Colic is frequent, prolonged and intense crying or fussiness in a healthy infant. Colic can be particularly frustrating for parents because the baby's distress occurs for no apparent reason and no amount of consoling seems to bring any relief. These episodes often occur in the evening, when parents themselves are often tired.
Episodes of colic usually peak when an infant is about 6 weeks old and decline significantly after 3 to 4 months of age. While the excessive crying will resolve with time, managing colic adds significant stress to caring for your newborn child.
You can take steps that may lessen the severity and duration of colic episodes, alleviate your own stress, and bolster confidence in your parent-child connection.
Fussing and crying are normal for infants, especially during the first three months. And the range for what is normal crying is difficult to pin down. In general, colic is defined as crying for three or more hours a day, three or more days a week, for three or more weeks.
Features of colic may include the following:
Sometimes there is relief in symptoms after the infant passes gas or has a bowel movement. Gas is likely the result of swallowed air during prolonged crying.
Excessive, inconsolable crying may be colic or an indication of an illness or condition that causes pain or discomfort. Schedule an appointment with your child's doctor for a thorough exam if your infant experiences excessive crying or other signs or symptoms of colic.
The cause of colic is unknown. It may result from numerous contributing factors. While a number of causes have been explored, it's difficult for researchers to account for all the important features, such as why it usually begins late in the first month of life, how it varies among infants, why it happens at certain times of day and why it resolves on its own in time.
Possible contributing factors that have been explored include:
Risk factors for colic are not well-understood. Research has not shown differences in risk when the following factors were considered:
Infants born to mothers who smoked during pregnancy or after delivery have an increased risk of developing colic.
Colic does not cause short-term or long-term medical problems for a child.
Colic is stressful for parents. Research has shown an association between colic and the following problems with parent well-being:
The stress of calming a crying baby has sometimes prompted parents to shake or otherwise harm their child. Shaking a baby can cause serious damage to the brain and death. The risk of these uncontrolled reactions is greater if parents don't have information about soothing a crying child, education about colic and the support needed for caring for an infant with colic.
Your baby's doctor will do a complete physical exam to identify any possible causes for your baby's distress. The exam will include:
Lab tests, X-rays and other diagnostic tests aren't usually needed, but in unclear cases they help to exclude other conditions as possible causes.
The primary goals are to soothe the child as much as possible with a variety of interventions and ensure that parents have the support they need to cope.
You may find it helpful to have a plan, a list of soothing strategies you can try. You may need to experiment. Some may work better than others, and some may work one time but not another. Soothing strategies may include:
Changes in feeding practices may also provide some relief. Bottle-feed your baby in an upright position and burp frequently during and after a feeding. Using a curved bottle will help with upright feeding, and a collapsible bag bottle can reduce the intake of air.
If soothing or feeding practices aren't reducing crying or irritability, your doctor may recommend a short-term trial of dietary changes. If your baby has a food allergy, however, there would likely be other signs and symptoms, such as a rash, wheezing, vomiting or diarrhea. Dietary changes may include:
Caring for an infant who has colic can be exhausting and stressful, even for experienced parents. The following strategies can help you take care of yourself and get the support you need:
One factor that may contribute to colic is an imbalance of the helpful bacteria in an infant's digestive tract. One treatment under investigation is the use of good bacteria (probiotics) to create an appropriate bacterial balance to improve overall digestive health.
Some studies have shown a reduction in crying times when babies with colic were treated with a bacterium called Lactobacillus reuteri. The studies have been conducted with small groups, and results have been somewhat mixed. Most experts agree there's not enough evidence at this time to support the use of probiotics to treat colic.
Several small studies have shown some benefits or mixed results for alternative treatments. There's not enough evidence, however, to judge the potential benefit over the risks. Alternative remedies under investigation include:
Known risks include the following issues:
Talk to your doctor before using an alternative medicine to treat your infant for colic.
When you take your baby to the doctor, it's a good idea to be prepared for your appointment. Here's some information to help you get ready.
To prepare for your appointment, keep a written record of the following information:
Write down any additional questions you have about your baby's health or development. During your appointment, don't hesitate to ask any other questions as they occur to you.
Your baby's doctor is likely to ask a number of questions, such as:
Your answers to these questions can help your doctor determine if there are other conditions that may be contributing to crying and discomfort.