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What's Colic? Does Your Baby Have Colic? How to Tell
3 Steps in Tracking Down the Cause of Colic
4 Possible Hidden Medical Causes of Colic
10 Tips for Comforting Colic
5 Coping Tips For Parents
Differences Between "Fussy" and "Colicky" Babies
Colic will soon pass
Colic Causing Foods in Breastfeeding

See also: Fussy Baby

It's 6:00 p.m. and the wailing begins. You're holding your two-week-old baby – the model of a thriving infant, apparently without a care in the world. Suddenly and unexpectedly he stiffens his limbs, arches his back, clenches his fists, draws up his flailing limbs against a bloated, tense abdomen, and lets out ear-piercing shrieks. If he could speak, he would yell, "I hurt and I'm mad!" As the intensity of baby's cries mount, your frustration escalates, and you feel helpless in determining the cause of his distress and alleviating your baby's pain. He's inconsolable, and you're both in tears. You hurt together.

You try to cuddle, but baby stiffens in protest. You try to nurse, but baby arches and pulls away. You rock, sing, and ride. The soothing techniques that worked yesterday aren't working today. And inside your head the familiar refrain, "What's wrong with my baby? What's wrong with me?" plays over and over again.

By the time you go through all of Aunt Nancy's herbal teas, the doctor- advised feeding changes, and every conceivable holding pattern, as mysteriously as the fight began, around three to four months of age, it stops, and life goes on. Your baby seems none the worse for wear, and you close one of the most difficult chapters in life with your new baby. That's colic.

Even though no one completely understands colic, let's make two assumptions: First, the baby has pain in the gut. (The term "colic" comes from the Greek kolikos, meaning "suffering in the colon.") Secondly, the whole baby is upset as a result. My perspective on colic changed years ago when a mother brought her baby in and wanted me to find out why he was crying so much. After I diagnosed her baby with colic, she challenged me. "Do pediatricians call it colic when they don't know why a baby is hurting?" she asked bluntly. She was right. A gastroenterologist I often work with once confided to me: "Colic is a five-letter word for 'I don't know'."

When an adult hurts, the doctor and patient do some detective work to track down the cause of the pain, so they can fix it. So, I started approaching my evaluation of colicky babies with this in mind. First, I dropped the term "colic" from my diagnosis list and adopted the term "the hurting baby." Besides being more accurate, this motivated both the parents and myself to keep searching for a cause, and a way to fix it. Labels can be therapeutic. By viewing your baby as "hurting" instead of "crying," you're more likely to be empathetic, like you would a baby who was hurting because of an ear infection, rather than viewing crying as an annoying tool babies use to manipulate their parents into holding them a lot, which tops the list of colic myths.

1. Don't call it colic. Call it "the hurting baby."
2. In partnership with your doctor, keep searching for a cause.

DOES YOUR BABY HAVE COLIC? HOW TO TELL If you wonder whether or not you have a colicky baby – you don't. The agonizing outbursts of inconsolable crying leave no doubt that your baby hurts. While no one knows the cause, or even the exact definition of colic, pediatricians tag an apparently healthy, thriving infant with "colic" if the baby follows what is called the "Rule of Threes." The episodes of inconsolable crying: Begin within the first three weeks of life Last at least three hours a day Occur at least three days a week Continue for at least three weeks Seldom last longer than three months Sometimes when parents think that they have a colicky baby, I'll send them to visit some members of the "colic club" – parents in our practice who truly do have colicky babies. They often return relieved, saying, "We don't have a colicky baby after all."

