By JENNIFER BARRETT
Salt Lake Tribune
Tuesday, November 06, 2007
Two and a half months ago, baby Isis came screaming into this world, and in the long, long days since, she's hardly stopped.
At first Shelly and Jeff Poole assumed their daughter had just been through a traumatic journey. But when the crying increased, they began to worry that something was terribly wrong.
"We thought maybe she had brain damage from jaundice," said Shelly.
So they embarked on an infant-calming odyssey: repeated trips to more than one doctor, a restrictive diet for Shelly, countless folk remedies, several prescription medications, a variety of slings, strollers and sleep positioners. Finally, they got some dispiriting advice:
"We can try this and we can try that, but it might just be colic and there's not much we can do," the family's pediatrician told them. "You might just have to figure out how to cope."
That advice is painfully common for parents of colicky babies. Some estimates say that as many as one in five infants suffers from inconsolable crying. It has also spawned as many pharmaceutical and folk remedies as it has sleepless nights, but there has been no definitive breakthrough.
Bryan Vartabedian and Barry Lester are two doctors pushing for change: better treatment not just for the baby but for the whole family.
Vartabedian, a pediatric gastroenterologist at Texas Children's Hospital and author of the book "Colic Solved: The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-to-Soothe Baby, believes that "colic is really a wastebasket term. Pediatricians use it when they have no idea what the heck is going on."
In his estimate, 60 percent or more of babies who are dubbed colicky have either milk-protein allergy or acid reflux disease, a condition in which the stomach contents come back up and irritate the esophagus.
Babies are especially prone to acid reflux for several reasons, he said. They drink only liquid, which is less likely to stay put, they don't benefit from gravity until they're old enough to sit up, and their stomachs don't empty effectively.
Both conditions are highly treatable.
Vartabedian is not the first to point to digestive issues as a major underlying cause, but he is waging a campaign to encourage parents to accept nothing less than a comprehensive medical workup of "colicky" children. His main goal is parent empowerment.
"If they feel that they've gotten the short end of the stick and have not had a (complete medical) history taken or a thorough exam done, they should look elsewhere until they feel that their baby is being well cared for," said Vartabedian, who was in Salt Lake City recently for a conference and is an assistant professor at Baylor College of Medicine.
Barry Lester agrees that there are many colicky kids whose reflux and allergies are undiagnosed. But he believes it's a smaller group than Vartabedian suggests.
A bigger problem is that entire families go untreated, said Lester, a professor of psychiatry at Brown Medical School and director of the nation's only clinic designated for treating colicky babies and their families.
Two babies who cry for hours on end in two different homes may spur completely different reactions in their families. For one, the crying may be annoying but survivable. For another, it may send a couple to the brink of divorce, drive a wedge between mother and child and cause older siblings to act out.
It's those cases that need the most medical intervention, he said, and not just from a physician.
Every family that comes to the clinic at the Infant Development Center at Women and Infants Hospital is seen by a pediatrician and a mental health specialist.
"Let's say a mother goes to their pediatrician and they're having a real problem with the baby crying, and the pediatrician says, essentially, 'Hey, lady, suck it up. This is normal. You'll get over it,' " said Lester.
"It raises doubts in the mother's mind about her ability to be an adequate mother. 'Am I making this up? Am I normal? What's wrong with me?'
"The insecurity and self-doubt makes the situation even worse."
Treatment is just as likely to include a prescription for a night out on the town without baby as it is a comprehensive exam for the infant. Developing routines to minimize crying and looking for signs of postpartum depression are also part of the plan.
The Pooles don't have access to Lester's Rhode Island clinic. But with the help of their pediatrician, family and friends, they've created their own treatment plan.
Shelly attends a postpartum depression group and sees a therapist. The couple has hired a baby sitter to take the baby out of their home so they can get some downtime.
These days, the baby's crying seems to be calming -- somewhat. But they are still shattered.
"We are so burned out now that we can't enjoy it. She's only 2 1/2 months old, and it almost feels like it's too late."
E-mail jbarrett(at)sltrib.com
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