Baby colic

It’s normal for babies to fuss and cry. Babies who have colic tend to cry more than other babies, even though they’re otherwise healthy. Features of colic can include:

• Intense and incessant crying episodes, lasting usually more than 3 hours, even in the absence of triggers like hunger or the need for a diaper change.
• Crying at the same time(s) every day. Colicky babies mostly get fussy towards the end of the day; however, crying can happen at any time.
• Clenching their fists, raising their legs above, and tightening their abdominal muscles while crying.
• Crying that is loud, piercing, and ceaseless in nature, as if they’re in pain.
• Turning bright red when crying.
• An increase in bowel activity may also be observed. They may break wind (pass gas) or spit up.

Worried that your baby may have infantile colic? Not sure if it's colic or normal crying? Read this article to assess the symptoms.

Colic usually starts in the second or third week of life, peaks around 6 weeks, and resolves by the age of 12 weeks in 60% of infants and by 16 weeks of age in 90% of infants. The exact cause of colic is not fully understood, but several factors are believed to contribute to or trigger this condition:

• Digestive issues in the infant:
  • Intolerance to lactose or cow's milk protein
  • Sensitivity to food in the breastfeeding mother's diet
  • Excessive gassiness or gas production
  • An immature digestive system
  • Acid reflux
  • Swallowing air
  • Overfeeding or underfeeding
  • Insufficient burping
• Exposure to medications through breastfeeding:
  • Caffeine and nicotine in breast milk have been related to infant irritability because the baby's body is unable to adequately eliminate these toxins.
  • Certain medications are also passed through breast milk. If you are breastfeeding, discuss your medications with your doctor.
• Neurodevelopmental issues:
  • Higher level of serotonin (a key hormone that can stabilize mood)
  • An immature nervous system
  • Infant temperament
  • An early form of childhood migraine
• Others:
  • Interruption in sleeping pattern
  • Sensitivity to light, noise, etc., or too much stimulation
  • Poor feeding techniques
  • Emotions such as fear, frustration, or even excitement
  • Underlying health issues like hernia or infection

There are several risk factors that may contribute to the development of colic. These include:

• Age: Colic typically begins within the first few weeks of life and peaks around 6 to 8 weeks of age. After this time, symptoms often start to improve.
• Sleeping pattern: Some studies suggest that babies with irregular sleeping patterns or insufficient sleep may be more prone to colic.
• Family history: Babies with a family history of colic or other digestive problems may be more likely to develop colic themselves.
• Parental emotional factors: Babies exposed to high levels of stress or anxiety may have a higher likelihood of developing colic.

To diagnose colic in infants, doctors typically rely on a set of criteria known as the "Rule of Three." These criteria include:

• Symptoms persist for more than 3 hours a day
• Occurs more than 3 days a week
• Lasts for more than 3 weeks

If an infant meets these criteria, a doctor may diagnose them with colic. However, before making a diagnosis, the pediatrician will conduct a physical exam and review the baby’s history and symptoms. The doctor may also perform tests to rule out other medical conditions that can cause similar symptoms.

Here are some tips that can help limit or prevent colic in your baby, sometimes even before a bout of crying starts.

1. Breastfeed: Breastfeeding provides the best nutrition for infants and can help prevent colic. Breast milk is easily digestible and causes no digestive issues.
2. Keep an eye on what you eat: If you're nursing, try to avoid milk products, caffeine, onions, cabbage, and any other potentially irritating items. Keep track of what you eat and drink. Everything you consume gets passed to your baby and can affect them. This is something you should address with your pediatrician first.
3. Avoid overfeeding the baby: In general, try to wait at least two to two and a half hours between one feeding and the next.
4. Rock, walk, and hold:
   • Rock your baby in your arms or in a rocking chair.
   • Put the baby in a swing.
   • Walk with your baby in a stroller or baby carrier.
   • Hold your baby against your chest.
   • Take the baby for a car ride.
   These motions and close contact can be soothing for your little one.
5. Burp your baby: Make sure you're efficiently burping your infant. It is recommended that you hold your baby upright after eating and tap on the back to get rid of any gas or air your baby swallows during feeding.
6. Attempt alternative feeding positions: Alternative feeding postures can aid in the prevention of colic symptoms. During feedings, try holding your baby upright or laying them on their side.

There are many tips for helping to soothe and deal with a colicky baby.

