Colic

Introduction to colic:

It usually strikes toward the end of a long day, when your baby is just about at the age when your sleep deprivation has really begun to set in. Your baby stops being the quiet, peaceful, miracle baby and begins screaming every evening. It is no wonder that parents become frustrated, discouraged, and depressed.

What is colic?

Almost all babies go through a fussy period. When crying lasts for longer than three hours a day, and is not caused by a medical problem (such as a hernia or an infection), it is called colic. This phenomenon is present in almost all babies, the only thing that differs is the degree.
The child with colic tends to be unusually sensitive to stimulation. Some babies experience greater discomfort from intestinal gas (and they tend to swallow even more air when they cry!). Some cry from hunger, others from overfeeding. Some breastfed babies are intolerant of foods in their mother’s diets. A few bottle-fed babies are intolerant of the proteins in formula. Fear, frustration, or even excitement can lead to abdominal discomfort and colic.
Whatever the mechanism, I believe that the fussy period exists in order to change deeply ingrained relationship habits. Even after the miracle of a new birth, many parents and families would revert to their previous schedules and activities within a few weeks – if the new baby would only remain quiet and peaceful. It would be easy to continue reading what you want to read, going where you like to go, doing what you like to do as before, if only the baby would happily comply. Instead, the baby’s exasperating fussy period forces families to leave their previous ruts and develop new dynamics that include this new individual. Colic demands attention. As parents grope for solutions to their child’s crying, they notice a new individual with new needs. They instinctively pay more attention, talk more to the child, and hold the child more – all because of the colic. Colic is a powerful rite of passage, a postnatal labor pain where new patterns of family life are born.

Who gets colic?

Almost all babies will develop a fussy period. About 20 percent of babies will cry enough to meet the definition of colic. The timing varies, but colic usually affects babies beginning at about three weeks of age and peaking somewhere between four and six weeks of age.

What are the symptoms of colic?

For most infants the most intense fussiness is in the evening. The attack often begins suddenly. The legs may be drawn up and the belly distended. The hands may be clenched. The attack often winds down when the baby is exhausted, or when gas or stool is passed.

Is colic contagious?

Colic is not contagious, but babies do respond to the emotions of those around them. When others are worried, anxious, or depressed, babies may cry more, which can make those around them more worried, anxious, or depressed.

How long does colic last?

Colic will not last forever! After about six weeks of age, it begins improving, slowly but surely, and is generally gone by twelve weeks of age. When colic is still going strong at 12 weeks, it’s important to consider another diagnosis (such as reflux).

How is colic diagnosed?

Colic is usually diagnosed by the history. A careful physical exam is wise to be sure the baby does not have a hernia, intussusception, a hair tourniquet, a hair in the eye, or another medical problem that needs attention.

How is colic treated?

Helping a child with colic is primarily a matter of experimentation and observation. Different children are comforted by different measures. Some prefer to be swaddled in a warm blanket; others prefer to be free. The process of treating colic involves trying many different things, and paying attention to what seems to help, even just a little bit.
Holding your child is one of the most effective measures. The more hours they are held, even early in the day when they are not fussy, the less time they will be fussy in the evening. This will not spoil your child. Body carriers can be a great way to do this.
Some babies are only happy when they are sucking on something. A pacifier can be like a miracle for some.
Singing lullabies to your baby can be powerfully soothing. It is no accident that lullabies have developed in almost every culture. The noise of a vacuum or of a clothes dryer is also soothing to many babies.
As babies cry, they swallow more air, creating more gas and more abdominal pain, which causes more crying. This vicious cycle can be difficult to break. Gentle rocking can be very calming (this is directly comforting and seems to help them pass gas). When you get tired, an infant swing is a good alternative for babies at least 3 weeks old with good head control.
Holding your child in an upright position may help (this aids the movement of gas and decreases heartburn). A warm towel or a hot water bottle on the abdomen can help. Some babies prefer to lie on their tummies, while someone gives them a backrub. The gentle pressure on the abdomen may help.
Some children seem to do best when they are going for a ride in the car. If your child is one of these, you might try a device developed by a pediatrician to imitate car motion and sound.
Some parents report an improvement by giving simethicone drops, a defoaming agent which reduces intestinal gas. It is not absorbed into the body and is therefore quite safe. Sometimes doctors will prescribe stronger medicines for severe colic (but this should only be done after a physical exam). If nothing else seems to work, you might try pretending your baby is sick, and taking a rectal temperature (do not use a mercury thermometer). This will often cause babies to pass gas and obtain relief.
There are many stories about foods that breastfeeding moms should avoid. Most often, I hear about abstaining from broccoli, cabbage, beans, and other gas-producing foods. The scientific evidence is strongest for avoiding stimulants such as caffeine and caffeine-related compounds (those found in chocolate). The other foods in mom’s diet that are most likely to cause a problem are dairy products and nuts. I would try eliminating these for a few weeks. Other foods may also irritate the baby. Experimentation and observation will guide you.
Switching formulas is not helpful for most babies, but is very important for some.
Taking a break is a good idea. Each of you can take charge and spell the other. Time for oneself is an important part of the new family dynamic. You will be able to pay more loving attention to your baby when you’ve had a chance to get refreshed.

How can colic be prevented?

A fussy period is likely no matter what prevention techniques are undertaken. Good feeding techniques (as advised by a lactation consultant, if appropriate), good burping, and early identification of possible allergies in the baby’s or mother’s diet may help prevent colic. Experimenting with the comfort techniques outlined above before colic develops can help you identify your baby’s needs and desires, and can help stop the fussy period from becoming so intense.

Related A-to-Z Information:

Diaper Rash, Food Allergies, Gastroesophageal Reflux, Hernia (Inguinal hernia), Intussusception, Nightmares