November 30th, 2016

A Colicky Conundrum

Emily F. Moore, RN, MSN, CPNP-PC, CCRN

Emily F. Moore, RN, MSN, CPNP-PC, CCRN practices pediatric cardiovascular care across the Pacific Northwest.

 

After my first baby, I always said that my second one was bound to be clingy, colicky, and skinny, as my first daughter was fat and happy. Aside from a few bursts of crying between 4 and 6 weeks of age, she was the perfect baby.

My second daughter is now 3.5 months old. When she was about 3 weeks old, I first noticed that no matter what I did, she cried, unless she was sleeping. Initially I had a pretty good attitude about it. I kept thinking she would outgrow it and life would move on. But then she started screaming herself hoarse and arching her back. I found myself getting nutty. I was very frustrated and doubting myself as a mom. I kept asking myself: What is going on? What am I doing wrong? Why won’t my baby stop crying? To make matters worse, she needed me so much that I felt like I was ignoring my two-year-old, who said to me more than once, “Baby sister is okay, Mama, I need you right now.” Or, “Baby sister cries all the time, Mama, what is wrong? When can I have you?” To say that I felt guilty is an understatement. There I sat — hormonal, postpartum, and torn, finding myself needing to choose between an infant and a toddler. That’s when I realized that this is how postpartum depression develops and, worse, how shaken baby syndrome happens. (Disclaimer: I never felt like shaking my baby).

baby_crying-126449571Multiple people offered their advice. My dad said to lay her tummy on my tummy, my sister said to sing to her, a friend said to let her cry and to walk away to get relief. My mom said to just hold her and rock or bounce her. I tried it all and nothing helped. I started her on over-the-counter anti-gas drops hoping that would do the trick. Nothing. She was relentless in her crying. Thankfully, my husband shared a lot of the care responsibilities with me.

At our two-month well-child checkup, my provider asked about crying. I said, yes, my baby cries. ALL. THE. TIME. She asked when, and I said all day every day. I explained that we really don’t get relief unless she is sleeping, that even when I hold her, she is fussy and crying. Our pediatrician suggested that we start ranitidine for reflux. I instantly said no, arguing that reflux is over-diagnosed and that I didn’t want to be ‘that’ mom whose infant with colic was being treated for reflux. I also argued that as a relatively big baby, she didn’t seem to meet the criteria for reflux. Shouldn’t she be failing to thrive if she had reflux? The pediatrician laughed and explained that infant colic follows the rule of threes: crying for 3 hours a day, 3 days a week, and for more than 3 weeks. She also explained that a lot of big babies have reflux and keep eating to soothe the pain, causing a vicious cycle of eating and crying. Reluctantly, I started the meds. Within days, her periods of crying lessened and she stopped arching her back. I felt horrible that I didn’t address the issue sooner. Now she still cries, but not nearly as much, and my mental health has improved.babymother-80711932

There is nothing more frustrating to a new mom than a baby who cries ALL the time. Moms need assurance that this is normal (and fairly common, affecting 10%–40% of children), empathy that it sucks, and validation that they are doing nothing wrong. My pediatrician knew I was at my wit’s end and needed a solution. I am so grateful that she took the time to ask, listen, and counsel me. Not once did she make me feel like a bad mom.

Being a pediatric provider, this experience opened my eyes to a few things. First, I am guilty of dismissing a baby with colic. This showed me how wrong I was. I know now that from my experiences as both a mom and a provider, I must take the extra time to sit with parents of newborn patients and listen to what is going on. I will provide the support needed to assure a mother that she is doing everything right. I will sympathize that hearing your baby cry all day every day is hard. Validating a mother and/or father is so important and can be incredibly therapeutic. I urge my colleagues to do the same. The time we spend on therapeutic communication might prevent or lessen colic-associated short-term depression and anxiety in stressed or exhausted parents, and might even save a parent from causing harm such as shaken baby syndrome.

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11 Responses to “A Colicky Conundrum”

  1. Jennifer Barnato says:

    Hi. Thank you for that post. It is very reassuring to me now that my daughter has colic. I will discuss reflux meds with our pediatrician. Great blog!!

  2. Sana Haq says:

    Feel good after reading this. My first one was like that and I was the primary care giver. No one else around to help for days at an end. When I would tell about the crying in my social circle my feelings were discounted. The first few months were a hard time for me.

    • Emily says:

      Sana,
      I am sorry to hear you weren’t supported. It was surprising to me how common colic actually is.
      Glad things are better!

      Emily

  3. Juanita Baranowski says:

    I suggest that before you start an infant on reflux medicine you consult with a pediatric gastroenterologist.

    • Emily says:

      Juanita,
      Thank you for your comment. I used to believe this same thing until I spoke with my colleague in GI.

      Emily

  4. Natalia Rodriguez says:

    As a pediatrician myself I’ve never asked mu new moms how they were.
    But with the very hard experience of having a 6 weeks old crier I changed a lot of my previous certainties….
    thank you for sharing! I could see myself In your experience

    • Emily says:

      Natalia,
      A game changer for sure! I can’t believe how much this experience has changed my practice. For that matter, how much being a mom has changed my practice. Especially with therapeutic communication.
      Thank you for your comment,
      Emily

  5. Cheri says:

    Thanks for sharing this. I will try to remember the rule of three regarding colic. Hope your postpartum has gotten better.

  6. Arielle Berger says:

    Nice post. But could you please change the picture at the end to reflect a more modern version of medicine, like perhaps a female physician (especially since 60% of pediatricians are women), or a male nurse, or a father. Pictures matter! Thanks.

  7. Jim Caggiano, MD says:

    My habit has been to initiate every post nursery discharge follow up by asking mom, “are you getting any sleep?” I started doing it as a demonstration of empathy, but soon found that if you are interested enough to ask questions, patients will begin to trust you enough for you to get answers. Every physician starts his or her education as a patient. Keeping that patient perspective in mind is never unhelpful.

NP/PA Bloggers

NP/PA Bloggers

Elizabeth Donahue, RN, MSN, NP‑C
Alexandra Godfrey, BSc PT, MS PA‑C
Emily F. Moore, RN, MSN, CPNP‑PC, CCRN
Harrison Reed, PA‑C

Advanced practice clinicians treating patients in a variety of settings and specialties

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