The point at which a fussy baby (one who cries a lot) or a "high-need baby" (one who fusses unless he's held a lot) becomes a colicky baby (one who hurts a lot) is often a matter of interpretation. What you call your baby's behavior isn't as important as what you do about it. In my pediatric practice, I've found it helpful to use the term "high-need baby" when I suspect it's the baby's temperament that's causing his behavior, and "hurting baby" when I suspect a medical reason for it. Colicky babies don't just fuss; they hurt. They shriek in agonizing discomfort. Colic calls for a more intensive approach. As one mother in our practice said, "Our daughter, now thirteen months, was the queen of colic. She'd start at three o'clock and cry non-stop until about midnight. When she wasn't colicky, she was just plain high-need. There IS a difference. "High-need" responds to lots of holding and comforting; almost nothing works for colic."

A diary is helpful for two reasons: You may uncover clues that help your baby's doctor diagnose a hidden medical cause of colic, and you may be surprised by the correlations you find. As one mother noticed, "On days that I wear my baby in a sling most of the time, he fusses less." Specifically, you want to record:

• What seems to trigger the outbursts of crying? What turns them off?
• Do they occur at roughly the same time each day? Does baby awaken in pain at night? How long do these bouts last? How frequently do they occur?
• Are the crying jags getting better, worse, or staying about the same?
• Does there seem to be a consistent relationship between the method of feeding—type of formula, type of bottle, type of nipple—duration, or position of feeding? What changes in feeding techniques or formulas have you tried? Does your baby spit up after feeding? How often? How soon after feeding, and with how much force? If you're breastfeeding, do you notice any correlation between what you eat and how much your baby fusses?
• Is your baby bloated, does he seem to gulp a lot of air or pass a lot of gas?
• Record your baby's bowel movements: how frequent are they? Are they easy to pass - soft? hard? Do you notice any changes in the frequency or characteristics of the stools in response to a change in feeding?
• What changes or techniques have you tried in an effort to soothe your baby? What seems to work? What doesn't?

Don't settle for a five-minute squeeze-in appointment. To thoroughly evaluate a hurting baby and the effects on his exhausted parents, a doctor needs time. Request an extended office visit, preferably when the doctor usually schedules consultations. Prior to your visit, it's a good idea to send the doctor a letter describing your baby's crying episodes. If possible, both mother and father should attend the appointment. While some mothers tend to downplay the magnitude of the problem, dads usually tell it like it is. I didn't fully appreciate the toll a colicky baby was taking on his family until his father volunteered, "I had a vasectomy last week. We'll never go through this again!"

Make a distress tape. To help your doctor appreciate how devastating these bouts of colic are, videotape one of your baby's crying jags and ask her to view it, preferably before your appointment. I've found that watching such a tape helps me appreciate whether baby is just crying or is really hurting. And the type of cry often gives a clue to the root of the problem. Besides being helpful to the doctor, these tapes are therapeutic for parents, who at last have solid evidence of the torture they're subjected to each evening. Frazzled parents of a fussy baby recorded one of their baby's crying jags and mailed it to me before their scheduled appointment. When I viewed the tape, I realized how much pain this baby was in and how frustrated his parents were by not knowing how to help him. Don't hold back about how much your baby's crying bothers you. As one exhausted mother told her doctor, "I'm not leaving this office until you find out why my baby's crying."

If your gut feeling tells you that your baby hurts somewhere, don't give up searching for the cause and experimenting with various comforting remedies, as this intuitive and persistent mother in our practice did:

"Amelia is our first child. Although she cried a lot after birth, we chalked it up to novice parenting and thought nothing of it. But life began to unravel and derail when she was two-weeks-old. Amelia's cries took on a distressing tone that we were unable to define. Her crying intensified hours on end and nothing I tried calmed her. Her cry was shrieking, howling, and obviously pain cries. We began to suspect that there must be some sort of internal problem.

Amelia was sleeping less than four hours a night on my chest. My nights were spent rocking and nursing, while my husband laid next to me on the floor for emotional support. It was simply overwhelming and frustrating. She would eat very little at a time, only to cry moments later for more. Her actions fit the colic checklist perfectly: drawn up knees, inch worming on our chests, inconsolable wails up to twelve hours a day. Our pediatrician insisted "all babies cry." Unhappy with that answer, we switched pediatricians.

