Q: A mother whose child attends our nursery is at the end of her tether with her crying baby. He has been suffering from colic and there has been no let-up in the crying. She is suffering from sleepless nights and feels depressed, while her husband also seems unable to cope.
A: It can be very upsetting for a mother to feel that she cannot do anything to help calm and soothe her distressed baby. However, a constantly crying baby can be stressful for even the most confident and competent of carers. What this mother needs to appreciate is that any parent can reach crisis point and that there is help available. It is important too that she draws on the support of others - her husband, parents, friends and, of course, nursery staff and such organisations as the NSPCC, which can suggest strategies on how to soothe her baby, or cope in the face of continued crying.
First, the mum needs to be aware why her child is crying. Babies cry to alert parents and carers to their needs and feelings. This is not always just about being fed and changed. Cuddling is just as essential. If the baby continues to cry from the discomfort of colic, the mother's comforting and emotional warmth is still really valuable. Remember, calmly picking up and cuddling a crying baby isn't "spoiling" them. Gentle touch is an important part of a child's healthy emotional and social development.
We would advise the mother to hang on to the fact that she is making a difference to her child feeling loved and consoled through the painful colic, even if the child continues to cry. She can try rocking her baby gently in a cradle or pram; playing peaceful music; walking up and down with the child in her arms or in a sling. Holding positions that put gentle pressure on the abdomen can sometimes relieve colic. It's worth remembering too that a baby's level of crying tends to reduce after three or four months.
Sometimes, however, these strategies do not work immediately, and the mother may feel overwhelmed and perhaps even angry as a result.
Babies are extremely sensitive to the moods of their caregivers and this might make the crying even more intolerable. If the mother cannot calm herself, she might find it harder to calm her infant.
In these cases, it is best if she puts the child in a safe place like a cot or pram and goes into another room, where she can sit for a few minutes, perhaps with the TV on to distract her from the crying. She could also call on a friend or relative who may be happy to take over for a while.
Again, it is important that the mother does not try to cope entirely on her own. She should never let things get so bad that she feels desperate. There are lots of ways she can get help.
In this instance, the mother should consult her health visitor or GP for specific guidance on how to deal with colic. She should also remember that she can speak to these professionals about how she feels.
GPs and health visitors should be able to offer a range of solutions, from joining a support group and counselling to some practical pointers and simple reassurance that many mothers face a constantly crying baby, and find it equally hard to cope.
Early years practitioners have an important role in identifying parental stress. Their support and advice can help parents through a particularly demanding period and, ultimately, may be protecting the baby. In this instance, the nursery staff may be able to offer the mother critical respite.
It is crucial too that early years practitioners are alert to the possibility that a mother's stress could tip her into a state that will affect the well-being of the child. Nurseries have a responsibility to work in partnership with parents and signpost agencies that offer families advice, such as Crysis, NCT, Family Lives (formerly Parentline Plus) and the NSPCC. Early years staff should also discuss any continuing concerns that they may have about a child's well-being and safety with their designated safeguarding children officer.
Recent research from NSPCC and the Welsh Child Protection Systematic Review Group has found that babies under the age of one year old are particularly vulnerable to harm.
The research notes: 'Excessive crying in babies can be difficult to manage and may make them more vulnerable to inflicted brain injury.
'Brain injury may arise from shaking or impact injuries. The condition occurs most commonly in children less than two years old, with an estimated prevalence of 1:3,000 in babies of less than six months.'
The harm caused to a shaken infant can be tremendous and life-lasting. The research goes on to say: 'Apart from children who die as a result of an inflicted head injury, those who survive may have significant long-term disabilities: 31 to 45 per cent experience ongoing problems - including cerebral palsy, visual problems, epilepsy, learning and behavioural problems.'
Early years practitioners should never ignore the possibility that one of the children in their care might be at risk. If in doubt, they should call the NSPCC 24-hour helpline in confidence at 0808 800 5000. The practitioner needn't know for certain that a child is being badly treated. If they are unsure or have a general worry about the child's well-being, they can discuss this with the helpline.
Ann Norburn is an NSPCC senior consultant at its National Training Centre in Leicester.