Effective Colic Relief

Understanding, Identifying, and Managing Colic in Babies

Colic is a common condition that affects many infants, causing distress for both babies and parents. This comprehensive guide aims to provide in-depth information about colic, its potential causes, symptoms, and management strategies, answering key questions that parents often have about this challenging phase in their baby's life.

What is Colic?

Colic is defined as repeated episodes of excessive, inconsolable crying in an otherwise healthy and well-fed infant. It's a temporary condition that typically begins around 2-3 weeks of age and often resolves by 3-4 months, though it can persist up to 6 months in some cases.

Key Points:

• Affects up to 40% of infants worldwide

• Usually starts around 2-3 weeks of age

• Often resolves by 3-4 months, but can persist up to 6 months in some cases

• More common in the late afternoon or evening

• Occurs equally in boys and girls, and in babies who are breastfed or formula-fed

How do I know if my baby has colic?

Identifying colic can be challenging, but there are several common signs to look out for. The most widely accepted criteria for diagnosing colic is the "Rule of Threes," also known as the Wessel's Criteria:

1. Crying for more than 3 hours per day

2. For more than 3 days per week

3. For more than 3 weeks in a row

In addition to these criteria, other symptoms of colic include:

1. Intense, high-pitched crying that seems to occur for no apparent reason

2. Crying that typically begins at the same time each day, often in the late afternoon or evening

3. Clenched fists

4. Arched back

5. Legs pulled up to the belly

6. Facial redness

7. Passing gas or straining as if having a bowel movement

8. Difficulty sleeping or waking frequently

9. Refusing to eat or difficulty feeding

10. Tensing of the abdominal muscles

How long does colic last?

The duration of colic can vary from baby to baby, but typically:

• Colic starts around 2-3 weeks of age in full-term infants (or 2-3 weeks after the due date for premature babies)

• Symptoms usually peak around 6-8 weeks of age

• In most cases, colic resolves on its own by 3-4 months of age

• Some babies may continue to have symptoms up to 6 months of age

Possible Causes of Colic

While the exact cause of colic remains unknown, several theories exist:

1. Digestive system development: The baby's digestive system may still be maturing, leading to discomfort.

2. Food allergies or intolerances: Some babies may be sensitive to certain proteins in breast milk or formula.

3. Overstimulation: Some infants may have difficulty processing sensory input, leading to irritability.

4. Tobacco exposure: Babies exposed to nicotine during pregnancy or after birth may be more prone to colic.

5. Infant acid reflux: Gastroesophageal reflux disease (GERD) can cause discomfort similar to colic symptoms.

6. Imbalance of gut bacteria: An imbalance in the baby's gut microbiome may contribute to colic.

7. Migraine headaches: Some researchers suggest that colic may be an early manifestation of childhood migraines.

8. Hormonal changes: Fluctuations in hormones like melatonin might play a role in colic.

Do breastfed babies get colic?

Yes, breastfed babies can and do get colic. Colic occurs in both breastfed and formula-fed babies at similar rates. The feeding method does not determine whether a baby will develop colic or not.

However, for breastfed babies, there are some specific considerations:

1. Maternal diet: Some foods in the mother's diet may cause discomfort in sensitive babies. Common culprits include dairy, caffeine, spicy foods, and gas-producing vegetables.

2. Overactive let-down: If a mother has a forceful milk ejection reflex, it can cause the baby to gulp and swallow air, potentially leading to gas and discomfort.

3. Foremilk-hindmilk imbalance: If a baby receives too much foremilk (the thinner milk at the beginning of a feeding) and not enough hindmilk (the fattier milk that comes later), it can cause digestive discomfort.

4. Allergies or sensitivities: Some babies may be sensitive to proteins passed through breast milk, such as cow's milk protein.

For breastfed babies, certain foods in the mother's diet may contribute to colic symptoms in sensitive infants. While every baby is different, some common foods that may cause discomfort include:

1. Dairy products: Cow's milk protein is a common allergen and can pass through breast milk.

2. Caffeine: Found in coffee, tea, chocolate, and some sodas.

3. Spicy foods: These can change the flavor of breast milk and may cause discomfort.

4. Gas-producing vegetables: Such as broccoli, cauliflower, cabbage, and onions.

5. Fruits high in acidity: Like citrus fruits and berries.

6. Wheat and other gluten-containing grains: Some babies may be sensitive to gluten.

7. Eggs: Another common allergen that can pass through breast milk.

8. Nuts: Particularly peanuts and tree nuts.

9. Soy products: Some babies who are sensitive to dairy may also react to soy.

10. Artificial additives and preservatives: Found in processed foods.

For formula-fed babies, colic might be related to:

1. Cow's milk-based formulas: Some babies may be sensitive to cow's milk protein.

2. Soy-based formulas: If a baby is sensitive to both cow's milk and soy proteins.

3. Formulas with added iron: While iron is important for baby's development, some parents report that iron-fortified formulas cause more gas.

