Colic and Crying in Young Infants

Crying is present to some degree in all babies during the first few months of life.  When crying is mild, occasional and has an identifiable cause, there is generally little concern.  Hunger, a soiled or wet diaper, desire to be held or need to burp are all easily correctable causes of crying.

However, inconsolable crying that occurs daily (or nightly) for hours at a time can be more distressing.  This more unsettling type of crying behavior is referred to as colic, and occurs in 10 to 20% of infants.  Colic generally begins between the second and fourth week of life, reaches peak intensity at six weeks of life and finally resolves at ten to twelve weeks of life.  The infant with colic may turn red, draw up the legs, pass gas and appear to have a painful belly.

The cause or causes of colic are very poorly understood despite much medical study.  Traditionally, colic has been thought to represent abdominal pain resulting from either swallowed air or gas formation in the bowels.  Attempts at proving and eliminating these underlying causes have been generally disappointing.  Newer theories blame colic’s discontent on sensory over stimulation or immature stress management mechanisms.  The exact cause (or causes) of colic remains to be fully explained.

Sometimes a few simple measures can relieve your baby’s colic. In other instances repeated trials of various techniques may be necessary to obtain any relief.  In addition to routine feeding, changing, and holding your baby, the following remedies may provide some relief for colic.

  1. Gentle, repetitive motions are often soothing to colicky infants.  Try walking, rocking, swinging, bouncy seats or car rides. Prone positioning, (on the stomach), can be tried, but only when the baby is awake.  Pacifiers may be soothing to some infants, and will NOT harm established breast feeding.  Snug swaddling, provided it is not too tight, may help.  Don’t worry about spoiling your baby the first three months. Comforting makes your baby feel better and will do the same for you.
  2. Calm the overall environment.  Dimming lights, quieting appliances, and limiting visitors will help babies and parents alike feel more at ease.
  3. Make sure your baby is getting the right amount to eat.  Either excess or insufficient intake may make a baby fussy. Consider your feeding technique.  Feeding should take 15-30 minutes.  Shorter times may indicate the need for a faster flow nipple or more frequent burping.  Longer feeds may result from too slow a bottle nipple, or a bottle cap screwed on too tightly.  Prop your baby up during and after feeding to minimize heartburn and spitting.  Don’t overheat formula; it should be given at body temperature.
  4. Occasionally, protein or milk sugar intolerance can cause symptoms of colic.  We may recommend changes in the nursing mother’s diet or changes in formula if this is suspected.
  5. Many parents try giving simethicone (Mylicon) to alleviate colic.  Despite tradition and anecdotal (testimonial) evidence, there is no scientific evidence to support its benefit.
  6. Give yourselves a break.  Allow a sitter to take over while you enjoy an evening out.