It Pays to Be Aware About Infantile Colic

Our experience with colic was such a frightening experience for both me and my husband that I decided to write this post on colic. I’m sharing this information with you so you won’t be caught off guard like we were. Again, knowledge is power. Ignorance is what causes fear and anxiety, which in turn can contribute toward PPD. Fortunately the colic that paid us a surprise visit lasted only a week, but, during that time, my intense exhaustion paved the way for PPD to start a week later.

One of the most difficult and stressful experiences parents may experience at some point during the first three months of their baby’s life, colic is very intense crying in an otherwise healthy infant that—per Wessel’s rule of 3s—cries for more than three hours a day for more than three days a week for more than three weeks.1  What the parents with a colicky baby must realize is that they did not cause the colic to occur. There are many babies out there—more than you know—that are colicky. In fact, it is one of the most frequent problems presented to pediatricians in the first three months of an infant’s life. Based on Wessel’s rule of 3s, some 16 to 26 percent of infants are categorized as colicky.2

Usual signs of a baby with colic, while crying:

  • face is red and grimacing
  • fists are clenched
  • legs are pulled up over the abdomen
  • back is arched

Let’s give you some background on why nearly every parent will tell you that the first three months postpartum are the toughest and most challenging for new parents, not just because babies don’t really sleep through the night but also because they tend to cry more on average.  To start with, infants aren’t born with very sizeable brains or it would make the baby passing through the birth canal and then the even tinier cervix a much more difficult process than it already is.  As such, what the newborn is capable of doing for the first one to two weeks is limited to sucking, drinking, peeing, pooping, and sleeping—the minimum with respect to instinctive behavior a baby needs to do for survival with a brain that is not fully developed.  In short, the baby runs out of room inside the womb and has to come out to continue developing. The first three months are like a fourth trimester as the baby continues to develop—with brain size increasing,  nervous system developing, and muscle control increasing—all while trying to adapt to the world outside of the womb.  Unlike the environment in the womb filled with swishing noises, motion, and being curled up and in tight quarters, the baby is expected to sleep flat on their backs, with arms and legs unrestricted, in a quiet, still room.  This is a period of adjustment with which many babies have a lot of difficulty.  Crying is their way to let mom and dad know that they’re hungry, uncomfortable, hurting, or otherwise needing to be comforted.   

Even after fifty years of research, no one is really sure what causes colic. There have been many theories as to the cause(s) behind colic. Pediatricians, when faced with having to examine the baby of panicked parents over the literally non-stop crying, have come up with all sorts of possible reasons, including gastrointestinal issues (e.g., lactose intolerance, allergy to milk, gas pain, acid reflux) and the baby’s continued development, both physically (immature nervous/digestive systems) and psychosocially (temperament, emotions, behavior). It’s no wonder that the majority of colic remedies address the possible digestive issues behind baby’s colic—colic remedies that would include probiotic/gas drops, herbal teas, bicycling legs, rubbing baby’s tummy gently, applying warm compresses to baby’s tummy, hypoallergenic formulas like soy milk, and having the breastfeeding mom avoid certain foods due to baby’s possible allergies.  Then, to address the “fourth trimester” theory, they suggest womb experience simulation techniques like slings, rocking, white noise generating, bouncing, and swaddling.

There may be a correlation between colic and size at birth relative to gestational age, which may be due to a small placenta, which may be due to the mother failing to take in adequate nutrition during her pregnancy—as in my case wherein I was constantly nauseous from the very beginning to the very end of my pregnancy, and my daughter was born two weeks early and weighing in at five pounds eleven ounces.

According to research by Dr. Ronald Barr, who has performed numerous studies on the causes and cures for colic, less than five percent of babies show evidence of a physical/medical problem that would explain the crying.3 Nevertheless, a pediatrician should be consulted to rule out any potential illnesses or medical causes. Parents should expect the pediatrician to ask about the baby’s behavior, including when crying episodes begin and how long they last. Parents will need to be able to indicate how often and how much the baby spits up in order to rule out acid reflux.

