOR A REASON

There's a lot of crying and demanding coming from such a diminutive body. Researchers once held that crying was the sole biological siren that alerted and motivated mothers and caregivers to come to the rescue.⁴

Turns out, there's more going on in the initial communication. If crying were the only tie designed by evolution to connect babies’ needs and mothers’ responses, the human race might have died out millions of years ago. If high-pitched, incessant screaming were the only thanks mothers living in caves got for their pain and effort, they might have thrown up their hands in frustration and walked away in a huff—hang the future of the human race.

Luckily, infants have other ways of keeping caregivers hooked. Those other physical and behavioral skills, too, have been evolving over millions of years. Think “baby” and see wide eyes, round face, large head, chubby cheeks, small nose and mouth, short and thick extremities, and a plump body shape.⁵ It's likely that evolution favored infants with characteristics that are universally thought of as adorable. Combine it all in one package, and we're inspired to take care of the baby's every need. In evolutionary terms, our attraction to the endearing details of this demanding being ensures the survival of the human species.

Babies of just about any species are adorable to adult humans—think kittens, puppies, and penguins. Walt Disney, Steven Spielberg, and Jim Henson understood the human nurturing reaction very well as they created some of the most beloved characters in American culture. What else could explain the appeal of creatures like Mickey Mouse with his oversized head, ET with his (her?) enormous eyes, or Elmo with his short, pudgy body?

The bottom line is that it's a good thing for the human race that babies are so adorable. Infants with waiflike eyes, plump thighs, and other classically appealing characteristics trigger activity in the reward centers of our brains. In the 1950s, the Nobel laureate Konrad Lorenz described a set of baby characteristics universally considered “cute.” Those cute newborn attributes trigger a nurturing response and motivate us to respond with caretaking, Lorenz found. Our brains are wired to respond to typical baby adorableness. There is much more to our loving response than attempts to quiet those incessant wails of distress.

In 2009, a group of scientists brought technology to Lorenz's work. Using functional magnetic resonance imaging to observe brain activity, they observed the brains of a group of adults as they looked at photographs of classically cute infants. The researchers showed that the centers of the brain involved in nurturing and caretaking light up when adults look at photographs of chubby-cheeked, wide-eyed infants.⁶

It doesn't require a biological link to trigger the brain's reaction. The same response to adorable that is found in mothers and fathers is also found in all other adults and even in children. The appeal of a vulnerable infant generates a near-universal desire to help. “Can I hold her?” the older brother will ask, stretching his legs out the width of a couch as he tucks himself between pillows and promises to be very careful with her. Her very helplessness contains a survival tool that inspires mothers, fathers, big brothers and sisters, and all who gaze her way to provide care, support, and a sincere attempt to answer her needs.

There is within each of us a neurobiological explanation for why we feel the urge to take care of anything that resembles a baby—even a talking mouse, a little alien from outer space, or a fuzzy red Muppet.

A NEWBORN'S ABILITY TO CREATE A DIALOGUE

We know that crying is a vital part of communication between mother, father, or caregiver and baby. And being adorable is an important part of the dynamic. But what else is needed to keep parents involved in the round-the-clock, sleep-robbing, often frustrating task of keeping a newborn baby alive and safe?

“After six weeks, none of us would still be here if crying were the only thing to keep us attached to our mothers,” says Dr. Heidelise Als, director of Neurobehavioral Infant and Child Studies at Children's Hospital in Boston.⁷ Evolution required that infants develop other features if they were going to entice their mothers to hang in there with them. Dr. Als began looking at those evolved baby tricks by studying mother-infant interactions. She got to know mothers well enough during their pregnancies that they invited her into the delivery room. She watched, listened, and took notes as they first laid eyes on their offspring. ("You look like Uncle Louie.” “You're here, and you're all mine.”) She came back the next day, and the next, and the next and kept watching, all the while asking herself the same question: What impact is the baby having on the mother?

