Surviving Colic in Newborns

Colic. Rarely have five letters elicited such torture. There are millions of parents with PTSD from having had a child with colic. Many a parent with a colicky child has questioned the existence of God and his benevolence when “blessed” with a colicky child.

As a parent and a pediatrician, few things are as frustrating as colic. Let’s be honest; colic has no known cause and no known cure. It has been around forever, and there is no end in sight. There is no vaccine or medication for colic on the horizon to offer hope for prevention or a cure.

Colic attacks us at our core. It can make parents feel inadequate, isolated, depressed, angry, and guilty in a vicious spiral. The stress of colic can spill over and erode our sense of self and our relationships with others. Colic is painful.

This article sounds encouraging, right? A bright light in a dark room? There can be hope, and there can be a happy ending. The importance is focusing on the right question. For me, as a pediatrician, the question is not how do I fix colic, but how can I manage it in a way that when all the dust settles, my sanity and my relationship with my colicky newborn and the ones I love are intact. Colic will come, and it will mercifully go, but its effects on long-term bonding are what I think are most crucial.

What is Colic? 

Colic is classically defined by the rule of threes. An infant meets the criteria of colic if they cry more than three hours a day, three or more days a week, and this persists for more than three weeks. A more practical definition is that colic is frequent, prolonged, and intense inconsolable crying in an otherwise healthy infant. There is a spectrum of colic, with some babies crying more than others. Crying is often predictably worse at certain times in the evening; it is not relieved by feeding, changing a diaper, or consoling. And it is intense. Studies have shown that a colicky cry can be twenty-five percent higher-pitched than a typical cry. An infant’s face is often red or purple, and their bodies tend to stiffen with tension. Crying tends to peak at six weeks and markedly diminish by three to four months. Luckily, some infants seem to have a few rough weeks, while in others it persists for the entire three to four months.

What causes Colic in babies?  

While no one really knows the cause of colic, here are a lot of interesting theories:

• An immature digestive system resulting in increased gasiness
• Imbalance of healthy gut bacteria
• Food allergies or intolerances
• Feeding difficulties
• Hypersensitivity to surroundings/stimulus

None of these theories have fully panned out. Why the fussiness at certain times? Why does it eventually go away without any intervention? And why don’t any of the interventions work consistently? Some misguided individuals question whether parents’ stress before or after giving birth causes colic, making parents feel even more stressed that colic is somehow their fault. Studies have shown this is false. Certainly, colic causes stress, and stress makes you even more acutely aware of your child’s echoing cries.

Colic Treatments and Diagnosis

There are no specific tests for colic. Your provider’s job is to make sure, at each well check, that your infant is otherwise healthy and that your child’s symptoms are not caused by painful spitting up, milk protein allergy, or other conditions. Your provider will conduct a physical exam, closely examining weight gain and inquiring about symptoms such as painful spitting up, bloody stools, and other signs that may indicate an underlying problem. They may consider a trial of medication for reflux or dietary changes to help clarify the diagnosis.

Easing Colic in Newborns

Some of you may have skipped directly to this section, hoping for a cure. Sadly, there is no cure for colic, BUT there are management strategies. Remember, curing colic is not the focus; surviving it with your mental health, your relationships, and your desire to bond with your baby intact is the goal. Colic will last for less than 3-4 months (hopefully way less), but your ongoing relationship with your child is really what is at risk here. Maintain your own sanity and your future ability to bond with your child by using these strategies to help manage colic and navigate this challenging stage.

• Use simple soothing strategies. Soothing strategies can include a binky, swaddling, a baby carrier, white noise, a car ride, a walk, and infant massage.
• Adjust feeding practices. Keep your infant upright during feeds and burp frequently. Try a curved bottle or bottle with a collapsible bag to reduce air intake; Elevate the head of the bed when your infant is lying down (blanket/towel underneath the firm mattress) to reduce spitting up.
• Make dietary changes. If breastfeeding, consider a two-week trial of eliminating dairy/soy/nuts/eggs and excessive caffeine or other trigger foods. If formula feeding, consider a week-long trial of an extensively hydrolyzed comfort formula, such as Alimentum / Nutramigen, or a similar product. Although it may be expensive and unpleasant, it can make a significant difference for some infants.
• Take probiotics. Some studies demonstrate benefit, especially with the Lactobacillus Reuteri strain; consider a two-week trial.
• Use gripe water. Gripe water contains herbal extracts that can be calming to an infant.
• Take a break. After feeding/changing diapers, make simple attempts to console. By all means, swaddle and put the baby down in their crib, then take a break (preferably in a quiet space where you can’t hear the crying); you will both be in a safer space.
• Ask for help. Schedule a break for yourself; this is your time to ask for help from friends and family. Even 1-2 hours a week can save your sanity and give you something to look forward to.
• Let go of guilt. Recognize that no one, and I mean no one, enjoys hearing or holding a screaming baby. There is no guilt if you are not “enjoying every moment” of parenting.
• Manage stress. Deliberately embrace your healthy coping mechanisms for stress or add some new ones to your list.
• Talk to someone. Talk to a non-judgmental person about how you are feeling—a friend, your pediatrician, a counselor—and you will realize you are not as crazy as you think.
• Focus on what you can control. Focus on where you want to be as a person and as a parent in a few months, when this is behind you. 

Some women experience morning sickness, some women have horrible pregnancies, and some women have colicky babies. It is not fair. But those tough beginnings inherently have nothing to do with your child’s future well-being. Make sure you survive, make sure your child survives, and make sure your desire to bond with your baby thrives when colic is in the rearview mirror. Colic is not a destination.

If you have any further questions, feel free to contact our offices in Stansbury Park, Bluffdale, West Jordan, Riverton, or South Jordan, UT!