Understanding and Managing Colic:Essential Tips for New Parents S4|EP108

Understanding and Managing Colic:Essential Tips for New Parents S4|EP108

 

There’s some very quick tips that we’ve mentioned today that can actually really prevent colic, you know, watching the awake times, understanding the signals and the womb world. Those things are quick tips. So 80% of babies will have normal levels of crying, which is maybe an hour or two a day.

It’s not a ridiculous amount. But then you get this 20% who cry kind of three hours of a day. And within that number of 20%, a tiny percentage, I’m talking like only like 5% of the 20%, very, very few babies end up where it doesn’t resolve at three months.

Colic is not actually an abdominal issue, or a digestive issue. It’s more of a neurological issue. If your baby cried incessantly from from birth, and by 12 weeks, they’re not settling, then there are a whole lot Welcome to Sense by Meg Faure, the podcast that’s brought to you by ParentSense, the app that takes guesswork out of parenting.

If you’re a new parent, then you are in good company. Your host Meg Faure is a well known OT, infant specialist, and the author of eight parenting books. Each week, we’re going to spend time with new mums and dads just like you to chat about the wins, the challenges and the questions of the moment.

Subscribe to the podcast, download the ParentSense app and Catchmaker every week to make the most of that first year of your little one’s life. And now meet your host. Welcome back mums and dads.

This is Sense by Meg Faure. And I am Meg Faure. And it is always my delight each week to join you and have you join me as we embark on a journey of discovery when it comes to parenting.

And every week we choose an interesting topic to talk about. And the topic for this week is a very topical one if you’ve got little babies, and that is the topic of crying and colic. And I have asked Tove, who is our regular host to come alongside me so that she can actually quiz me and pick my brain in terms of what it is, why do babies get it, and what can we do about it.

So that’s the journey we’re going on today. And Tove, thank you so much for joining us as host today. Thanks for having me Meg, I love being here.

And just to kick off today’s episode, it’s brought to you by Babocush, a lifesaver for parents struggling with babies suffering from colic and reflux. The Babocush cushion offers a comforting embrace for your little one, providing relief from gas, colic and reflux discomfort. So on that note Meg, let’s dive straight into it.

Can you explain what is colic? Because I know, I remember when my little one was crying and screaming and everyone’s like, some people are like colic’s a bit of a myth. They’re just crying and screaming. You know, what is colic and how does one distinguish between a baby cry and a colic? Yeah, absolutely.

Colic was kind of this word that hung over my head when my firstborn was born. Like, is he going to have colic? You know, I had this thing in my head. It’s also known as purple crying because babies cry until they’re purple.

And it really is like a hectic cry and it’s for a longer period of time. So normal infant crying is generally less than three hours in a day. So, which in and of itself is still a long time.

When you are faced with a little one who’s crying a lot, it can feel like a huge amount. But most babies don’t cry more than three hours and, you know, and it kind of, most days they don’t cry that much. So, you know, normal infant, early infant crying is really not that severe.

Where it kicks into colic and, you know, this term was kind of almost defined and coined by Vessels and he talked about the Vessels rule of threes. So the Vessels rule of three is that little ones cry for more than three hours of a day, for more than three days of a week, for more than three weeks of a stretch. And actually it’s usually under three months of age.

So that’s the Vessels rule of threes. And that’s kind of become what we define colic as. So when a little one has that much crying, they are then said to have colic.

The problem with colic is that it’s actually a bit of a misnomer, you know, because it actually means abdominal discomfort. I mean, if you are a horsey person or if you’ve ever ridden, and if you go and Google colic, in fact, you will come up with a million things about horses colic. And horses colic is actually a very serious condition.

In fact, horses die of colic. And it has to do with an abdominal disorder. I think it might be the twisting of their gut.

So I actually don’t know what it is, but it is really to do with their guts. And so colic traditionally was always associated with the tummy. And so this Vessels rule of three has then become associated with, you know, what’s going on inside of the gut.

So what we think of as colic very often traditionally is an enormous amount of crying that’s related to something that’s going on in the tummy. And what are the, I mean, for me, it’s kind of like the teething thing, right? You go through a stage where your baby is just like, every time they’re uncomfortable when they’re a toddler, you’re like, there must be a tooth coming. And it’s the same thing when you’ve got like a newborn, right? Every time they’re crying, you’re like, they must have colic.