As time passed, Dr. Als found something that she didn't expect. There was a dialogue of facial expressions between mothers and newborns that immediately became a two-way street. From day one, the baby's open eyes made mother happy and inspired her words. The baby's yawn led to a winding down of the mother's words. A sneeze would elicit words of comfort. A scrunched-up face would trigger a tender laugh.⁸

Each baby, if you pay close attention, is keeping up his end of a conversation of signals, moods, and rhythms. He's helping to steer adult response, even as individual responses are teaching him to call up new conversational signals. Babies have ways of keeping the people who love and pay attention to them involved, and they'll begin the dialogue immediately with a birth mother, or with an adoptive parent or other committed caregiver, as soon as they get the chance. Those skills, refined through millions of years of evolution, prove to be enough to get the adults in their lives to put up with crying, sleeplessness, dirty diapers—and a transformation of life that new parents can't possibly have anticipated.

THEORIES ABOUT EXCESSIVE CRYING

Excessive crying happens a lot. In 10 percent to 25 percent of families, unexplained infant crying is the most common parental concern. The peak in crying time comes at about six weeks to two months, but can last until four to six months of age. Episodes of crying, nerve jangling for even minutes, can last for hours, with scarcely minutes of quiet respite.⁹

The traditional theory about excessive crying used to be that it was gas or an upset stomach. Now, unexplained and prolonged crying in the fourth trimester is seen primarily as an inability to regulate the sleep-wake cycle, or an immature ability to get to a calm state internally. An infant has normal states, ranging from deep, quiet sleep to fully awake lusty crying.¹⁰

Colicky or irritable babies are somewhat less organized in their initial sleep-wake cycles. While excessive crying generally peaks at about six weeks, and while, in about three months, most babies mature and possess a greater ability to calm themselves, some babies during the fourth trimester may be more sensitive to overstimulating environments. They get overwhelmed by a lot of activity in the household—a football game on the television, siblings fighting, the chaos of a routine dinner hour—and have not yet figured out how to soothe themselves and tamp down their arousal enough to fall asleep. Instead, they cry.

COLIC AND THE RULE OF THREES

Colic is defined not by physical problems but most commonly by time. A baby is considered colicky if she has unexplained crying for more than three hours a day, for at least three days a week, for three weeks running. By the time those numbers, or worse numbers, are racked up, parents are pretty stressed out.

A highly popular book, The Happiest Baby on the Block by Dr. Harvey Karp, suggests providing what he calls the “Five S’s.” Those are swaddling, side or stomach position while holding, shushing sounds, swinging, and sucking (bottle, breast, pacifier, or even a finger).¹¹ For some families, these work like a charm. Others need additional help.

If the numbers in the crying pattern are lower than in the colic guideline of threes, the infant may still be considered fussy in her parents’ eyes. However one labels the problem, the crying will usually lessen as the infant matures in the fourth trimester and is better able to calm herself and regulate her sleep and wake cycles.

FUSSY OR COLICKY: MOTHERS AND FATHERS NEED SUPPORT

With a truly fussy or colicky baby, parents need help. No caregiver can do it alone, and adults have to take care of themselves if they're going to be able to care for the infant. Professionals like physicians, social workers, or mental health workers can help. So can parenting groups, a mother, father, or in-law, or a friend who has survived a colicky baby. Spouses and partners can take turns giving each other a respite. All of that can amount to a schedule of relief—time to catch up on sleep, leave the house, and spend some time without infant responsibilities. Time out from parenting is a basic need, especially when a newborn cries excessively. The fourth trimester is, in the scheme of things, a short time. But it's incessantly demanding and tense.

In 2003 Dr. Linda Gilkerson founded the Fussy Baby Network at Chicago's Erikson Institute. The network has expanded to include programs in cities throughout the country, including one at Southwest Human Development's Arizona Institute for Early Childhood Development in Phoenix; one at the Children's Hospital and Research Center in Oakland, California; one operated by the University of Colorado Denver at the Children's Hospital; and another at the Boston University School of Medicine. Similar programs are being developed in the Los Angeles and Washington, D.C., areas. There are other organizations similar to the Fussy Baby Network, such as the colic clinic Dr. Barry Lester founded at Brown University in Providence, Rhode Island.

