What to Do About Colic
Crying is a part of any baby’s life, but some babies seem to cry a whole lot more than others. In most cases, there’s no medical problem at all. They’re just blowing off some steam, working through the ordinary transition that babies have to make. Other times, crying can be a sign of a more-important problem. Excessive newborn crying is often called “colic.”
How much crying is considered “excessive”? It depends on the parents. A good working definition to start with is probably, “more crying than parents feel they can deal with.” It probably doesn’t matter exactly how many minutes the baby is crying. The more important questions are “Does the crying mean that anything is medically wrong?” and “How can the parents help their crying baby feel better?”.
Understanding colic starts with understanding babies. It’s tough being a newborn. You’ve been warm and snug underwater for your whole life, used to the quiet and dark. Then, whammo, the world turns literally upside down. There’s light and air and your arms and legs can stretch and wag around. Worse, your tummy — for so long, quiet and unmoving — is now churning, moving, making gas, and who-knows-what-else. Try to imagine such a huge transition. You’d cry a lot if it happened to you.
It’s tough being a newborn’s parent, too (especially the first time around). You’re not sure what to do, and you’re not sure if things are going right. Lack of sleep makes nothing easier. And babies, even newborns, can tell when their parents are stressed. Put together stressed, tired, and worried parents with anxious, frazzled babies — you’ve got to expect some crying, and probably quite a bit.
The excessive crying of ordinary, healthy babies who are blowing off steam follows a specific pattern. These babies tend to cry at a set interval each day, almost always in the evenings. Many parents will say they can set their clocks by the crying period. The crying peaks at about 4-6 weeks, and goes away by the time the baby is three months old. Although this kind of crying can be exhausting, it’s reassuring if your baby only cries excessively during a set time each evening. After all, there is no medical problem that only occurs in the evening. This sort of crying is not caused by any medical issue. The main way to treat it is to learn good soothing techniques, and work out a way to get some rest and take a break once in a while.
If your baby has excessive crying that doesn’t fit into the classic evening crying pattern, it’s more likely that there might be a genuine medical issue going on. These babies are more likely to be “fussy all the time” or “fussy at random times”. Some problems that might cause this kind of crying include:
- Reflux, which can lead to pain and heartburn. All babies spit up some, and if it’s not causing pain, this doesn’t need treatment. But spitting that’s causing heartburn needs to be discussed with the pediatrician.
- Food allergy — either formula intolerance or a problem with something in mom’s breast milk.
- Temperamental fussiness. This refers to babies who have a hard time settling down, are anxious, and cry a lot. These babies need extra reassurance, and their parents need extra support. Sometimes, this kind of crying is referred to as “gas pain” — though when you think about it, passing gas doesn’t really hurt. It’s more that it feels funny, and makes some babies worry and cry. The best treatment for “gas” is reassurance.
- Constipation. It’s not common in little babies, but if your child is having firm and painful stools, it needs to be addressed. Note that many babies (especially breast-fed) can go days without stool. It’s not constipation, as long as the stool is soft.
- Maternal health problems, including post-partum depression. This can cause or be caused by excessive baby crying.
- Rare, unusual medical problems. These can include urinary tract infections, glaucoma, a broken bone from birth trauma, or really almost anything else. There is no way to “test for everything,” but a careful history and physical exam will reveal almost any sort of problem like these. Rarely, specific directed tests like a urinalysis or an x-ray might be needed.
The first step for parents of fussy babies is to work on getting some respite care. You especially need time to unwind and get some rest. If there’s no family in town, you may need to rely on a neighbor, close friend, or a hired nursery helper. No matter what the underlying cause of the fussing, you’ll be able to deal with it better if you have a chance to catch your breath once in a while.
Then, make sure that your pediatrician gets the whole story and a good complete physical exam. Bring notes with a log of the fussiness. When is it? How does it relate to meals and bowel movements? What have you tried that has helped? In my experience, the answer to the mystery of a fussy baby is much more likely to be found in clues the parents provide than in any sort of medical tests.
Some techniques can soothe a fussy baby. A nice, tight swaddle helps a baby feel like she’s “back in the womb” and can be reassuring. A pacifier, swing, and/or buzzing bouncy seat can also help. Some babies like a ride in the car, or like to sit near (NEVER on top of!) a clothes dryer as it spins. A small white noise generator makes a soothing, rain-like sound that many babies find relaxing.
Babies, especially newborns, can seem to cry a lot. Most of the time, it’s just exhaustion and blowing off steam rather than any medical problem that needs medical attention. Look for the pattern of the crying as the best clue to know if there’s anything to worry about, and visit your pediatrician for a good history and physical to make sure you’re taking the best steps to help your crying baby feel better.