So is there like something that is very, you know, you’ve got your three rules, is there like, do they go blue around the mouth? Is there something else that we can like pinpoint and be like, this is definitely colic. Is it that they cramp or like clinch in or does their body do something? Yeah. So that usually do.

And that’s actually why people think it’s got to do with the tummy because they usually pull their legs up. They’re crunching towards their tummy. It really looks like something’s going on in their tummy.

They generally are grimacing and grunting and then screaming. And they often will, the scream will then kind of move towards being a purple cry, which is this like extreme crying. And the other thing about it is that it’s very, very often, it’s quite unsuitable.

So as a mum or dad, you kind of paste the floor and it’s almost like the more that you do, the worse that it gets. And that’s why it kind of ends up lasting for a long time. And the other thing that’s quite hallmark about it, and it’s not completely universal, but it is quite hallmark, is that it often is in the late part of the afternoon, early evening.

And that’s why we often refer to that time of day as horror hour, because they cry often between five and seven in the evening. And does that tell us that it’s actually less to do with the stomach and more to do with something else? Yeah. So that was what was interesting.

When I embarked on my journey and I’m an occupational therapist, my focus was always on the sensory systems, it still is. And so I would look at colic and I used to treat these colicky babies and very often they had gone on to have other things as well. Now that is not always, and that’s a very important thing for us to say right now, is that colic does not indicate a long term disorder in most babies.

So I would say the numbers are around about 20% of babies will have these extended periods of crying. So that means that 80% won’t. So 80% of babies will have normal levels of crying, which is maybe an hour or two a day.

It’s not a ridiculous amount, but then you get this 20% who cry kind of three hours of a day. And within that number of 20%, a tiny percentage, and I’m talking like only like 5% of the 20%, very, very few babies end up where it doesn’t resolve at three months. And that’s also an important thing to mention is that classic colic happens on what we call a colic curve, which is that for the first two weeks of a baby’s life, they’re typically very calm.

And this is for almost all babies. And from two weeks to 12 weeks is the patch where you would get maybe more colicky crying or a higher incidence of crying daily. It usually peaks at about six weeks and starts to diminish from six weeks down, kind of going all the way down to 12 weeks and then disappears.

So that’s your normal colic curve. Three hours in the evening, starts at two weeks, finishes at 12 weeks. And for those babies, it’s 20% of all babies.

Now, within that percentage where they don’t stick to that curve, or it doesn’t dissipate at 12 weeks, it’s a very, very small percentage of babies. So a very tiny percentage of babies start crying from the day they’re born. So they don’t give you the two-week honeymoon patch.

It doesn’t peak at six weeks, and it doesn’t disappear at three months. And so, you know, and I think, I mean, Terve, we’ve had you on many times before, and mums probably know that you have got a special needs eldest daughter, and her colic was on the extreme end. And she was part of that kind of very small percentage of babies that didn’t actually just have colic, they had something else, which we’ll talk about as well.

So what are the misconceptions about colic? Because I know there’s a lot of, again, it’s kind of like the teething thing, right? There’s all these myths, like does colic really exist? Is it really a thing? And how do we separate kind of fact from fiction as parents, when you’ve got Dr. Google and, you know, a host of wonderful information out there that’s not always the most valuable? Well, if you’re a mum with a baby with colic, you’re going to say straight off the bat colic exists. So we can’t say that this doesn’t exist. Of course, it does exist, because by nature, the fact that up to 20% of babies cry more than three hours of a day, then yes, it definitely exists.

It’s a good chunk of babies that will be really fussy. So, A, it exists. The misnomer or myth part of it relates back to what I was talking about earlier, which is the whole tummy issue.

Like, is this actually a tummy issue? Is this actually, and you know, I think what often happens is that babies start to cry and immediately it is they’re allergic to something. They might even be allergic, people say they might even be allergic to breast milk or because that’s the only thing they’re being fed or, yeah. So people go down this it’s an allergy thing.

Then they go, if that’s disproven or not thought about, then they think, okay, well, it’s an intolerance thing. So mum’s drinking milk in her tea and therefore there’s an intolerance to dairy and that’s why it’s coming through. You know, so there’s a lot that happens around this gut and it is accompanied very often by very frothy poos.

And so, you know, there’s this kind of crying’s going on, baby’s pulling their legs up, poos are frothy, therefore, you know, it definitely is something that’s abdominal. The piece that doesn’t fully fit that picture is the fact that it happens between five and eight in the evening, which is exactly what you alluded to just now. Like if it was tummy related and you’re feeding kind of eight times in a day, then it should happen at eight o’clock in the morning as likely as it happens at eight o’clock in the evening.

