We talked a little about colic earlier this week, so now it’s time to talk about some of the theories about what causes colic and some of the different approaches to treating it.

Hypothesis:

#1 Minor GI problems:  gas, cramps and tummy issues. But if that is the case why does colic start at 2 -3 weeks of age as babies have gas beginning at birth and they will pass gas well after they are 3 months old. I do hear parents complain that gas gets worse at about 4 weeks of age?  Babies also swallow a lot of air when they are crying and parents often try OTC simethicone drops, although typically with little help. There may be some placebo effect?

Some parents feel as if they get some relief by changing formula and at times an elemental formula such as Nutramigen nor Alimentum seems to help. For a breast fed baby many recommend eliminating many different foods from a mother’s diet. I too tried eliminating almost everything and would try to only have chicken, rice and bland foods. In my case (not statistically significant) my colicky baby remained colicky and I was miserable giving up so many foods.

I decided to eat what I wanted as it did not seem to make a difference and I was less stressed and also felt better eating again. Baby was still fussy.

#2 Major GI problems:  Gastrointestinal reflux is the buzz word these days. The diagnosis has increased at least 20 fold.  It is estimated that only 2 – 4% of colic is really related to reflux .  Reflux actually peaks at a later age, around 4 months, and resolves around 8 months, long after symptoms of colic have resolved. Regardless, many parents want a trial of anti-reflux medication but the latest studies show that PPI’s (proton pump inhibitors) rarely help the symptoms of reflux and are not routinely recommended.  

#3 Maternal Anxieties: this is counter intuitive as it seems that a colicky baby typically causes the anxiety and not vice a versa.  Colicky babies are not necessarily first born children either and most mothers would admit that they were more anxious with their first child (who might have been a placid baby).  I just don’t see the correlation. It does become a vicious cycle though as everyone ends up stressed, tired and anxious.

#4 Infants have immature neurological systems:  Babies are not yet “hard wired” when they are first born. They have all sorts of immature reflexes including a moro reflex, irregular breathing patterns (called periodic breathing of the newborn), quivers etc. During the first 3 months a baby’s entire neurological system slowly matures and an infant begins to have purposeful movements, starts to smile and just seems to get easier. Some call this period of time the 4^th trimester. This makes a lot of sense to me, as colic seems to gradually improve, with TIME.

What is there to do to soothe a colicky baby:  DO WHATEVER HELPS (within reason), I can remember taking advice from total strangers and I was a pediatrician!! Some seemed absurd but I can tell you I bought all sorts of gizmos to see if anything would soothe my unhappy baby.

Babies who are colicky usually like the following:

Swaddling – Whoever invented the “miracle blanket” really was a genius!! It makes swaddling so easy. There are numerous methods to swaddling but with practice it is easy. 

Swaying – whenever you have a baby you learn to “rock” while you are holding them. After about a week of parenting, it almost seems like instinct. Once you have been a parent, any time someone hands you a baby you automatically begin to SWAY. Swings work well too

Shshshing……..  Quietly whispering this sound to a baby seems to be calming as well.  Babies also like to hear soft music or soft lullabies with the same sounds repetitively.  Remember, “Hush Little Baby”, always a good one. When your voice wears out try the hairdryer or vacuum cleaner in the background. Some parents swear by a white noise machine.

Sucking - As I have said many times, I am a huge believer in a pacifier. Infants need to suck to calm themselves. They need to suck to eat but there is also a need for non- nutritive sucking.  The biggest problem is that baby’s have a tongue thrust and often spit out the pacifier just as you get them calmed, but even having to put it back in is often worth it!

Stomach – fussy baby’s often calm when they are on their tummies. But, with that being said NEVER let your baby sleep on their tummy. It is hard to turn that quieted baby over once asleep but you MUST, even if you are watching them!

I wish I knew the reasons for colic or the miracle to end the long days and nights. I do know that the majority of these irritable colicky babies suddenly blossom into happy, joyful 4 month old infants.

Lastly, any help is welcome when you have a newborn, especially a fussy one. Accept offers of help and take a break and get out of the house for an hour to take a walk or grocery shop in solitude. All parents need breaks!

That’s your daily dose for today.  We’ll chat again tomorrow.