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Crying Infants and Colic

One of the most stressful experiences for new parents (or seasoned parents for that matter) is dealing with a crying baby.

It is normal for babies to cry some (up to 2 – 3 hours per day).  They cry for all sorts of reasons, and its sometimes difficult to figure out why your baby is crying and how to console them.

Sometimes, a thorough history and physical examination by your doctor is necessary to evaluate your baby when he/she cries excessively.

What are the reasons why a baby may cry?

Common reasons why a baby may cry for which we have some control of:

  • Hungry
  • Thirsty
  • Sleepy
  • Wet diaper
  • Lack of contact
  • Temperature not right – too hot or too cold
  • Overstimulation – lights too bright or too noisy
  • Colic

What is colic?


  • Colic is defined as excessive crying (at least 3 hours a day, for more than 3 days a week, for at least 3 weeks) in an otherwise healthy baby.
  • In general, it appears at around 2 – 4 weeks of age and usually ends by 3 months of age, although it may last for another month or so.
  • Although this crying can occur at any time, it usually worsens in the evening (always seems to be at dinner time).
  • Colic is not considered a serious condition. Research shows that despite the crying, babies with colic continue to eat and gain weight normally.
  • Colic affects up to 20 – 25% of infants in the first months of life and it equally affects boys and girls, first-born children and those born later.

What causes colic?

  • The cause of colic is unknown. There have been several theories made on the cause for colic, including:
  1. Gas (this may just result from air swallowing while crying)
  2. Lactose intolerance
  3. A problem with the movement of food through the babys digestive system
  4. Undiagnosed gastroesophageal reflux disease (GERD)
  5. Allergy to human and cow’s milk protein
  6. A normal part of infantile crying for some babies due to their temperament.
  • There is no evidence that a parents personality or anxiety causes colic.
  • Breastfed infants can get colic just as bottle-fed babies can.

What are some other signs of colic besides crying?

  • A baby with colic may look uncomfortable or appear to be in pain.
  • Babies may lift their head, draw their legs up to their stomach, clench their fists, become red in the face and pass gas.
  • Difficulty falling and staying asleep are also common.

Could my baby’s crying be anything serious?

  • Yes, there are other possibilities that could explain excessive crying in a baby.
  • This is why we say that colic is a diagnosis of exclusion, meaning that other causes of the crying, some potentially life-threatening, should be ruled out by a physician before the diagnosis of colic is made.

Some other reasons that may explain excessive crying in an infant, in some cases potentially serious or life-threatening include:

  • Pain- ear pain
    - teething
    - constipation
    - scrape in the eye (corneal abrasion)
    - acid reflux [(gastro-esophageal reflux disease (GERD)]
    - hernia
    - foreign body encircling a finger or toe (e.g., hair)
  • Fever
  • Traumatic injury as a result of abuse (e.g., fracture)
  • Medications- antihistamines
    - pseudoephedrine (a decongestant)
  • Infections- meningitis
         - ear infection
    - gastroenteritis (stomach infection)
    urinary tract infection

What are some of the signs and symptoms that may indicate something more serious than colic?

  • Poor appetite
  • Weight loss
  • Repeated vomiting
  • Diarrhea, especially if bloody
  • Fever
  • Difficulty breathing

 

How can I calm my baby if the crying continues despite addressing issues such as hunger, a wet diaper, proper temperature, etc…?

Overall, studies have shown that interventions aimed at decreasing crying in colicky babies do not consistently work.  Many different things can be tried to comfort a colicky baby; some babies may respond to one specific intervention while others may not.

  1. carry your baby in a front sling or back pack
  2. swaddle your baby (wrap him or her snugly in a blanket)
  3. keep the baby moving in a baby swing
  4. sit with your baby in a rocking chair
  5. give your baby a pacifier
  6. place your baby across your lap on his or her belly and rub your babys back.
  7. place your baby near continuous noise or vibrations from household appliances like the dishwasher or washer-dryer
  8. sing to your baby (if you sing like me, you best just play music)
  9. take your baby for a car or stroller ride
  10. give your baby a warm bath

What can I do to help myself in such a stressful situation?

