Dealing With Colic

By Bonnie Owens on May 22nd, 2009

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Many new parents goes through a very scary situation in the first few weeks of their new baby’s life.  Your healthy little baby is laying in your arms, quiet and content, when suddenly he stiffens his limbs, arches his back, clenches his fists, draws up his flailing limbs against a bloated, tense abdomen, and lets out ear-piercing shrieks.   It is obvious he is in pain, but you are unsure of the cause or the solution.  Welcome to the world of colic. My second baby had severe colic that would cause him to behave like this for 3-4 hours at a time.  I would try everything I could think of to calm him, but I often ended up crying right along with him.  I was frustrated with myself for not being able to meet his needs and upset from watching him go through so much pain.  But as with most things in life, colic is a lot easier to handle when you thoroughly understand it.

What is Colic?

No one completely understands colic.  Some doctors will admit that they use colic as a diagnosis why they can’t find anything else wrong with a baby.  The only thing known for sure is that colic causes your baby to have gastric distress and as a result causes them intense pain.  Colic cases are determined by the rule of threes.  If you baby’s bouts of inconsolable crying begin within the first 3 weeks of life, last at least 3 hours a day, occur at least 3 days a week,  continue for at least 3 weeks and last no longer than 3 months then your baby is most likely suffering from colic.

How Do I Determine the Cause?

Step One: Keep a Colic Diary You may uncover clues that help your baby’s doctor diagnose a hidden medical cause of colic.  You want to record:

• What seems to trigger the outbursts of crying?
• Do they occur at roughly the same time each day? How long do these bouts last? How frequently do they occur?
• Are the crying jags getting better, worse, or staying about the same?
• Does there seem to be a consistent relationship between the method of feeding—type of formula, type of bottle, type of nipple—duration, or position of feeding? What changes in feeding techniques or formulas have you tried? Does your baby spit up after feeding? How often? How soon after feeding, and with how much force? If you’re breastfeeding, do you notice any correlation between what you eat and how much your baby fusses?
• Is your baby bloated, does he seem to gulp a lot of air or pass a lot of gas?
• Record your baby’s bowel movements: how frequent are they? Are they easy to pass – soft? hard? Do you notice any changes in the frequency or characteristics of the stools in response to a change in feeding?
• What changes or techniques have you tried in an effort to soothe your baby? What seems to work? What doesn’t?

Step Two: Get A Medical Evaluation Don’t settle for a five-minute squeeze-in appointment.  To thoroughly evaluate a hurting baby, a doctor needs time.  Request an extended office visit.  To help your doctor appreciate how devastating these bouts of colic are, videotape one of your baby’s crying jags and ask them to view it, preferably before your appointment.

Step Three: Keep Searching for Answers If your gut feeling tells you that your baby hurts somewhere, don’t give up searching for the cause and experimenting with various comforting remedies.

What are the Common Causes?

1. Food sensitivities. Gassy foods ingested by a breastfeeding mother can cause gassy babies.  Nursing mothers have long noticed a correlation between what they eat and how colicky their baby gets.  Here is a list of common fussy foods: dairy products, caffeine-containing foods and beverages (soft drinks, chocolate, coffee, tea, and certain cold remedies), cruciferous vegetables (cabbage, green peppers, broccoli, cauliflower, brussel sprouts, and onions), spicy foods (such as garlic or curry), wheat, and corn.
2. Formula allergies. Babies fed a cow’s-milk-based formula may become colicky if they’re allergic to the protein or can’t tolerate the lactose in cow’s milk. If a formula allergy is suspected, a hypoallergenic formula (“alimentum“, “nutramigen“, “pregestamil“) or a lactose-free formula may be recommended by your doctor.  The American Academy of Pediatrics Committee on Nutrition does not recommend changing to soy formula, since studies have shown that colicky infants do not improve when switching from cow’s milk to soy formulas.
3. Gastroesophageal reflux (GER), a newcomer to the hidden causes of colicky and nightwaking behavior, occurs when the muscular tissue at the junction of the esophagus and the stomach doesn’t function like a one-way valve and allows irritating stomach acids to be regurgitated into the esophagus, causing pain similar to what adults call heartburn.

How Do I Comfort My Baby?

Treatment is aimed at relaxing the whole baby and particularly the baby’s abdomen.  Most comforting measures come down to motion, untensing tiny tummies, and administering the right touch at the right time.  Some strategies to try are:

1. Slower, more frequent feedings.Feeding too much, too fast, can increase intestinal gas from the breakdown of excessive lactose, either in mother’s milk or in formula.  As a rule of thumb, feed your baby twice as often and half as much.  A baby’s tummy is around the size of her fist.  To appreciate the discrepancy between usual feeding volume and tummy size, place your baby’s fist next to a bottle filled with four to six ounces of formula or breastmilk. It’s no wonder tiny tummies get tense.
2. Colic Carries. Here are some carrying positions that work particularly well for fathers.  Football hold.  Place your baby stomach-down along your forearm, with his head near the crook of your elbow and his legs straddling your hand.  Press your forearm into baby’s tense abdomen.  Or, try reversing this position so that his cheek lies in the palm of your hand, his abdomen along your forearm, and his crotch snuggled into the crook of your elbow.   The neck nestle. Snuggle baby’s head into the groove between your chin and chest.  While swaying back and forth, sing a repetitive tune.
3. Baby bends. When your baby is at the peak of an attack, try these abdominal relaxers.  The gas pump. Lay baby face-up on your lap with her legs toward you and her head resting on your knees.  Pump her legs up and down in a bicycling motion.  The colic curl. Place baby’s head and back against your chest and encircle your arms under his bottom, then curl your arms up.
4. Tummy touches. Sit baby on your lap and place the palm of your hand over baby’s navel, and let your fingers and thumb encircle baby’s abdomen. Let baby lean forward, pressing her tense abdomen against your warm hand.  Dad’s bigger hands provide more coverage.
5. Babywearing.Anthropologists who have studied infant care practices throughout the world have noted that babies worn in a wrap tend to fuss less.  One of the theories about colicky behavior is that it’s a symptom of disorganized biorhythms.  During pregnancy, the womb automatically regulates baby’s systems.  Birth temporarily disrupts this organization.  The more quickly a baby gets outside help with organizing these biorhythms, the more easily she adapts to life outside the womb.  By extending the womb experience, the babywearing mother and father provide an external regulating system that helps to organize their baby.  In comforting colicky babies, it helps to think of the womb experience as lasting eighteen months – nine months inside the mother, and nine months outside.