The new doctor suggested that I quit nursing and that it was perhaps my milk. Yet, when the crying resumed with force, we plodded on searching. Our marriage, family life, and emotional well-being began to suffer.

I began to do research on my own. Combing the library I read every childcare book available. That is when I came across Dr. Sears' books: THE BABY BOOK and PARENTING THE FUSSY BABY AND HIGH NEED CHILD. My husband read aloud the GER (gastroesophageal reflux) symptoms, and we began to feel that we had an answer. I called Dr. Sears and made an appointment. Amelia was in rare form that day and cried the entire visit. Dr. Sears determined that she did have GER and prescribed two medications that have greatly reduced her crying and discomfort.

Amelia is now 6˝-months-old. I am beginning to understand why my friends have so enjoyed motherhood. My memories of those first three months are a blur of tears. We were in over our heads and it felt as though the water was rising. If I were to offer encouragement to fellow parents, it would be to trust your instincts. You are your child's only advocate and voice. Make yourself heard."

In general, a medical cause is likely if the so-called colic isn't getting better by four months and your intuition tells you that your baby is in pain. Suspect a medical cause for colic if baby is:

• Getting worse or not gradually getting better
• Awakening frequently with painful cries
• Unable to be consoled
• Not thriving: poor weight gain, frequent respiratory or intestinal illnesses

Among the possible underlying causes for colic are:

1. Gastroesophageal reflux (GER), a newcomer to the hidden causes of colicky and nightwaking behavior, occurs when the muscular tissue at the junction of the esophagus and the stomach doesn't function like a one-way valve and allows irritating stomach acids to be regurgitated into the esophagus, causing pain similar to what adults call heartburn. Clues that your baby suffers from reflux are many, but not necessarily all, of the following:

• Wails and shrieks in pain, causing you to feel that he's not just crying but truly hurting
• Spits up after feedings
• Experiences painful bursts of nightwaking
• Most painful cries occur after eating
• Draws up his legs, knees to his chest, and arches his back as if writhing in pain
• Has frequent, unexplained colds, wheezing, and chest infections
• Often seems happier when he's upright rather than lying flat.

Your doctor may suspect GER based on the information from your colic diary and the way you describe baby's crying episodes. GER can be confirmed by placing a tiny tube into the baby's esophagus and leaving it in place for 12 to 24 hours while continuously recording the amount of stomach acids regurgitated into the esophagus. About one-third of infants have some degree of reflux, so simply measuring the stomach acids doesn't prove that GER is why baby is hurting. For this reason, a parent or trained observer records the timing of baby's colicky episodes. If these coincide with the time the baby refluxes, the hidden cause of colic has been found.

If your doctor suspects severe GER, the doctor may suggest an esophagoscopy: placing a thin flexible tube into baby's esophagus under anesthesia to see if there is any damage to the lining of the esophagus from the regurgitation of stomach acids. Your doctor may choose to begin treatment without subjecting baby to these studies and instead do a less invasive test, called an upper G.I. series, where baby swallows some formula- like fluid to be sure there isn't a blockage in the intestines causing the reflux.

Your doctor may prescribe medications that lessen the amount of stomach acid produced and accelerate the emptying of the stomach which, along with the comforting measures listed later, will diminish the reflux and alleviate the baby's discomfort. Holding your baby upright for twenty to thirty minutes after a feeding, in addition to feeding him smaller amounts more frequently, will often reduce reflux as well. (See Treating GER)

2. Food sensitivities. Do gassy foods ingested by a breastfeeding mother cause gassy babies? Nursing mothers have long noticed a correlation between what they eat and how colicky their baby gets, and they have compiled their own fussy foods list. Suspects include: dairy products, caffeine-containing foods and beverages (soft drinks, chocolate, coffee, tea, and certain cold remedies), cruciferous vegetables (cabbage, green peppers, broccoli, cauliflower, brussel sprouts, and onions), spicy foods (such as garlic or curry), wheat, and corn. (See Elimination Diet).

