Colic - Symptoms, Causes & Treatment
When I worked in primary care as a pediatric nurse practitioner, I saw countless visits on my schedule with the chief complaint being “fussy baby”. An extremely fussy baby, or colicky baby, is something that is very hard to deal with as a parent. It is very frustrating to take care of all of your baby’s needs and still have them crying constantly. I can speak from experience, I can tell you my first child was the textbook definition of a colicky baby.
So what is colic? How does the medical world define this widely used term?
A diagnosis of colic has to meet the rule of threes. A baby has to cry for no apparent reason or be hard to console for greater than 3 hours per day, for more than 3 days per week. This pattern technically has to occur for more than 3 weeks to be diagnosed as colic. To tell you the truth, a clinical diagnosis of colic doesn’t really matter, other than to make a parent feel like they aren’t crazy for thinking their baby cries an abnormal amount. I can also speak from experience when I say, that an official diagnosis from a medical professional also helps parents to not feel guilty for not being able to “fix” what is making their baby cry. Having a colicky baby can be an exhausting and defeating season of life. The good news is, it is just a season. Let's dive into how long colic typically lasts.
Colic typically peaks at about 6 weeks of life. In most cases, it resolves completely by 3-4 months of life. Colic tends to be predictable in that your baby’s fussy time tends to happen around the same time of day each time, commonly known as a “witching hour”. You may see that your baby is continually “whining” or “fussy” even if they aren’t crying. Their faces can become flushed or their bodies may be tense with clenched fists, arched backs, or their arms and legs extended out. Basically, they do not look comfortable. Parents often think this is constipation in their infants, however when their baby poops, it is still loose or soft.
Colic is not well understood in the medical community. There are many circulating theories as to what the cause is for this frustrating time in a baby’s development. Some theories are that a baby’s gastrointestinal tract is immature and does not process milk well at this stage, causing gas and bloating, making an infant more fussy. Another theory is that there are gut imbalances causing discomfort. Food allergies or intolerances can also cause belly upset and increased fussiness. This is a time period that many parents will change their infant’s formula or you will see mother’s start an elimination diet while breastfeeding in an effort to help.
It has been shown that colicky babies are more gassy than other babies, however this has been determined to likely be because they cry more than typical babies and therefore take in more gas during crying spells. Basically, it is believed that they are more gassy BECAUSE they are colicky, not colicky because they are gassy.
Studies have been done which have proven there is no difference in the occurrence of colic based upon sex of the baby, if they were pre-term vs. full term, or if they were formula fed vs. breast fed. Studies have shown there is an increased risk of colic in babies whose mothers smoked during and immediately after pregnancy.
Colic is very hard on families. It has been shown to be correlated with increased post-partum depression, quitting breastfeeding early, and an increased feeling of guilt in parents.
There are some suggested treatments, but none have been proven by studies. Probiotic drops are often recommended to address any possible gut imbalances. Many different baby companies are now marketing infant probiotic drops as “soothing” drops. There is no evidence for or against the use of these probiotics either. I tend to tell parents they are welcome to try these over the counter products, however the research isn’t strong enough for me to be confident it will help. Other things that may help are soothing techniques such as putting infants in the carseat and taking a drive around the block, as the motion in the car sometimes soothes infants. Use of a baby swing, white noise, or just rocking in the dark to decrease stimuli may also improve symptoms.
As a parent of a colicky baby, I can attest that during crying spells, I felt helpless and guilty for not being able to soothe my baby. I was a first time parent and felt that I was failing every night when my girl hit these crying spells that I could not fix.
I now understand that there was nothing proven that I could do to help other than keep her safe and protect my own mental health during this period. There were periods that my husband and I would place our daughter in a clean diaper after a feed, and lay her in her crib for 10 minutes, even if she cried the whole time. If we had tried everything we could do to soothe her and it wasn’t working, we sometimes had to take a few minutes to walk away and re-center ourselves.
This is the advice I gave parents in the office often. If your child is fed, clean, and in a safe place, it is okay for you to walk away for a few minutes to protect your mental health. If you are in a season with a colicky baby at home, know that you are not alone. My best advice is to protect your mental health by using your help. Call grandparents, family, and friends to come hold a crying baby. Walk away when you need to as long as your baby is safe and know this season won’t last forever.