And the reality is that it doesn’t. Majority of colic happens in the late afternoon. And I’ve worked quite extensively with the Fussy Baby Network, which is part of the Erickson Institute in Chicago and actually went over and did a talk for them probably about 10 years ago.

And it was all around colic and crying and fussiness. And when you look at the number of people that reach out to the Fussy Baby Network in America and the times of day that they do it, it follows exactly the colic curve. First of all, very few contacts before two weeks, majority of contacts at around six to seven weeks, disappears by 12 weeks and between five and eight in the evening.

So if it is that it’s between five and eight in the evening, then how does that fit with this picture of it being an abdominal issue? Because that should happen at any time of day. Now, that’s where we start to piece together a little bit of a clue about what actually causes colic. Now, we all have got sensory thresholds and I have often spoken about sensory thresholds.

It’s basically the threshold with which we start to respond to sensory information in the world. So if I have a low threshold, I can very quickly respond to sensory information in the world. If I’ve got a higher threshold, I don’t respond as much.

Now, that sensory threshold for all of us, for absolutely all of us, becomes a whole lot more sensitive in the late part of the afternoon. We over-respond to sounds, sights, smells, touch in the late afternoon. That’s because our sensory threshold is dipped.

And that is for all of us. Like if you think about if anybody’s been on a commuter, like either in a taxi in South Africa or on a train in London, the morning commute is a lot easier than the afternoon commute. The afternoon commute, you’re at the end of your tether, you can’t really cope with it.

It’s not, you know, sensory overload. Same as dealing with a two-year-old. The way you deal with your two-year-old at eight o’clock in the morning versus five o’clock in the evening when you’ve reached the end of your threshold is very different.

And it’s just the same for babies. Those bubbles and abdominal discomforts that are evident at eight o’clock in the morning are identical at eight o’clock in the evening. The difference is that the baby’s threshold for dealing with that is a whole lot lower.

So that bubble that they could ignore at eight o’clock in the morning, they can’t ignore at five in the afternoon. They start to respond, they’ve become more fussy. The interventions we gave them at eight o’clock in the morning, which is a swaddle, a change, a bath, a change of nappy, a feed, whatever it is, a walk outside, talking to, a lie under the mobile, all of that which was fine in the morning, suddenly becomes something that can overstimulate them very easily in the evening.

And often what happens in the evening, we are doing things with our babies that is overstimulating. We’re bathing them, we’re massaging them. Dad or mom is coming home from work and the other parent is handing the baby over.

So there’s a change of person. So there’s a lot that happens in the evening on the basis of a very low threshold. And that’s why we see colic in the evenings.

So that scenario, which is very logical. And as you hear me discuss it, you can nod and you can go, yeah, yeah, that makes sense. But that scenario gives us the clues to the fact that colic is not actually an abdominal issue or a digestive issue.

It’s more of a neurological issue. And I think that’s where the main misnomer sits or the main myth sits is that it’s not necessarily an abdominal and digestive issue. It’s actually neurological.

And a neurological issue by nature, the fact that it is to do with the brain and to do with the development, babies can outgrow it. And that’s why we see babies come to 12 weeks where they’re starting to become calmer. They’re starting to deal with more sensory stimulation and they actually outgrow colic.

That’s so interesting. So it’s just the advice to parents is just hang in there past those 12 weeks. Yeah.

It’s not exactly the most helpful piece of advice because hang in there when you’re like at the rock face at six weeks old doesn’t really feel like the next six weeks feels like forever. But the reality is that it is actually self-limiting and that’s the word we use. It disappears on its own.

And are there any known triggers for colic that parents should be aware of? Is there anything that we do that exacerbates it then? I mean, you’ve spoken about the sensory systems and you’ve spoken about that kind of overload in the evenings. Is there anything we can do to reduce that? Or is it just that that’s like a whole day’s worth of stuff that’s just compounding at the end of the evening and it doesn’t matter what you do, it’s happening and just like ride it out? No, there are definitely things you can do. And actually, I think this would be a very useful toolkit for a mom who is dealing with colic at the moment.

These are the little tips that you should look at. Number one, there are digestive things that can make more bubbles in the tummy or more irritability. And that will then obviously on the basis of a low threshold actually make for a more colicky baby.

So there are some things that you can do that do affect digestion. One of those things is that, and I do recommend this to moms, is to just cut out dairy for a little bit of time. If you’ve got a very colicky baby, cut out dairy and particularly if you’re breastfeeding, because it actually weirdly can make a difference.

