Introduction
What is Colic?
How Much Should
a Normal Baby Cry?
Babies are Different
from One Another
Sensitivity to Stimulation
How Else Can Parents
Cope?
When Should I Call My
Pediatrician?
Conclusion
Introduction
“My baby cries all evening and night! What could be wrong
with her? What can we do?” I have heard these words often as a practicing
general pediatrician. After the excitement and challenges of pregnancy
and the immediate newborn period in the weeks after birth, one out of five
families faces the frustration of a baby who cries excessively despite
their best efforts. No matter how much the parents hold, carry, or feed
these babies, the crying continues.
What is
Colic?
Infant colic has many definitions. One of these is unexplained,
sudden fussing and crying lasting more than three hours a day, for more
than three days a week, for more than three weeks duration. More simply
stated, colic may be described as prolonged or excessive crying. Colic
occurs more often in the late afternoon and evening, especially from 5
p.m. to midnight, but may last through most of the night.
Colic is not really an illness. It is a frequent variation
of infant behavior, and occurs in about 20 percent of all babies. It usually
happens between two weeks and three months of age. There is sudden onset
of loud, continuous crying, lasting several hours at a time. The baby’s
face may be flushed, and the area just around his mouth may appear pale.
His abdomen may be swollen and tense. Often, the baby’s legs are drawn
up to the abdomen, and his hands are clenched.
The baby may appear hungry, but feeding does not quiet
her. There may be temporary relief with passing feces or gas, but this
break usually does not last long. Many parents believe that colic is caused
by gas, but often, the gas may be an effect of excessive crying and swallowed
air. The colic episode typically ends when the baby is completely exhausted.
How
Much Should a Normal Baby Cry?
Many parents are not familiar with the normal amount of
crying that babies do in the course of a day. At two weeks of age, the
average baby cries two hours per day. This increases to three hours per
day at three weeks, and reduces to one hour per day at three months. But
not every normal baby is average: up to 25 percent of infants will cry
three and one-half hours or more at six weeks of age. Normal babies differ
in how much they cry, how loud the crying is, how sensitive they are to
stimulation, and how easily they are comforted. Babies also cry more when
they are tired.
Babies
are Different from One Another
Infants are born with different temperaments, and their
environments from the moment of birth influence these personalities. While
one baby may have colic—his or her sibling may not, even at the same age.
Premature babies may be especially prone to fussiness and excessive crying.
And some parents are more disturbed by prolonged crying than others.
Sensitivity
to Stimulation
Many babies with a tendency to prolonged crying have an
increased sensitivity to extreme or inappropriate stimulation, such as
bright lights, loud sounds or too much touching. Often, parents of these
sensitive infants may reach to pick them up, rock them, and talk to them
when they are crying. This may backfire and make the crying worse, since
the stimulation may be too much for them.
Most babies with colic will reduce their duration of crying
when their parents or caretakers modify the babies’ environments and change
their response to the crying. A quiet room with dim lighting is often helpful.
Soft, soothing music is OK, but loud jarring music or other noise may make
the crying worse. Parents should reduce stimulation, although close physical
contact is often helpful. If these guidelines are followed, most colicky
infants will reduce the duration of their symptoms, although they still
will have periods of crying. Remember: comfort more—stimulate less!
How
Else Can Parents Cope?
Crying babies are very frustrating. It is often helpful
to trade off between caretakers, to take a break away from the infant.
And, remember, never shake a baby!
If reducing stimulation doesn’t help, some remedies that
may possibly be effective in managing colic are:
-
In breastfeeding mothers, a low allergen diet (free of milk,
egg, wheat, and nut products) has sometimes helped. Also, breastfeeding
moms should look at whether other items in their diets influence their
babies’ discomfort, such as caffeine, spicy or gas-producing foods.
-
In formula-fed infants, hypoallergenic or soy formulas have
helped some infants.
-
Herbal tea containing chamomile, vervain, licorice, fennel,
and balm-mint showed some benefit in one study—but watch the quantities,
since young babies can get water-overloaded very easily!
Make sure to let your pediatrician know before trying any
of these remedies. Some commonly used medications, including simethicone
and “gripe water,” which is a mixture of dill with water, have not shown
any real effectiveness in treating colic. Beware of unsolicited advice
from relatives and friends. Above all, realize that colic is not your fault
and that it will go away!
When
Should I Call My Pediatrician?
Whenever you are frustrated in managing your baby’s crying,
you should call her doctor. Before calling, it is often helpful to keep
a diary. Note the time of crying, when the baby was fed, and what you did
to try and comfort her. Also note any stresses going on in the family.
If the crying is out of the ordinary, take the baby’s temperature.
When you bring your baby to see the pediatrician, the
doctor will make sure there is nothing physically wrong that would explain
the colicky crying. Medical disorders that may masquerade as colic include
ear and urinary infections, intestinal blockage, injuries to the surface
of the eye, incarcerated hernia, and other causes of pain. Food allergy
or intolerance may also cause excessive crying.
Conclusion
For further information on infant colic, call your pediatrician.
