Colic in Babies

You bring your newborn home, and for weeks you marvel at your baby who does little more than sleep, eat, pee and cry.

Then one day a few weeks later, he erupts in prolonged, ear-shattering wails, complete with clenched fists, flailing legs and an unhappy red face.

No matter what you try, you can’t comfort your crying baby — and that's not all: He repeats these heartbreaking, stressful episodes every night at the same time for what seems like forever. Welcome to the world of colic.

What is colic?

The reality is, all babies cry. It's the best (and only) way for them to communicate their needs at this tender age. And as parents, we’re biologically programmed to respond so those needs get met.

But in babies with colic, the crying starts suddenly for no apparent reason … and has no apparent cure.

Colic is not a disease or diagnosis but a combination of baffling behaviors. It's really just a catch-all term for excessive crying in otherwise healthy babies — the problem being, there’s no solution to it besides the passing of time. And it’s common, occurring in roughly 1 in 5 infants.

These fussy periods can go on for hours at a time, sometimes late into the night. Worst of all, try as you might — and try you will — it's extremely difficult to calm a colicky baby, which only compounds your own frustration, worry and exhaustion.

Doctors usually diagnose infant colic based on the "rules of three." Your baby's crying:

• Totals at least three hours a day
• Occurs at least three days a week
• Persists for at least three weeks in a row

How to soothe colic in babies

In addition to frustration and exhaustion, you may have feelings of inadequacy and guilt as you try in vain to soothe your fussy baby. So while staying calm is easier said than done, these strategies may help ease the strain until colic passes.

Just give each a fair shot before you switch to another (and don't pull out too many tricks at one time, or you'll overload baby's circuits — and step up the crying you're trying to stop). Talk to your doctor for tips and possible causes of your baby's colic too.

If you suspect overstimulation:

• Respond. Crying is a baby's only way of communicating his needs. But it's also his only way of wielding any control at all over a vast and bewildering new environment: He cries, you come running to his side — powerful stuff when you're otherwise completely powerless. In fact, studies show that responding promptly to your baby's cries will reduce his crying in the long run. 
• Excise excitement. Limit visitors and avoid exposing your baby to new experiences in stimulating environments, particularly in the late afternoon and early evening. Watch how your baby responds to certain stimuli — and steer clear of any that seem to offend.
• Create calm. Trying to make your baby's environment peaceful might help him relax. Dim the lights, speak or sing in soothing tones (or don't speak at all) and keep other noise and distractions to a minimum.

If you suspect gastrointestinal issues:

• Apply pressure to baby’s tummy. Some colicky babies find relief when pressure is placed on the abdomen — and the power of touch alone can be very soothing for both parent and child. So place your infant face-down on your lap or upright with his tummy against your shoulder, or try the “colic carry,” where your little one lies face-down with his belly resting on your arm. Then gently rub or pat his back as you hold him.
• Try burping your baby. If your baby's inconsolable fussiness is due to gas, sometimes burping him will help relieve the pain. Make sure you're burping your baby effectively.
• Ask about antigas drops. Studies show that reducing gas may reduce the discomfort (and crying). So ask your pediatrician about trying gas drops made with simethicone, which works by breaking up gas bubbles and can relieve your baby's symptoms. Though research hasn’t yet shown that this treatment definitively helps with colic, your doctor may think it's worth a try.
• Consider probiotics. Probiotic drops may potentially curb the crying in some colicky babies, probably because they ease tummy troubles (probiotic bacteria grow naturally in the digestive tract and help promote intestinal health). Again, research is very limited, but check with your pediatrician to see if you should give it a go.
• Watch what you eat. If you’re breastfeeding, talk to your doctor about whether you should try temporarily eliminating any foods from your diet that can cause tummy troubles for your baby, such as gas-causing cruciferous veggies (cabbage, cauliflower and others), acidic citrus fruits or allergenic foods (dairy, soy, wheat, eggs, peanuts, tree nuts, fish).
• Ask about switching formulas. For some formula-fed infants, swapping a standard variety for one designed for sensitive tummies or one that doesn't contain cow's milk can make a difference. Studies have found that giving colicky babies hypoallergenic whey-hydrolyzed formula decreases colic symptoms in some babies. Just be sure to get your doctor’s approval before making the switch. Also, steer clear of casein-hydrolyzed formula or partially hydrolyzed formulas as therapies for colic — there simply isn't enough evidence that they work.

