Managing colic in babies
What to Know
- The Rule of Three’s
- The difference between ‘fussy’ and ‘colicky’
- Possible medical causes for colic
Colic is often discussed but seldom understood. Colicky babies have seemingly never-ending episodes of inconsolable crying, no matter what you may try do to calm them. The term colic comes from the Greek word kolikos meaning “suffering in the colon.” Doctors and scientists assume that colicky crying is the result of pain in the gut, but often no clear answer exists as to why a colicky baby is so hard to soothe and the crying is so intense.
While the causes and diagnoses of colic are challenging to pinpoint, colic is assumed if an otherwise well (and well-fed) baby meets the Rule of Three’s for a week or more, with unremitting crying jags:
- Beginning within the first three weeks of life
- Lasting at least three hours a day
- Occurring at least three days a week
Any baby can suffer from colic, as the condition does not discriminate between gender, birth order, or feeding method. Worldwide, the prevalence of colic occurs between an estimated 6-20% of infants. Episodes of intense crying seem to appear more often during growth spurts or at the end of the day and seem to peak at about 6 weeks of age. The good news is that the condition resolves itself in up to 90% of infants by the age of 4 months (though if your baby has colic, these may be the longest 4 months of your life!).
Parents often mistake colic for general fussiness. Many babies are fussy – they need extra comfort, nursing and holding in the evening hours or when they are over-tired. Whereas colicky babies actually appear to be in pain, and are not comforted or relieved no matter what you try. If you are questioning whether your baby may have colic, then she likely doesn’t. The intense crying of a colicky baby is dramatically different than a fussy baby. You’ll just know.
If your baby is colicky and things do not seem to be improving, there may be a medical issue to blame, such as food allergies or sensitivities, reflux, or other issues. Look out for these symptoms and if you notice them, contact your pediatrician, as a further evaluation is in order:
- The pain and crying is getting worse or not getting any better, especially by age 3-4 months
- Frequent wakeups with painful cries
- Poor weight gain
- Frequent respiratory or intestinal illness
- Straining, grimacing, and drawing legs to chest with bowel movements
- Frequent spit-ups and more intense crying post-feedings and when lying down
- Symptoms suggestive of allergies, such as rashes, diarrhea, runny nose and wheezing
What to Do
Keep a colic diary
Keep track of what seems to trigger the crying and what eventually helps to calm it. Record duration, intensity, time of day, and how close the episode is to a feeding or a nap. Also make a note of things like how often you used a baby carrier that day, how many bowel movements she had, and if the crying seems to be getting better, worse or staying the same.
Do not make yourself paranoid by recording every second of the day, but if you start to see correlations, then you can start implementing interventions that will calm both of you. These details and clues may also help your pediatrician identify a medical cause of colic.
Try smaller and more frequent feedings
If over-feeding or over-supply is causing gas or belly pain, try to nurse your baby for less time and more frequently or twice as often and half as much. More frequent nursing – with the resulting skin-to-skin and holding – may also comfort, soothe and calm your baby.
Babies usually have their most colicky times at the end of the day, so use the more peaceful and restful morning times to plan the rest of the day. If you know that the fussiest time usually starts around 3 pm after she wakes from a nap, be ready to immediately go into a relaxing ritual of massage, baby wearing, a long walk and anything else that seems to calm the both of you.
Turn up background noise
Some babies cry less when they hear steady background noise. When holding or rocking your baby, make a continuous “”shssss”” sound, turn on a kitchen or bathroom exhaust fan, or play environmental sounds, like ocean waves, a waterfall, gentle rain or a human heartbeat. Or keep the steady tick of a clock or metronome near your baby, as this can sometimes do the trick.
Apply gentle pressure on baby’s belly
Tummy Time: This position can put gentle pressure on her belly, helping to push out the trapped gas. Wait at least 30 minutes after a feeding to allow your baby’s belly to settle before starting tummy time. Or try a more advanced move – use both hands and a lot of guided support to lay your baby tummy down on a large beach or exercise ball and gently roll her on the ball in a circular motion.
