What is colic?
Colic does not have a standard definition. It is best described as a state of prolonged and excessive crying in a baby that is otherwise well. A baby with colic is probably not hot, hungry, cold, or in any kind of pain. Crying is normal in infancy. All infants cry more in the first 3 months of life than at any other time. In fact, babies normally cry for up to 2 hours per day.
Infants with colic cry excessively for no apparent reason. In order to diagnose a colicky baby, the “rule of three’s” should be present – the baby cries for at least 3 hours per day, at least 3 days per week, and this should continue for at least 3 weeks.
Babies with colic cry in bursts (paroxysms) that can last up to 2 hours. These crying episodes may occur several times a day but are more common in the late afternoon or early evening. The cry of a baby with colic tends to be louder, higher in pitch, and more intense. The colicky baby may become tense, draw up his legs, and clench his fingers. Babies with colic are difficult to console and do not stop crying despite changing the room temperature, removing clothing or attempting to feed.
Age of Colicky Babies
How old are babies with colic?
Colic usually begins around 3 weeks of age. Fortunately, most infants outgrow colic by 3 months of age but it can continue for 5 to 6 months. Colic is a very common problem that affects at least 10 to15 percent of all infants. Both boys and girls are equally affected.
Causes of Colic in Infants
The cause of colic is unknown. Some of the possible, though unproven, causes of colic include :
- Problems with digestion. Some infants may have an intolerance to the protein in cow’s milk while others may not adequately digest lactose, a sugar, in cow’s milk.
- Overactive intestines. Some studies have indicated that babies with colic may have a more active digestive tract resulting in a more rapid transit of food from the stomach into and through the intestines.
- Different bacteria in the intestines. The digestive tract normally has certain bacteria living within it which aid in the digestion of food and maintain a healthy digestive system. Babies with colic have been shown to have different types of bacteria in their intestinal tracts than babies without colic.
- Feeding issues. Overfeeding, underfeeding, not burping, and swallowing air are feeding issues that may contribute to colic.
- Exposure to tobacco smoking. Babies who are exposed to smoking, either while in the womb or after they are born, have been shown to have a greater risk for colic.
- Temperament/personality. Colicky babies tend to be more sensitive, irritable, intense, and harder to soothe.
- Immature nervous system. Babies with colic may have immature nervous systems that are not yet capable of regulating stimulation and cannot “self-console.” This ability develops as the baby grows older.
- Parental factors. Family stress, inexperience with a baby, or poor parenting skills can contribute to colic. Stressed or depressed mothers are not able to respond appropriately to their babies needs and this can contribute to colic.
Signs and Symptoms of Colic
How will you know if your baby has colic?
- Excessive crying : more than 3 hours per day, more than 3 days per week, lasts at least 3 weeks.
- A baby with colic may have a flushed face and firm belly (abdomen). The belly is tense because a baby needs these muscles to cry.
- The legs may be drawn up. Drawing up the legs is a normal posture for a crying baby.
- Fists and fingers may clench.
- Arms may extend and become stiff.
- Back may be arched.
The baby is completely normal between episodes of colic. Growth and development are unaffected.
Coping with Colic
Coping with colic can be very difficult and extremely stressful for parents, especially mothers. It is important to stay as relaxed as possible. Even the youngest babies are sensitive to stress and tension in their environment and can react by crying even more.
Parents should ask for help from friends and family if they are feeling exhausted or overwhelmed. The most serious and dangerous outcome is when parents become completely frustrated with a colicky baby and resort to shaking or abusing their baby. Never shake a baby. Shaking can cause serious injuries including blindness, brain damage, and even death.
Techniques to Soothe a Baby and Remedies for Colic
There a a number of strategies to soothe a baby with colic. No single treatment works for all babies and each specific tactic may work in only one-third of babies. It may be necessary to try several different interventions because not all will be effective for your baby.
- Repetitive or rhythmic movement. Rocking, walking with baby in a carrier, or swinging a baby can be effective. These movements may remind babies of being in the womb. Riding in a car may also quiet the colicky baby.
- Reducing stimulation. Swaddling or wrapping a baby snugly in a blanket can reduce stimulation. Calming sounds such as soft music, white noise, or a humming fan can create a more tranquil environment.
- Warmth. A warm water bottle on the stomach or a warm bath is soothing for some babies.
- Touch. Gentle stroking of the head, rhythmic massage of the stomach, or patting of the back can be helpful
- Formula issues. Some paediatricians will recommend a change in formula if a food sensitivity is a concern. A one-week trial of a special hypoallergenic or soy formula may be worth trying. If the baby’s colic does not improve, cow’s milk or regular formula can be resumed.
- Breastfeeding issues. Mother’s who are breastfeeding should watch their diets, limiting their intake of dairy products, nuts, wheat, caffeine, spicy foods, and chocolate as these foods can potentially contribute to colic.
- Feeding suggestions. Be sure not to overfeed. It takes about 2 hours for a baby’s stomach to empty after eating. Therefore, feeding a baby too often can cause bloating and even cramping.
- Reducing swallowed air. Using appropriate feeding bottles that will minimize how much air a baby swallows when eating. Feeding a baby in an upright position and frequent burping will also help with air swallowing and relieve trapped gas bubbles.
- Limit daytime sleeping which may promote nighttime sleeping. Do not force an infant to wake up if sleeping but avoid putting the baby for repeated naps as a way of avoiding spending time and playing with your baby.
- Herbal remedies. Teas from various herbs have been tried with no scientific proof that it is effective. These remedies should be avoided in infants as some may contain potentially harmful ingredients.
- Simethicone drops. This harmless medication is used to reduce gas but has not been shown to be effective.
- Probiotics. There is some evidence that treatment with probiotics such as Lactobacillus may be helpful but further study is needed.
- Antispasmodics. These medications have many serious side effects and are not recommended for the treatment of infantile colic.
Long Term Consequences of Colic
Colic can affect family functioning but these effects are not long lasting. It has no effect on the long-term development of learning and intellect. Colicky infants may be more difficult and emotional as toddlers. Several studies have shown that temper tantrums are more common in babies that had colic.
Parents need reassurance and support as those with colicky babies should take breaks – leaving a crying baby in a safe place such as their crib for a short period of time is fine. Parents should know that feelings of frustration, guilt, anger, exhaustion, and helplessness are normal. Seeking help from friends, family, and your pediatrician may be necessary.
Be patient and never take your baby’s crying personally. It is important and reassuring to remember that colic is not the result of bad parenting, causes no harm, and will resolve over time. However, it is prudent to get professional medical advice in order to exclude serious underlying conditions that may be the cause of excessive crying.