Other calming remedies for colicky babies:

• Get close. Not only does cuddling, wearing or carrying your baby give him the pleasure of security and physical closeness to you (and after 9 months of constant closeness, that may be just what baby's crying for), but it may help you tune in better to his needs. Worried that holding your baby too much will make him spoiled or clingy? Set those fears aside. You can't spoil a newborn — so if holding him seems to soothe him, cuddle away. 
  
• Swaddle. Toss a blanket in the dryer and while it's still warm, wrap it snugly around your little one. The combination of warmth and the feeling of security may help dry baby’s tears.
• Try white noise. The hum of the vacuum cleaner or dryer can be comforting to babies (it reminds them of the womb). A white noise machine can also help.
• Play soothing music. A crying baby might also respond to the quiet singing of a lullaby or softly playing classical music. Other infants enjoy the sounds of nature or the whir of a fan. Repeating "shh" or "ahh" to your little one can also help. Experiment to find something your baby seems to like.
• Get in motion. Try swinging or rocking. Newborns find gentle movement comforting, since it feels like what they experienced in the womb. 
• Offer a pacifier. Some colicky babies seem to want to eat all the time — and that might be because sucking is soothing, not because they’re hungry. So if your child seems ravenous frequently and adequate feedings don't seem to satisfy him, a pacifier might help. Check in with your doctor if you're not sure whether baby is getting enough to eat at mealtimes, though.
• Get out of the house. Sometimes just a change to an outdoor location will magically change a baby's mood. Movement can help too. Take your baby for a walk in the stroller or carrier, or strap him into the car seat for a drive (but turn around and head home if the crying continues in the car — otherwise it could distract you from the road).

Remember, you should never give your baby any medication, herbal or otherwise, without talking to your pediatrician first. And always talk to your doctor before making major changes in your diet or your baby’s.

Colic symptoms

How do you know for sure if your baby's colicky? Here are some signs of colic to look out for:

• It bears repeating, but colic generally follows a "rules of three" pattern: The crying lasts a total of at least three hours a day, at least three days a week and for at least three consecutive weeks.
• Crying often occurs at around the same time every day (usually in the late afternoon or early evening, but it can vary).
• Your baby seems to be crying for no reason (not because he has a dirty diaper or is hungry or tired).
• Baby may pull up his legs, clench his fists and generally move his legs and arms more.
• Your baby will often will close his eyes or open them very wide, furrow his brow and even hold his breath briefly.
• Bowel activity may increase, and he may pass gas or spit up.
• Eating and sleeping are disrupted by the crying — baby frantically seeks a nipple only to reject it once sucking has begun, or dozes for a few moments only to wake up screaming.

What's the difference between colic and normal crying?

There isn't a clear definition of exactly what colic is or how (and if) it differs from other types of crying.

But doctors typically agree that colic crying is louder, more intense and higher-pitched than normal crying — sometimes almost like screaming.

Colicky babies also seem inconsolable, and tend to cry more throughout the day than babies without colic. (It may very well feel like around the clock, much to tired and fraught parents' dismay, but in reality it could amount to a few hours total.)

Most often, colicky periods recur daily, though some babies take an occasional night off.

When does colic start and end?

The good news is that baby colic doesn't last forever. Most bouts start when baby is about 2 to 3 weeks old (later in premature infants), peak at around 6 weeks and then typically begin to taper off by 10 to 12 weeks.

By 3 months (though usually a little later in preterm babies), most colicky infants seem to be miraculously cured. The colic may stop suddenly — or end gradually, with some good days and some bad days until most of them are good and it's clear the stage has passed.

In the meantime, a little knowledge and a lot of patience will help you survive until the storm subsides.

What causes colic in babies?

While the exact cause of colic is a mystery, experts do know that it’s not the result of genetics or anything that happened during pregnancy or childbirth. Nor is it any reflection on parenting skills. And it's also not anyone's fault.