It’s not necessarily that they are lactose intolerant, and we’ll talk about that just now, or that they’re dairy intolerant. It just seems to make a little bit of a difference. Second thing is, is that all babies’ digestive systems are born with X amount of lactase.

And actually it’s quite interesting. I’ve been doing some deep dives into the gut microbiome lately, and actually our baby’s gut microbiome is not a very lively place. It’s not a very diverse place early on, and it takes time for baby’s gut microbiome to be colonized by all the wonderful microbiota that can actually break down our food and kind of work in our favor.

And part of that is that the enzyme for breaking down lactose, which is called lactase, is also not there in the same type of proportion that would be needed to break down the lactose in milk. And so we see very early on in infancy that there’s this gut that isn’t absolutely perfect for digesting the quantities of milk and dealing with the milk that we give to babies, because babies are on a milk-only diet. Now, of course, their gut will mature.

There’s nothing we can do. We’re not going to change them off milk. Their gut will mature.

The more we feed them, the more breast milk we give them in particular, the more it feeds that gut microbiome. And so again, it’s a self-fulfilling thing that eventually our guts will mature. However, one of the things that we do know that seems to cause a little bit more irritability is overfeeding of babies and really loading them with very high levels of particularly full milk, which is very sugary and sweetened and watery.

It doesn’t have all the fats in it. And so one of the other things that I say to moms, aside from limiting maybe dairy in your diet, is to make sure that you’re not overfeeding your baby. Now, this isn’t a situation where a baby is gaining weight not just well, but maybe too well.

They’re kind of on the chunky side. You demand feeding, you’re breastfeeding kind of every hour or two. It feels like you’re on a never-ending feeding journey.

And the more you feed, the more irritable they get. So the more you feed them because they might be hungry and you’re kind of in this cycle. And we definitely see that the cycle of feed, cry, feed, cry, feed, cry, actually can seem to exacerbate things.

So if your baby is gaining weight nicely and your milk supply is well-established, you can actually start to space your feeds a little bit. And that spacing of feeds, of breast feeds and even bottle feeds, seems to also prevent the niggles that go alongside colic. So that’s the second thing you can do, is you can just make sure that you’re not overfeeding your baby.

So those are kind of two of the more practical things. The next thing that absolutely makes a difference is now swinging back around to the sensory, is making sure that your baby doesn’t become too overloaded and have too low a threshold in the later afternoon. And the way that you will do that is by making sure that your baby has regular sleeps during the day.

Because when we are overtired, our threshold drops. And when our threshold drops, we’re more likely to be triggered and therefore more likely to cry and then enter into this whole cycle. So babies who have very good day sleep routines tend to do better and tend to not cry as much.

And that’s one of the things that I think is a massive advantage with the ParentSense app, because we’ve got this responsive routine built into the app, whereby as we log that we fed our baby or that our baby has finished to sleep, our responsive routine updates and it says, okay, that’s great. So your next feed will be due now and your next sleep will be due then. And that helps you to give a very regular kind of spacing to the day in terms of both feeds and sleep.

So getting your baby into a rhythm actually can be quite helpful when it comes to colic as well. And then the last thing that I want to mention is just less is more for babies, that sometimes we are just overstimulating them and there’s just too much going on. And that particularly goes for first-time moms where we are obsessed with milestones and we want to stimulate as much as possible and we put them under mobiles all the time.

And all of that stimulation actually can overstimulate little ones and lead to more colic and crying. And since the fourth trimester is all about kind of transitioning from the womb to the world, how can parents kind of create a calmer environment to ease that transition and hopefully reduce those colic symptoms? I mean, you’ve spoken about the overeating, are there things we can do visually or is there anything else we can do to support that? This episode is brought to us by ParentSense, the all-in-one baby and parenting app that help you make the most of your baby’s first year. Don’t you wish someone would just tell you everything you need to know about caring for your baby? When to feed them, how to wean them, and why they won’t sleep? ParentSense app is like having a baby expert on your phone guiding you to parent with confidence.

Get a flexible routine, daily tips, and advice personalized for you and your little one. Download ParentSense app now from your app store and take the guesswork out of parenting. You know, is there anything else we can do to support that? Yeah, so you know, I always, I had a talk that I used to do at antenatal classes all the time which was called From Womb to World, it was a womb to world talk.

