Michelle got worse and worse. And we got more and more tired, more and more frazzled, and more and more testy. Then we got the swing.
The swing was one of those windup numbers where you place the baby in the seat, turn the crank fifty times, and the seat swings back and forth with a mechanical click.
The swing was the true definition of a mixed blessing. While it was in action, clicking away, Michelle was quiet and often fell asleep. But within two minutes after the final click, Michelle would stir, stretch her arms, fill her lungs, and scream.
One good cranking would last about twenty minutes. So we organized our lives into neat, twenty-minute intervals, always trying to catch the sound of lessening momentum so we could crank up the swing again before Michelle got cranked up. And it worked.
It worked so well that Michelle would accept no substitute. Unless she was hungry, there was no longer any time that we could hold our child without her screaming. All of our fears, all of the subliminal messages we had received, were coming true. We were rotten parents. A mechanical swing could calm our child, but we could not. We hated the swing, but we dared not, could not, put it away.
Dr. Weissbluth gave us a copy of his book Crybabies. Sharon and I each devoured the book in one sitting. One section was particularly important and encouraging to us. It was a bell-shaped curve. Along the horizontal axis was the amount of what was laughingly called “unexplained fussiness.” “Unexplained fussiness” is medical jargon for unending, sharp, fierce shrieks that push parents to the edge of insanity.
The point is this: All newborn babies cry a lot. A portion of that crying is for no good reason, as far as we in the grown-up world can tell. If you normalize the daily variations in the amount of this crying, what you find is that it keeps going up for the first six weeks of life, then gradually falls off over the next six weeks. Then it's gone.
We weren't sure it was true, but we decided to delay our mutual suicide pact for twelve weeks to see if it was. As Michelle reached her eighth week of life, we started to notice a strange phenomenon: There were brief periods of time when she was awake and not crying! And those periods of calm were starting to increase! We were believers.
Of course, nothing kids do ever conforms entirely to what the books say. Getting Michelle settled down to sleep remained a long, drawn-out ritual well past her twelfth week. And getting her to sleep through the night was still an impossible dream. We were still tired (especially Sharon, who had gone back to work but still nursed her at night and expressed milk for Michelle to take during the day), but we were no longer frantic and frazzled. We had regained a sense of time, a sense of day and night. We no longer felt like miserable failures at the baby business.
We let it ride until Michelle reached five months. Then, after another series of consultations with our doctor, we decided to aggressively manage Michelle's sleep patterns so that both she and we could get some meaningful rest.
The theory was that Michelle was waking up at night at various times just as we all do. But instead of turning over and going back to sleep, she was demanding food and attention from us. She no longer needed the food, and the attention was robbing both her and us of a satisfying night's sleep.
The first rule was no more middle-of-the-night feedings. And because of that, we decided that Sharon should not go to the baby at all during the night, since the sight and smell of her would be too tempting for Michelle. When she cried, I would go in and rock, cuddle, sing, or swing … whatever it took to get her back to sleep.
The next phase was no more talking. Now when I was summoned to her room for a soiree, I would just lean over her crib and pat her on the back until she was fast asleep. In fact, anything short of a full five minutes would lead to a revival meeting shortly thereafter.
A few days later we held our final strategic planning session with our pediatrician. He suggested that we make the room as dark as possible, put Michelle in her bed, and not open the door until morning. He recommended that Sharon spend the night with a friend, and promised us that this final step would not take more than three nights of prolonged screaming. Very encouraging.
Sharon decided to gut it out with me. When the designated time approached, we started the bedtime ritual. Then we put Michelle in her crib, turned, marched out of the room, and shut the door. The crying started immediately. But it lasted only ten minutes. Ten minutes! That was it.
Neither of us slept well that night. We kept straining our ears to hear the cries. But there were none. When daylight came, we rushed into Michelle's room and, lo and behold, she was fine.
And that was it. Ten tough minutes, and the three of us were free from this five-month ordeal. As the days passed, we noticed some very positive side effects. Just like us, Michelle was becoming much more pleasant and fun now that she was well rested. She was thriving, and we were loving it. Life has resumed.
While this father's story may sound extreme, it is actually typical of die lengths parents will go to help their babies through their crying spells. I would like to emphasize that soothing a fussy or crying child is something both parents can do. Even if she is breast-feeding, it is not solely die mother's responsibility.
Fathers can, and in my opinion should, help with their children. If a father can be at home to help the mother for a time after she arrives home from the hospital and again for a period when the baby is about six weeks old, then the mother will be able to adjust to die changes in her baby. One father called this “tag-team parenting” because whenever one parent became exhausted, the other one took over for car rides, walks, or trips in the stroller to let the other get some much-needed rest. Two exhausted parents don't make a good couple!