That said, here are some theories on possible causes of colicky crying:

• Overstimulated senses. One explanation: Newborns have a built-in mechanism for tuning out sights and sounds around them, which allows them to sleep and eat without being disturbed by their environment. Near the end of the first month, however, this mechanism disappears — leaving babies more sensitive to the stimuli in their surroundings. With so many new sensations coming at them, some infants become overwhelmed, often at the end of the day. To release that stress, they cry (and cry and cry). Colic ends, the theory goes, when baby learns how to filter out some environmental stimuli and, in doing so, avoids a sensory overload.
• An immature digestive system. Digesting food is a big task for a baby's brand new gastrointestinal system. As a result, food may pass through too quickly and not break down completely, resulting in pain from gas in the intestines.
• Infant acid reflux. Research has found that infant GERD (gastroesophageal reflux disease) can trigger episodes in colicky babies, though it doesn't cause colic. Infant GERD is often the result of an underdeveloped lower esophageal sphincter, the muscle that keeps stomach acid from flowing back up into the throat and mouth, which can irritate the esophagus. Symptoms include frequent spitting up, poor eating and irritability during and after feedings. The good news is, most babies outgrow GERD by age 1 (and colic usually goes away long before then).
• Food allergies or sensitivity. Some experts believe that colic is the result of an allergy to cow's milk proteins (or lactose intolerance) in formula-fed babies. Less often, colic may be a reaction to specific foods in Mom’s diet in breastfed babies. Either way, these allergies or sensitivity can cause tummy pain that may set off colicky behavior.
• Tobacco exposure. Several studies show that moms who smoke during or after pregnancy are more likely to have babies with colic, and secondhand smoke may also be a culprit. Though the link exists, it’s unclear how cigarette smoke might be related to colic. The bottom line for many more significant health reasons: Don’t smoke or let anyone else smoke around your baby.

Gripe water and colic

In the category of “little evidence, lots of anecdotes” is gripe water, touted as an herbal remedy for everything from baby gas to colic.

Some parents swear by gripe water as a way to calm a colicky baby, but no reliable studies have shown its effectiveness in relieving colic symptoms. And because it's not regulated by the Food and Drug Administration (FDA), gripe water can also be a wild card in terms of what's actually in it and in what quantities. Always check with your pediatrician before giving your baby gripe water or any other treatment marketed as baby colic drops.

Tips for parents on coping with colic

Though it can safely be said that even hours and hours of daily crying doesn't seem to hurt a baby, it certainly does leave its mark on parents. Listening to a baby's screams can be heartbreaking, upsetting and anxiety-provoking and can take a physical and emotional toll.

To cope with colicky crying that just won't quit, try the following:

• Break it up. A fresh set of arms sometimes induces calm in a crying baby. If there are two parents at home during baby's witching hours, make sure colic duty is divided up equally between the two of you (an hour on, an hour off, a night on, a night off, or whatever arrangement works best).
• Take a break. It's important to respond to crying, which is an infant's only way to communicate. But every once in a while, taking a 10- to 15- minute break during a particularly trying crying marathon won't hurt — and it might help both of you get through this challenging phase of babyhood.
• Tune out a little. Use earplugs, noise-canceling headphones or listen to music to lessen the effect of your baby's wails. Don't tune out your baby so much that you can't hear him at all or for long periods of time, but at least the bouts of wailing won't be as loud for a little while.
• Talk about it. Do a little crying yourself — on a willing shoulder: your spouse's, the pediatrician's, a family member's, a friend's. Just knowing you're not alone in the world of inconsolable babies can make a world of difference.
• Get help. If you’re at the end of your rope, don’t hesitate ask for help — whether from your partner, mother, friend or babysitter. And if you find that you're consistently feeling overwhelmed or are having trouble coping, talk to your doctor or a mental health professional. You'll not only feel better — parental counseling has actualy been shown to reduce infant crying.

When to call the doctor about colic in babies

While the odds are that your baby’s daily screaming sessions are due to colic, if it seems like your baby is crying excessively, start by seeing the pediatrician.

The doctor can examine your baby to rule out any other potential causes of excessive crying. And if they think you're definitely dealing with colic? It's good to get some reassurance and maybe a few extra soothing strategies. 

Describing the crying (its duration, intensity, pattern, any variation from the norm and any accompanying symptoms) will also help the doctor rule out any underlying medical condition (like reflux, an infection or a milk allergy) that could be triggering the crying.

Keep in mind, too, that this shall pass: Just when you think you can't take another night of it, the crying will let up — and then it's gone forever.