Extreme Fussiness & Colic

Excerpted from
Your Fussy Baby
By Marc Weissbluth, M.D.

The Curious History of Extreme Fussiness & Colic

Historically, extreme fussiness/colic has escaped medical understanding. While reliable scientific research, as above, documents the phenomenon in terms of its behavioral manifestations, no one has yet provided a persuasive explanation of why it happens. At various times researchers have blamed extreme fussiness/ colic on overfeeding, underfeeding, food with too much carbohydrate, too much starch, too much protein, allergy (a reaction to horsehair, feathers, orange juice, or other substances), overly permissive parents, too much attention, too little attention, exposure to cold, and lack of oral satisfaction. These explanations are the result of an underlying belief that the condition is a medical problem instead of a stage of development.

To all of the above "medical diagnoses," "cures" were only wishful thinking. Some suggested older "cures" have included weaning the baby from the breast; adding goat's milk, olive oil, or banana powder to her diet; treatment with bicarbonate of soda, chlorohydrate, opium derivatives, peppermint, or dill water; giving an enema or suppository; offering a pacifier; handling the baby more gently; and a drink of whiskey (which Illingworth specifies is to be "taken by the parent!").

Of course, a review of the literature on almost any medical condition provides an array of absurd notions taken seriously at one time or another. In the case of extreme fussiness/colic, however, because no cause has been isolated nor a definition agreed upon, mistaken-even absurd and irrational-ideas regarding the condition persist even today Only in the last thirty or forty years have controlled experiments been conducted that compare groups of extreme fussy/colicky babies. Modern "cures"-familiar, I am sure, to many-include crib vibrators, recordings of heartbeat or womb sounds, antigas drugs, drugs to reduce gastroesophageal reflux, elimination of milk products from a nursing mother's diet, and the admonition to carry your baby more often.

Extreme Fussiness, Colic Is Not the Sort of Problem Doctors Like

Even today, little is taught about extreme fussiness/colic in medical schools. As we now know, it is not a disease and it has no definite cause. It does not even have an exact diagnostic set of symptoms. Nothing about extreme fussiness/colic shows up on X rays, stool analyses, or blood tests. Diagnoses strike many as arbitrary and subjective. There is no treatment of choice, which is why most doctors understandably shy away. They take comfort in the fact that extreme fussiness/colic does not kill or harm infants. They know that infants will outgrow the behavior. Often, however, they do not recognize the devastating effect extreme fussiness has on parents. A physician might say to a mother whose child suffers from extreme fussiness, "This is not serious. If only you would relax and take it easy, then your baby would calm down." Yet when I give talks on extreme fussiness to groups of physicians I play for them a tape of an extreme fussy/colicky baby at the height of paroxysmal crying. After no more than a minute the audience itself cries, "Enough! Turn it off!" I imagine if these pediatricians spent an entire evening with an extremely fussy/ colicky baby, they would be more sympathetic.

The Nature of Extreme Fussiness/Colic in Behavioral Research

Another possible explanation for the neglect of extreme fussiness is traceable to methodological difficulties involved in medical research on human behavior. Some doctors and researchers prefer to observe children only when awake, while others like to study children asleep. Like larks and owls, these professions do not flock together-they rarely talk to one another, let alone share findings. Extreme fussiness/colic, a condition that actually resides somewhere between awake and asleep behaviors, falls in an academic no-man's-land.

There is also a species of researchers I call hawks. Rather than observe, they like to prod and provoke babies in order to measure their responses. They snap rubber bands against their heels, block airflow through their noses, and make them breathe a low-oxygen air-gas mixture. Some of these hawks are probably overly aggressive. Others, however, have contributed significantly to our knowledge of child development. Unfortunately, there is no reliable way to provoke an extreme fussy/colicky spell in the laboratory, and few researchers care to be out taking measurements in the evening, when most extreme fussiness occurs. Since ever)' baby is different and no baby's extreme fussiness/colic is exactly the same from day to day, controlled experiments pose real challenges. This is why extreme fussiness/colic has been described by the larks but only recently really studied by owls and hawks.

Pressing the metaphor even further, in the academic aviary larks, owls, and hawks live in different trees. These various professions have their own schools, their own journals, and even their own distinctive songs. Specific kinds of behaviors are often separated from one another: Crying is studied separately from social smiling, and night awakening is studied separately from length of night sleep periods. Yet a thorough understanding of extreme fussiness involves comprehension of these other behaviors as well My intention in the next section is to explain how these seemingly separate infant behaviors relate to each other: extreme fussiness, crying, temperament, and sleeping. Extreme fussiness/colic has not fallen successfully into the territory of any single discipline. Perhaps, as we will see, it comprises a territory of its own.