And you know, for me, the womb environment is just the most perfect environment for the development of the human brain and for the neurological system. We know that actually for the whole of the fetus and the whole of the baby. But for the neurological system, it’s just this incredible environment.

And if we want to know what an amazing sensory environment looks like after birth, we should just go back to the world of the womb. And so let’s think about the world of the womb. So it is quiet, sounds unmuted, but it’s also noisy in that it’s got a consistent background white noise.

So that gives us our first clue. On an auditory level, the sensory environment should be not too loud and noisy and kind of lots of changing jarring sounds, but should be a whole lot more soothing sounds. So like white noise, lullabies, low tones, low vibrations.

That’s the type of thing that will help little ones and to prevent colic and to create a womb world in their new world. So that’s the first thing is sounds. Second thing is that visually the womb world is very muted.

There’s not a lot of light, not a lot of contrasting visual information. So this whole thing of kind of putting a bright, like a red, white and black mobile over the baby’s cot so that they can, you know, so that they will, you know, hone their visual skills actually overstimulates them. So I’ve always said that your baby’s nursery should be a very soothing space.

And in the book, Baby Sense, we go through what it should look like, you know, it’s muted colors, not very contrasting. It’s maybe cream walls. Don’t go for all those funky fabrics, just go for something that’s very soothing, you know, really make for a very calm space, block out lining on the curtains or blinds so that, you know, you can have dark sleep times.

Those are the type of things that reenact that womb world. So that’s sort of sense of sound, sense of sight. And then of course the sense of smells.

So not having overwhelming lavender smells in the room because you think that’s going to help them to sleep well. Just having really soothing smells, you know, not overpowering smells. Don’t use detergents that have smells in them.

Watch the smells in the fabric softener. You know, it’s all of those things. Don’t wear perfume around your baby if they’re colicky because that’ll also trigger them.

So, you know, I think the principle here is try and go back to have a look at the womb world and then say, right, if that’s what it’s like in the womb world, then that’s what our real world can also be like. And Meg, are there like three top tips or techniques for colicky babies to provide some kind of relief? Because as you said, like if you’re in it, you’re in it. So what can we do? So we can do all of that to kind of mitigate it and bring it down, but inevitably it’s probably still going to happen.

What are the three things that we can do to try and help relieve baby and also just relieve mum and dad? Yeah, so the first thing is, you know, I mean, I think the first thing before we even get onto the three sensory aspects of things that we can do is you need to learn your baby’s signals because your baby will give you signals as to when they’re going to get overstimulated and start to fuss and cry. They might do gaze aversion, just looking away from you, just losing attention, starting to grimace, starting to rub their eyes, rub their ears, starting to have their hands move away from midline into kind of startle reflexes, extending their legs very straight and their arms very straight with fingers splayed out. Those are all signs that the baby is stressed and is needing a little bit of containment.

So that’s your first thing. Hiccups, absolutely. Hiccups is definitely one, overstimulation with hiccups.

So when your baby goes blue around the mouth, starts to hiccup, those are all signs that your baby is like a little bit stressed, trying to contain themselves and they’re going to start to cry. So definitely watching for signals. And in baby sense, we go through that very clearly, like these are the signals that your baby’s getting overstimulated.

So that I would say is the first technique ahead of the crying, actually starting us to be able to watch those signals. But now let’s say your baby has started to cry. And so you’ve done all those things.

You’ve less is more. You’ve done watching the awake times. You’ve spaced the feeds.

You’ve done watching the signals. Those are all the foundations. But now your baby starts to cry and fuss.

What can you do? So a couple of things. The first thing that is, is the touch is very, very powerful and it needs to be still touch and deep touch. So not fussing with your baby.

And so that means not picking them up, juggling them, moving them around, giving them a massage, passing them to another person. Because every time you do something like that, you’re just loading the sensory system further. Deep touch, still touch and holding them in a carrier is a wonderful way to soothe your baby.

So I always love putting them in a sling or snuggle root carrier or just laying them down on a mattress with your hand on them is actually very soothing rather than fussing with them. So that’s the first principle is use touch, but it needs to be still and deep touch. The second thing is that movement is super powerful.

And this goes back to the world of the womb, that movement, which goes in through our vestibular system, soothes babies. And as it soothes them, they settle. So that’s why babies want to be carried and want to be held.

And they also like to be slightly upright. So movement is really fabulous. And also when you’re moving with your baby, when you’re holding your baby, you’re often holding their tummy against your chest, which means they’re getting some deep pressure on their tummy as well.