POSSIBLE FUSS FOODS	FUSSY BEHAVIORS
Dairy products, nuts, corn	Frequent painful night-wakings, frequent outbursts of abdominal pain – especially after feeding

FOODS ELIMINATED	BEHAVIOR CHANGES
Nuts	No difference detected
Dairy products	Slept better, seemed less colicky

3. The colic-cow's milk connection. New research supports what old wives tales have long suspected: some breastfed babies become colicky if their mothers drink cow's milk. That's because potentially allergenic protein called beta-lactoglobulin in cow's milk is transferred to baby through the breastmilk. This allergen upsets the intestines as if the baby had directly ingested the cow's milk.

4. Formula allergies. Babies fed a cow's-milk-based formula may become colicky if they're allergic to the protein or can't tolerate the lactose in cow's milk. If a formula allergy is suspected, a hypoallergenic formula (Alimentum, Nutramigen, or Pregestamil) or a lactose-free formula may be recommended by your doctor. The American Academy of Pediatrics Committee on Nutrition does not recommend changing to soy formula, since studies have shown that colicky infants do not improve when switching from cow's milk to soy formulas.

Suspect sensitivity to formula or to something in your breastmilk if any of the following ring true:

• Baby's pain escalates within an hour after feeding.
• Baby seems gassy or bloated, rather than contented, after feeding.
• Baby spits up profusely soon after feeding.
• Baby begins to nurse or bottlefeed, but keeps pulling off, crying as if he's in pain. (The irritated gut starts churning during a feeding, which can make feeding time torturous for the allergic, yet hungry, baby and frustrating for mothers.)
• Baby has constipation or diarrhea.
• Baby's bowel movements are extremely watery, mucousy, or explosive.
• Baby shows the "target-sign": a red, circular rash around the anus, caused by the skin reacting to irritants in his feces.

If you're nursing, make a diary of possible "fuss foods." List the foods you've eaten most frequently in the past week, especially those you tend to eat a lot of. From your diary, see if you can correlate a cause-and-effect relationship between what you eat and how much pain your baby is in. Be objective. In your desperation to comfort your baby, it's easy to pin the wrap on food sensitivity. You're willing to try anything, and your desire for a solution can cloud your objectivity. In my experience, if a food allergy is behind a baby's colic, he'll also show other signs of allergy (for example, rashes, diarrhea, runny nose, or wheezing). Eliminate the most suspicious fuss foods from your diet for at least a week, and then add them back into your diet one by one and see if your baby's symptoms return.

Our daughter-in-law, Diane, shared her experience as a colic detective:"At three weeks of age Lea started to cry all day long. She would awaken in the morning fussing, and by late afternoon it would turn into uncontrollable screaming fits. There was no way to calm her down. After a few sucks at my breast, she would throw her head back, arch her back, and start screaming. Within three days of eliminating all dairy products from my diet, her colic greatly improved. I'm glad we didn't just accept that she was 'colicky' and that 'some babies just cry all the time'."

Other hidden medical causes of colicky behavior that your doctor will look for are: ear infections, urinary tract infections, constipation, and a cause that receives little attention – a tight rectal opening, which prevents easy passage of bowel movements. A clue that this may be the problem is that baby grimaces, gets red in the face, draws her legs up to her distended abdomen before having a bowel movement, cries while moving her bowels, and seems greatly relieved after passing a large stool. Your doctor may perform a finger dilation of baby's rectum, enabling baby to pass stools more easily.

Traditionally, colic has been "treated" by laying a reassuring hand on the tummy of the baby and the shoulders of the parents and temporizing, "Oh, he'll grow out of it!" Most approaches to colic are aimed more at helping parents cope than at relieving baby's pain. By maintaining the mindset "the hurting baby" rather than "the colicky baby" you and your doctor form a partnership to find the cause and the remedy for your baby's pain.

