Wednesday, December 30, 2009

My return and thoughts on motherhood anxiety and infant colic

Ah. I feel much more relaxed. During our much needed break from school and its stress, we traveled to visit my family. While there, we were pampered. I did not cook, I slept in and took naps, and I rarely changed a diaper. The Queen was monotonized by my wonderful siblings. She was entertained, fed, and quite spoiled by her many aunts and uncles (7 to be exact). Manly was loved, photographed, and given ample attention by his grandparents.

The week we spent there was splendid. We felt much more ready to return and greet the new semester with refreshed minds and rejuvenated spirits. What is even more lovely is we have until Monday to relax and enjoy each other. Alone. Just the 4 of us. I love being with extended family and I love returning to our independent life.

As I promised, I have many new things for this wonderful new year. The keyboard feels alive under my fingers as my mind spews out thoughts like a gumball machine given a quarter. I know the new year doesn't start until Friday, but I could not wait until then to start. So, to give you a wonderful taste of what is to come in my little area of the blogosphere, I present to you my first forum, or something. Okay, I haven't quite figured out what to call this new thing. If you have any ideas drop me a line (or a comment).

Have I mentioned what my degree is in? I haven't? To inform your curious minds, I graduated in Family Science (or, in my University, Marriage, Family, and Human Development). During my course of study, I researched many topics in a variety of areas. I read and wrote, studied and taught, a wide array of subjects. I could not choose my favorite area, so I will be pulling from my vast space of knowledge many different things.

Oh, what will I be doing? This is the best part. I will be researching some topic, in my area of specialty, and writing about it. This helps me keep up with the most current research, while also refining my writing skills. To begin this new thing, I will start with colic. Why colic? As you all know, I have a cute little infant who has colic. I thought it would be exciting to learn more about it and share what I learned with all of you. If you find this to not be interesting, e-mail me something you are wantint to learn more about (in the family realm) and I will research it and present it on a different day! How about that? All of YOU can learn with me! Let's begin, shall we?

Infant Colic and Motherhood Anxiety

Incessant crying from 5 pm onward characterized the first 3 months of the Queen's life. I tried everything to soothe her. Nothing worked. I thought I would not have that same issue with my next baby. I was wrong. Manly has been as difficult (in terms of crying) as his sister. Since this has been so much a part of my life for the last 3 weeks, I wanted to see what research has to say. First, I sought a comprehensive definition. Second, I looked at the available treatment options and their viability. Third, I reviewed possible explanations for the onset of colic. Last, I examined the effects of colic on a mother's anxiety levels, feelings of efficacy, and separation anxiety.

In the research, finding a comprehensive definition of colic was quite difficult (1-6).  One that seemed the best is as follows: In an otherwise healthy baby, paroxysms of inconsolable fussing lasting up to three or more hours on three or more days of the week. (10).

Manly cries three or more hours every day. Based on this definition, Manly has colic. Why does colic develop?

Researchers offer a variety of reasons for the on-set of colic. Some suggest allergies or difficulties digesting certain proteins (like the lactose found in milk products) (5, 10). Other research has suggested parent characteristics (9). Stifter and colleagues suggest that mothers who report variables like parenting stress and low marital satisfaction are more likely to report excessive crying during the first three months. They indicate that infant crying gradually increases from 2 weeks until 3 months. These mothers, however, begin to notice it by 6 weeks and categorize it as colic because of negative things impacting their lives at that time. They imply that these mothers are less able to handle the crying than their counterparts who are not experiencing marital distress, or have more familial help.

I disagree with this branch of research. I can only disagree from personal experience, I hope you will excuse my use of anectdotal evidence. I am a "seasoned" mother. I could, possibly, understand agree if they were referring to first-time mothers because the adjustment to parenthood can be difficult. However, this is my second baby. I am quite comfortable in my role as a parent. I can recognize different patterns of crying. My relationship with my husband, while not perfect, is not strained. I may not have too much family help because I do not live close to relatives, but I have plenty of friends who offer their services. I am also a college graduate in FAMILY STUDIES. I took a few infant development course. I think their "proof" is purely coincidental.

To these researchers credit, they did suggest their results could have been counfounded by another possibility. The possibility that marital satisfaction decreases and parental stress increases because of an infant's excessive cries. You think?

It is obvious, and recognized in the scientific community, that the development of colic is not understood. At the same time, treatment options are severely under-researched.

Treatment options for colic can be grouped into four categories: behavioral (rocking, taking walks), herbal remedies (tea, gripe water), drug therapies (gas relief drops), and, if breast-feeding, limiting certain victuals (spicy foods, milk). Research is limited for each of these treatments. Thankfully, I found one study looking at the first three treatment options (3). In this study, drug treatments seemed to be the most effective, working for about 31% of mothers in one study. Herbal treatments were the next best method. Mothers recommended sweet drinks as soothing their infants crying. Behavioral treatments were the least effective. Mothers reported that their infant cried whether they were held or not. Unfortunately, this study did not look at the effectiveness of limiting certain food items.