And so that deep pressure on their tummy, still touch, holding is very, very powerful if you are in that moment. And I can remember with my third baby, she had her colic time at about one o’clock in the morning. It was unusual.

And the best thing I could do was just pop her in a carrier and just walk the passage. And I used to do that kind of at one o’clock in the morning. So it’s still touch and movement.

And then the last one is that kind of shushing vibration and sounds that come from within our chest. So it can be humming like, or like those sort of sounds. And even having just white noise playing in the room can be very powerful.

And that goes back to, again, the womb world where there was this regular sound, the low sounds, the low frequency, the soft sounds in the background and the white noise. So you can see that when I talk about the still deep touch, the movement and the sounds, I’m kind of really bringing back the womb world and reenacting that for little ones. And that’s really the best way to suit them.

And in terms of, I mean, I think in a world where this is baby number one, all of those things are somewhat achievable. When you’ve got like a toddler running around or someone running around, if you had to choose one of the things to do, you can’t like, you’re not going to have, you can, I mean, you can have the noise, but you’re going to have a toddler. Cause you know, that time of the day, you’re generally feeding one of your other kids, right? It’s quite a busy time of the day when you get home.

Is there one that kind of, of those three techniques that kind of trumps all of them, would it be the movement, put baby in a sling while you’re doing dinner and while you’re doing other things? Because that closeness kind of is the, maybe the number one tip or? So what I would do with a toddler, look, I mean, a toddler in an environment is very frenetic and I think trying to take down, you know, trying to follow the rule of less is more is important. So things like, you know, don’t have your toddler playing with a noisy tingy toy in the background because those tingy toys, I know it’s something you and I have battled with in your scenario because you had a prim baby that came home to that environment. And that’s what I’m thinking.

Like, we get to work really hard on these kinds of strategies because of the age of the other two kids. Absolutely. So I think as much as possible, you want to try and get your older toddlers or your older siblings to not have tingy toys and noisiness.

Try and do things with them that involve not being too noisy, like going for a walk in the pram so that they’re looking at the environment or reading a story quietly to them. Those sort of things would be what you would do with the older child. And in any situation, whatever you’re doing with them, whether you’re going for a walk or you’re reading them a story, with your newborn, you’re putting them in a sling and they’re against your body.

So that for me would be the number one thing is that get them into your arms, get them against you and try and see whether or not you can work with them to soothe them like that while the older toddler then can be pushed around the block or whatever it is in their pram. So yeah, it’s hard. I mean, I don’t take this away from mums.

I’ve had three children, so I know. It’s very hard to try and maintain calmness around a newborn, which is what they need when you’ve got these noisy toddlers. But I think that that movement piece or that sling piece or having that movement being kind of on you, being quite essential, is something mums can manage with their other children, which I think is a nice strategy for parents that have more than one child.

Absolutely. Look, and I think the hard part, and this is where the Babacrush who’ve sponsored this episode comes in, is that sometimes you just need to have babies out of your arms because, you know, yes, having them against you is amazing, but there also come times when you actually need to just have hands free for five minutes because you need to be able to, you know, toilet the older one or whatever it is.

And I think that’s where the Babacrush comes in. So on that note, this week’s episode is brought to you by Babacrush, the newborn comfort cushion inspired by Kerry Nevin’s quest to soothe her baby’s silent reflux and colic. Babacrush is more than a cushion.

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Discover the peace Babacrush brings to you and your baby because sometimes you just need a little help. So moving on Meg, at what point should parents be concerned that their baby’s colic is a sign of something more serious? So, I mean, I would love to know the difference between this because this was definitely a journey we struggled with with Grey, was that constantly being told it’s colic or it’s typical, or you’re a first time mom, just relax, it’s gonna go away. And it just went on and on and on and on, you know, distinguishing between colic and a bigger medical problem.

Yeah, so look, I think first of all, very straight off the bat, if your baby’s crying a lot in the early days, there are two things you need to do. One is to check whether or not they are healthy, which means check that the stamp of the umbilical cord is not red and inflamed, make sure they don’t have a fever and make sure they’re not listless because any of those things are medical emergencies in little babies and need to be seen to. That is not colic, that is a medical emergency.

So, baby with a fever, baby who’s listless and not feeding, baby who is, you know, who’s crying incessantly and has got some redness on them anyway, you know, so that’s health, you have to clear that up. But again, very small percentage of babies. Second thing you absolutely have to clear up with very little babies is their weight gain because it could be that your milk hasn’t come in adequately and babies, you know, as soon as your milk has come in should be gaining weight every week.

