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Colic


Baby and colic

The hardest thing for parents to experience is watching their baby erupting in ear-shattering wails, complete with clenched fists,  and an unhappy red face and no matter what you try you cannot comfort your miserable, crying baby. I remember when my daughter was only a few weeks old when she got colic. I did not know much about it then, but read and tried everything to help her relieve her discomfort. 

Looking after a colicky baby can be very frustrating and distressing. Fortunately, colic does not last long. Most bouts peak at around six weeks and then typically start to taper off by 10 to 12 weeks.  By the time your baby reaches its 4th month of life all the symptoms of colic and crying are usually gone.

The aim of this article is to explain what colic is, what causes colic and its signs and symptoms and how you can help your baby to settle and relieve some of the discomfort and pain she is experiencing. 


What is colic?


Colic is the name for excessive, frequent crying in a baby who appears to be otherwise fit and healthy. It's a common problem that affects up to one in five babies.


Colic tends to begin when a baby is a few weeks old, peak at six weeks of age and get better around week 10 -12. It normally stops by four months of age, or by six months at the latest.


Crying episodes can go on for hours at a time, sometimes late into the night. Worst of all, it's extremely difficult to calm a colicky baby, which only compounds your own frustration, worry, and exhaustion.


Doctors usually diagnose colic based on the "rules of three".

Your baby's crying:

Lasts at least three hours at a stretch

Occurs at least three days a week

Persists for at least three weeks in a row


Signs and symptoms of colic include:


  • Intense crying bouts which seem to occur for no reason. 

  • Crying in the late afternoon or evening that lasts several hours

  • Your baby's face being red and flushed when they cry

  • Your baby clenching their fists, drawing their knees up to their tummy, or arching their back while crying

  • Bowel activity may increase, and your baby may pass gas or spit up. 

  • Eating and sleeping are disrupted by the crying — baby frantically seeks a nipple only to reject it once sucking has begun, or dozes for a few moments only to wake up screaming.

Your baby's  crying outbursts are not harmful, and your baby should continue to feed and gain weight normally.


What causes colic?


The cause or causes of colic are unknown, but some theories have been suggested. These include indigestion, trapped wind, or a temporary gut sensitivity to certain proteins (cow's milk protein) and sugars (lactose) found in breast and formula milk.


Indigestion and trapped wind


Doctors don't clearly understand why some babies cry excessively and others don't, but a new study suggests abnormal gut bacteria could play a role.


The research identified a distinct bacterial "signature" in the guts of infants with colic, a term that describes babies who cry for more than three hours a day without a medical reason.


In the first few weeks of life, the research found, colicky babies had higher numbers of bacteria from a group called Proteobacteria in their guts compared to babies without colic. Proteobacteria include bacteria known to produce gas, which may cause pain in infants and lead to crying, said study researcher Carolina de Weerth, a developmental psychologist at Radboud University Nijmegen in the Netherlands.


Cow's milk sensitivity


Cow’s milk (either in the mother’s diet or engineered into formula) is a common source of food sensitivity in babies. Cow’s milk sensitivity or allergy can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea (including bloody diarrhea), constipation, hives, and/or a stuffy, itchy nose. Around 10% of babies with colic symptoms have cow's milk sensitivity.


Although cow’s milk protein sensitivity and lactose intolerance are not the same thing, they can sometimes occur at the same time, since food allergy can cause secondary lactose intolerance due to the damage of the intestine wall due to inflammation, thus reducing lactase activity (lactase is the enzyme which breaks down lactose - milk sugar).  


Lactose 


Congenital lactose intolerance or congenital lactase deficiency is extremely rare in babies. 


However, lactose overload can occur in baby when mom has an oversupply of milk. The milk that baby gets earlier in a feeding (foremilk) is higher in lactose and lower in fat than the milk later in the feeding (hindmilk).


Although infants are not lactose intolerant by nature, a high volume of lactose can overwhelm a baby’s digestive system. When there is not enough lactase to break down all the lactose, the excess lactose causes gassiness and discomfort, and frequently green, watery or foamy stools. Over time, large amounts of undigested lactose can irritate the lining of the intestines so that even a little bit passing through can cause irritation. Occasionally, this can result in small amounts of bleeding into stools that can be misdiagnosed as a food allergy. Some pediatricians will mistakenly diagnose lactose intolerance if there is undigested sugar in the baby’s stool.


Colic occurs equally in girls and boys, and both in babies who are breastfed and those who are bottle-fed.


Treatment for colic

Colic and baby
Colic gets better on its own after a few months, although you may find the following tips helpful in the meantime.

The following suggestions may help:


  • Holding your baby during a crying episode can sometimes help, as can wrapping them snugly in a blanket or baby sling.

  • Hold your baby in different positions – such as on your shoulder, cradled in your arms, or lying with their tummy faced down along your forearm. 

  • Sit or hold your baby upright during feeding to prevent them swallowing air.

  • Don't drink too much tea, coffee, and other caffeine drinks if you're breastfeeding – some women also find spicy food and alcohol can aggravate colic.

  • Burp your baby after feeds – to do this, sit your baby upright or hold them against your shoulder and gently rub their back and tummy until they burp. They may vomit a small amount of milk when you do this.

  • Avoid overstimulating your baby by continually picking them up and putting them down – gently comforting your baby in a quiet, darkened room may be better. If you're satisfied your baby isn't hungry, tired, too hot or cold, or in need of a nappy change, it may help to leave them in their cot for a short while.

  • Babies like movement – pushing them around in their pram or pushchair or going for a drive can be comforting. Rocking them gently over your shoulder or carrying them around the house may also be helpful: but never shake your baby.

  • Some babies find white noise soothing – this is the background sound of a washing machine, vacuum cleaner or radio static.

  • Gentle stomach or back rubs or a warm bath may help.

  • Try gently massaging baby's tummy


Try gently massaging your baby's tummy in a clock direction.
  • You can do a "bicycle exercise" with your baby's legs to reliev some of the wind.