Danica had her two month check-up yesterday; she is blessedly healthy and well. My wife asked the Doctor about Dani’s routine crying spell at 7pm every evening. It has been like clockwork for the past month or so. We call it her Witching Hour. Some nights there’s just mild fussiness and she is easily soothed to sleep by swaddling and rocking. Other times she gets herself so worked up that only a stint in the bouncy chair on top of the dryer seems to calm her. (Tonight is one of the bad nights – I am writing this post on top of the washing machine because I am afraid to remove the sleeping baby from her second round on the dryer.)
I was surprised and disappointed to hear the Doctor dismissively reply, “that’s colic” and move on. I know from my training in the Infant-Parent Mental Health Fellowship that Dani’s behavior is very much not colic. Dani’s daily tears are part of a normal developmental phase first identified by Dr. T Berry Brazelton. Most infants between 0-3 months old have fussy periods in the evening, usually between 6-8pm. Crying time – both overall and during the evening hours – peaks at 6-8 weeks-old and diminishes markedly by 12 weeks (Barnard p84).
Babies who cry for more than 3 hours per day for more than 3 days a week are considered to be excessive criers. Approximately 20% of infants in Western cultures are in this category. Colic defers from both normal and excessive crying by the following features: babies are inconsolable, the crying begins and ends without warning, it is a screaming, high pitched cry that sounds like a pain cry, and it is accompanied by clenched fists, flexed legs, grimacing or a distended abdomen (Gilkerson p196).
The folk wisdom passed down among parents and providers is that the Witching Hour, whether colic or not, is caused by digestive issues. Many providers still suggest that breastfeeding moms remove “gassy” foods from their diet as the first form of treatment. However, the prevailing theory among developmental psychologists and pediatricians alike, is that both colic and normal developmental crying are a form of psychological discharge, not related to digestive problems at all, and not caused by pain. The immature neurological system of the young infant is overwhelmed by the routine sights, sounds and other sensory input of the day. It is too much for them to integrate, as they are still used to the darkness, steady rhythms and containment of the womb. So they cry to release the excess energy, effectively hitting the reset button so they can sleep well and start again tomorrow. Dr. Harvey Karp, author of The Happiest Baby on the Block says, “How could it be pain if so many colicky babies calm down while hearing a vacuum cleaner or going on a drive?” (Springen p3).
The “psychological discharge” explanation makes intellectual sense to me; it jives with everything I have been learning about neurological development. Yet the mother in me still believes that Dani’s crying spells are related to stomach pain. She tenses her legs and needs to be held in positions that put pressure on her tummy. She responds well to bicycling her legs and rubbing her belly clockwise – traditional mommy remedies for poor infant digestion. In fact, Dani’s belly troubles seem to extend beyond the evening fuss into and through the night. She frequently squirms and grunts in her sleep, sometimes for long periods, then toots loudly before settling down again.
Something clicked for me the other day during a conversation with a friend and fellow mother: the line between psychological discharge and stomach pain is fuzzy to say the least. After all, the gut contains more neurons than any other part of the body besides the brain. Chronic stress leads to inflammation of the gut, and there is scientific consensus that stress and anxiety are direct causes of both stomach pain and more severe digestive illnesses. Children are the most likely to somaticize psychological distress as a tummy ache. Why not infants too? Couldn’t Dani’s need for psychological discharge manifest as stomach pain as well as tears?
Though I am embarrassed to admit it, my daughter’s tummy troubles actually mirror my own. I too frequently experience gas that begins in the evening and lasts through the night, accompanied by belching and heartburn. This has been going on since the month I started trying to get pregnant, two and a half years ago. I have tried to blame it on prenatal vitamins, since they were the major addition to my diet at that time, and the only thing I have ingested on a daily basis since then. I switched to easily digestible liquid prenatals during pregnancy, with no change. And a few weeks ago I finally stopped taking them all together – no effect. I have also tried eliminating all the other classic trouble foods: dairy – which I love so much I actually consider it a form of self soothing; broccoli, kale and other brassica vegetables; garlic and onion; beans; and I have not had a piece of chocolate since Dani was 8 days old. Nothing has made any difference for me or for her. Multiple practitioners have assumed our issues were food related and recommended I keep a daily food diary. But the reality is, it does not matter what I eat. We experience the same symptoms nearly every day, regardless.