They don’t have to be gaining massive amounts of weight, but they have to gain weight. If a baby has a flat week or has not regained their birth weight in a short period of time, then that is something that needs to be checked out. So, that’s why regular weigh-ins are important.

You know, mums have weigh-ins in the first month of their baby’s life a lot. And it’s simply to see that, to see that they’re gaining weight. So, a baby who is feeding a lot and not gaining weight would be the second thing that I would be, right, this is not colic, this is something that you need to go and get checked out.

So, those are your two main things. They’re physiological, one’s a medical emergency, the other one is get your feeding sorted out. And both of those things can rule out the crying.

Then there are other medical issues. And this more pertains to the baby who has an atypical crying curve. So, an atypical crying curve is a baby who starts crying on day one, like crying from in the hospital, never has a two-week honeymoon period.

And where the crying doesn’t dissipate at 12 weeks or 13 weeks. If your baby cried incessantly from birth and by 12 weeks they’re not settling, then there are a whole lot of warning bells. And the reason for that is that the normal crying curve, which is what a lot of babies, maybe one in five, one in six babies will be experiencing does follow this very typical curve.

Two weeks of honeymoon, peaks at six weeks, gone by 12, 13 weeks. And when that doesn’t happen, there are warning bells. Now, what are those warning bells? In the context of a baby who didn’t make a lot of eye contact and didn’t smile at six weeks and is still crying at 14 weeks, I would want an occupational therapist who’s specialized in sensory integration or a neurodevelopmental kind of physician to actually just have a look at them, developmental pediatrician.

And the reason is that that can indicate something like an autistic spectrum or social emotional disorder. We call it IRD, infant regulatory disorders. So the infant regulatory system is a system that allows babies to be calm in the context of stimulation and socialization.

And when that doesn’t happen and they have an IRD, an infant regulatory disorder, it can indicate that there’s gonna be a march towards some sort of social emotional difficulty, which is of course, we know what happened with Gray. And Meg, just staying on this, what is the PREMI timeline with things like this? Does that, because PREMI, you work on an adjusted age and it’s so complicated. Do you then take the adjusted age for the curve? Like how does that work? Because technically, if your baby’s PREMI, then they should still be in the womb.

And so, if I look at Nova’s journey, you’re in the hospital. And as much as you try and keep that space peaceful, there’s machines beeping and there’s people coming in and out and there’s lights on and off and it’s a very overstimulating environment. Yeah, so there’s two aspects to this.

The one is the period in which they are actually still PREMS. In other words, before their due date. And that period needs to be considered to be a complete womb time.

And that means that everything in the environment must cater towards sensory development. And that optimally happens through what the womb world would look like. So it needs to be quiet, it needs to be dark, there needs to be good positioning.

And this is what we call sensory developmental care. And this episode is not sufficient to go through that. And we will definitely do another episode on that, but we have done episodes on PREM babies, which moms should go and listen to.

So that’s the first thing is you want to make sure your sensory developmental care is really good so that they’re not going to have long-term sensory sensitivity. In terms of the normal color curve, as with most things with PREM babies, it’ll follow their adjusted age. So in other words, the age at which your baby would have been or the date at which your baby would have been two weeks old had they been born a term, that’s usually when the crying will kick in.

So we’ll often see with PREM babies, like if they’re born kind of eight weeks early, you’ll often see that for the first 10 weeks of their life, which will be partly in hospital and partly at home, they’re relatively calm. And then suddenly they become super fussy because they’re following the normal crying curve, that their brain is waking up, they’re starting to become overstimulated. And then by 12 weeks adjusted age, so not chronological age, everything should dissipate.

So you know what I said earlier about if your baby’s colic is still going on after 12 weeks, you know, maybe there’s a warning bell for PREM babies that would be adjusted age. So in other words, when they would have been 12 weeks had they been born on their due date. So I think we’ve spoken a lot about kind of strategies and tips and what we can do.

Is there any kind of tricks of the trade or essentials for parents to take home in terms of kind of managing their own mental health? I know with Gray’s colic, or ended up not being colic in its own journey, my mental health took a massive, massive decline. Is there any advice you have for parents on coping with the kind of stress, the incessant crying, the emotional toll that this takes on parents? Yeah, look, I mean, there’s nothing more difficult than dealing with a crying baby on your own hours and hours on end. It just, it’s depleting, utterly depleting.