Gilkerson wanted to provide support for parents concerned about their infants’ crying or temperament, a desire rooted in her experience with her own colicky son, Michael, during his fourth trimester. Dr. Gilkerson and Michael had endured an extremely difficult fourth trimester—for more than three months he cried inconsolably. There had been trips to the pediatrician, where he was declared healthy. Nothing was wrong, yet each day was unpredictable, adding to the stress. Michael would have endless crying bouts that his family came to call “Big Mac” attacks. He cried through feedings, diaper changes, and endless, futile attempts at comfort. Then a peaceful day would come, with no crying jags, followed by another day of “Big Mac” attacks. Through it all, he was a healthy baby. The diagnosis, common among babies who cry a lot, was the ill-defined “colic.” After each medical trip, Gilkerson went home assured that her baby was fine. But she received no advice on how to deal with excessive crying herself: how to help her baby through it, or what to make of it. Despite the assurances of good health, he remained fussy—and there seemed to be no end in sight.

By the end of the fourth trimester, the excessive, inexplicable tears and howls were almost over. She recalls a moment of shared pleasure that was a long time coming. “He was born on April 3,” Dr. Linda Gilkerson says. “I remember on July 4 [three months later], I was upstairs in the bedroom. I had my feet up like this,” she says, demonstrating the classic infant-holding, knees-up posture, “and it was a moment of discovery. There was a sense of no barriers, limitless joy. I think it was just those cheeks and the sparkling eyes and the ability to sustain the engagement.”¹²

She had already been hooked, in love with him since his birth, but now she felt he loved her in return. She could see it in his eyes, in his recognition of her, in his relaxed pleasure as he lay in her lap. It is a moment that all parents feel, when love moves in both directions and, for a lifetime, grows on both sides.

BABY ANNIE'S STORY: what is wrong with this baby?

Annie was born to John and Courtney Bowles on September 18, 2009. She was an inconsolable bundle the moment she came home. “That first night, she cried and cried. Nothing seemed to soothe her,” said Courtney. As a hospital social worker, Bowles had seen hundreds of newborns. But they seemed to sleep all the time, and she just wasn't prepared for Annie's crying. Her expectation had been that if Annie needed a diaper change, she'd cry for a few minutes, then coo with gratitude once clothed in a clean diaper. If she were hungry, she'd cry until she was fed.

Instead, she cried with a wet diaper, and continued crying with a dry diaper. She cried when she was hungry, and continued crying after she was fed. She cried when lying down, when sitting up in her infant seat, and when held this way and that.

Courtney and her husband tried swaddling, but Annie hated it, kicking through the tight wrap. Courtney talked to her, stream-of-consciousness talk that grew increasingly anxious—with an edge of fear to her voice—as Annie kept crying.

John would take her into the bathroom, the darkest room in the house, and flip on the fan, trying for a white-noise effect. They experimented with how they held her: upright with a face against her head, or in the traditional cradle position while pacing, pacing the hallway of their Chicago apartment. If something worked, they kept it up: three paces forward, quick turn, three paces back, quick turn. Cradled against an adult's pounding heart, Annie seemed to like the pacing—until one unpredictable moment when she didn't and cried some more.

“We worried that something was medically wrong,” says Courtney. “Every time Annie started crying, it panicked me. It affected me to my core.” After about six weeks, Courtney was crying almost as much as her baby. “I would doubt myself. I'd think, ‘I don't know how to soothe my own child. I'm a failure.’ “ For the first five weeks of Annie's life, they were weekly regulars at her pediatrician's free walk-in clinic. Annie would be declared wide-eyed, alert, and growing normally.

Courtney's mother, who had moved in to help with the newborn, had to leave after four weeks. At six weeks, when Courtney found herself panicking the minute Annie started to cry, she decided it was time to get help. She called the Fussy Baby Network's Warmline in tears. The next day they sent an infant specialist to the Bowles home. “By the time they see us, they're at their wits’ end,” says Michelle Lee Murrah, infant mental health practitioner with the Fussy Baby Network.¹³ They've read every parenting book they can lay their hands on, they've called their pediatricians, they may have rushed to the emergency room, they've heard the conflicting advice of their own parents, in-laws, and friends, and the baby still cries a lot.

