Colic in Newborns

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Colic

Colic is a common problem, affecting 10-25% of all newborns. It is defined as recurrent inconsolable crying in a healthy and well-fed infant. It usually begins at about two to three weeks of age, is at its worst at six weeks of age and then gradually improves and finally resolves on its own by three to four months.

The most common symptoms of colic are the sudden onset of screaming and crying that can last for more than two to three hours at a time. Babies with colic will often seem as if they are in pain and are difficult to console. While crying they will usually pass a lot of gas, draw up their legs and their abdomen may seem hard or distended. Most babies with colic have one or two episodes of this type of crying each day. In between these episodes they usually act fine.

Causes Of Colic

It is not known what causes colic, but it is not usually thought to be from abdominal pain, formula allergies, the iron in infant formula or gas. It is known that normal babies have a fussy period toward the end of the day that begins when they are two to three weeks old and that this may be their way of ‘blowing off steam' or dealing with the normal stimulus of their day. It may be that babies with colic are more sensitive to this normal everyday stimulation. It is also known that babies with colic do not have more difficult temperaments and are not more hypersensitive as they grow older.

Causes of Crying

There are medical problems that can cause crying in newborns, but in general, infants with these problems usually cry through out the day.

If crying always seems to occur during feedings or right after a feeding and your child is spitting up a lot, then he may have reflux esophagitis.

A formula or milk allergy may be suspected if the crying always occurs 30-60 minutes after a feeding and your child also has vomiting and diarrhea and does not seem to be gaining weight well. In this case a 1-2 week trial of a soy formula or an elemental formula (such as Nutramagen) can be used.
If you are breastfeeding and your baby seems to always cry after you eat or drink certain foods, then it would be reasonable to try and stay away from those foods. A one to two week trial off of dairy products and/or caffeine may also help.
Managing Colic
Unless your baby has reflux or a formula allergy, there are no medicines to make colic go away. Some tips to help deal with colic until it clears up on its own include:

• Reassure yourself and other family members that this is a benign problem that always clears up on its own without any long term effects.
• Some things that you may try to comfort your baby include:
  • swaddling
  • cuddling
  • rhythmic rocking
  • going for a walk or ride
  • warm baths
  • singing
  • rhythmic sounds
  • massages
  • using a pacifier, windup swing or vibrating chair.

None of these measures work for all children, but you can try one or two at a time until you find what works for your baby.
If nothing works, it is okay to just put your baby down and let him cry for short periods. Always remember that it wasn't anything that you did or didn't do that caused your baby to have colic and as a last resort try to take a break by having a family member or friend help care for your baby.
Important Reminders

• Be patient. This is a frustrating problem without good treatment options, but it always improves as your child gets older.
• It can be frustrating taking care of a crying baby, so get help if you are having trouble coping with your infant's crying. Remember that you should never shake your baby, which can cause shaken baby syndrome. Get help if you think you might harm your baby.
• Avoid frequent changes of your babies formula, unless instructed to do so and do not use a low iron formula.
• Call the office if your child has a rectal temperature over 100.4, has persistent vomiting, if she does not seem to be gaining weight, or if the crying is not improving or does not go away by the time she is 3-4 months old.