Now that you and your doctor have canned the term colic and approach your child as a hurting baby, here is a step-by-step approach to tracking down why your baby hurts and what to do about it:

Step 1: Keep a colic diary. Recording your baby’s outbursts is helpful for two reasons: you may uncover clues that help your baby’s doctor diagnose a hidden medical cause of why your baby hurts, and, by trial and error, you will develop your own home remedies and comforting tools. Record the following in your diary:

• What triggers the outbursts of crying? What turns them off?
• How frequently do they occur and how long do they last?
• Does Baby awaken in pain at night, or are the crying jags mainly a daytime occurrence? Night waking in pain usually means a medical cause of Baby hurting.
• Are these episodes getting better, worse, or staying about the same over time?
• Do the episodes consistently seem to be related to feeding: method of breastfeeding, type of formula, type of bottle? What changes in feeding techniques or formulas have you tried?
• Does your baby spit up frequently? How often? With how much force? How soon after feeding?
• If breastfeeding, do you notice any correlation between what you eat and how much your baby fusses?
• Does your baby seem to have “gut problems”? Is she bloated? An air swallower? Gassy?
• Record your baby’s bowel movements. How frequent are they? Are they easy to pass? Are they soft or hard? Do you notice any changes in the frequency or characteristics of the stools in response to a change of feeding?
• What changes or comforting techniques have you tried?
• What consistently works? What doesn’t?

Step 2: Video record your baby’s episodes. To help your doctor appreciate how devastating these painful episodes are, videotape a few of your baby’s crying jags and bring it with you as part of your baby’s medical evaluation. We have found that watching the distress tape helps us appreciate whether Baby is just crying or really hurting, and the type of cry often gives a clue to the diagnosis.

Step 3: Schedule a medical evaluation. Don’t settle for just a five-minute squeeze-in appointment. To thoroughly evaluate a hurting baby, your pediatrician needs time. Request an extended office visit, preferably the last one of the morning or when the doctor usually schedules consultations. To get the most out of your “hurting baby medical evaluation,” do the following:

• Bring along your diary and your videotape.
• Don’t hold back how much your baby’s crying bothers you. As one exhausted mother told us, “I’m camping out in your office until you find out why my baby is crying.”
• If possible, both mother and father should attend the doctor’s visit. Mothers downplay how much Baby is crying and the impact on the family because of the myth that Baby must be crying because of “something Mother is doing or is not doing.” Fathers will often tell it like it is: “My wife is burning out, and our baby’s crying is taking a toll on our nerves.”

Step 4: Suspect an underlying medical cause in these cases:

• The baby frequently awakens in pain (hypersensitive babies who cry a lot for no obvious medical reason often sleep well at night).
• The “colic” is not going away.
• The baby’s cry is so intense that your intuition tells you, “My baby hurts somewhere.”
• The baby is not thriving; for example, his weight gain is poor, and he has frequent respiratory and intestinal illnesses.