What is colic?

Colic is unexplained crying (not due to pain or hunger). The bouts of crying usually last 1 to 2 hours and the child acts fine between bouts. Your child usually stops crying when held. Colic usually begins before 2 weeks of age.

What is the cause?

Normally babies do some crying during the first months of life. When babies cry excessively and without being hungry, overheated, or in pain, we call it colic. About 10% of babies have colic. While no one is certain about what causes colic, these babies seem to want to be soothed so they can go to sleep. Colic tends to occur in babies with a sensitive temperament. Keep in mind that all babies are not the same. Your baby probably just has extra energy and persistence. Ask your mother if you were that way as a baby because temperament tends to be genetic. These traits will be an asset someday.

There are some misconceptions about what causes colic. Colic is not the result of bad parenting, so don't blame yourself. Colic is also not due to excessive gas, so don't bother with extra burping or special nipples. Colic is not due to inadequate breast-feeding. Cow's milk allergy may cause crying in a few babies, but it is a possible cause of crying only if your baby also has diarrhea or vomiting. Colic is not caused by abdominal pain. The reason the belly muscles feel hard is that a baby uses these muscles to cry. Drawing up the legs is also a normal posture for a crying baby, as is flexing the arms.

How long does it last?

The hard crying starts to improve at the age of 2 months and is gone by 3 months. In the long run, these children tend to remain more sensitive and alert to their surroundings.

This fussy crying is harmless for your baby. Although the crying can't be eliminated, the minutes of crying per day can be dramatically reduced by following the suggestions below.

How can I take care of my child?

1. Hold and soothe your baby whenever he cries without a reason.

   A soothing, gentle 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 4 months. Consider using the following to calm your baby:

   • cuddling your child in a rocking chair
   • rocking your child in a cradle
   • swaddling your baby in a light blanket
   • placing your child in a frontpack or pouch, which frees your hands for housework
   • placing your child in a windup swing or vibrating chair
   • going for a stroller ride, outdoors or indoors (instead of a ride in the car)
   • running a washing machine or vacuum cleaner, or playing a CD of a monotonous sound
   • anything else you think may be helpful (for example, a pacifier, massage, or warm bath).
2. Swaddle your baby in a blanket.

   Snug swaddling is extremely helpful for calming crying babies. It also reduces awakenings caused by the startle reflex and increases the length of sleep. To swaddle your baby use the 3-step "burrito-wrap" technique. Start with your baby lying on the blanket and the arms at the sides. Then pull the left side of the blanket over the body and tuck. Next, pull the bottom up and then pull the right side over and tuck. It is a useful technique from birth to 4 months of age. For more details, check out Dr. Harvey Karp's book, The Happiest Baby on the Block.

3. 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 tightly swaddled and place him on his back in his crib. (This is the sleep position recommended by the American Academy of Pediatrics for healthy infants.) He will probably be somewhat restless until he falls asleep. Close the door, go into 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. If he cries for over 15 minutes, pick him up and try the soothing activities again.

4. 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 rock your baby every time he goes to sleep, you will become indispensable to your baby's sleep transition process. Your baby's crying during the night won't stop 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 comfort himself and go to sleep by himself. Don't rock or nurse him to sleep at these times. Colic can't be prevented, but sleep problems can be prevented.

5. Promote nighttime sleep (rather than daytime sleep).

   Try to keep your child from sleeping excessively during the daytime. If your baby has napped 3 hours, gently awaken and play with or feed your baby, depending on his needs. This will help to cut down the amount of time your baby is awake at night.

6. Try these feeding strategies:

   Don't feed your baby every time he cries. Being hungry is only one of the reasons babies cry. It usually takes more than 2 hours for the stomach to empty, so wait at least that long between feedings unless you are concerned that your baby is hungry. If you are breast-feeding, avoid taking or drinking excessive coffee, tea, colas, and other stimulants (2 servings a day is usually fine).

   If your child also has diarrhea, vomiting, eczema, wheezing, or a family history of milk allergy, he may be allergic to cow's milk in your diet. If you are breast-feeding, avoid drinking or eating any forms of cow's milk for 1 week to see if your baby's condition improves.

   If you are feeding your baby formula, and he also has symptoms of allergy, try a soy formula for 1 week. Soy formulas are nutritionally complete and no more expensive than regular formula. If your baby's condition dramatically improves when he is on the soy formula, call your baby's health care provider for additional advice about keeping him on the formula. Also, if you think your child is allergic, but soy formula doesn't seem to help him feel better, call your baby's health care provider about the elemental formulas.

7. Get rest and help for yourself.

   Avoid fatigue and exhaustion. Get at least one nap a 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 a 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.

8. Avoid these common mistakes.

   If you are breast-feeding, don't stop. If your baby needs extra calories, talk with a lactation nurse or specialist about ways to increase your milk supply.

   The available medicines for colic are ineffective and some are dangerous for children of this age. The medicines that slow intestinal motion (the anticholinergics) can cause fever or constipation. The ones that remove gas bubbles are not helpful, but they are harmless.

   Don't place your baby on a waterbed, sheepskin rug, bead-filled pillow, or other soft pillow. While these surfaces can be soothing, they also run the risk of suffocation and crib death. A young infant may not be able to lift his or her head adequately to breathe.

   Inserting a thermometer or suppository into the rectum to "release gas" does nothing except irritate the anal sphincter.

   Stay with TLC (tender loving care) for best results.

When should I call my child's health care provider?

Call IMMEDIATELY if:

• Your baby cries constantly for more than 2 hours.
• Your baby is less than 1 month old AND acts sick.
• You are afraid you might hurt your baby.
• Your baby is acting very sick.

Call during office hours if:

• You can't find a way to soothe your baby's crying.
• The crying continues after your baby reaches 4 months of age.
• Your baby is not gaining weight and may be hungry.
• You have other concerns or questions.