Is it Colic? What Your Fussy Baby Could Be Trying to Tell You

The medical definition of colic is when a healthy baby shows intense, unexplained fussing/crying lasting more than 3 hours a day, more than 3 days a week for more than 3 weeks. However, not all crying is colic, and not all colic follows this definition.

What causes colicky behavior in a baby?

  • True colic peaks at 6 weeks and ends typically by 4 months of age – and is thought to be caused from a developmental lag in the ability of the gut to neurologically and mechanically handle food
  • Stomach gas/intestinal gas
  • Sensory overload
  • Lactase deficiency (that enzyme responsible for breaking down the principle sugars in mammal milk)
  • Inability to tolerate components of mom’s milk, her medications/maternal diet resulting in a localized inflammation in the colon – may progress to bloody or mucousy green stools
  • Inability to tolerate proteins/components in formula
  • GERD (gastroesophageal reflux disease) – especially suspected if baby has poor weight gain, respiratory symptoms, vomiting >5 times daily, significant feeding problems

Why is it important to address colic?

True colic that is not medically based has been shown in studies to cause:

  • Relationship stress
  • Increased risk of physical harm to baby
  • 10-15% increased risk post partum depression
  • Excessive healthcare visits
  • Increased maternal smoking
  • Less breastfeeding
  • Unnecessary medical treatment
  • Increased risk of SIDS (sudden infant death syndrome)

So what can we do to soothe a colicky baby?

First, try a change in diet. If breastfeeding, your doctor may ask you to eliminate dairy or other proteins to see if improvement. If using formula, feeding a hypoallergenic elemental formula like Nutramigen or Alimentum may be recommended, especially if baby has mucousy or bloody stools.

Next, try different positions for baby. Burping after feeds and in between helps reduce gas buildup. Over the shoulder holding puts gentle pressure on the tummy, which may work for some. Also, try holding baby on the side, facing outwards, with gentle pressure on the tummy (called the guitar hold.)

Let baby’s tummy rest on a warm hot water bottle (only when awake and supervised.) Make sure the bottle is not too hot to avoid burns.

Shushing, swaddling, monotonous sounds  may also help. Putting baby in his or her carseat on the floor near a running drier or washer provides monotonous sounds that may help baby chill.

Also take a strong, in depth look at baby’s environment. A change might be just what’s needed. Try reversing what is currently happening (i.e. going from a noisy room to quiet, or vice versa; changing the light level in the room, etc.)

Always be sure to rely on your support system. Take a break from baby and the crying – calling in your peeps to help, getting outside for a walk, and making sure you try your best to rest when you can is of crucial importance.

Red Flags

Here are some of they symptoms doctor will be looking for:

  • Infection
  • Intestinal pain – allergy, GERD, constipation/obstruction – again, these are things your doctor should be thinking about
  • Respiratory compromise – aspiration – if significant reflux, stomach contents can enter the airways and cause rapid and/or labored breathing, or cough, especially after meals. With reflux sometimes comes inflammation of the esophagus causing pain, and fear of eating, even in an infant
  • Skin issues – rashes, hair tourniquet
  • Oral thrush – a white cottony like rash on the inside of the cheeks or tongue caused by yeast – your nipples may be cracked and hurt as well, and both baby and mom are treated for this
  • Injury – corneal abrasion – little nails can scratch the eye accidentally and cause lots of crying
  • Renal pain – kidney pain caused by a blockage in the urinary tract
  • Medication related pain – maternal medications (or even caffeine) passing to baby via breast milk
  • Environmental – smells (perfumes, etc), noise, air quality, temperature in the room

The good news is, despite the angst that colic may cause, it is a RARE state. In the past, every fussy baby was labeled as “colicky,” and many babies and families suffered unnecessarily. What we do know now is that most often, there are treatable reasons why baby is fussy, so have a solid discussion with your doctor, and get to work finding the best solution for your baby.

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About Dr. JJ Levenstein

Dr. JJ Levenstein is a board-certified pediatrician and fellow of the American Academy of Pediatrics and in 2012 retired from her thriving private pediatric practice in Encino, California. She served on the staff of CHLA and Encino Tarzana Hospitals for 20 years and was consistently voted one of the Best Doctors in America® from 2003 through 2012. Drawing from her experience as a pediatrician and mom, Dr. Levenstein serves as president and co-founder of MD Moms, makers of Baby Silk, the first personal care line for babies developed by pediatrician moms. She serves on the board of United Cerebral Palsy LA, is an active writer and sits on the advisory boards of several child-centered websites. She is an accomplished chef and completed culinary school in 2013! She has had a lifelong interest in child nutrition and all things related to preventive health.

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