Oh My Crying Baby! Is It Colic?

23 Jan

So all babies cry…let’s just get that out there.

But some babies cry more and some babies cry less and most babies cry juuuuust right.  (I wonder if baby bear was colicky, probably not … cause they would’ve moved his bed out of the room sooner).

So, if you have a really fussy baby, how do you know if it is colic?  What is colic anyway?  And most importantly, what do I do about it?

Let’s just get it out there that no one really can say how much crying is normal.  The most widely accepted definition of colic is based on something called the “rule of 3’s.”

The rule of 3’s describes a child who is crying for no obvious reason who has been:

  1. Crying for more then 3 hours per day.
  2. Crying more than 3 days per week.
  3. Crying for more than 3 weeks.

In addition to these guidelines there are some other points that most families with true colic will also mention:

  1. Seemingly comes out of nowhere and has a definite start and stop time (doctors call this paroxysmal)
  2. The cry is different than their normal baby cry
  3. The baby is really rigid
  4. Nothing you can do works to calm the baby (inconsolable)

OK, so you probably have a good idea by now if your baby’s crying is colic or not.  If you are having to sit there and really concentrate on the rules to see, then your baby probably doesn’t.  If you read them and said “Yes, yes, yes, oh my gosh yes” then welcome to the land of colic.

Before we completely chalk your screaming baby up to colic we should probably run a quick checklist to make sure we aren’t missing something else.  Here are some other causes of excessive crying:

Hunger – Is your milk supply good?  Should we increase the amount per bottle?  Is the baby going through a “growth spurt” where they want to feed more often?

Pain – Strip the baby down and look head to toe.  Occassionally pieces of hair will get wrapped around a finger or penis (yeah, ouch).

Fatigue or overstimulation – Change scenery with a walk or car drive.

Food sensitivities – see below

It’s impossible to get a good picture of how many babies out there actually have colic because the definitions are hard to keep consistent.  What’s excessive crying to one family is actually normal and what’s normal to another is excessive.

There have been lots of reasons studied as to what could be the cause of colic.  Many have believed over time that colic has something to do with the stomach or intestines although most studies have not shown this to be true.

There may be a subset of infants with cow’s milk protein allergy that require a change in formula or alteration of mom’s diet (if breastfeeding) but even these studies have been wishy-washy, at best.

Let’s look at all the myths you’ll hear about colic from UptoDate:

  • Babies do not cry to manipulate you.
  • It is not possible to spoil a baby by holding or comforting them.
  • Rice cereal does not improve colic. Infants should be given only breast milk or formula until they are 4 to 6 months old, unless told otherwise by a healthcare provider. (See “Patient information: Starting solid foods during infancy (Beyond the Basics)”.)
  • Studies show that simethicone (sample brand name: Mylicon®) and lactase (the enzyme that helps to digest lactose, the sugar in milk) do not help with colic…
  • Sedatives, antihistamines (diphenhydramine [sample brand name: Benadryl®]), and motion-sickness medications (dicyclomine [sample brand name: Bentyl®]) are not safe or effective for colic. Dicyclomine can temporarily stop breathing or cause seizures or coma.

I am going to recommend some things that I have seen (or had reported to me) that might help.  There are no population based studies that show definite remedies for every (or even a majority) baby with colic.  My recommendations might help, and I’ll stay away from anything that has potential side effects or risks.  There are lots of medical (natural and not) remedies that have been proposed for colic but none have consistently shown to work in a majority of babies.  I listen to all patients who think they have found THE remedy and then research what they are reporting.  If it hasn’t been studied and shown to be effective and there is any risk of side effects, I will not personally recommend it.  This is a philosophy thing and you can talk to your pediatrician if you have questions about a specific product or remedy.

  1. Carrying the child – Many children with colic calm with being carried.  Devices that help you walk with the child and still do some stuff around the house can be helpful.
  2. Change in environment – Getting the child in the car or going for a walk can help.
  3. Swaddling – Nice constant pressure is helpful to any baby (including those with colic) when they are fussy.
  4. White noise – The radio in-between stations or the clothes dryer.

Since I really haven’t told you much positive about studies regarding colic to this point, let’s look at some data that at least let you see the light at the end of the tunnel…

85% of babies stop having colic at 3 months and 95% stop at 4 months.  So, depending on where you are, you can get an idea of how much longer your are likely to have to endure.

There is one final remedy that any parent of a child with colic needs to be aware of.  Unfortunately, it’s not a remedy that stops the baby’s crying but it does go a long way to maintaining sanity in the house.  If your child does have colic, you have to find a way to take a break.  I think grandparents are some of the best cures for colic and should be used to get away for a few hours every now and then to allow yourself to recharge for the next night.  Having a stressed parent doesn’t help your baby with their colic and they do not interpret you taking a break as you abandoning them.  I cannot stress this enough…


2 Responses to “Oh My Crying Baby! Is It Colic?”

  1. Dr. Roy April 22, 2014 at 7:44 am #

    Good post Dr. J!

    What do you think of the recent studies about probiotics and colic? They seem to be the latest “hammer in search of a nail,” but seem safe enough.

    • jrsmith120880 April 22, 2014 at 12:55 pm #

      Wouldn’t it be great to find something simple? Hopeful for more studies/information.

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