Inside a Colic Clinic

Difficult to define, even harder to treat, colic can turn a family's life upside down. In Rhode Island, one center is paving the way for new thinking about how to treat crying babies and the parents who are desperate to help them.

Introduction, p.1

Delaney Sullivan is fast asleep in her car seat. All of 2 months old, she doesn't wake on a recent Tuesday afternoon as her mother and grandmother are buzzed through the foyer at the Brown Center for the Study of Children at Risk in Providence. In the spacious, sunlit, and at that moment, hushed waiting room, the receptionist greets them by name and peeks over her desk at Delaney. Her mom removes the baby's hat, revealing peach-colored fuzz that causes everyone to coo, but Delaney doesn't stir.

The irony is supreme. Delaney is a patient at the Infant Behavior, Cry and Sleep Clinic, better known as the Colic Clinic, a collaboration between Brown University/Brown Medical School and Women & Infants Hospital of Rhode Island. At 3 weeks old, Delaney started to exhibit signs of colic, the newborn condition characterized by sudden, intense, inconsolable bouts of crying; disordered feeding; and difficulty sleeping. During the day, she'd grunt, fuss, and cry; in the evening, she sobbed for seemingly endless intervals. "My very happy baby turned into a very unhappy baby," says her mom, Athena Sullivan, 33, of Warwick, RI, who works as a school psychologist at Attleboro High School in Massachusetts.

When she wasn't crying outright, Delaney was so fussy and agitated that Sullivan felt she had to rock, shush, and walk her nonstop to keep her from screaming again. Delaney rarely napped, wasn't sleeping well at night, and often seemed to be in genuine pain, especially after a feeding session.

After unproductive discussions with their pediatrician, the Sullivans sought out the services of the Colic Clinic. With more than 270 patients per year, most from New England but some from beyond, the clinic sees families who find it through healthcare professionals, mothers' groups, desperate Internet searches, or word of mouth. What draws these families? Quite simply, the clinic's revolutionary, research-backed approach: It treats excessive crying in infants not just by investigating what's bothering the baby but by tending to the psychological needs of the child's beleaguered parents as well.

During this visit, Sullivan makes two insurance co-payments—one for one of the clinic's two pediatricians, billed to the baby's account, and another for one of the clinic's psychologists or social workers, billed to her parents' account. Soon, Delaney is surrounded by four women—her mom; her grandmother; Pamela High, M.D., a pediatrician and the medical director of the clinic; and Jean Twomey, Ph.D., a social worker. Behind a darkened window in one wall of the examining room is an observation area, complete with video cameras, recorders, and microphones, where two other people, graduate students of Dr. High's, watch the proceedings.

For the next 20 minutes, Sullivan talks almost without taking a breath, chronicling every aspect of Delaney's days and nights since their last visit two weeks ago. Drs. High and Twomey listen intently, taking notes and nodding sympathetically. The clinicians then study timesheets on which Sullivan had tracked Delaney's fussing, crying, eating, and sleeping over three recent days and nights, with details about where Delaney had fallen asleep (her swing, her car seat, her crib, her parents' arms).

Now Dr. Twomey spreads out Delaney's "cry diary" on the floor, with fussing and crying episodes highlighted in fluorescent green and yellow. A quick glance shows plainly that the Sullivans had a miserable day the previous Saturday, with hour upon hour filled with either F's or C's.

"I can see from the chart this must have been a very difficult day," Dr. Twomey says gently. "When I see all those F's, I think you must have been working hard then to keep her from crying, yes?" Sullivan nods, her deep brown eyes threatening to tear up.

As the appointment winds down two hours later, Sullivan wakes Delaney to be weighed and measured, and at last the baby starts to produce some of the hoarse, unmistakable cries of colic. "Here we go," says Sullivan, rolling her eyes as she jiggles Delaney on her shoulder.

But she's able to smile. Not only had she been given an enormous chunk of undivided attention from top pediatric specialists, she's also received a three-page printout summarizing the progress she's made and detailing strategies and goals for Delaney's sleeping and feeding regimens over the next two weeks. Most important, Sullivan leaves with the conviction that she can do something about her baby's colic—perhaps the most noteworthy prescription the Colic Clinic dispenses.

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