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Colic (The Crying Baby)

What is colic?
Colic is when an otherwise healthy baby cries more that three hours a day, for more than three days a week, between ages three weeks and three months. The crying usually starts suddenly at about the same time each day. This is actually just an arbitrary definition made years ago [1] . By this definition, a surprising number of babies actually would have colic: some experts have even estimated as many as half of all babies!

If your baby is crying a lot, you should call your doctor. Your pediatrician will want to check your baby to make sure there is no medical reason for the crying. If your baby's doctor finds no underlying cause, then they will probably say your baby has colic. Colic is perfectly normal, and does not mean there is anything wrong with either baby or parents. It does not have any lasting effects on the child or the mother in later life. [2]

How does a baby with colic act?
The baby's cry is loud and they may have a red face and a tense, hard belly, because the abdominal muscles tighten with crying. Baby's legs may be drawn up and fists clenched. This is often just the typical baby crying posture. However, the first time your baby has a long jag of inconsolable crying like this—with a tense, hard belly—you should call your doctor. This can sometimes be a sign of a serious condition that requires medical attention.

How do I know when to get medical help for my baby's crying?
Call your baby's doctor or go to the emergency room if:

• Your baby cries constantly for more than three hours or the cries are unusually shrill or intense
• Your crying baby cannot be comforted has a tense, hard belly, and this has not ever happened before, or been checked by a doctor
• Your baby seems to be in pain or acts sick
• Your baby's temperature is over 100.5 º
• Your baby is vomiting or has diarrhea
• You are afraid you might hurt your baby or you feel you cannot care for your baby.

How does colic affect parents?
It's really tough to see your baby in this state. You may find yourself getting very upset and worried about your baby. Your stress level may shoot though the roof if the crying and distress go on for hours. You will probably feel resentful and angry toward your baby at times. This is normal. Remember that having a colicky baby does not mean you are a bad parent!

If you find yourself getting stressed out, find ways to “decompress,” and get as much help and support as you can from your co-parent, family members, friends and neighbors. If it just gets to be too much, you can always put your baby in the crib where they will be safe and leave the room to take a break, calm down and take a deep breath.

You will be better able to take care of your high-need baby if you are taking care of yourself! Here are some parent survival tips that may help.

What should I do if I'm so frustrated with the crying that I can't stand it any more?
One thing you should never do: Never shake your baby . Shaking your baby can cause shaken baby syndrome (SBS). Learn more about SBS , including information in Spanish.

If you reach that level of frustration, put your baby in a safe place like the crib , and walk away. Call a friend or your partner. It can help to talk about what you are feeling.

• Call the free Parent Helpline at 1-800-942-4357 (in Michigan). They will not ask your name, and can offer helpful support and guidance. The helpline is open 24/7. Calling does not make you weak; it makes you a good parent.
• Parents Anonymous has local groups that teach parenting and coping skills, and offer support and kids programs. You can also find your local help line through their website.

What causes colic?
No one is really sure, but there are a few suspected causes, such as intestinal gas, food sensitivity or allergy, or an immature nervous system. This last idea speculates that Baby's immature nervous system can't handle the stimuli of everyday life, and that crying is their only way of communicating this “overload.” An opposite hypothesis is that Baby needs more stimulation, and gets it through crying. Colic is mysterious, but not harmful to your baby.

What are the popular myths related to colic?
Let's debunk some of the popular myths about colic. Here are the facts:

• Babies do not cry to manipulate their parents.
• Holding babies and picking them up when they cry cannot “spoil” them.
• We do not know whether colicky babies are in pain or not, but they sure seem to be, and that can really stress out parents. Keep in mind that your baby may not actually be in pain or distress, but just doing what they need to do for their immature nervous systems.
• Giving rice cereal does not help solve colic.
• Studies have shown that Simethicone (Mylicon) and lactase (the enzyme that helps digest lactose—the sugar in cow's milk—which is in breast milk if the mother consumes dairy products) do not help colic. [3] [4] ,
• Sedatives, antihistamines, and motion-sickness medications, like dicyclomine (Bentyl) are NOT safe or effective in treating colic in babies. Often grandparents will suggest these medications. They were commonly used years ago, but now we know better.

How can I help my baby relieve their colic distress?
Colic usually starts to improve at about six weeks of age, and is generally gone by the time your baby is 12 weeks old. While you are waiting for that magic resolution, try these techniques to help soothe your infant:

• Respond consistently to your baby's cries.
• Don't panic and don't worry. If you are worried, bring your baby to their pediatrician.
• When your baby cries, check to see if they are hungry, tired, in pain, too hot or cold, bored, over-stimulated, or need a diaper change.
• Some parents find that carrying their baby more reduces colic. You can try different baby carriers to make it easier and free your hands. Many parents (and babies!) love slings once they get the hang of them—but sometimes it takes a little experimentation. One study found carrying babies four to five hours a day resulted in less crying at six weeks of age, as compared to carrying them only two to three hours a day. [5] On the other hand, a later study by the same researcher did not find significantly less crying in babies carried more. So your best bet is just to see if it makes any difference with your baby. [6]
• Vacuum while wearing your baby in a baby carrier.
• Rock your baby.
• Change formula . Talk with your baby's doctor first.
• Breastfeeding moms can try changing their diets .
• Play music and dance with your baby.
• Talk a walk with your baby in the stroller. This can really help with your stress level, in addition to soothing your baby.
• Get support from family, friends, your religious community, neighbors, etc. Let them help in any way possible.
• Take care of yourself and manage your stress. Eating a well-balanced diet, getting sleep and exercise, and having people to talk to can do wonders. If the stress or blues become too much, it's good idea to get professional help. Your or your baby's doctor might be able to help you figure out where to start.
• Nurse your baby every 2-3 hours if you are breastfeeding.
• Don't smoke, and don't allow anyone to smoke around your baby. Babies of smokers cry more, and get sick more often, too. Smoker's babies also have an increased risk of SIDS .
• Quitting smoking during pregnancy may reduce the likelihood that your baby will develop colic [7] . in addition to all the other benefits to you and your baby.
• You could try a device that attaches to the crib. It's designed to simulate a car ride, but it is not clear that the device actually works. The Sleep Tight Infant Soother consists of a vibration unit that mounts under the crib and a sound unit that attaches to the crib rail. Your pediatrician can tell you whether it would be a good idea to try in your baby's case. The device is not promoted directly to consumers. Some insurance companies may reimburse the cost if you have a physician prescription. You can reach the manufacturer at 1-800-NO-COLIC or 1-800-662-6542. There is no research to prove that the Sleep Tight works, and some parents have been dissatisfied with it. [8 ] [9]
• Provide white noise, such as running the vacuum cleaner, clothes dryer, or hair dryer near your baby while in their car seat. (Do not put your baby on top of the dryer—they could fall off!) White noise machines are also available. White noise simulates the whooshing sound your baby heard constantly while in utero. You can also do your own “whooshing” or “shushing” with your voice as you rock or carry your baby.
• Go for a car ride.
• Massage your baby . Find out how to do infant massage for colic . Massage has many benefits for both the baby and the giver of the massage.
• Some parents have found that herbal tea is helpful. The combination of chamomile, fennel, vervain, licorice, and balm-mint was found to be effective in one study. [ 10] Other traditional herbs for colic tea include anise, catnip, caraway, mint, fennel, dill, cumin, and ginger root. Gripe water, available in Britain and Canada, is made from dill. These remedies are not produced or regulated in the same standardized ways that medications are—so you don't know exactly what you are getting. These herbs have not all been studied, and therefore it is not certain that they are all safe. More research is needed to be sure these preparations are safe and effective. [11] If you choose to give herbal tea, start by giving only an ounce, and never give more than four to six ounces per day. Babies who fill up on tea don't drink enough breast milk or formula and then have trouble growing. Please remember that just because something is “ natural ”, it is not necessarily safe .

Where can I find more information about colic?
On the Web:

• Cólicos (niño llorón) —Spanish fact sheet
• Have hope: Colic will not last forever!
• How to massage a colicky baby
• Fussy babies —here is a wealth of suggestions for comforting fussy and colicky babies
• Handling the crying child —with tips for soothing baby, and for parents' coping.

Recommended reading:

• The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer , by Harvey Karp
  This book teaches you simple techniques based on other cultures whose babies do not get colic, and on the idea the baby's first three months are like a fourth trimester.
• Check out the chapter on colic in the book, The Holistic Pediatrician (second edition), by Kathi Kemper.
• Infant Massage: A Handbook for Loving Parents , by Vimala Schneider McClure
• Crying Baby:  Resource List —recommended books about soothing crying babies.
  

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Literature Cited:

[1] Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics 14(1954):421-35.

[2] Clifford TJ, Campbel, MK, Speechley, KN, et al. Evidence of transient infant distress and absence of lasting effects on maternal mental health. Arch Pediatr Adolesc Med. 156( 2002):1183-1188.

[3] Metcalf TJ, Irons TG, Sher LD, et al. Simethicone in the treatment of infant colic: a randomized, placebo-controlled, multicenter trial. Pediatrics 94(1994):29-34.

[4] Miller JJ, McVeagh P, Fleet GH, et al. Effect of yeast lactase enzyme on “colic” in infants fed human milk. Journal of Pediatrics 117(1990):261-3.

[5] Hunziker, UA, Barr, RG. Increased carrying reduces infant crying: a randomized controlled trial. Pediatrics 77 (1986):641-8.

[6] Barr RG, McMullan SJ, Spiess H, Leduc DG, Yaremko J, Barfield R, Francoeur TE, Hunziker UA. Carrying as colic "therapy": a randomized controlled trial. Pediatrics. 1991 May; 87(5): 623-30.

[7] Sondergaard C, Henriksen TB, Obel C, Wisborg K. Smoking during pregnancy and infantile colic. Pediatrics 108(2001):342-6.

[8] Huhtala V, Lehtonen L, Heinonen R, Korvenranta H. Infant massage compared with crib vibrator in the treatment of colicky infants. Pediatrics 105(2000): E84.

[9] Sosland JM, Christophersen ER. Does SleepTight work? A behavioral analysis of the effectiveness of SleepTight for the management of infant colic. J Appl Behav Anal 24(1991): 161-6.

[10] Weizman Z, Alkrinawi S, Goldfarb D, et al. Efficacy of herbal tea preparation in infantile colic. Journal of Pediatrics 122(1993):650-2.

[11]Lucassen PL, Assendelft WJ, Gubbels JW, van Eijk JT, van Geldrop WJ, Neven AK. Effectiveness of treatments for infantile colic: systematic review. BMJ 316(1998):1563-9.


Written, compiled and updated by Kyla Boyse, R.N. Reviewed by Julie Lumeng, M.D. and Richard Solomon, M.D.

Updated April 2005

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