Even though no one completely understands colic, let's make two assumptions: First, baby has pain in the gut. Secondly, the whole baby is upset as a result. Treatment, therefore, is aimed at relaxing the whole baby and particularly the baby's abdomen. While parents need to experiment with comforting measures, most of them come down to motion, untensing tiny tummies, and administering the right touch at the right time. Some strategies to try are:

1. Slower, more frequent feedings. Feeding too much, too fast, can increase intestinal gas from the breakdown of excessive lactose, either in mother's milk or in formula. As a rule of thumb, feed your baby twice as often and half as much. A baby's tummy is around the size of her fist. To appreciate the discrepancy between usual feeding volume and tummy size, place your baby's fist next to a bottle filled with four to six ounces of formula or breastmilk. It's no wonder tiny tummies get tense.

2. Colic Carries. Here are some carrying positions that work particularly well for fathers who call them favorite fuss-busters: Football hold. Place your baby stomach-down along your forearm, with his head near the crook of your elbow and his legs straddling your hand. Press your forearm into baby's tense abdomen. Or, try reversing this position so that his cheek lies in the palm of your hand, his abdomen along your forearm, and his crotch snuggled into the crook of your elbow.

The neck nestle. Snuggle baby's head into the groove between your chin and chest. While swaying back and forth, croon a low, slow, repetitive tune, such as "Old Man River." A father in our practice scheduled his daily exercise routine during baby's evening fussy times. While holding baby in the neck nestle position, he took his daily walk. This took the tension out of baby and pounds off daddy.

3. Colic dances. The choreography that works best to contain colic is movement in all three plains: up and down, side to side, and forward and backward – essentially, the movement that a baby was used to while in the womb. Favorite dance positions are the neck nestle, the football hold, and the colic curl. Our favorite colic-soothing dance is one we called "the elevator step." Spring up and down, heel to toe, as you walk, while holding baby securely in the neck nestle position. Bounce at a rate of 60 to 70 beats per minute (count "1-and-a-2-and-a…"). Interestingly, this rhythm corresponds to the pulse of the blood to the uterus that baby was used to in the womb. Another comforting ritual that worked for us is one we called the "dinner dance." Some babies love to breastfeed in a sling or carrier while you dance. Your movement, plus baby's sucking, is a winning combination for settling even the most upset infant. Babies usually prefer dancing with their mother; she is the dance partner he came to know even before birth. This also explains why some fathers get frustrated when they try to cut in, offering some relief to a worn-out, dancing mom. Yet, many fussy babies like a change in routine and welcome the different holds and steps of a sympathetic sub. (For more dance steps see Dancing with Baby)

4. Baby bends. When your baby is at the peak of an attack, try these abdominal relaxers:

The gas pump. Lay baby face-up on your lap with her legs toward you and her head resting on your knees. Pump her legs up and down in a bicycling motion while making a few attention-getting facial expressions.

The colic curl. Place baby's head and back against your chest and encircle your arms under his bottom, then curl your arms up. Or, try reversing this position by placing baby's feet against your chest as you hold him. This way you can maintain eye contact with your baby and entertain him with funny facial expressions.

5. Tummy rolls. While laying a securing hand on baby's back, drape him tummy-down over a large beach ball and gently roll in a circular motion. Another use for a large beach ball (you can purchase "physio balls" from infant-product catalogs) is the baby bounce. Hold baby securely in your arms and slowly bounce up and down while sitting on the ball. We still have "the big red ball" rolling around our house as a memento of our bouncing past.

6. Tummy tucks. Place a rolled-up cloth diaper or a warm (not hot) water bottle enclosed in a cloth diaper under baby's tummy. To further relax a tense tummy, lay baby stomach-down on a cushion with her legs dangling over the edge while rubbing her back. Turn her head to the side so her breathing isn't obstructed.