In line with the theories on colic, our pediatrician mentioned the possibility that our daughter’s colic could be due to the following:

  • Her still immature and developing nervous system
  • Her temperament
  • Digestive issues
  • Difficulty in adjusting to her environment
  • Overstimulation in terms of sights and sounds

Since no one really knows what causes colic, there is no real cure at this time. The following suggestions may or may not improve matters:

  • Colic hold – place baby face down along your forearm with inside elbow supporting her head and hand supporting baby’s pelvis (doing this puts gentle pressure on baby’s tummy) while gently rubbing baby’s back with other hand.
  • Bicycling legs – Gently press his legs up to his chest, one at a time, in a peddling-type movement.
  • Rubbing tummy gently.
  • Applying warm compress on tummy.
  • Simulating the womb experience (baby spent so much time in the mother’s womb but, once born, we expect that they can adjust to being left in a quiet room to sleep, lying flat):
    • Create motion via carrying in a sling, rocking (in arms while shushing, infant swing, or car seat), setting baby in car seat on drying machine, bouncing (in car seat on drying machine, driving around), swaying, or dancing.
    • To simulate womb sounds that the baby might be accustomed to hearing all the time, generate white noise via shushing or a white noise machine.
    • Swaddle.
  • Pediatric chiropractic care (make sure the chiropractor treats infants).
  • Infant probiotic drops or gas drops. (We used Mylicon.)
  • Herbal teas, like chamomile.
  • If breast-feeding, try formula (consulting with pediatrician about whether or when you should try a hypoallergenic or soy formula) or try eliminating caffeine, dairy, eggs, nuts, certain vegetables, and even wheat products from your diet.

Our pediatrician suggested that decreasing exposure to noise and interaction is what our daughter needed after what is considered a long day for an infant. Then, even after the colic went away, our daughter was quite cranky over the course of several weeks due to what the pediatrician attributed to gas. Being the antimedication advocate that she was, she recommended making light chamomile tea a couple of times daily, though we gave that up after a couple of weeks and ended up using Mylicon as it seemed to help. The doctor also recommended bicycling our daughter’s legs, and we did that for the duration of her abdominal issues, never knowing for sure whether that helped or not. We also had to keep her head elevated while she slept at night in case she had reflux, so we invested in sleep positioners, which also helped keep her sleeping safely on her back to reduce the risk of SIDS. 

It goes without saying that a baby that cries inconsolably—crying so hard that his body distorts—can cause parents to feel alarmed and fear that there is something seriously wrong with the baby. It’s easy to understand how a mother of colicky infants would experience feelings of guilt, anxiety, frustration, desperation, and helplessness for not being able to find a way to console her baby. Don’t be too hard on yourself. Several days of sleep deprivation and/or a baby crying inconsolably for hours can make practically anyone deprived of sleep for several days straight—even fathers and mothers who don’t have PPD—feel like they’re going crazy and join their babies in crying themselves.

Studies have shown a definitive link between colic and depression. Whether colic contributes to PPD or PPD contributes to infantile colic is yet to be definitively determined. As a parent, you think you’re supposed to not only be able to know what your baby wants and needs but also how to fix the problem. After a few days of crying with seemingly no end in sight, at her wit’s end with anxiety and exhaustion, the new mom may slip into depression. They say that babies can sense their parents’ anxiety, so they only cry harder, louder, and longer, which is all the more painful for the parents to bear. It is a vicious cycle. 

In addition to a link with depression, colic can put a huge dent in the confidence of both parents in terms of their ability to care for their baby. Due to the process of elimination to determine an underlying cause of colic, mothers end up weaning earlier and possibly even changing formulas multiple times. With colic, there is unfortunately also an increased risk for shaken baby syndrome.

If you feel like you’re having trouble coping, the best thing you can do for yourself and your family is to ask for some help. Make sure you have enough support lined up to take over when necessary. Have someone else watch your baby for a little while so you can get a break. If finances allow, consider hiring a postpartum doula. Postpartum doulas are usually experienced with colicky babies. If no one is around at the time, put the baby down in the crib and go to another room to take five minutes to calm down and take a few deep breaths. You are allowed (and it’s important) to take a break. It’s the best thing you can do for yourself and to retain your mental well-being!

– – – — – – – – – – –

1 Morris A. Wessel et al., “Paroxysmal fussing in infancy, sometimes called colic.” Pediatrics 14 (1954): 421–434.

2 Grace Monfort, “How Much Crying Is Normal?” Parents.com.

3 Ronald G. Barr, “Crying behaviour and its importance for psychosocial development in children.” In: Tremblay RE, Barr RG, Peters RDeV, eds. Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development; 2006:4.

Advertisements