When Murrah arrived at the Bowles's apartment, she attentively watched as Courtney and Annie did what they normally did. Courtney fed the infant and then put her on the floor. Mother and baby were down playing with the infant gym when Annie started crying. Murrah saw a yawn that Courtney missed. She wondered with Courtney what could be happening for Annie. Together, they continued to watch, and Murrah helped Courtney see Annie's sleepy signs. “She's tired,” said Murrah, and suggested she put Annie down and leave her alone. Courtney had never, for an instant, let her baby go to sleep without holding her. Murrah encouraged Courtney to give her just a few minutes to see if Annie could comfort herself to sleep. The two women talked while Annie cried in her crib. Courtney said she felt guilty, inadequate, a mother who couldn't comfort her child. Within a few minutes, Annie was sleeping as the women continued to talk.

When Murrah left, Courtney practiced swaddling Annie in a looser fashion, the way she had tried with the support of the specialist—and it worked. She began to pay closer attention to Annie's yawns and other signals that she was tired, putting her down at the first signal. Courtney recalls, “I started paying attention to cues like yawning, rubbing eyes. When I thought she couldn't be tired, [Annie] was telling me she was tired. When I thought she couldn't be hungry because she just ate, she was telling me she was hungry again. It was a matter of learning how to really listen to her.” Right about that time, Annie stopped crying. Not completely, of course. She just developed a normal, recognizable pattern of crying that her mother could now decode. Also, as Courtney grew less fearful and more confident, Annie could relax and feel that her mother was ably in charge.

WHAT'S THE ANSWER?

There is no magic formula. Babies are human, and all humans are different.

The first three months of a baby's life are not about training him to be an independent person. That comes later. The first months are all about helping him to shift from depending on the comfort of the womb to adjusting to the world he's been born into. What he needs to know is that when he is distressed, someone who cares about him is there—even if his problem is inexplicable. The response he gets as he makes his transition from womb to world is his first lesson in how life can be expected to respond to his woes.

Maybe an infant is telling her parents that their best-laid plans might not suit her needs. Dr. Heidelise Als, director of the Neurobehavioral Infant and Child Studies program at Children's Hospital in Boston, has seen thousands of babies and their parents. She says,

I've seen parents, often professional, who had everything planned. They had their careers going, the house ready, the nursery ready, everything on schedule. They expected the baby to fit in.

Then the baby screams, and they're befuddled and don't know what to do, because he's not doing what they want him to do. I see that baby as a strong baby. He's asking, “Are you there for me? How much time can you make for me?”

We can be so pushed now. Women can be so focused from pregnancy on to get things scheduled. And that's not how parenting goes. That's not how growing up goes. I would prefer to support parents earlier, to tell the truth. This is a big step. This will reorganize your whole life, your whole emotional life. You'll gain a ton from it, but it's a dimension that a nonparent can't appreciate.¹⁴

A study of 157 infants, whose mothers recorded the duration of their crying for a full year, found that when mothers responded rapidly to crying, infants cried significantly less.¹⁵ The sound of an infant's cry has been found to increase heart rate and blood pressure in adults, and to elicit feelings of anxiety and irritation. The common adult reaction is to run to the baby and try to relieve his distress. When a baby is described as “easy,” caregivers still have increases in heart rate and blood pressure, but not as great as those in parents who describe their offspring as “difficult.” According to research from the University of Michigan, those with “easy” babies were more alert and attentive to a crying infant than those with “difficult” babies. In other words, nonstop crying, excessive crying, and the crying of premature babies—which occurs at a higher and more irritating octave than that of full-term infants—can turn parents off, to the point of making them slower to respond.¹⁶

While that is understandable, it's important to try the opposite approach. Rather than shutting out the sound, try to provide comfort. Those attempts can be clumsy, but nevertheless they provide the kind of visual, auditory, and tactile stimulation that promotes infant development. Even the most bumbling attempts to soothe a baby, when performed as calmly and consistently as possible under jarring circumstances, have a positive effect. The infant is learning that someone important takes his distress seriously.

Newborns provide plenty of clues to how to care for them. And evolution has equipped people, whether biological parents, adoptive parents, or other adult caregivers, with the right instinctive responses: they hold their newborns close, offering soft words, kissing them tenderly, and gently stroking, warming, and feeding them. Even during interminable minutes or hours when none of it seems to be working, the comfort that is offered lays important groundwork.

