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Tuesday, April 18, 2017

Firmly embedded in the psyche of Caribbean medicine is the triad of baby conditions: virus, teething and colic. Where would the average GP be if she did not have those three words to say to worried mothers? What else is designed to make those moms feel good but the magic words, virus, teething or colic? Baby crying? Is ah virus. Baby crying? Is teething. Baby crying? Is colic. All that changes is the age. Under three months, colic. Four to six months? Teething. Above that, anything could be a virus.

Of these the most interesting is colic. The other two have evidence to support their existence. Despite years of research, there is no evidence to support the view that colic exists because no one knows what colic is or what causes it.

Colic is defined as uncontrollable crying of unknown origin in an otherwise healthy baby. It starts around one month of age, occurs more or less daily, always in the afternoon, especially between four to seven pm, and disappears by three months. It’s often accompanied by tensed abdominal muscles, curled up legs and fists and often seems to end when the baby passes gas or has a bowel movement.

For this reason it’s often called “gas” or “gripe,” the idea being that the distress is caused by an intestinal problem, similar to the gas story beloved of West Indian adults and which is said to be accompanied by “gripe” followed by the relief-attaining passage of gas.

This is a fine example of adults deciding what’s wrong with a baby based on adult experience. It’s analogous to the anthropomorphizing that we do with animals, talking about them as if they were human (the Easter Bunny is an anthropomorphized rabbit). “Adultpomorphizing” babies to fit our experiences. It shows a complete lack of understanding of babies and the fault for that must lie in our educational systems, our medical schools and most of our doctors who do not have a clue what to do with a crying baby.

The common scenario surrounding “colic” is new parents, new baby, often the first. How is the baby doing? Good, doctor but plenty “colic”, we giving……. and the usual litany of medications, teas, waters, anti-reflux drugs, herbs, alcoholic tinctures etc, is trotted out, sometimes literally from the bottom of the baby bag. My lord, is a pharmacy they have in there and the poor baby not yet a month old—and all useless.

Question, when does the baby cry? Any time, said with satisfaction usually, occasionally anxiety. For it is taken as a sign of health when the baby has “colic”. It’s expected. It’s common. All the babies have it. It’s taken as a sign of Trinidadianism or Grenadianism or Venezuelanism or any one of the countries where colic is common.

Because it’s interesting that “colic” is common in only certain countries. It’s rampant in the West Indies and Venezuela, the two countries I have most worked in but almost unheard of in the USA especially in the North-East where I worked for five years and seldom heard a mother complain about colic.

There’s even been a recent study showing that “colic” is most common in Canadian, British, and Italian babies and least in Danish, German and Japanese babies. Thirty-four per cent of Canadian babies got “colic”; 28 per cent of the British did too, and 21 per cent of Italian babies. Yet the prevalence was only five per cent in Danish babies and seven per cent in Germany. In Japan it was barely two per cent.

The baby above cannot not have “colic” according to the medical definition. That baby is crying because one of its basic needs is not being fulfilled. For the first few months a baby’s basic needs are four: food, warmth, cleanliness and stimulation. Absence of any one will cause crying. Of these the most lacking is stimulation. Some how or the other, the idea has risen that babies must be seen but not heard and the little “angels” must sleep a lot. Feed’em, clean ‘em, tuck them in and leave ‘em!

Nothing could be further from the truth. Newborn babies need stimulation just as much as they need food. Stimulation is food for the baby’s brain. Stimulation means you have to spend time with your baby if you want your baby to be content. Mobiles and monitors don’t do it, human faces, human voices and especially human touch does it.

So the baby cries when you leave her alone, someone says “colic”, the drugs come out, homemade or not they are drugs, they don’t work (unless they tranquilise the baby). What works? Picking up the baby and playing with the baby. Now that creates all kinds of psycho-social problems in the West Indian home where the first-time mother is told sagely that she is “spoiling” the baby by picking her up. Or “spoiling” her by sleeping with her.

What passes for “colic” in T&T and the West Indies is the normal reaction of a newborn baby whose needs are not being satisfied. Especially the need to be picked up and held closely to the mother’s body and comforted. Moreover, babies are exquisitely sensitive to tensions around them tensions which are expressed through the mother’s body. An uptight mother creates an uptight baby who cries. Hence the need for someone in the household who is calm to take the baby. A baby whisperer. That someone could be the father, a friend, an auntie, someone sensible who realises that babies need hand, need attention, need stability and above all need to feel loved.


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