7. Tummy touches. Sit baby on your lap and place the palm of your hand over baby's navel, and let your fingers and thumb encircle baby's abdomen. Let baby lean forward, pressing her tense abdomen against your warm hand. Dad's bigger hands provide more coverage. Or, with baby lying on her back, picture an upside down "U" over the surface of your baby's abdomen and using warm massage oil on your hands and kneading baby's abdomen in a circular motion with your flattened fingers, massage from left to right along the lines of the imaginary "U." (See )

8. Warm touches. A warm bath for two often relaxes both you and baby. Or, a famous fuss-preventer I have used with our babies is a technique I call the warm fuzzy: while lying on a bed or the floor, drape baby tummy-to-tummy and skin-to-skin with his ear over dad's heartbeat. The warmth of your body, plus the rise and fall of your chest, is a proven fussbuster.

9. Magic mirror. This technique pulled our babies out of many crying jags. Hold a colicky baby in front of a mirror and let him witness his own drama. Place his hand or bare foot against his image on the mirror surface and watch the intrigued baby grow silent.

10. Babywearing. Anthropologists who have studied infant care practices throughout the world have noted that carried babies tend to fuss less. We use the term "babywearing" because wearing means more than just picking up a baby and putting her in a carrier when she fusses. It means carrying a baby several hours a day, before baby begins to fuss. Carrie, a mother in our practice, had a colicky baby who was content as long as she was in a sling. But Carrie had to return to work when her baby was six-weeks-old. I wrote the following "prescription" to give to her daycare provider: "To keep Tiffany content, wear her in a sling at least three hours a day." One of the theories about colicky behavior is that it's a symptom of disorganized biorhythms. During pregnancy, the womb automatically regulates baby's systems. Birth temporarily disrupts this organization. The more quickly a baby gets outside help with organizing these biorhythms, the more easily she adapts to life outside the womb. By extending the womb experience, the babywearing mother and father provide an external regulating system that helps to organize baby. In comforting colicky babies, it helps to think of the womb experience as lasting eighteen months – nine months inside the mother, and nine months outside. (For additional comforting tips see Fussy Baby)

When will it stop? Colic that has no diagnosed medical cause begins around two weeks of age and reaches its peak around six to eight weeks. Seldom do the outbursts continue longer than four months of age, but fussy behavior may last throughout the first year and mellow between one to two years of age. In one study of fifty colicky babies, the evening colic disappeared by four months in all the infants. What's magic about four months? Around that time, babies develop more internal organization of their sleeping patterns. Other exciting developmental changes also lead babies to the promised land of fuss-free living: They can see clearly across the room. Babies are so delighted by the visual attractions that they forget to fuss. Next, they can play with their hands and engage in self-soothing finger sucking. Babies can enjoy more freedom to wave their limbs free-style and blow off steam. Also, after the first several months, a baby's intestine is more mature and milk allergies may subside. Or, by this time the cause has been found or comforting techniques perfected.

Besides comforting your baby, it's important to comfort yourself. Here are some time-tested ways of surviving and thriving with your colicky baby:

1. Realize it's not your fault. Oftentimes the cause of your baby's cries cannot be found. You need not feel that it's your fault if your baby cries a lot, nor is it your job to make your baby stop crying. Colicky cries not only pierce tender hearts; they may also push anger buttons. If baby's escalating cries are getting to you, hand baby over to another person or put baby safely down and walk out of the room until your scary feelings subside. Don't take your baby's cries personally. Your job is to create a supportive environment that lessens your baby's need to cry, to offer a set of caring and relaxing arms so that your baby does not need to cry alone, and to do as much detective work as you can to figure out why your baby is crying and how you can help. The rest is up to your baby.

