Colic

All babies cry. It is a simple and effective means of communication, and is your baby's way of letting you know that they are hungry, tired, cold, or in need of a nappy change.

However, sometimes babies cry for no obvious reason, even though they are well-fed, clean, warm and well cared for. If your baby has repeated episodes of excessive and inconsolable crying, and they otherwise appear to be thriving and healthy, then they probably have colic.

Colic is very common in newborn babies and it is thought to affect around 20% of infants. The condition normally starts a few weeks after birth, and continues for the first three to four months of life. Although it may appear that your baby is in distress, colic is not harmful, and your baby will continue to feed and gain weight normally. There is no evidence that colic has any long term effects.

Colic can be extremely upsetting for parents. You may feel like you are letting your baby down, or that you are doing something wrong. However, although colic can be distressing at the time, remember that it is a common phase which will pass in a few weeks, or months.

The causes of colic are unknown. Some researchers have suggested that indigestion, or wind, may play a role. Others claim that babies who have colic may, for a few weeks while their gut is maturing, be sensitive to certain substances found in breast, or formula, milk, such as lactose (a natural sugar), or molecules found in cows' milk. It is thought that these substances may be passed on to the baby through breast feeding. However, there is little evidence to support these theories.

Lactose intolerance and milk allergies are rare conditions that can cause symptoms similar to those of colic. Some researchers have suggested that some babies may be more sensitive than others, or have a problem 'turning off' their crying response.

Smoking, during pregnancy, doubles the chances of your baby developing colic.

In an otherwise healthy, and well-fed baby, symptoms of colic include:

- intensity of crying - your baby's face is red and flushed, the crying is intense and furious, and there is little, or nothing, you can do to comfort them, and
- body posture - your baby may clench their fists, draw up their knees, or arch their back.
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 than in others, and 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 usually thought to have colic. About 20% of babies get colic, and it affects boys and girls equally. It usually appears when the baby is between 2-4 weeks old, and disappears when they are about four months of age.

If you suspect that your baby is unwell, or if you are worried that their symptoms may be something other than colic, it is important to see your GP to rule out other possible causes of 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.

Colic always improves on its own after a few months. There are not many treatment options for colic, but there are a number of tips that you may find useful for dealing with a colicky baby. These are outlined below.

Comforting your baby

There is no single 'best' way of comforting your baby, or reducing the symptoms of colic. Different babies respond to different methods, so you may have to try a few methods to see what works for you. You may find that some of the suggestions outlined below are useful.

- Holding your baby during a crying episode can sometimes help, as can wrapping them snugly in a blanket (swaddling).
- Prevent your baby from swallowing air by sitting them upright during feeding.
If- you are breastfeeding, avoid drinking too much tea, coffee, and other drinks that contain caffeine. Some women also find that spicy food and alcohol can aggravate colic.
- 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 useful alternative.
- Always burp your baby after a feed. To do this, sit your baby upright, or hold them against your shoulder, making sure that you support their neck and head. Gently rub their back and tummy until they burp. They may vomit a small amount of milk when you do this, which is normal.
- 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 that your baby is not 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, 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 a vacuum cleaner. Gentle stomach or back rubs, or a warm bath, may also help to relieve colic.
Medical treatment

As colic always improves on its own, medical treatment is not normally recommended. However, if you find that you are having problems coping then you should contact your GP.

Unfortunately, there is no magic cure for colic. However, there are several treatments that may work, and it is worth giving them a try (one at a time) for a week or so. These treatments are outlined below.

- Simeticone drops - a one week trial; they are suitable for both breastfed, and bottle fed babies.
- Excluding cow's milk protein - for breastfed babies: a one week trial of a dairy-free diet for the mother. For bottle fed babies, a one week trial of hypoallergenic formula (a formula designed to reduce the possibility of an allergic response).
- Lactase drops - a one week trial that is suitable for both breastfed and bottle fed babies.
If you baby responds to the exclusion of cow's milk protein, or to lactase drops, it does not necessarily mean that they have permanent milk intolerance. In most cases, any milk intolerance is temporary and passes after a month or two.

Alternative and traditional therapies

Although there are many alternative and traditional therapies for colic, there is little evidence to suggest that they are effective, and some may harm your baby. Some of these therapies are outlined below.

- Dicycloverine - also known as dicyclomine, is a medication that is used to control stomach cramps. Dicycloverine used to be widely used as a treatment for colic, but it is now known to be unsafe for infants because it can cause breathing difficulties, seizures, loss of consciousness, weakening of the muscles, and coma.
- Star anise tea - is a herbal tea that has traditionally been used for the treatment of colic. However, its use is no longer recommended because certain types of star anise are highly toxic and could poison your baby.
- Chiropractic and massage therapy - some people suggest that a series of massages, or chiropractic manipulation of a baby's spine, may be effective therapies against colic. However, detailed medical trials have failed to find any convincing evidence of the benefit of such therapies.

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