Having a colicky baby can be very stressful and frustrating.  Although it is easy to focus all the attention on our crying baby, parents do need to take care of themselves as well.  Babies may pick up on stress around them, which could make colic worse.

  • Take time out. Put the baby safely in a crib, then walk away and let the child cry while you take a breather for a few minutes in another room.
  • Call a friend or relative who can just comfortably vent your frustration to.
  • Ask a trusted friend or neighbor to watch your child while you take a short break in which you can get a nap or some fresh air.
  • Try to be positive – remind yourself of the times during the day when your baby didnt cry and that it will not always be like this.
  • No matter how upset you feel, do not grab or shake your baby! This will not stop the crying and it can cause severe injury or even death.
  • If you feel as though you are losing control and might hurt your child, call a hotline, such as the 24-hour National Child Abuse Hotline (1-800-4-A-CHILD).

What is the treatment for colic?

  • There is no single medicine or proven cure for colic.
  • Many studies have been done to evaluate what feedings or medications work best for colic.
  • Any change to your baby’s diet that you are considering should be discussed with your pediatrician first.

Mother’s diet

  • In a 2005 study, elimination of allergenic foods such as cows milk, eggs, peanuts, tree nuts, and soy from the mother’s diet was found to reduce the amount of crying time in some breastfed infants with colic.

o  However, removing certain foods from a person’s diet
has some risk, especially if done over a long period of time.

  • Some women find that certain foods in their diet seem to make colic worse and they may find that cutting these foods out helps. These might include certain vegetables (e.g., cabbage, broccoli and cauliflower), beans, onions, garlic, spicy foods, caffeine and alcohol.

o  By reintroducing foods gradually, women may be
able to identify which food, if any, is causing the problem.

Baby’s diet

  • It is not recommended to stop breastfeeding.
  • Burp frequently.
  • Babies who are bottle-fed may swallow air from the bottle
  • Consider using a bottle that can reduce the amount of air the baby swallows during a feed (e.g., curved bottles, bottles with a collapsible bag inside or bottles with a vent).
  • The American Academy of Pediatrics; Committee on Nutrition does not recommend changing to soy formula for colicky babies; there is no scientific evidence that this is helps a colicky baby.
  • Studies have not shown that feeding babies with colic a fiber-enriched formula really makes a difference.
  • Your doctor may recommend a trial of hypoallergenic formula (e.g., casein or whey hydrolysate) for a week.
  • If your baby has a good response, they can be tried back on their cow’s milk formula at 3 – 4 months of age.

Medications and herbal remedies

  • Many different items can be bought over the internet that have not been proven to be effective for colic.  Some products are “guaranteed” to pacify colic symptoms.
  • Any over the counter, over the internet or herbal remedy that you are considering for your baby should be discussed with your pediatrician first.
  • Simethicone (Mylicon), used to lessen gas, has not been shown in studies to benefit babies with colic.
  • Although some studies have shown some improvement of colic with herbal teas, you should proceed with caution as mixtures of herbs are not the same, thus the strength may vary.

When should I call my pediatrician concerning my crying baby?

  • If you have addressed the common causes of crying in babies but your baby continues to cry do not hesitate to call your pediatrician.
  • If your baby has one of the warning signs for something more serious listed above.
  • If you are unsure whether your babys crying is colic or a symptom of another illness.
  • Remember, the diagnosis of colic should be made by your doctor after excluding other reasons for constant crying in babies.

Your baby’s crying behavior should be recorded for your doctor to help
them make a proper diagnosis, including:

  • time of day of the crying
  • how long your baby cries for on average
  • how long your baby is well
  • eating and sleep habits
  • pattern of bowel movements

(This can be done with pen and paper or even some of the newer smart phone apps)