The most difficult aspect of colic is the inability for mothers to soothe their infant with traditional methods. As a mother, it seems intuitive that if you pick up your infant, he or she will stop crying. Not so for colicky infants. This decreases a mother's efficacy. According to Porter and Hsu (7), mothers who have infants with a difficult temperament (i.e. colicky) report feeling less competent as a mother after the first month. This has been verified through further research which indicates that mothers of non-colicky babies feel less efficacious as a parent as compared to mothers with colicky babies (8).

I can attest to this. Even though I am an "experienced" mother, I still have days where I feel incompetent. What does this do to my emotions? It depends. Some days I feel shattered. Lost. Completely alone. Other days I feel fit and ready to handle any and all crying fits that come my way. Why the complete shift from day to day?

Humphry and Hock (4) suggest that mothers feel more anxious about their infants' cries when they have less sleep. I can agree with that. Those nights (ahem, like last night) when I am up quite often eat my spirit, chew my body, and spit out an exhausted and cranky mother. The following days are a nightmare. I am close to tears and frequently lash out at my husband. 

It is natural to assume that colic breeds anxiety in mothers. Non-stop crying could drive the most sane person nuts. This is the reason experts suggest taking breaks from an infant. Leaving the children with your husband, a family member, or friend, will alleviate the tension brought by a fussy infant. However, research concludes opposite. While mothers of colicky infants feel it helps an infant develop independence and social skills to be watched by someone different (8), it does not lessen their anxiety. In fact, it increases their anxiety to leave their infant (4, 8). These mothers have grown accustomed to their infants crying. Even though the infants' cries are difficult or impossible to soothe, these mothers feel the need to offer more affection. They also feel protective and self-conscious, sure that only they can offer their infant what he or she needs. It creates more anxiety for them to think about leaving their infant than thinking about ways to soothe their fussy baby.

As I read this research, I realized how effectively this applies to me. During the day, I will often look at the clock and count down the hours for when Mr. B will return home and "relieve" me of my duties. Yet, when he offers to watch the kids while I run to the store or do some other little errand, I often defer the tasks to him. I feel more comfortable staying with Manly than leaving him. I know I can soothe him, even if it takes an hour, or two, or three. I do leave Manly, but not often. And, for now, I am okay with that. I know as he gets older, I will feel more comfortable. It happened with the Queen, it will happen with him.

During the long nights of frightful fussy periods, it is easy to forget that it will eventually get better. However, research supports that it will and, in most cases, does. By month three, infants extreme fussiness will have mostly disappeared(1, 5-7, 9, 10). As the crying begins to dissipate, mothers begin to feel much more confident in the mothering abilities. Porter's (7) research supports this, denoting an increase in efficacy in mothers by month three. As the colic disappeared, those mothers who reported feeling less competent in month one usually reported feeling very competent at month three.


While sifting through the research available on colic, I began to feel much less stressed over my little guy's symptoms. I began to remember the Queen's colic. As the studies indicated, her colic began to decrease by month two, and by month four was completely gone. Manly's incessant cries have begun to lessen. There are still some days where he cries excessively. Other days I am happily surprised with only little bouts of fussiness. All in all, I am feeling much more comfortable taking care of my little guy.

I recorded my thoughts throughout this piece, now I want to hear your feelings about this.
Do you think parent characteristics could lead to the development of colic?
What treatment options worked, or didn't work, for you?
If you had an infant with colic, did you experience separation anxiety? Was it comparable to your infants without colic?
Do you think colic decreases confidence in mothers?

References for your pleasure.
1. Asnes, R.S., & Mones, R. L. (1982). Infantile colic. A review. Developmental and Behavioral Pediatrics, 4, 57-62.
2. Carey, W. (1984). “Colic”—Primary excessive crying as an infant-environment interaction. Pediatric Clinics of North America, 31, 993-1005.
3. Ciftci, E. K, & Arikan, D. (2007). Methods used in eliminating colic in infants in the eastern parts of Turkey. Public Health Nursing, 24, 503-510.
4. Humphry, R. A. & Hock, E. (1989). Infants with colic: A study of maternal stress and anxiety. Infant Mental Health Journal, 10(4), 263-272.
5. Illingworth, R. (1954) Three months colic. Archives of Disease in Childhood, 29, 165-174.
6. O’Donovan, J. (1980). Infantile colic, or what to do until the fourth month comes. Comprehensive Therapy, 12, 9-12. 
7. Porter, C. L. & Hsu, Hui-Chin. (2003). First-time mothers’ perceptions of efficacy during the transition to motherhood: Links to infant temperament. Journal of Family Psychology 17(1), 54-64.
8. Stifter, C. A., & Bono, M. A. (1998). The effect of infant colic on maternal self-perceptions and mother-infant attachment. Child: Care, Health, and Development, 24, 339-351.
9. Stifter, C.A., Bono, M., & Pinrad, T. (2003). Parent characteristics and conceptualizations associated with the emergence of infant colic. Journal of Reproductive and Infant Psychology, 21, 309-322.
10. Wessel, M. A., et al. (1954). Paroxysmal fussing in infancy, sometimes called “colic.” Pediatrics, 14, 421-435.     