Although many remedies have been suggested for extreme fussiness/colic, including catnip or herbal tea, papaya juice, peppermint drops, heartbeat or womb recordings, hot-water bottles, or trying new baby formulas, only three maneuvers have been found to calm fussiness and crying. Additional treatments such as simethicone drops and chiropractic spinal manipulation have been proven to be completely ineffective. Gastroesophageal reflux disease is the newest popular diagnosis in fussy and crying babies, but research has shown it to be a coincidental finding and not die cause of irritability in babies. The three manuevers are:
Rhythmic motions: rocking chairs, swings, cribs with springs attached to the casters, cradles, carriages, and strollers; walking, taking ceiling tours, using your baby for curling exercises to strengthen biceps, and taking car rides. Maybe all rhythmic rocking soothes babies by encouraging regular breathing, thus taking away the need for the baby to “make” colic in order to breathe well. However, avoid water beds, which are dangerous because they may cause suffocation. Other dangerous colic “treatments” include certain herbal remedies, which have caused poisoning; beanbag pillows, which have caused suffocation; and trampolinelike devices suspended in the crib, which have caused strangulation. Tryptophan was once used to help babies sleep well, but we now know that this is dangerous; similarly, melatonin should not be given to babies.
Sucking: at breast, bottle, fist, wrist, thumb, or pacifier.
Swaddling: wrapping the child in blankets; snuggling, cuddling, and nestling. After the first few weeks, however, this maneuver is often less effective.
You should avoid trying gimmick after gimmick; it will only make you feel more frustrated or helpless as the crying continues. You may also feel resentment or anger if your child, perhaps unlike your friend's child, doesn't seem to respond well to home remedies.
PRACTICAL POINT
Feelings of anger toward your crying child are frightening—and normal. You can love your baby and hate her crying spells. All parents sometimes have contradictory feelings about their baby.
Take breaks when your baby is crying. This will enable you to better nurture your child; it's a smart strategy for baby care, not a selfish idea for parent care.
You may feel, during the first few months, that you are not influencing your extremely fussy/colicky child's
behavior very much. And you are right, but consider this period to be a rehearsal. Your hugs, kisses, and loving kindness are expressing the way you feel. Practice showering affection on your baby, even when he's crying. This loving attention is important for both of you.
However, unceasing attention showered on a fussing or crying baby, whether he is extremely fussy/colicky or just common fussy, during the first few months can have complications if you continue this strategy of intervention for the older, post-colic child at bedtime and nap times. Thus, after the extreme fussiness/colic passes, the older child is never left alone at sleep times and is deprived of the opportunity to develop self-soothing skills. These children never learn to fall asleep unassisted. The resultant sleep fragmentation or deprivation in the child, driven by intermittent positive parental reinforcement, leads to fatigue-driven fussiness long after the biological factors that caused the extreme fussiness/colic have been resolved.
Temperament at Four Months
When the excessive crying and fussiness of your baby's first few months have passed and the child seems more settled, what next? After about four months of age, most parents have learned to differentiate between their child's need for consolidated sleep and the child's preference for soothing, pleasurable company at night. Most parents can learn to appreciate that prolonged, uninterrupted sleep is a health habit they can influence; they can quickly learn to stop reinforcing night wakings and irregular nap schedules that rob kids of needed rest. A process of “social weaning” from the pleasure of a parent's company at nap times and bedtimes is underway. As one young mother said, “I see—I should now forget the company she [the baby] wants.”
But parents of postcolic children still have a few challenges to face. That's because children who have had extreme fussiness/colic appear more likely than other babies to develop a difficult temperament, shorter sleep durations, and more frequent night wakings between four and eight months of age. My research also has shown that parents of postcolic kids are more likely to view frequent (instead of prolonged) night wakings as a problem. Furthermore, boys are more likely than girls to be labeled by their parents as having a night-waking problem. Let's see how these patterns could have emerged.
Dr. Alexander Thomas, a pioneer in child development, described temperament differences among babies. In a study based on both his own careful observations and parent interviews, Dr. Thomas noted interrelations among four temperament characteristics: mood, intensity, adaptability, and approach/ withdrawal. Infants who were moody, intense, slow to adapt, and withdrawing in Dr. Thomas's study were also rated as irregular in all bodily functions. Thus they were diagnosed as having “difficult” temperaments because they were difficult for parents to manage! We don't know why these particular traits cluster together, but we do know that infants with “easy” temperaments had opposite characteristics. In Dr. Thomas's study, four additional temperament characteristics were described: persistence, activity, distractibility, and threshold. (Threshold means how sensitive or insensitive the child appears to be to noises or changes in lighting.) These four temperament characteristics were not part of either the easy or difficult temperament clusters.
The term “temperament” means behavioral style or the manner in which the child interacts with the environment. It does not describe the motivation of an action. All parents naturally make their own assessment of their babies’ temperaments. You may be surprised to know that there is a standardized system for evaluating infant temperament. It is not absolutely objective, and it has a number of limitations that I will point out later, but it has proved over the years to be very useful.
The researchers who developed this system did not have extreme fussiness/colic anywhere in their minds. There is not even a crying dimension in their system. No one connected temperament, as rated on this scale, with extreme fussiness/ colic until much later. However, as you will see, the connection proved to be striking.
