It doesn't require a biological link to trigger the brain's reaction. The same response to adorable that is found in mothers and fathers is also found in all other adults and even in children. The appeal of a vulnerable infant generates a near-universal desire to help. “Can I hold her?” the older brother will ask, stretching his legs out the width of a couch as he tucks himself between pillows and promises to be very careful with her. Her very helplessness contains a survival tool that inspires mothers, fathers, big brothers and sisters, and all who gaze her way to provide care, support, and a sincere attempt to answer her needs.
There is within each of us a neurobiological explanation for why we feel the urge to take care of anything that resembles a baby—even a talking mouse, a little alien from outer space, or a fuzzy red Muppet.
A NEWBORN'S ABILITY TO CREATE A DIALOGUE
We know that crying is a vital part of communication between mother, father, or caregiver and baby. And being adorable is an important part of the dynamic. But what else is needed to keep parents involved in the round-the-clock, sleep-robbing, often frustrating task of keeping a newborn baby alive and safe?
“After six weeks, none of us would still be here if crying were the only thing to keep us attached to our mothers,” says Dr. Heidelise Als, director of Neurobehavioral Infant and Child Studies at Children's Hospital in Boston.7 Evolution required that infants develop other features if they were going to entice their mothers to hang in there with them. Dr. Als began looking at those evolved baby tricks by studying mother-infant interactions. She got to know mothers well enough during their pregnancies that they invited her into the delivery room. She watched, listened, and took notes as they first laid eyes on their offspring. ("You look like Uncle Louie.” “You're here, and you're all mine.”) She came back the next day, and the next, and the next and kept watching, all the while asking herself the same question: What impact is the baby having on the mother?
As time passed, Dr. Als found something that she didn't expect. There was a dialogue of facial expressions between mothers and newborns that immediately became a two-way street. From day one, the baby's open eyes made mother happy and inspired her words. The baby's yawn led to a winding down of the mother's words. A sneeze would elicit words of comfort. A scrunched-up face would trigger a tender laugh.8
Each baby, if you pay close attention, is keeping up his end of a conversation of signals, moods, and rhythms. He's helping to steer adult response, even as individual responses are teaching him to call up new conversational signals. Babies have ways of keeping the people who love and pay attention to them involved, and they'll begin the dialogue immediately with a birth mother, or with an adoptive parent or other committed caregiver, as soon as they get the chance. Those skills, refined through millions of years of evolution, prove to be enough to get the adults in their lives to put up with crying, sleeplessness, dirty diapers—and a transformation of life that new parents can't possibly have anticipated.
THEORIES ABOUT EXCESSIVE CRYING
Excessive crying happens a lot. In 10 percent to 25 percent of families, unexplained infant crying is the most common parental concern. The peak in crying time comes at about six weeks to two months, but can last until four to six months of age. Episodes of crying, nerve jangling for even minutes, can last for hours, with scarcely minutes of quiet respite.9
The traditional theory about excessive crying used to be that it was gas or an upset stomach. Now, unexplained and prolonged crying in the fourth trimester is seen primarily as an inability to regulate the sleep-wake cycle, or an immature ability to get to a calm state internally. An infant has normal states, ranging from deep, quiet sleep to fully awake lusty crying.10
Colicky or irritable babies are somewhat less organized in their initial sleep-wake cycles. While excessive crying generally peaks at about six weeks, and while, in about three months, most babies mature and possess a greater ability to calm themselves, some babies during the fourth trimester may be more sensitive to overstimulating environments. They get overwhelmed by a lot of activity in the household—a football game on the television, siblings fighting, the chaos of a routine dinner hour—and have not yet figured out how to soothe themselves and tamp down their arousal enough to fall asleep. Instead, they cry.
COLIC AND THE RULE OF THREES
Colic is defined not by physical problems but most commonly by time. A baby is considered colicky if she has unexplained crying for more than three hours a day, for at least three days a week, for three weeks running. By the time those numbers, or worse numbers, are racked up, parents are pretty stressed out.
A highly popular book, The Happiest Baby on the Block by Dr. Harvey Karp, suggests providing what he calls the “Five S’s.” Those are swaddling, side or stomach position while holding, shushing sounds, swinging, and sucking (bottle, breast, pacifier, or even a finger).11 For some families, these work like a charm. Others need additional help.
If the numbers in the crying pattern are lower than in the colic guideline of threes, the infant may still be considered fussy in her parents’ eyes. However one labels the problem, the crying will usually lessen as the infant matures in the fourth trimester and is better able to calm herself and regulate her sleep and wake cycles.
FUSSY OR COLICKY: MOTHERS AND FATHERS NEED SUPPORT
With a truly fussy or colicky baby, parents need help. No caregiver can do it alone, and adults have to take care of themselves if they're going to be able to care for the infant. Professionals like physicians, social workers, or mental health workers can help. So can parenting groups, a mother, father, or in-law, or a friend who has survived a colicky baby. Spouses and partners can take turns giving each other a respite. All of that can amount to a schedule of relief—time to catch up on sleep, leave the house, and spend some time without infant responsibilities. Time out from parenting is a basic need, especially when a newborn cries excessively. The fourth trimester is, in the scheme of things, a short time. But it's incessantly demanding and tense.
In 2003 Dr. Linda Gilkerson founded the Fussy Baby Network at Chicago's Erikson Institute. The network has expanded to include programs in cities throughout the country, including one at Southwest Human Development's Arizona Institute for Early Childhood Development in Phoenix; one at the Children's Hospital and Research Center in Oakland, California; one operated by the University of Colorado Denver at the Children's Hospital; and another at the Boston University School of Medicine. Similar programs are being developed in the Los Angeles and Washington, D.C., areas. There are other organizations similar to the Fussy Baby Network, such as the colic clinic Dr. Barry Lester founded at Brown University in Providence, Rhode Island.
Gilkerson wanted to provide support for parents concerned about their infants’ crying or temperament, a desire rooted in her experience with her own colicky son, Michael, during his fourth trimester. Dr. Gilkerson and Michael had endured an extremely difficult fourth trimester—for more than three months he cried inconsolably. There had been trips to the pediatrician, where he was declared healthy. Nothing was wrong, yet each day was unpredictable, adding to the stress. Michael would have endless crying bouts that his family came to call “Big Mac” attacks. He cried through feedings, diaper changes, and endless, futile attempts at comfort. Then a peaceful day would come, with no crying jags, followed by another day of “Big Mac” attacks. Through it all, he was a healthy baby. The diagnosis, common among babies who cry a lot, was the ill-defined “colic.” After each medical trip, Gilkerson went home assured that her baby was fine. But she received no advice on how to deal with excessive crying herself: how to help her baby through it, or what to make of it. Despite the assurances of good health, he remained fussy—and there seemed to be no end in sight.
By the end of the fourth trimester, the excessive, inexplicable tears and howls were almost over.