Colic

All babies cry, and this can be very draining for parents. It is often difficult to work out whether your baby is hungry, cold, tired or in need of a nappy change. Sometimes there is nothing you can do to soothe them, and your baby may continue to cry and scream for a long period of time.

The intensity and regularity of the crying varies between babies, but it usually continues for three hours or more every day, on most days of the week. If you and your doctor are sure that there is no other medical reason for the baby’s distress, then colic may be diagnosed.

Colic is very common in newborn babies, and may continue for the first three to four months after birth. Although it is often distressing for parents, colic does not harm the baby and there are no associated long-term problems. Babies with colic will continue to feed and gain weight normally.

Colic is an extremely common trait in babies, but the exact cause is unknown. Many parents learn by trial and error how to soothe their baby’s crying, and how to recognise what it is the baby wants.

Possible causes of colic include:

- Poor digestion - some research suggests that babies get cramps as milk is passed through their immature digestive system. Colic usually disappears before weaning onto solid food begins.
- Lactose intolerance - some bottle-fed babies may be sensitive to the lactose present in formula milk. Lactose from dairy products in the mother’s diet may also be present in breast milk. Occasionally, this can cause a build up of undigested lactose in the intestines. By the age of three to four months, most babies produce enough of the enzyme, lactase, to break down lactose.
- Wind - babies may swallow tiny air bubbles as they feed or cry, which can cause pain in the intestines.

Some parents worry that they are responsible for their baby crying a lot, but all babies cry as a way of informing other people that they need something. Colic is simply an extreme version of this, and has nothing to do with bad parenting.

Babies with colic often cry in the early evening, and you may find it is repeated at a similar time each day. The crying is often frantic and may be more high-pitched than normal. Usual methods of calming the baby down are not very effective, and the crying may continue on and off until the baby finally settles and falls asleep.

Colicky babies often draw their knees up to their chests and clench their fists when crying, as if they are in pain. They may also become red in the face from all the screaming. There may be several attacks of vigorous crying in a row. The baby may appear to be calming down when another bout of crying occurs.

Babies with colic often have difficulty sleeping, and feeding patterns may be disrupted by the bouts of crying. Feeding is not normally reduced, but it may take longer if the baby is crying persistently. It is also common for babies to pass wind during periods of vigorous crying.

Colic is milder in some babies. Periods of restlessness in the evenings may be all that is noticed.

An otherwise healthy baby who cries excessively in the first four months of life is generally thought to have colic. About 20% of babies get colic, and it affects boys and girls equally. It usually appears at around two to four weeks of age and disappears by about four months of age.

If you suspect your baby is unwell, or if you are worried it may be something other than colic, it is important to see your doctor to rule out other possible causes of the distress. However, it is important to remember that as a parent, you know your baby best. Familiarity with your baby’s temperament and behaviour can be invaluable in helping you to recognise a more serious problem.

There is no treatment to prevent colic, but there are things you can do to reduce the distress to your baby that is caused by colic. For parents, it is important to try to remain calm and take regular breaks. If you are tired and stressed, you may find it harder to cope with the situation. The following measures may help to soothe a crying baby:

- Prevent your baby from swallowing air by sitting them upright to feed
Some babies are intolerant to lactose, which is found in cow’s milk. Although babies under twelve months should not be given cow’s milk without first consulting your doctor, most formula milk is based on cow’s milk. Try giving your baby a lactose-free formula (e.g.- soya) for a week, to see if the colic improves. If you are breast-feeding, try avoiding dairy products for week, as some evidence suggests that traces of lactose may be present in breast milk.
- Avoid drinking too much tea, coffee, and other caffeine containing drinks if you are breastfeeding. Some women also find that spicy food and alcohol in their diet can aggravate colic.
- Breastfeeding mothers can also try cutting down on cruciferous vegetables such as cabbage, broccoli and cauliflower. These foods encourage the production of wind, and may aggravate colic. As with dairy products, you should resume your normal diet if there is no improvement. It is important that breastfeeding mothers have a balanced diet with plenty of calcium.
- Holes in bottle teats that are too small may cause babies to swallow air along with their feed. ‘Fast flow’ teats with larger or several holes are available and may be a good alternative.
- Always burp your baby after a feed. Sit your baby upright or hold it up against your shoulder to do this.
- Some evidence suggests that ‘over-stimulating’ a baby by continually picking them up and putting them down may aggravate the crying. Gently comforting your baby in a quiet, darkened room may be more beneficial. If you are satisfied your baby is not hungry, tired, in need of a nappy change, or at an uncomfortable temperature, it may help to leave them in their cot for a short while.
- Let reliable friends and family look after your baby from time to time to ensure you get a break.
- Babies like movement, so pushing them around in their pram or pushchair, or going for a drive can be comforting. Rocking them over your shoulder or carrying them around the house may also be helpful.
- Some babies find ‘white noise’ soothing. This may be the background sound of a washing machine or vacuum cleaner. Gentle stomach or back rubs may also help to relieve colic, as can a warm bath.
- Your pharmacist can advise you on simple medicines and/or gripe water that will help prevent colic. Lactase and simeticone (for example Colief and Infacol respectively) are two useful preparations that may ease the symptoms of colic. Lactase is a food supplement that can be added to formula or breast milk. The enzyme lactase, breaks down lactose. If your baby is lactose intolerant this may relieve wind and bloatedness that can cause discomfort in the intestines. Simeticone is an anti-flatulent. It works by changing small bubbles in the intestines into larger ones that are easier for the baby to burp. You should give your baby Simeticone before every feed. It usually takes a few days to become effective.
- Having a colicky baby can be stressful and your partner or family or a reliable friend may need to give you a few hours break from the your baby so that you can rest or sleep.

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