2. If you resent it, change it. If you are beginning to resent your style of parenting and your constant babytending and are feeling at the mercy of your baby's cries, take this as a signal that you need to make some changes. The key to surviving and thriving with the colicky baby is to keep working until you find a parenting style that meets the needs of your infant, but at the same time meets your needs and does not exceed your ability to give. Yes, you will have to stretch yourself, but not until you snap. Get help with household chores that drain your energy. Also, oftentimes it's necessary to hand baby over to a caring and experienced pair of substitute arms and go out and do something just for yourself.

PARENTING TIP In the exam room that I do most of my colic counseling, hangs a sign that reads: "Each day remind yourself what your baby needs most is a happy, rested mother."

A mother in our practice shared this story with me: "One day when my baby was one-month-old, I was talking to my mother on the phone and I said, 'Mom, I've been crying for two days, I can't stop, and I'm getting scared.' Mom came right over. We had a talk and she said, 'Donna, it's okay to feel resentful that your life has been turned upside down by this precious little baby girl.' I said, 'That's exactly how I feel. I don't resent her, but I resent the fact that I have no life anymore. I feel isolated and depressed.' Mom said, 'I'll take Lauren tonight and you and Michael go out for dinner.'

In our pediatric office we collect pictures of cute T-shirt sayings. One of our favorites, worn by a two-year-old, is: Mom's having a bad day. Call 1-800- GRANDMA.

3. Job share. The person who shared in the conception must also share in the care of the colicky baby. Hand the well-fed baby over to dad and go take a SOAK.

4. Plan ahead. Mornings are usually an easier time for colicky babies and their rested parents, yet evenings take their toll.

HAPPY HOUR For unknown reasons, some colicky babies seem to go to pieces in the late afternoon or early evening and, by a quirk of injustice, just when your parental reserves are already drained. If your baby is a "P.M. fusser," plan ahead for "happy hour" before baby's colic rears its ugly head. Prepare the evening meal in advance, so that you can devote one hundred percent of your attention to her during this time. Frozen, precooked casseroles and colicky babies mix well. Treat baby and yourself to a late afternoon nap. Upon awakening, go immediately into a relaxing ritual, such as a 20-minute massage, followed by a 40-minute walk carrying the baby in a sling or carrier (a good way for you to work in some post-baby exercise, too). With this before-colic ritual, baby is conditioned to expect an hour of pleasure rather than an hour of pain.

5. Take the long view. There is life after colic. The time in your arms is a very short period in the total life of your child, but the memories of love and availability last a lifetime.

FEATURES FUSSY BABY (high-need baby) COLICKY BABY (hurting baby)Intensity of cryingSettles when held, consolableShrieks inconsolablyBehavior patternNo consistent patternPainful outbursts interspersed with periods of calmness, usually occurs in late afternoon and evening, alternating periods of contentment and violent outbursts: "He seemed perfectly happy and content just a minute ago, now he's a wreck, and so are we."Body language and facial featuresUpset, a fretful look, tense muscles, often relaxes when held"Ouch" signs: facial grimaces, furrowed forehead, crying with wide-open mouth, clenched fists, hard tummy, flailing arms and legs, arms clenched tightly closed to chest and knees drawn up against a bloated abdomen; back arching; brief post-colicky snooze as if "spent."Parents' intuition"It's her temperament.""I know he hurts somewhere."

"At three weeks of age Leah became very fussy and cried all day long. She would awaken in the morning fussing and by late afternoon it would turn into an unreachable screaming and crying fit. Unreachable because there was no way to calm her down and she seemed totally unaware of her surroundings. Her eyes were opened but she did not "see." Her crying was very loud and her whole face would turn red, and I often thought she was going to stop breathing. During the day, she nursed very infrequently and only for a few minutes if she did at all. She would latch on to the breast and after a few sucks throw her head back, arch her back, and start screaming. It was nearly impossible to get her to sleep during the day, and transitioning from wakefulness to sleep was very difficult for her. I do believe that in some ways it made me become more "attached" to my daughter because of all we've been through, and I think I will be a more sensitive and responsive parent because of it. I never let her "cry it out" and I never stopped looking for answers, and I probably never will."