What foods cause colic in babies?

Colic itself doesn't necessarily change the appearance of a baby's stool. However, parents often wonder if their baby's poop might provide clues about colic or its causes. Here's what you need to know about baby poop in relation to colic:

1. Color: Colic doesn't typically affect the color of a baby's stool. Normal baby poop can range from yellow to green to brown, depending on whether the baby is breastfed or formula-fed.

2. Consistency: Colicky babies usually have normal stool consistency for their age and feeding method. Breastfed babies often have looser, seedy stools, while formula-fed babies tend to have firmer stools.

3. Frequency: Colic doesn't necessarily change how often a baby poops. However, some colicky babies may seem to strain or draw up their legs as if they're having a bowel movement, even when they're not.

4. Mucus: Occasionally, you might notice stringy, mucus-like strands in the stool. While this can happen for various reasons, it might indicate a milk protein sensitivity in some cases.

5. Blood: If you ever see blood in your baby's stool, contact your pediatrician immediately. This is not a symptom of colic and requires medical attention.

6. Diarrhea: Colic doesn't cause diarrhea. If your baby has watery stools, especially if accompanied by other symptoms like fever, contact your pediatrician.

What does colic poop look like?

Why is colic worse at night?

Many parents notice that their baby's colic symptoms seem to worsen in the evening or at night. This phenomenon, sometimes called the "witching hour," is common and can be attributed to several factors:

1. Overstimulation: By the end of the day, babies may become overwhelmed by all the stimuli they've encountered, leading to increased fussiness.

2. Fatigue: Babies, like adults, can become cranky when they're tired. As the day progresses, fatigue can build up, leading to more crying.

3. Circadian rhythm development: Newborns haven't yet developed a clear distinction between day and night. As they start to develop this rhythm, they may become more unsettled in the evening.

4. Decreased milk supply: For breastfed babies, mothers' milk supply can naturally decrease slightly in the evening, potentially leading to frustration for hungry babies.

5. Build-up of gas: Gas accumulated throughout the day from feeding and swallowing air may cause more discomfort by evening.

6. Decreased parental patience: Parents are often more tired and less patient by the end of the day, which can indirectly contribute to increased perception of colic symptoms.

7. Hormone fluctuations: Some researchers suggest that natural dips in maternal hormones like prolactin in the evening could affect breast milk composition or baby's comfort.

8. Digestion changes: The baby's digestive system may slow down in the evening as part of the developing circadian rhythm, potentially causing discomfort.

9. Separation anxiety: As babies become more aware of their surroundings, they may experience increased anxiety as bedtime approaches.

10. Environmental factors: Changes in the home environment in the evening, such as dimmer lighting or increased household activity, might contribute to baby's unsettledness.

How to calm a colicky baby?

Calming a colicky baby can be challenging, but there are several strategies that parents can try. Remember that what works for one baby might not work for another, so it may take some trial and error to find the most effective methods for your baby.

1. Gentle motion:

   • Rocking the baby in your arms or in a rocking chair

   • Using a baby swing

   • Going for a car ride

   • Walking with the baby in a carrier or stroller

2. Sound therapy:

   • White noise machines or apps

   • Gentle music or lullabies

   • Rhythmic shushing sounds

   • Running a vacuum cleaner or hair dryer (from a safe distance)

3. Swaddling:

   • Wrap your baby snugly in a blanket to provide a sense of security

   • Ensure the swaddle isn't too tight and allows for hip movement

4. Massage:

   • Gently massage your baby's tummy in a clockwise direction

   • Try bicycle leg movements to help relieve gas

5. Change of environment:

   • Move to a dimly lit, quiet room

   • Step outside for fresh air

   • Give your baby a warm bath

6. Feeding techniques:

   • For breastfed babies, try adjusting your diet or feeding position

   • For bottle-fed babies, experiment with different bottles or nipples to reduce air intake

   • Feed your baby in a more upright position to minimize gas

7. Pacifier use:

   • Some babies find comfort in non-nutritive sucking

8. Gripe water:

   • Natural remedies like Babies Magic T Gripe Water can provide relief for colic symptoms

9. Skin-to-skin contact:

   • Hold your baby against your bare chest for comfort and regulation

10. Babywearing:

    • Using a sling or carrier can provide constant comfort and motion

11. Distraction:

    • Try changing your baby's position or showing them different objects

How to burp a colic baby?

Video by Eugene Pediatric Associates

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