PARENTS HAVE NEEDS, TOO

When an infant's crying overwhelms you, it's time to step back. I have an uncomfortable memory from my firstborn's infancy. I tucked my inconsolable daughter safely in her crib, and then trekked down two flights of stairs to our basement. I think I was crying, maybe shaking with frustration. I picked up a plastic laundry basket and hit it against a wooden support beam, and then hit it again. After a minute or two of this highly physical but harmless exercise, I was somewhat relieved, definitely spent, and more than a little ashamed. By the time Jenny was three months old, the laundry basket was ripped, tattered, and unusable.

I shouldn't have been ashamed. I didn't know it then, but I was doing exactly what experts today say is the right thing to do.

When frustration over a baby who won't stop crying gets out of control, first make sure the baby is safe, out of harm's way. Then walk away for the minutes it will take to regain calm control. Away from their infants, mothers and fathers can then do whatever makes them feel better: Clench and unclench their fists. Hit a laundry basket against a beam. Ears covered, jog in place. Call a friend, neighbor, or relative and ask for help. Do anything necessary to get the frustration out, as long as it's away from the baby. Then, relieved and refreshed, they can go back and tend to the infant's needs.

CONFIDENCE

Parents should remember: they're still the people they always were. When infants continue to cry despite all the best efforts of parents, it's easy to follow them down that rabbit hole into escalating fear and panic. But rather than take that route, it's time for parents to flex their parental muscles—not by being cold and unresponsive, but by holding on to the confidence and certainty that they're truly doing all they can. Sometimes doing all they can means simply being with the baby through moments that are particularly hard.

The infant is disorganized internally, but the adults around him don't have to be. They can take a cue from Saturday Night Live’s character Stuart Smalley and recall: I'm good enough, I'm smart enough, and doggone it, this baby likes me. This is true even when the baby's face is red, his stomach is tight, he's looking in all directions, and he's screaming. As mothers, fathers, and caregivers stick with it through the difficult times, they're teaching infant brains that, when in distress, help is nearby.

It helps to share calming information with a baby. We'll get through this, sweetheart. Remind the baby that the last time he cried for a long time, he eventually stopped and fell asleep. Remember this morning? You cried hard then, and after a while you had a good sleep. You will again. Mustering up a confident voice, parents can remind their infant that someone is there for him when he's happy, and remains there for him when he's distressed. In the process, those brain connections that signal comfort will be formed and strengthened; those that signal neglect will be ignored.

A confident voice sounds far different, even to an infant, than a voice shaking with uncertainty. Courtney Bowles, during those weeks when she was unable to soothe crying Annie, lost what was probably the most crucial element in her arsenal—her self-confidence. And don't think Annie didn't notice. Babies take everything in through their developing senses. When a parent's body speaks with calm conviction—the voice, the face, the movements—it must sound to an infant like reassurance.

REASSURANCE, EMPATHY, SUPPORT, AND TIME-OUTS

Reassurance is crucial for parents of colicky or fussy babies. They understandably want certainty that nothing is physically wrong with an infant who cries more than average, and this reassurance is the first step in helping parents deal with a baby who cries inexplicably and excessively. A physical checkup can rule out any health problems, but plenty of parents get that from a pediatrician or an emergency room team, only to go home with a baby who continues to cry. Parents also need reassurance that they're competent and capable of helping their infants through a trying time. Friends and family, the circle of people who know the capabilities of new parents, can be good at providing encouragement.

It's important for parents to find people who listen without judging, whether they're friends or professionals. People who work with parents of colicky babies hear the stories of parents who are at their wits’ end. They hear stories of bone-wearying nights of pacing, of a midnight walk in a stroller or ride in a car seat to induce calmness. They hear confessions: I get worked up and I'm not capable of soothing her. She feels my heart racing. She hears me crying. They hear parents say things they're not supposed to admit: I know I'm supposed to love him, but honestly, sometimes I feel that I don't even like him. Parents need objective support, not harsh judgments.

“We take a lot of time to hear their stories,” says Murrah of Erikson Institute's Fussy Baby Network. “We don't dismiss anything a parent says.” They get SOS calls from multimillionaire parents and from housing project parents, from mothers who breast-feed and mothers who bottle-feed, from biological parents and parents who have adopted their infants. Parents of all stripes may experience the plight of sleeplessness, a lack of positive feedback from their infant, and the disappointment of limited gratification for their efforts.