Forearm Hold: Also called the football hold, magic hold, and the colic carry. Try carrying your baby face down with her body resting on your forearm, the front of her diaper area in your hand with her chin cradled in your elbow. Carrying your little one in this face-down position will place the same gentle pressure on her belly that is achieved during tummy time. While in the football hold, you can also gently tap your baby’s back or give a gentle bounce with your arm to give gravity a helping hand.
Gentle bouncing and movement
Hold your baby securely and dance with her around the house, bouncing gently up and down, swaying side to side, and using any mild movements that you find helpful. Bouncing carefully with your baby while sitting on an exercise ball may also do the trick.
Take a warm bath along with your baby and practice skin-to-skin
Draw a warm bath and climb in with your little one. Warm baths can help soothe and relax both of you!
Once out of the bath, give your baby lots of time to practice skin-to-skin time with either parent. Lay back and place your baby on your naked chest in a diaper with her ear over your heartbeat. The combination of the rise and fall of your breathing and the warmth of your body with be a great comfort to your baby.
Infant massage on your baby’s tummy to relieve gas pressure
While your baby is laying on her back, gently rub her tummy in a clockwise motion and then pull your hands down the curve of the belly. Massaging in a clockwise direction helps to move gas along as that is the route the intestinal tract follows. Repeat several times to help move trapped gas. See Baby massage benefits and techniques for more information.
Bicycle baby’s legs
Bicycling your baby’s legs in a circular motion can help to move the intestines and release gas trapped lower in the abdominal track. With your baby lying on her back, take her legs in your hands and cycle them slowly back and forth as if they were riding on a bike. Take a break every now and then to press both of her knees gently into her own tummy for some extra pressure.
Wear your baby whenever you can
Research shows that wearing your baby (in a sling, wrap or carrier) during calm and non-colicky hours can actually shorten excessive crying later in the day. Carriers extend the womb experience for your baby and help with the adaptation to her new life on the outside. Use a carrier for several hours every day to help her stay calm.
Make a distress tape
Take a short video of your baby’s crying and behavior during a colicky episode and play it for your physician so he or she can help you determine whether your baby is fussy or in pain.
Schedule an appointment with your doctor to examine your baby thoroughly
Ask your doctor’s office for an extended time slot (not just the 5 minute check-in visit) to ensure enough time for a thorough evaluation of your baby’s condition. Make sure all parents and primary caregivers are present for this appointment so the doctor can get a full and complete picture of what the baby is going through – one parent may downplay while the other parent may exaggerate so being there together will benefit everyone.
And speak with your physician before trying any herbal or alternative therapies for colic, like herbal teas or oils, gas drops, gripe water, or sugar water. These treatments are unregulated and research is inconclusive on their safety and efficacy. Always ask a doctor first.
Take a break
Caring for a baby with colic stresses out all parents who are living through it. There is no shame in stealing a moment or two for yourself. Hand your baby off to another caretaker (call grandma or grandpa!) or place her down in a safe space and walk away for a few minutes. Use this time to practice some breathing exercises, sit and stretch, step outside for some fresh air or just lie on the couch and close your eyes. Sometimes just a few moments away can re-energize you and make those feelings of frustration and even anger drift away. This will pass!
Ask for help
Research indicates that parents of difficult to soothe babies are at risk for depression. Feeling overwhelmed from caring for a fussy baby coupled with plaguing self-consciousness about taking a crying baby out in public can lead to isolation at the very time when you need the most support.
Ask family and friends to help you by taking a turn, so that every day you get a break of some kind. Look into hiring a mother’s helper or joining a mothers’ group for colicky babies (or any other mothers’ support group!). You and your baby deserve more not less community.
Understand that clarity may be evasive
It’s completely normal for the cause of your baby’s cries to go unknown. While this will be frustrating, don’t take it personally. Your job is to provide as much appropriate care, comfort and support as you can, to offer a set of caring and relaxing arms so that your baby does not need to cry alone, and to do as much detective work as you can to figure out why your baby is crying and how you can help. The rest is up to your baby.
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Rogovik, Alex L, and Ran D Goldman. “Treating Infants’ Colic.” Canadian Family Physician. Volume 51. Issue 9 (2005): pages 1209-1211.