Colic refers to loud, persistent crying in a young infant without an obvious cause. Typically, infants are between 6 weeks and 3 months old when they first start having these crying fits. Babies will suddenly draw up their legs, turn red in the face, clench their fists, and scream! Sometimes screaming fits will last for hours at a time. Colic typically worsens about 4:00 pm and gets better by about 8:00 pm. Colic in a healthy baby has never harmed a baby, but it is very frustrating and difficult for parents, who themselves may be sleep-deprived!
Note that colic is seen in otherwise healthy infants. Obviously, a hungry infant, an infant with fever, one with a wet cold diaper, etc. will scream inconsolably -- but that's not colic. If your baby is having other symptoms besides just screaming, you'll want to get him or her checked out.
What causes colic?
By definition, colic doesn't have an identifiable cause! Physicians used to think it had to do with excessive gassiness in the intestines. However, this is probably a chicken-and-egg issue: persistent crying for ANY cause means babies swallow more air. More swallowed air means being more gassy, which isn't fun for any baby. But why do babies cry to start with?
More recent information suggests it's probably a behavioral issue. Some "easy babies" cry but it doesn't seem very unusual to the parent. Some infants seem to cry a lot more than others. There may also be a relationship between the infant's personality and the parenting style.
Note that infants of mothers who smoked during pregnancy have twice the risk of being "colicky" than infants of non-smoking mothers.
How much crying is abnormal?
It may be of some comfort to know that the average 6 week old infant typically cries about 3 hours a day. This means that half of healthy infants cry even more. Considering most infants this age are awake perhaps 8 hours a day, some infants can spend more than half their awake time crying.
You may be also interested in knowing that, by 3 months, the average infant cries about an hour a day. (So it does get better!)
What can I do for colic?
We want you to do something, but we want you do to something that is SAFE and will HELP. Because colic is so common and frustrating, many physicians have tried a number of things, including medication, to reduce a baby's crying. Unfortunately, most medications aren't any difference from sugar water (placebo.) There has been one medication that was very successful, though: In the "olden days," physicians used to prescribe paregoric drops. This was quite effective to make a baby stop crying: it's a narcotic, related to opium that would make the baby go to sleep! Because colic is so common, many studies have been done trying to determine what medications and therapies help.
What doesn't seem to help?
- Simethicone drops. Studies have compared simethicone drops to placebo (Pediatrics 1994;94:29-34) and showed that there was no difference in relief of symptoms or duration of symptoms. In fact, infants on placebo actually did a little better!
- Dicyclomine drops. This is related to hyoscyamine (Levsin). Dicyclomine is effective at controlling crying. Unfortunately, some infants stopped breathing, or had seizures or coma from the medication. The manufacturer and FDA no longer recommend its use for colic (even though some physicians still use it.)
- Methylscopolamine drops. Methylscopolamine is comparable to placebo, but 20% of infants getting methylscopolamine actually got much worse with it (ActaPaediatr1995;44:203-208)
- Lactase drops. This is based on the assumption that colic is caused by lactose intolerance, but no difference has been found between lactase and placebo in stopping crying.
- Switching formulas. A small percentage of colicky infants do have a true formula intolerance, and switching formulas sometimes helps. (These children tend to have other symptoms as well.) However, this is pretty rare and usually doesn't make a difference. See our handout, "Should I change my baby's formula?" for more information.
- Chiropractic manipulation. A study in Norway (Arch Dis Child 2001; 84: 138-41) tried to examine this issue. It found that a 10-minute chiropractic adjustment was no more effective than a nurse's cuddling for 10 minutes.
What does seem to help?
Some safe, natural things you can do for colic:
- The most important thing to do: Switch caregivers! Let the baby (as well as yourself) get a change of scenery and a new face. A baby actually gets fussier if she senses mom or dad is frazzled, and a frazzled parent isn't an effective parent anyway. If you don't have a second caregiver to help out with your baby, you will need one.
- Swaddle the baby firmly in a soft receiving blanket.
- Gently massage the baby's back, arms, and legs.
- Take the baby for a car ride or stroller ride.
- Hold the baby prone, one hand on the stomach, one hand on the back, and rock the baby back and forth.
- Offer a pacifier, the breast, or the baby's hand for sucking comfort.
- Burp the baby well.
- Slow down feeding times. Barracuda "guzzlers" have more gas.
- Put the baby near of a repetitive noisemaker, like a clothes dryer, dishwasher, or vacuum cleaner. Avoid television, which can be over stimulating.
- Stop smoking. Babies whose mothers smoke during pregnancy and breastfeeding undergo nicotine withdrawal and cravings later. Passive smoke exposure even after birth may worsen colic as much as threefold.
- Camomile tea. One study suggests small amounts of camomile tea might be helpful (J Pediatr1993;122:650-652). However, parents should be careful not to "fill up" the baby on herbal tea, which lacks the protein, fats, etc. of breast milk or formula. Other herbal teas, such as catnip, can be dangerous and we do not recommend them. If you are interested in trying camomile tea, please let us know.
- Wait a few months! Babies outgrow colic by 3-4 months of age.
If your baby's colic is driving you nuts, or if you think there may be something else wrong (like an ear infection, diarrhea, etc.) please let us know.
For more information on calming a crying or colicky baby, check out these online resources:
- Period of Purple crying at http://purplecrying.info/what-is-the-period-of-purple-crying.php
- The Happiest Baby on the Block at http://www.happiestbaby.com/5-ss-system-may-help-colic-symptoms/