For crying out loud, it's natural and normal
Every evening for three weeks straight, the nightmare began like clockwork for second-time parents Steven and Louanne Midgley. At 6:30 p.m., their tiny new bundle started crying, hard and loud, face bunched like a small fist and red as a fire truck. He didn't stop until three hours later, on the nose, at which time he fell exhausted into a deep sleep, leaving his parents with frayed nerves-and 21 hours to prepare for the next round.
"He seemed out of control, and it was frightening. You felt so sorry for him. Then you felt sorry for yourself," Louanne Midgley said from the couple's home in Coquitlam during a telephone interview with the Georgia Straight. "It wasn't until we had Dylan that I understood what inconsolable really meant."
Mercifully, the nightmare stopped when Dylan was about eight weeks old, as abruptly as it started. Now 20 months of age, his parents say he is a bright, well-adjusted, active child who, like any toddler, cries occasionally when he's hurt or doesn't get what he wants, but not for too long.
The Midgleys' experience is not unusual. There's no shortage of parents with similar horror stories, unscathed but for the memories. Others, however, are permanently scarred. Research by Vancouver pediatrician Ronald Barr, a leading authority on infant development, shows that extreme crying is the trigger for 95 percent of cases of shaken-baby syndrome, in which a baby or child is shaken hard enough that the brain rotates inside the skull, damaging or destroying nerves and detaching/shearing blood vessels feeding the brain. Close to one out of four of these cases is fatal, according to Barr's findings, and 80 percent of survivors suffer permanent neurological damage or other handicaps such as cerebral palsy, blindness, learning disabilities, and developmental delays. Barr is on the international advisory board of the National Center on Shaken Baby Syndrome, where you can find more information at dontshake.com/.
Despite the dire consequences, Barr insists, ordinary people shake babies. Bombarded by well-meaning magazine articles on how parents can determine baby's needs by the sound of the cry and advice from friends on how to cure colic, parents often end up on a frantic search for possible solutions-gripe water, non-dairy formulas, long car rides, stints on top of a moving dryer, regular burping, constant rocking-all of it to no avail. Add to the frustration the guilt and anxiety that come from believing that a crying infant might be in pain, and it's not so hard to imagine giving baby a shake to get him to stop.
The answer, says Barr, is not to try and stop the crying, but to change the way we think about it. Dylan Midgley's extreme crying bouts fit a pattern particular to babies during the first three to five months of life starting at about two weeks: the crying is not related to hunger, fatigue, or a full diaper; it's resistant to soothing, appears related to pain, and can last for up to two or three hours. "It's a pattern that does not occur again," says Barr. "Later on in a child's development, crying is a signal that something is wrong. But during this early period, this pattern of crying is as normal a part of infant development as sleeping."
In other words, it's part of our hard wiring, not a result of experience. There's plenty of evidence to support this, reports Barr. Studies show that the onset of this pattern of crying in premature babies corresponds not with their age from the date of birth, but their "actual" age if they'd gone full-term. While full-term babies typically start the pattern of extreme crying at two to three weeks old, a baby born two weeks early, say, won't exhibit the pattern until they are four or five weeks old .
Barr cites other studies on the !Kung San tribe of South Africa, whose hunter-gatherer lifestyle allows mothers to do everything possible to soothe crying babies. "They carry their babies constantly, sleep with them, feed them every 13 minutes, respond to every whimper within seconds," says Barr, "and their babies still exhibit this particular pattern of crying."
Although nobody knows for sure the purpose of such crying, Barr says it's generally believed that it's a throwback to early human history when infancy was much riskier and babies often died during the first few months. Any behaviour that guaranteed a baby's protection by those caring for them would have been a valuable one, and crying assured babies would be picked up and held. It also stimulates the mother's milk let-down reflex and is part of the cry-feed cycle. "Our lifestyle has changed dramatically, but the mechanisms for assuring protection, closeness, caregiving, and nutrition are still there," says Barr.
While such mechanisms can be a nightmare for parents, the good news is the behaviour doesn't go on forever. Typically, extreme crying is over in three to five months or less. What's more, these babies don't grow into difficult, temperamental children. And the parents are not bad parents. "If they understand this," says Barr, "it makes a huge difference when they're going through it." And sometimes the best thing to do is put the baby down and walk away.
Even the Midgleys, who came through the crying nightmare exhausted but all right in the end, say they would have benefited from the knowledge that their baby's crying was "normal". "To this day, when we talk about that time," said mom Louanne, "we still look scared."
For other parents, it could well mean the difference between shaking a crying infant and being able to walk away.