11 comments:

  1. I am glad you had a wonderful time!! Happy New Year!!

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  2. Hi there! I'm an old mama (42 years) and have three children - 18 year old son, 5 year old daughter, and 21 month old daughter.

    It was my 5 year old who had colic. We discovered through exhaustive research that a milk protein (not lactose) allergy was the cause of her colic. When I eliminated all dairy foods and accidental dairy (small amounts found in other foods) the colic disappeared. She was just under two months of age when we finally found and eliminated all dairy in my diet.

    All symptoms - the gas, the green mucously stools, and the discomfort and crying ceased with the elimination of dairy.

    Not all infants with dairy allergies will exhibit the same symptoms. Some will have hives or other rashes. Some have nasal congestion, sneezing, and wheezing as symptoms. This last set is often missed as an allergy indicator since it also mimics cold virus symptoms.

    My daughter's case was relatively easy to diagnose since her case was extreme and constant. She had symptoms such as loose mucousy stools and painful gas along with the constant fussing and crying.

    I can also attest to the fact that she was empathetic to anxiety - meaning her fussiness increased with my frustration levels.

    If you'd like to learn more about infant dairy allergies I recommend these sites:

    http://www.kellymom.com/babyconcerns/food-sensitivity.html

    http://www.allergicchild.com/milk_allergy.htm

    Hopefully your son doesn't have an allergy, but so many babies with colic do and the sooner it's discovered the sooner they can heal!

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  3. Kari, thanks for stopping by!

    Something that is frustrating is the lack of cohesive advice concerning colic. One pediatrician will say one thing, another ped. another thing. Goodness gracious.

    I have tried limiting milk...but have not completely eliminated it from my diet. Based on your description of your daughter's stools, I need to consider this option.

    Thank you for your comments and links!

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  4. I tried gripe water and it did miracles! you can buy it at any drug store! Some docs dont recommend it bc its not fda approved, its more of an all natural thing with ginger and stuff in it. I loved it and totally recommend it, it totally soothed her stomach!

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  5. Ambrosia, it's so good to see you back; I missed you. I think that anything you do that makes you feel more empowered as a parent is good, so if researching the problem helps, then do that. I think that any ceaseless crying increases the stress of both parents, puts strains on the relationship, and makes everything more difficult. Just like you were, I would also be extremely wary of research that attempts to blame everything on the mother! Ridiculous. Move on to the next study.

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  6. I remember reading a fascinating and terrifying article on colic in The New Yorker (http://www.newyorker.com/reporting/2007/09/17/070917fa_fact_groopman) just after Big Boy was born. Reading about the experiences of the parents in that article and knowing about the trials and tribulations of friends - like you - whose babies have had colic makes me feel both extremely grateful and extremely lucky that I did not have to deal with colic with either of my boys. And I really believe that that's what it is: luck. There's nothing you've done or haven't done that has caused colic in your babies - just like there's nothing that I've done or haven't done to prevent my kids from having it. I just hope that one day medical science can find the cause of colic so that no more parents have to deal with the familial stress of a colicky infant.

    Welcome back! Happy new year!

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  7. I was fortunate not to have colicky babies. However, I did have some crying fits that were soothed with Gripe Water. Actually, my sister recommended it to both my brother and I and it did wonders.

    I deduced that the crankiness and frequent nighttime waking of my last baby was due to a dairy sensitivity. I went through an elimination diet before figuring this out and, once I did, things got better for all of us.

    I think it is wonderful of you to dig deeper into research as well as other mothers' personal stories to try and help you with your own circumstance.

    Here's hoping your little boy comes out of it soon. Sounds like you are just the right mama for the job.

    Happy New Year!

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  8. ARGH!!!!! These people are blaming the mother for a colicky baby!??? ARRRRRRRGGGGGGHHHHHHHH!

    That is complete dreck. And jeez, isn't it hard enough to be a new mother without having to shoulder the blame for ONE more thing?

    As you can tell, steam is coming out my ears right now.

    Dancing around with Miss D., singing to Lyle Lovett helped. But that's it. Take that, scientists. Lyle Lovett cures colic!

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  9. I am extremely fortunate that none of my crew had colic, but as a doula I did get a crash course in helping mama's who were not so lucky.

    There's no way colic is caused by the mom. Fuck that.

    Does it increase feelings of incompetency? How can it not? Mothers of colicky babies deserve a special place in mommy heaven.

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  10. Yes, Natalie, a special place in mommy heaven. I didn't know you were a doula!?! That, my friend, is amazing!

    As you said, colic does increase feelings of incompetency. It is almost inevitable, no? I guess that is what we moms go through for our colicky children. I know it gets better. Thank goodness I have a wonderful little girl to remind me of what the future holds!

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