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Colic

By Mary Bibb, BA, IBCLC

Colic is a term for an otherwise thriving, healthy infant who has regular episodes of intense crying.  The crying can last for several hours at a stretch, often in the evening. Colic is self-limiting; most babies grow out of it by 6-12 weeks of age. The first thing to rule out when a baby cries is hunger.  Many babies feed more frequently in the evening, perhaps as a way to fill up on high fat milk before their longest sleep period. If a crying baby cannot be comforted by breastfeeding, ask your physician and local IBCLC for help. Your physician can weigh your baby to make sure he is feeding and gaining weight well, and can rule out illness as a cause of persistent crying.

Research has shown that the best way to decrease infant crying is to increase the amount of holding. An extra hour of carrying decreased crying by 43-50%! Carrying your baby in a soft carrier will free your hands to take care of yourself while you comfort your baby.

Increased holding and feeding at the first sign of hunger (bringing hands to mouth, making sucking motions) help reduce crying. If baby is already crying, try body contact and movement. Walk with your baby pressed close to your shoulder.  Some infants respond to rocking, or dancing to soothing music. The colic hold is another helpful maneuver. Some infants will respond to mechanical swings, or a car ride to help them sleep. White noise, such as running the vacuum cleaner or a sound machine soothes some babies. Fathers, grandparents, or willing friends can give the mother of a colicky baby a much needed break.

Some parents of colicky babies feel anger and frustration. If you find yourself feeling this way, place baby in the crib and take a minute to compose yourself. It will probably help to remember that your baby is communicating pain and distress.  Think of times when you were in pain and needed someone to comfort you. Talking to other new parents at a La Leche League meeting or a mother’s support group can be invaluable.

Both breast and bottle fed babies can experience colic.  One large study in Portugal found that breastfeeding may protect against colic. Research has identified some possible causes for colic. One common cause is lactose overload from switching breasts before baby gets to the high fat milk. If baby is often fussy, try offering one breast at each feeding. Let the baby come back to the same breast several times before switching sides.

Sometimes colic can be caused by a sensitivity to a food in mom’s diet. Breastfed babies can be allergic to a food that mother has eaten. If you can avoid the food that causes the crying, baby’s symptoms should cease within 3-7 days.

The most common allergy-causing foods are cow’s milk, eggs, wheat, and peanuts. Elimination diets can help mothers of allergic babies continue breastfeeding.  If you decide to wean to formula, it would be wise to pump frequently for 3-4 weeks so you have the option of resuming breastfeeding if baby's colic worsens. It can take this long for a formula allergy to become apparent.

Cow's milk protein allergy has been linked with colic in some infants, along with other symptoms such as flecks of blood in the stools.  However, new research suggests that cow milk allergy is less common than previously believed.  Trial removal of dairy products for 2-3 weeks to see if symptoms improve should be followed by a cow milk challenge (where dairy is re-introduced into the mother's diet).  This should be medically supervised and will tell whether improvements have occurred  because of the elimination diet. Putting mothers on food eliminations diets is stressful and should be avoided unless clearly required.  Other things besides allergy can cause colic symptoms such as excessive fussing and blood in the stools.  Infection should be ruled out.

Infant colic is one of the most difficult things a parent can go through. It is temporary, however, and with time, patience, help and support, families get through it.

Recommended reading: "The Fussy Baby", Rev. ed., 2002, by Dr. William Sears, www.lalecheleague.org

Reviewed by:  Barbara Wilson-Clay, BSEd, IBCLC 

References:

Arvola T, Ruuska T, Keränen J, Hyöty H, Salimen, S, Isolauri E, Rectal Bleeding in Infancy:  Clinical, Allergological,and Microbiological Examination, Pediatrics 2006; 117(4):e760-768.

Hunzicker UA, Barr RG: Increased carrying reduces infant crying: A randomized controlled trial, Pediatrics 77:641, 1986.

Saavedra MA, da Costa JS, Garcias G, Horta BL, Tomasi E, Mendonça R, Infantile colic incidence and associated risk factors: a cohort study.  J Pediatr (Rio J). 2003 Mar-Apr; 79(2): 115-22.

Woolridge MW, Fisher C. Colic, "overfeeding", and symptoms of lactose malabsorption in the breast-fed baby: a possible artifact of feed management? Lancet. Aug 13;2(8607):3

 

 

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