Colic

What is it?

No one really knows for sure what colic is, or what causes it. We use the term "colic" to describe the condition of an infant between a few weeks and a few months of age who cries more than usual for no detectable reason. This means, by definition, that if we find a cause for the crying, it isn’t colic. That is only one of the many frustrating things about colic.

All babies increase the amount of time they cry during their first few months of life. Colic is really just the upper end of this normal increase. Babies cry for only a few specific reasons. They cry if they are uncomfortable. They cry if they are hungry. They cry if they are lonely. AND – they cry to communicate with their parents. Just as there are grown-ups who don’t talk much, and grown-ups who are very talkative, there are babies who tend to be quiet, and babies who cry a lot. Most doctors and scientists now believe that crying babies who aren’t uncomfortable, hungry, lonely, or otherwise in distress are simply communicating in a healthy way.

What all this means to the parent of a baby with "colic" is that if you are reasonably sure that the baby is comfortable, fed, warm, and dry, there isn’t much more you can or should do to get the baby to stop crying. Instead, you’ll want to look after yourself and your other family members to be sure that the crying isn’t driving you crazy or making you so exhausted that you can’t continue taking care of things (including yourself).

The biggest concern with a crying baby is to make sure that there’s not something serious going on. The first few times a baby cries inconsolably, all parents are very worried. We want to be sure something isn’t hurting the baby and that the baby isn’t sick. We want to be sure the baby is fed and that the diaper is dry and empty. Chances are, if you are reading this you have been through all that, and even probably seen your doctor who has diagnosed colic. The biggest concern in colic is to keep the parent and the baby loving each other and in control!

Since there is no known cause for colic, there is no specific treatment. Some things can help, though. Many people believe that at least some babies with colic have excessive gas. Please try burping your baby a little more often, particularly if s/he is a vigorous or "greedy" bottle-fed baby. These babies often swallow a lot of air that expands in the warmth of the baby’s belly. The swelling can cause pain. It may help to interrupt a bottle-feeding halfway through and get a good burp. The over-the-counter gas medication called "simethicone" (Mylicon®, Phazyme®, and others) breaks up gas bubbles. It has never been proven to help babies, but it is safe and some parents think it has helped their own baby. Please check with your doctor before using this or any other medication in a young baby. Please do not use sedatives or relaxing medicines, or add anything to the baby’s formula to "help him or her sleep."

It is always a good idea to try feeding a crying baby, just to be sure that s/he isn’t hungry. Don’t force the issue, though – if the baby won’t feed after five minutes or so, turn to something else. Also, check to be sure the diaper is dry, and that clothing isn’t too tight or snagged. If you use cloth diapers and pins, be sure the baby isn’t being poked.

Most parents find that some kind of gentle and regular movement helps to calm a crying baby. Holding, rocking, gently bouncing up and down, or walking around the room with the baby can all help. You can try holding the baby in the "airplane position," on his or her tummy over your arm, with baby’s arms and legs stretched out like an airplane. Some parents like to use swings, vibrating chairs, or other movement devices. There are even specially-made vibrating platforms that can hold a bassinet and may work to soothe the baby. Or, you may find that a drive in the car will help – anything to provide some gentle movement. Please remember, of course, that anything that moves the baby can also hurt the baby, so don’t leave a baby unattended in any of these situations.

If you’ve tried all of these things, and nothing works, you may feel frustrated, angry and helpless. Please remember that these are all normal feelings – all parents have them. At this point the best thing you can do for your baby may be to tuck him or her into a safe crib, and walk away. You’ll keep hearing the crying, of course, and that will make you anxious. It is always best for parents to take shifts with a crying baby. The parent who is "on" should stay close enough to be sure the baby is ok. The parent who is "off" can go as far away as s/he wants to, to get some rest and quiet. Even the "on" parent might want to set a time limit during which s/he does not go in and check on the baby. Start with a short time, like a few minutes, and as you gain confidence that nothing is wrong, let the time limit get longer. Sooner or later the baby will fall asleep. You are not a bad parent if you let your baby cry him or herself to sleep. And remember – babies outgrow colic by the time they are 3-4 months old, so this is not your life for the rest of your life!

If your doctor has already seen your baby, done a thorough examination, and diagnosed colic, chances are there is not much to worry about in terms of the baby. If you haven’t seen your doctor, or if you have, but the baby’s cry sounds different or abnormal to you, there could be something else going on. Signs of a serious illness include:

• Any fever over 100.4° F or 38° C, or a low body temperature (under 98° F or 36.5° C)
• Vomiting more than once or twice
• Vomiting greenish or yellowish material (bile)
• Vomiting that increases in amount or frequency
• A sudden change in bowel movements – diarrhea, sudden constipation, or blood in stool
• Paleness or blueness of the skin, or cool skin
• Trouble breathing
• Decreased appetite
• Decreased urination
• Sunken appearance of the eyes or soft spot (fontanel)
• Bulging of the fontanel
• A marked change in the sound of the baby’s cry – either shrieking and high-pitched, or weak and soft.

The biggest impact of colic is on the parent. Parents often feel out of control, helpless, frustrated and angry when their baby has colic. Many parents become angry with each other, or with the baby. That is normal. Many parents feel as if they want to hurt their baby, if only to get some peace and quiet. That is also normal. In fact, doctors usually say that a parent who says s/he has never thought about hurting his or her baby is lying. Unfortunately, some parents actually do hurt their babies. That is not normal, and is dangerous. Hardly any parent who has caused a serious injury to their child really meant to do it. They just "lost control." Anyone can "lose control" if things get bad enough. Parents who do not hurt their babies have learned how to walk away or to get help before things get out of control. You are not showing weakness or being a bad parent if you have to ask for some help dealing with a crying baby. Parents with partners can work out ways to take turns caring for the baby and getting rest. It is harder for single parents. If you are a single parent you may want to find a relative, one of your own parents, a friend, or even a neighbor whom you trust. It is a good idea to have several people you can call so that if things seem about to get out of control, you can find someone who can help.

If you can’t find anyone at all, and you are afraid you will hurt your baby, tuck the baby in the crib safely and walk away. Don’t go far, of course, but you may have to get as far from the baby as you safely can. NEVER, EVER SHAKE A BABY. If you get so stressed that you are worried about your baby’s safety, call your local Parents’ Anonymous Hotline or visit the Parents Anonymous website to find a group near you.

Things that can look like colic but are more serious include twisting of the bowel, blockage of the stomach exit, severe constipation, or a broken bone. Some milder things that can cause pain include a scratch on the surface of the eye or a hair or thread wrapped around a small part like a finger, toe, or penis. These are usually accidental, but a doctor should examine the child. Sadly, colic can lead to child abuse because of the crying. Although none of us wants to think about it, if your baby comes home from the sitter or day care and cries non-stop, the baby could have an injury. If this happens, and you cannot calm the baby easily, or you see an unexplained injury, please bring your baby to the doctor or the emergency room right away.

Having a sick child at home can be tiring and frustrating. As badly as you feel for your child, you yourself may feel out of control, inadequate, or even angry – these are normal feelings. Babies and children who are sick are often fussy and irritable, and parents often feel stressed to the breaking point, especially when there are other children or adults to take care of. One of the best things you can do for your child is to be sure you take care of yourself. If possible, try to have other adults take care of your child for an hour or two each day so you can get some rest or just some quiet time. If you get so stressed that you are worried about your baby’s safety, call your local Parents’ Anonymous Hotline or visit the Parents Anonymous website to find a group near you.