• Parental reassurance and stress management: Parental reassurance and support are the cornerstones of treatment. Colic is a common condition that can be extremely distressing for both the newborn and the parents. The doctor will reassure parents and counsel them about the benign and self-limiting nature of colic.
• Comfort measures: Massage your baby's back while holding them across your arm or lap. The pressure against their stomach may provide some relief. Place them in their cot on their back if they fall asleep this way. Swaddling them in a warm blanket or giving them a warm bath are other options to help them feel safe and warm.
• Change in feeding technique: Ensure that your baby is getting enough to eat and that he or she is burping frequently during and after feeding to release any trapped air in their stomach. While feeding, try to keep your infant in a vertical (sitting up) position.
• Reduction of allergens from the mother's diet: Breastfeeding moms can try changing their diet to avoid foods that might exacerbate the baby's colic. Common allergens include dairy, soy, eggs, peanuts, wheat, and shellfish. They can work with a doctor to identify possible triggers and may need to temporarily eliminate certain foods to see if it helps the baby. Afterwards, they can gradually reintroduce foods to check if any worsen the colic.
• Changes for bottle-fed infants:
• Use anti-colic bottles or nipples: Anti-colic bottles aim to minimize the air a baby ingests during feeding, which may help ease colic symptoms.
• Switch to a hydrolyzed formula: Transitioning to a special "hydrolyzed formula" could be beneficial. This formula contains proteins that are partially broken down, making it easier for a baby's stomach to digest. It could be helpful for babies who have trouble with regular cow's milk-based formula. Before making this switch, consult a doctor to ensure it's suitable for your baby.
• Probiotics: Probiotics are beneficial bacteria that can help restore the balance of gut bacteria in colicky newborns. Several studies have shown that certain probiotic strains (such as lactobacillus reuteri) can reduce crying time and improve overall colic symptoms. However, before giving your baby any medication, consult with your pediatrician. Probiotics are also beneficial for older children.
• Medications: The following medications are prescribed to help soothe your baby's discomfort:
• Simethicone: This medication is readily available for the management of colic as it prevents the formation of gas bubbles and helps reduce crying spells in some babies.
• Dicyclomine Hydrochloride: This medicine relaxes stomach muscles and was previously tried for colic. However, it is contraindicated in infants younger than six months due to potential side effects like drowsiness, constipation, diarrhea, and apnea.

While colic can be distressing for both the infant and the parents, the following tips can help you make it more manageable.

1. General tips

• Warm bath: A warm bath can help calm an infant's digestive tract and relieve colic. Fill a bathtub halfway with warm water and gently massage your baby's abdomen.
• Massage: Massage may assist in alleviating colic symptoms. Massage your baby's tummy in a gentle, circular motion, beginning at the navel and progressing outward.
• Paddling exercise: Bicycling a baby’s legs can help them pass gas. Lay your baby in a supine position, hold their ankle gently, and press one leg towards their tummy. Hold for a few seconds and then release.
• Kangaroo Care: This method involves carrying infants, usually by the mother, with skin-to-skin contact. It helps calm and soothe a baby.
• Keep a routine: Establishing a routine can help your baby feel more secure and may reduce colic symptoms. Stick to a consistent feeding, sleeping, and playtime schedule.
• Feed: Try to feed your baby before they become overly hungry or distressed. Overfeeding can exacerbate colic symptoms.
• Experiment with feeding: If you're breastfeeding, adjust your diet to see if it affects your baby's colic symptoms. If formula-feeding, consult your pediatrician about trying different formulas.
• Try a pacifier: Sucking on a pacifier can soothe a fussy baby. Use a pacifier only after breastfeeding to avoid nipple confusion.
• Soothe your baby: Use different soothing techniques such as gentle rocking, swaying, or carrying them in a baby carrier.
• Pleasant sounds: Use soothing sounds in your child's room, such as a fan or a heartbeat CD, to calm a fussy baby and promote sleep.
• Check for medical issues: Colic can sometimes indicate an underlying medical issue, so it's important to have your baby evaluated by a pediatrician.
• Take a break for yourself: Caring for a colicky baby can be exhausting, so take breaks whenever possible. Seek help from friends or family, or consider hiring a babysitter for a few hours.

2. Herbal remedies

Some herbal remedies have been used traditionally for ages. You can try them to soothe your baby’s colic. Consult with your child’s pediatrician before trying them.

a. Herbal-infused water

Several herbs, including peppermint, chamomile, lemon balm, fennel, and licorice, are thought to be helpful for colic. These herbs may help calm the infant and reduce abdominal distension.

How to use: Prepare a calming herbal infusion by boiling a suitable quantity of these herbs in hot water for 10-15 minutes. Strain and allow it to cool. Offer a small amount (1-2 teaspoons) to your baby using a dropper or baby bottle.

b. Hing (asafetida)

This spice is traditionally used as a digestive aid.

How to use: Apply one teaspoon of water with a pinch of hing around the baby's navel. You can also apply the Hing roll-on, which is quick, easy, and safe to use.

There are several alternative therapies that may help alleviate colic symptoms in infants. Here are some of them:

• Homeopathy: Some parents turn to homeopathic preparations, including gripe water, which is believed to ease digestive discomfort. It is essential to consult a qualified homeopath and a pediatrician before using any such remedies.
• Acupuncture, Acupressure, and Reflexology: Gentle pressure on specific points on the body, such as the feet, may promote relaxation and potentially alleviate colic discomfort.