What is colic?
For many parents, there is nothing more stressful than listening to an inconsolably crying newborn. Colic generally leads to long stretches of such crying. It can be a very difficult for parents, friends, and family who are already dealing with one of the most rewarding but potentially stressful experiences in life, a new baby at home.
- Colic is self-limited and episodic.
- Overfeeding, undiluted juices, food allergies, and emotional stress can aggravate colic.
- It is important for a baby with new abdominal pain and crying to be evaluated by a doctor who can exclude other more serious conditions.
- Don't give medications or other treatments to an infant unless they've been approved by the child's medical practitioner.
What is colic?
Infantile colic has been around for a long time. In 1954, Dr. Morris Wessel, a well-known New Haven pediatrician, defined an infant with colic as "one who, otherwise healthy and well-fed, had paroxysms of irritability, fussing, or crying lasting for a total of three hours a day and occurring on more than three days in any one week for a period of three weeks." It is also important to remember that not all fussy babies suffer from colic. Most infants normally cry two to three hours per day, but this is usually spread out during the 24-hour period.
What are the symptoms for colic?
Crying symptom was found in the colic condition
Fussing and Crying are normal for infants, especially during the first three months. And the range for what is normal Crying is difficult to pin down. In general, colic is defined as Crying for three or more hours a day, three or more days a week, for three or more weeks.
Features of colic may include the following:
- Intense Crying that may seem more like screaming or an expression of pain
- Crying for no apparent reason, unlike Crying to express hunger or the need for a diaper change
- Extreme Fussiness even after Crying has diminished
- Predictable timing, with episodes often occurring in the evening
- Facial discoloring, such as reddening of the face or paler skin around the mouth
- Bodily tension, such as pulled up or stiffened legs, stiffened arms, clenched fists, arched back, or tense abdomen
Sometimes there is relief in symptoms after the infant passes gas or has a bowel movement. Gas is likely the result of swallowed air during prolonged crying.
When to see a doctor
Excessive, inconsolable Crying may be colic or an indication of an illness or condition that causes Pain or discomfort. Schedule an appointment with your child's doctor for a thorough exam if your infant experiences excessive Crying or other signs or symptoms of colic.
What are the causes for colic?
The cause of colic is unknown. It may result from numerous contributing factors. While a number of causes have been explored, it's difficult for researchers to account for all the important features, such as why it usually begins late in the first month of life, how it varies among infants, why it happens at certain times of day and why it resolves on its own in time.
Possible contributing factors that have been explored include:
- Digestive system that isn't fully developed
- Imbalance of healthy bacteria in the digestive tract
- Food allergies or intolerances
- Overfeeding, underfeeding or infrequent burping
- Early form of childhood migraine
- Family stress or anxiety
What are the treatments for colic?
This is a very common problem (up to 25% of all babies suffer from colic). Discuss any concerns with the child's pediatrician and talk to other parents or relatives who have had similar experiences. Also keep in mind that colic generally occurs in big, healthy, active, vigorous babies who are great eaters and who grow very well. Sickly, poor-feeding, unhealthy babies or babies with significant underlying problems may well be cranky, miserable, and unhappy; however, these infants tend to be this way most of the time, whereas the baby with colic generally has episodes at a very predictable ("set your clock by the beginning and end") time of the day.
Here are some suggestions:
- Do not overfeed! Stick to the baby's regular feeding schedule of timing and amount of milk taken, as measured in ounces in the bottle-fed baby or in minutes on the breast in the breastfed baby.
- Breastfeeding mothers should avoid too many milk products ("you don't have to drink milk to make milk"), caffeine, onions, cabbage, beans, broccoli, and other gas-producing, irritating foods. Be sure that if the baby is taking juices, that they are very diluted, or just offer plain water. If babies are really thirsty, they will drink it.
- Avoid juices (young infants should not be drinking juice anyway).
- In the formula-fed baby, try changing to a formula containing whey hydrolysate (such as Good Start) or try a low-allergy formula (such as Nutramigen, Alimentum, or Pregestimil). Some research suggests that making these changes can result in a decrease in the number of episodes and duration of symptoms in some infants. It is worth the expense of a week's trial to see if the formula is at all contributing to the colic.
- Take a break! When the anxiety, fear, and tension get to be too much (or perhaps an hour before!), try to have someone else watch the baby, even for an hour, and leave the house. Try to keep a positive attitude.
- Try walking the baby in a front-pouch-style carrier with his legs drawn up and pressure off of his belly.
- Though there is no clear evidence that physical stimulation helps, many parents swear by it. Some babies seem to be soothed by rhythmic, steady movements, like rocking gently or by sounds, like running the vacuum, or having the clothes dryer within earshot. (Never leave a baby unattended near the dryer, as there is a serious risk of injury.)
- Wrap the baby firmly in a comfortable blanket ("swaddling").
- Medications, such as simethicone (Phazyme, Flatulex, Mylicon, Gas-X, Mylanta Gas), and other homeopathic treatments have not conclusively proven to be more effective than placebo (sugar pill) and should be avoided unless prescribed by the infant's medical provider. Hyoscyamine (Levsin), an antispasmodic medication used to treat adults with various intestinal ailments, has been associated with serious side effects in young infants.
- Be cautious with herbal remedies. Although there are some who recommend chamomile, fennel and others, there is little evidence that colic is cured with these treatments. Try to avoid using gripe water, unless recommended specifically by the pediatrician, because there are often unregulated ingredients (alcohol, etc.) that may be harmful to the infant.
- Recently, there have been some interesting results using certain probiotics (dietary supplements containing live bacteria or yeast and used to aid digestion). It is important to discuss these options with a health-care professional prior to using them.
What are the risk factors for colic?
Risk factors for colic are not well-understood. Research has not shown differences in risk when the following factors were considered:
- Sex of the child
- Preterm and full-term pregnancies
- Formula-fed and breast-fed babies
Infants born to mothers who smoked during pregnancy or after delivery have an increased risk of developing colic.
Is there a cure/medications for colic?
The primary goals are to soothe the child as much as possible with a variety of interventions and ensure that parents have the support they need to cope.
Several small studies have shown some benefits or mixed results for alternative treatments. There's not enough evidence, however, to judge the potential benefit over the risks. Alternative remedies under investigation include:
- Herbal teas
- Herbal remedies, such as fennel oil
- Sugar water
- Gripe water, a mix of water and herbs
- Massage therapy
- Chiropractic manipulation
Known risks include the following issues:
- Regular use of herbal teas or other liquid preparations may lead to decreased milk intake or a drop in sodium levels in an infant's blood.
- The lack of product regulation may result in contamination, unlabeled ingredients or inconsistent dosages in herbal remedies.
- Some homeopathic remedies contain low amounts of potentially toxic substances.
Talk to your baby's care provider before using an alternative medicine to treat your infant for colic.