Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD
Colic is excessive, fussy crying in infants. Although all children will cry as infants, colic is generally lengthy stretches of crying at least 4 hours a day for at least 3 days a week. Many infants with colic cry more often than this. Colic generally starts at about 2-3 weeks of age and ends by 4 months or so. Sometimes it is called "100 days of hell."
Many infants with colic pull their legs up and tighten their stomach muscles during these episodes. They have a lot of gas. They have hiccups. These are all from crying. All of these.
We do not completely understand what causes colic. It is currently thought to be a developmental stretch some infants go thru as their stomach and intestines mature. A combination of gas, normal digestion, and the bowels contracting to help move the bowel movements thru can cause some infants to be uncomfortable.
One researcher thinks of it as these infants need a "fourth trimester" of development and that is why colicky infants need being snuggled and held and that it goes away in three months.
What Else Could Cause These Symptoms?
If My Baby Has Colic, What Do I Do?
Remember, for those that are gaining weight just fine with good wet diapers and bowel movements, this is going to pass. It is stressful and exhausting, but it will pass. Crying itself does not cause harm to the infant. You are not going to spoil your child in these first 3-4 months by holding them for long period of time. Getting help from friends and family so you can "get a break away" sure helps. Never choke or shake your infant. If you are ever at the "end of your rope," place your crying baby in their crib or bassinet and go to another room for a brief break.
- Dr. Harvey Karp, MD, a pediatrician, has written a book about colic called The Happiest Baby on the Block. I highly recommend this book if your infant is struggling with colic. Although there is much to read in the book, his recommendations about the Five S's are good advice: swaddling, side/stomach lying while awake, shushing, swaying, and sucking. Many crying infants find these to be calming.
- Many infants calm down if placed in a vibrating infant seat, baby swing or moving vehicle. The motion can be quite effective. Many infants are calmer if as if you hold them you are moving and rocking.
- Infants heard lots of noises in the womb, including amniotic fluid, mom's heart and blood vessels, and gurgling stomach and intestines. Many crying infants will calm with moderate noise: the washing machine, the vacuum cleaner, showing running, and snuggling them close so they can hear the heartbeat.
- Swaddling helps infants feel secure. Snugly swaddling your crying infant can help calm their crying.
- Try switching things up: if things are not going well, change something. If it is light and noisy, try a dark and quiet room. If it is quiet, try some background noise. Sometimes the infants can get "over stimulated" or "under stimulated" and have a bad stretch. Changing things can help to calm the infant.
- Infants who cry frequently are often fed more often. If your infant has shown good weight gain, it can be tricky to decide when to feed the infant when the infant cries, but the following are good guidelines:
- Do not feed your baby every time they cry. They will be over-fed and that can lead to constipation, excessive spitting, and excessive weight gain.
- For breast-feeding infants, nurse them every time they cry until your milk is in and we know the baby is gaining weight well (usually at the 2 week appointment). Many breast-fed infants that feed frequently cause lots of soreness for the mother and are not getting the full nutrition of the breast milk as they may never empty the breast well.
- For formula-fed infants, feed every 2-3 hours until your infant is seen at the 1 week appointment. Most infants thereafter can feed every 2-3 hours on average.
- Whether you should try gas drops or gripe water is tricky. Pediatrician Dr. Michel Cohen says "Since there is nothing wrong with (your infant), there's no need for colic medications." In large studies with lots of colicky infants, gas drops (simethicone, such as Mylicon®) and gripe water do not generally help the amount or intensity of crying. However, we certainly have some infants do better when given one or both of these. The truth is there is no harm in giving gas drops or gripe water. Generally, the worst thing that can happen is they do not work. Then you stop them. So if you do gas drops for 3-5 days with no change, stop them. If they help, continue giving them as often as every feeding. They are safe to do for long periods of time (years, if you needed to!). We would recommend the same about gripe water: you may find it helpful, it is fine to try for a few days, and if you find it helps it is fine to continue. If you do not notice it helping, stop using it. Both of these are available in stores over-the-counter without a prescription. The simethicone gas drops dose is 0.3 ml. by mouth as often as every feeding.
- Do not hesitate to call and make an appointment to discuss how to help you and your infant through colic. We can weigh the baby to make sure they are still having good weight gain and discuss other things to try.
On a personal note: one of my twins had colic and it was stressful for everyone in our home. He is now a healthy, happy young adult. You and your child will get through this!
Last Updated: 05/2019