Infant Temperament Characteristics
Activity (General Motion, Energy)
Does your baby squirm, bounce, or kick while lying awake in the crib? Does she move around when asleep? Does she kick or grab during diapering? Some infants always appear to be active, others only in specific circumstances, such as bathing. Activity levels in infants have nothing to do with “hyperactivity” in older children. I have examined a few babies who previously had been referred to a pediatric gastroenterologist because of extreme fussiness/colic. When he recognized that there were no gastrointestinal problems, he decided that the problem was “hyperactivity.” This diagnosis was made on the false motion that wakeful, reactive, or difficult infants are hyperactive. There is no proven association between high activity levels in infancy and hyperactivity when older.
Rhythmicity (Regularity of Bodily Functions)
Rhythmicity is a measure of how regular or predictable the infant appears. Is there a pattern in the time he is hungry, how much he eats at each feeding, how often bowel movements occur, when he gets sleepy, when he awakens, when he appears most active and when he gets fussy? As infants grow older, they tend to become more regular in their habits. Still, some babies are very predictable at age two months, while others seem to be irregular throughout the first year.
Approach/Withdrawal (First Reaction)
Approach/withdrawal is a temperament characteristic that defines the infant's initial reaction to something new. What does he do when meeting another child or a baby-sitter? Does he object to new procedures? Some infants reach out in new circumstances—accept, appear curious, approach—others object, reject, turn away, appear shy, or withdraw.
Adaptability (Flexibility)
Adaptability is measured by observing such activities as whether the infant accepts nail cutting without protest, accepts bathing without resistance, accepts changes in feeding schedule, accepts strangers within fifteen minutes, and accepts new foods. It is an attempt to measure the ease or difficulty with which a child can adjust to new circumstances or a change in routine.
Intensity
Intensity is the degree or amount of an infant's response, either pleasant or unpleasant. Think of it as the amount of emotional energy with which they express their likes and dislikes. Intense infants react loudly with much expression of likes and dislikes. During feeding they are vigorous in accepting or resisting food. They react strongly to abrupt exposure to bright lights; they greet a new toy with enthusiastic positive or negative expressions; they display much feeling during bathing, diapering, or dressing; and they react strongly to strangers or familiar people. One mother described her extremely fussy/colicky baby's intense all-or-nothing reactions: “Her mood changes quickly; she gives no warning—she can go from loud and happy to screaming.” Intensity is measured separately from mood. Infants who are not intense are described as “mild.”
Mood
If intensity is the degree of response, mood is the direction. It is measured in the same situation described above. Negative mood is the presence of fussy/crying behavior or the absence of smiles, laughs, or coos. Positive mood is the absence of fussy/ crying behavior or the presence of smiles, laughs, or coos. Most intense infants also tend to be more negative in mood, less adaptable, withdrawn. Most mild infants also tend to be more positive in mood, more adaptable, and approaching.
Persistence
Persistence level, or attention span, is a measure of how long the infant engages in activity. Parents may value this trait under some circumstances but not under others. For instance, persistence is desirable when the child is trying to learn something new, like reaching for a rattle, but it is undesirable when the infant persists in throwing food on the floor. Unfortunately, some babies persist in their prolonged crying spells and their prolonged wakeful periods. One father described his persistently crying baby as follows: “We have a copper-top, alkaline battery-powered baby and we're powered by regular carbon batteries. He outlasts us every time.”
Distractibility
Distractibility describes how
easily the baby may be distracted by external events. Picking up the infant easily consoles a distractible infant's fatigue or hunger; soothing can stop fussing during a diaper change. New toys or unusual noises easily distract the infant. Distractibility and persistence are not related to each other, and neither trait is related to activity or threshold levels.
Threshold (Sensitivity)
Threshold levels measure how much stimulus is required to produce a response in the infant in specific circumstances, such as loud noises, bright lights, and other situations previously discussed. While some infants are very reactive or responsive to external or environmental changes, other infants barely react.
Difficult Temperament
As previously mentioned, while observing many children and analyzing many questionnaires, Dr. A. Thomas and Dr. S. Chess noticed that four, and only four, of these temperamental traits tended to cluster together. In particular, infants who were extreme or “intense” in their reactions also tended to be slowly adaptable, negative in mood, and withdrawn. This appeared to be a personality type.
According to their parents’ descriptions and direct observation by the researchers, these infants seemed more difficult to manage than other infants. Consequently, a child whose temperament scores fall into this pattern is said to have a difficult temperament. One mother referred to her infant as a “mother killer.” Infants with the opposite temperamental traits are said to have easy temperaments. These are sometimes called “dream” babies. One father described his “easy” infant as a “low-maintenance baby.” The difficult temperament and the easy temperament are only descriptions of a behavioral style. Temperament research usually does not ask why a child behaves in a particular way. There is no scientific basis for labeling a child with a difficult temperament as a “high needs” child. In fact, there is no scientific support for labeling a child a “high needs” child under any circumstances.
Healthy Sleep Habits, Happy Child Page 18