Crying Baby (Colic)

Definition

  • Unexplained crying
  • Intermittent crying one or two times a day
  • Healthy child (not sick or in pain)
  • Well-fed child (not hungry)
  • Bouts of crying usually last one to two hours
  • Child is fine between bouts of crying
  • Child usually consolable when held
  • Onset under 4 weeks of age
  • Resolution by 3 months of age

Cause

Normally infants do some crying during the first months of life. When babies cry without being hungry, over-heated, or in pain, we call it "colic". About 10% of babies have colic. Although no one is certain what causes colic, these babies seem to want to be cuddled or to go to sleep. Colic tends to occur in high-needs babies with a sensitive temperament. Colic is not the result of bad parenting, so don't blame yourself. Colic is not due to excessive gas, so don't bother with extra burping special nipples. Cow's milk allergy may cause crying in a few babies, but only if your baby has diarrhea or vomiting. Colic is not caused by abdominal pain. The reason the belly muscles feel hard is that the baby needs these muscles to cry. Drawing up the legs is a normal posture for a crying baby, as is flexing the arms.

Expected Course

This fussy crying is harmless for your baby. The hard crying spontaneously starts to improve at 2 months and is gone by 3 months. Although the crying can't be eliminated, the minutes of crying can be dramatically reduced with treatment. In the long run, these children tend to remain more sensitive and alert to there surroundings.

Coping with Colic

  1. Cuddle and rock your baby whenever he cries. A soothing, rhythmic activity is the best approach to helping a baby relax, settle down, and go to sleep. You can't spoil a baby during the first 3 or 4 months of life. Consider using the following:
  • Cuddling your child in a rocking chair
  • Rocking your child in a cradle
  • Placing your child in a baby carrier or sling (which frees your hands for other activities)
  • A windup swing or a vibrating chair
  • Anything else you can think may be helpful (for example, a pacifier, a warm bath, or massage)
  • If all else fails, "Sleep Tight" is a device that attaches under the crib and simulates the motion and sound of a moving car. This gadget lessened colicky behavior in over 90% of babies. Prices start at about $80. For more information call 1-800-662-6542.
  1. A last resort: Let your baby cry himself to sleep. If none of these measures quiets your baby after 30 minutes of trying and he has been fed recently, your baby is probably trying to go to sleep. He needs you to minimize outside stimuli while he tries to find his own way into sleep. Wrap him up and place him stomach down in his crib. He will probably be somewhat restless until he falls asleep. Close the door, go to a different room, turn up the radio, and do something you want to do. Even consider earplugs or earphones. Save your strength for when your baby definitely needs you. But if he cries for over 15 minutes, pick him up and try the soothing activities again.
  2. Prevent later sleep problems. Although babies need to be held when they are crying, they don't need to be held all the time. If you over interpret the advice for colic and rock your baby every time he goes to sleep, you will become indispensable to your baby's sleep process. Your baby's colic won't resolve at 3 months of age. To prevent this from occurring, when your baby is drowsy but not crying, place him in the crib and let him learn to self-comfort and self-induce sleep. Don't rock or nurse him to sleep at these times. Although colic can't be prevented, secondary sleep problems can be prevented.
  3. Promote nighttime sleep (rather than daytime sleep). Try to keep your infant from sleeping excessively during the daytime. If your baby has napped 3 hours gently awaken your baby, and entertain or feed him, depending on his needs. In this way the time when your baby sleeps the longest (often 5 hours) will occur during the night.
  4. Try these feeding strategies. Don't feed your baby every time he cries. Being hungry is only one of the reasons babies cry. It takes about 2 hours for the stomach to empty, so wait that long between feedings or you may cause cramps from bloating. For breast-fed babies, however, nurse them every time they cry until your milk supply is well established and your baby is gaining weight (usually 2 weeks). Babies who feed too frequently during the day become hungry at frequent intervals during the night. If you are breast-feeding, avoid drinking coffee, tea, and COLAs and avoid taking other stimulants. Suspect a cow's milk allergy if your child also has diarrhea, vomiting, eczema, wheezing, or a strong family history of milk allergy. If any of these factors are present, try a soy formula for 1 week. Soy formulas are nutritionally complete and no more expensive than regular formula. If you are breast-feeding avoid all forms of cow's milk for 1 week. If the crying dramatically improves when your child is on the soy formula, call your doctor for additional advice about keeping him on the soy formula. Also, if you think your child is allergic, but he doesn't improve with soy formula, call your doctor about the elemental formulas.
  5. Get rest for yourself. Although the crying can be reduced, what's left must be endured and shared. Avoid fatigue and exhaustion. Get at least one nap each day in case the night goes badly. Ask your husband, a friend, or a relative for help with other children and chores. Caring for a colicky baby is two-person job. Hire a baby sitter so you can get out of the house and clear your mind. Talk to someone every day about your mixed feelings. The screaming can drive anyone to desperation.
  6. Avoid these common mistakes.
  • If you are breast-feeding, don't stop. If your baby needs extra calories, talk to a lactation consultant about ways to increase your milk supply.
  • The available medicines are not effective and many (especially those containing phenobarbital) are dangerous for children of this age.
  • The medicines that slow intestinal activity (the anticholinergics) can cause fever or constipation. The ones that remove gas bubbles are not helpful according to recent research, but they are harmless.
  • Inserting a thermometer or suppository into the rectum to "release gas" does nothing except irritate the anal sphincter.
  • Don't place your baby face down on a water bed, sheepskin rug, bead filled pillow, or other soft pillow. While these surfaces can be soothing, they also increase the risk of suffocation and crib death. A young infant may not be able to lift the head adequately to breath.
  • Stay with TLC (Tender Loving Care) for best results.

Call Your Doctor

Immediately if:

  • It becomes a painful cry rather than a fussy one.
  • Your baby cries constantly for more than 3 hours.
  • You are afraid you might hurt your baby.
  • You have shaken your baby.
  • You can't find a way to soothe your baby (inconsolable crying).
During regular hours if:

  • The colic type of crying occurs three or more times a day.
  • The crying began after 1 month of age.
  • The crying continues after your baby is 3 months of age.
  • Diarrhea, vomiting, or constipation occurs with the crying.
  • Your baby is not gaining weight and may be hungry.
  • You are exhausted from all the crying.
  • Your baby mainly cries when you are trying to sleep.
  • You have other questions or concerns.