Finally, I am having to face the facts: my stomach troubles have little to no relation to diet and have everything to do with stress. Stress is the other common denominator consistent in my life since I started trying to conceive. My 18-month journey towards pregnancy was the most stressful thing I have ever experienced. Micro-managing my diet, exercise and relaxation routine in an attempt to be as healthy as possible, as though that would help me to conceive more easily, which it did not. Navigating the unfamiliar world of western medical tests and interventions, including hormonal medication. Monitoring every sign of my cycle to pinpoint ovulation, then having to juggle the often conflicting schedules of myself, my wife, our donor and our practitioner to align us all at the exact right moment for conception to occur. Dealing with the impact of this adventure on my relationship and the subsequent impact of relationship stress on my reproductive health. And most challenging of all, dealing with the monthly roller coaster of hope and disappointment, and the sadness and self doubt that accompanied each failed attempt. Not to mention the well-meant advice of practitioners and friends alike to “stop stressing because it is preventing you from getting pregnant” as if I could simply flip a switch and turn off all of the above.
I knew I was stressed when I was trying to conceive. But I failed to see that it continued in pregnancy. Because I absolutely adored being pregnant – experiencing the changes in my body and psyche while I nurtured the growing, sacred, secret connection with this beautiful new being whom only I knew. I neglected to acknowledge the fact that pregnancy is inherently taxing on the mother’s body, while the intense transition to motherhood is psychologically taxing as well. Not to mention the stress of juggling full time work and navigating relationship changes with my wife and extended family.
My postpartum experience has been similar. I love everything about mothering my dear, precious child. In my conscious mind I have been fully embracing my new role, sacrifices and all, and feeling as though I am managing even the biggest challenges with openness and grace (well, except the relational challenges with my wife, but that is best saved for another post). But I have been ignoring the inherently stressful impact of intense hormone changes and chronic sleep deprivation on the body, and the stress that adapting to motherhood places on the psyche.
I was not able to fully integrate my conception journey before moving on to the next major change. And I have approached all three of these life phases with the same driven determination that has always defined me – giving 150% to my efforts to be the “perfect” parent since before she was even conceived. Currently, I love giving my all to Dani. There is nothing I want more than to be fully present with my 2-month old, witnessing every moment of her rapidly changing days, offering all my energy to the development of our exquisite relationship. But I have paid the price for that total dedication, turning my back on all the self-care activities that previously eased my inherently anxious personality.
And thus came the revelation that drove me to tears. For it is not only food molecules that pass from me to my daughter in my breast milk. My stress hormones pass on to her as well. Dani’s digestive symptoms are remarkably similar to my own. Perhaps their source is the same too. What if it is not only her own stress that Dani is discharging every evening with an accompanying belly ache, but mine as well? What if the very efforts I have made to be all I can be for my precious babe are actually causing her pain as I neglect my own well-being?
Dani will likely outgrow the Witching Hour in another month or so. But who knows what long term impact my stress hormones may have on her developing body and brain. And I would hate to be sending her down the path towards a life of stress related stomach trouble. Clearly, it is time to take back a little of my energy for myself, and return to some of the self-care activities that have always eased my body and mind.
Bibliography
Brazelton, T Berry and Joshua D. Sparrow. Touchpoints: Birth to Three. Cambridge, Ma: Da Capo Press, 2006.
Gilkerson,Linda and Larry Gray. “Fussy Babies” Infant and Early Childhood Mental Health: Core Concepts and Clinical Practice. Ed. Kristie Brandt, et.al. Washington, DC: American Psychiatric Publishing, 2014. pp 195-208.
Barnard, Kathryn E. and Karen A. Thomas. Beginning Rhythms: the Emerging Process of Sleep Wake Behavior and Self-Regulation. Seattle, Wa: NCAST Programs, 2014.
Springen, Karen. “The Colic Chronicles.” The Fussy Baby Network. Erickson Institute, June 1, 2010. web. October 21, 2014.