And by the way, you sleep deprived. So now like you have got no resilience anyway. The problem is that that raises the risk of something called shaken baby syndrome.

And interestingly, shaken baby syndrome, which is where a mom does a tiny little shake of the baby. It’s a tiny little shake to stop them from crying. And it often is successful, babies stop crying.

But what it does is it jolts the brain inside of the cranium and it causes tiny little bleeds on the brain and can cause brain damage. So it’s a very, very precarious and dangerous thing to happen to babies. And we see that the shaken baby syndrome curve follows the colic curve by one week entirely.

I mean, it’s quite fascinating when you look at the research. So in other words, if crying peaks at six weeks, shaken baby syndrome peaks at seven weeks. So it’s very interesting and it is associated with that.

And it’s because parents are depleted at the end of their tether. So a couple of tips. First of all, if you are having a moment where you are thinking like, I could just get rid of this baby, I could just shake this baby, I could just post them out the window.

My mom always tells a story about how she just, I was crying incessantly and she just looked out of the window and saw a soft bed of a vegetation and thought if I just drop her out the window, she’ll land on the vegetation and she’ll be fine and I’ll stop hearing the crying. And so I think if you are having those thoughts, the first thing to do is to get yourself some space from your baby. And I think we all are totally panicked by leaving babies on their own, but actually there are times when babies are safer on their own than they are in arms.

And that would be a situation. If your baby is crying incessantly, you feel like you might be hurting, going to hurt them, actually placing them back in their cot, walking out the room, closing the door and taking a deep breath, that’s okay. I think it’s important that moms understand that while we don’t wanna be leaving babies to cry on their own a lot, if you’re feeling desperate, walking out of the room is an absolutely fine strategy and not to feel guilty about it.

Just take space away from your baby if you need to. The second thing is that you need time away from your baby. And this often is not necessarily something that you can get, especially if you are the primary caregiver, dad’s at work all day, but there needs to be some time in your day and in your week where you know you’ve got some respite.

And that might be calling in a neighbor, it might be calling in your husband to take over for that period of time. It might be having a mom-in-law who pops in on a Saturday morning so you can sleep in, whatever it is. Little bit of time for yourself is very important.

And in that time goes the self-care, going for a walk, having a massage, going to a gym class, going and having a cup of coffee with a friend. Those things are very, very important. And then I think, kind of to finish off that, kind of about the self-awareness and self-care is that when things are really dark and you cannot see the light for tomorrow, you need to question whether or not you’ve got some postnatal depression.

And there’s definitely a link between this feeling of high levels of anxiety and depression that go with PND or perinatal distress and a crying baby. So, I think giving yourself time, space, and actually recognizing when you’re not coping is very, very important. All right, Meg.

Well, thank you so much. I think there’s been some incredible tips and advice and insight for parents, especially those first time on the journey and are deep in the colic space. We all feel you.

It can feel like a very dark place. It’s so hard. Yeah, it is definitely a hard place.

But I think what is really nice to know is that you do come out the other side. You’ve just got to kind of hang in there for the 12 weeks. 12 weeks can feel like two years sometimes.

It can, but the moments do pass. And I think the important messages are that it is not a reflection on you as a parent. And I think often you can feel like that, that, you know, I must be a bad parent and that’s why I’m not getting that.

I’m failing. Why is everyone else kicking? Exactly. Mine’s not and they are.

Exactly. So, I think the first thing is that it has a lot more to do with your baby than it does actually has to do with you. Second thing is there’s some very quick tips that we’ve mentioned today that can actually really prevent colic.

You know, watching the awake times, understanding the signals and the womb world. Those things are quick tips. And then if you’re in the moment, you know, again, going back to your sensory, holding your baby, containing them and yeah, and knowing that it will end.

It does end. Well, thanks so much, Meg. Thanks for having me and thanks for another awesome episode.

And everyone, don’t forget to like us, subscribe, follow the page and we look forward to seeing you again next week. Thank you, Taveh. As we wrap up today’s episode, if you’re a parent on the lookout for tranquillity in your home and the sweet sound of a content baby, then a Babocush might be just what you need.

Dive into the world of calm for both you and your little one by visiting their website at www.Babocush.co.za. Remember, Babocush stands by their promise of happy baby, happy you. Explore how Babocush can transform your parenting journey. Thanks to everyone who joined us.

We will see you the same time next week. Until then, download ParentSense app and take the guesswork out of parenting.