Dr. Greene

Colic FAQ with Dr. Greene

It usually strikes toward the end of a long day, when your baby is just about at the age when your sleep deprivation has really begun to set in. Your baby stops being the quiet, peaceful, miracle baby and begins screaming every evening. It’s no wonder that parents become frustrated, discouraged, and depressed when their child has colic.

All babies cry, but colicky babies cry more. When crying lasts for longer than three hours a day, more than three days a week, for three weeks or more (and it is not caused by a medical problem), it is called colic. Today I’m answering some of the most common questions moms have about colic.

What is the #1 cause of colic?

The cause of colic is considered “unknown” and only about 5% of colicky babies have any type of underlying condition like gastroesophageal reflux disease (GERD)  or food allergies. I have come to agree with other physicians and researchers who believe that colic is part of the spectrum of normal infant behavior. As Ronald G. Barr, Professor of Pediatrics at the University of British Columbia, wrote, “colic is something normal infants do, rather than a condition they have.”

I believe that the fussy period exists in order to change deeply ingrained lifestyle habits. It’s an intense learning curve that forces parents to establish new routines and develop new dynamics that include this new individual. Colic is a powerful rite of passage, a postnatal labor pain where new patterns of family life are born.

Is colic hereditary?

Almost all babies will develop a fussy period. About 20% will cry enough to meet the definition of colic and every child, no matter whether it’s your first or fourth, has the same chance. It’s not hereditary, however, if allergies run in the family, there can be a slightly higher tendency for colic.

How do you know the difference between colic and an actual problem?

As a parent, watch for the following signs that may indicate your child is more than just colicky:
  • Fever
  • Vomiting and/or diarrhea
  • Eating less than usual
  • Changes in latch or sucking
  • Abnormal sounding cry
  • A sudden change in breathing (either faster, slower, or taking more effort)
  • Increased sleepiness or sluggishness
Call your child's healthcare provider if you notice any of these symptoms.
Is colic a stage and eventually you get past it? If so, at what age is normal?

Colic will not last forever! After about six weeks of age, it begins improving, slowly but surely, and is generally gone by twelve weeks of age. When colic is still going strong at twelve weeks, it’s important to speak with your child’s doctor and to consider another diagnosis (such as reflux).

Are there any long term complications from colic?

No, there are no long term problems associated with colic. All that will remain after these few, but seemingly endless, months will be your memories of this trying period. Close your eyes, breathe deeply, and remember - this will pass.

Is there anything I can do during pregnancy to ensure my baby doesn’t suffer from colic after they are born?

There’s nothing to be done during pregnancy and a fussy period is likely, no matter what prevention techniques are undertaken. Good feeding techniques (as advised by a lactation consultant, if appropriate), good burping, and early identification of possible allergies in the baby’s or mother’s diet may help limit symptoms. Experimenting with comfort techniques outlined below before colic develops can help you identify your baby’s needs and desires, and can help stop the fussy period from becoming so intense.

What's the best, safest, most natural way to treat colic?
Helping a child with colic is primarily a matter of experimentation and observation. Different children are comforted by different measures. Here are some methods that have proven effective for many babies:
  • Babywearing and carrying - Holding your baby is one of the most effective measures. The more hours they are held, even early in the day when they are not fussy, the less time they will be fussy in the evening. Body carriers can be a great way to do this. Despite what some people say, this will not spoil your baby. After the colicky phase is over, a child can be weaned from the carrier.
  • Sucking - Some babies are only happy sucking on something. A pacifier can be like a miracle for some.
  • Motion - Some families report relief with gentle movement, whether from a swing, a car ride, a ride in a jog stroller, or a parent’s arms.
  • Massage - Baby massage in general and belly massage in particular. A warm bean bag can be a nice tool for this. Some babies are helped with the addition of one of the infant vibrating products during massage.
  • Soothing noise - Heartbeat recordings, white noise machines, recordings of babies yawning, or the gentle voices of parents shushing, humming, or singing a lullaby.
The process of treating colic involves trying many different things, and paying attention to what seems to help, even just a little bit. Here are additional tips on ways to reduce colic.

What can breastfeeding moms do to help a colicky baby? Does a mom’s diet affect colic?

Sometimes mom’s diet can impact baby’s disposition. For breastfed babies who are colicky, eliminating certain foods could help. Cow’s milk, eggs, nuts, or wheat are the most likely to make a difference – especially if there is asthma, eczema or allergies in the family.

Can how you hold your baby while breastfeeding cause them to be more gassy than other positions?

Babies that lie flat while feeding can develop more gas, so holding your baby in at least a 45 degree angle (either sitting or completely upright) is a preferable position. Also, switching from nursing at both breasts at each feed to prolonged emptying of one breast cut colic in half in one study. Sucking on a pacifier or thumb between feeds can help regardless if a baby is breast or bottle fed. Frequent burping after feeding can also help.
What natural remedies do you recommend to help with colic?

Chamomile, fennel, and balm mint each decrease intestinal spasms and have been shown to reduce colic in some studies. But be sure not to give enough tea to decrease a baby's intake of milk. Also, compared to placebo, taking beneficial bacteria reduces crying for some.

Does gripe water work, and is fennel water safe to help with colic?
Every baby is different, so all you can do is try these methods to see what works for your child. As mentioned above, just be sure not to give your child so much of these liquids that it decreases milk intake.

What makes a bottle a "good" bottle for fussy/colicky babies?

“Good” bottles help decrease or eliminate how much air is swallowed during feedings, which reduces gassiness and abdominal discomfort. Bottle changes can produce improvement in colic. In a recent survey, over 90% of Moms agreed that Born Free® Bottles were better in helping to reduce all colic symptoms compared to their current bottle system due to the innovative ActiveFlow® venting system that mimics breastfeeding and reduces ingestion of air.

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Dr. Greene

Dr. Greene is a practicing pediatrician, author, speaker, children’s health advocate, and father of four.

Dr. Levine

Dr. Alanna Levine is a New York based pediatrician and a mom of two children.