Frequently Asked Questions about Colic

Almost all babies go through a fussy period. When crying lasts for longer than about three hours a day, and is not caused by a medical problem (such as a hernia or an infection), it is called colic. This phenomenon is present in almost all babies; the only thing that differs is the degree.

Colic 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 is no wonder that parents can become frustrated, discouraged, and depressed.

The child with colic tends to be unusually sensitive to stimulation. Some babies experience greater discomfort from intestinal gas. (Then, they tend to swallow even more air when they cry!) Some cry from hunger, others from overfeeding. Some breastfed babies are intolerant of foods in their mothers' diets. Some bottle-fed babies are intolerant of the proteins in formula. Fear, frustration, or even excitement can lead to abdominal discomfort and colic. When other people around them are worried, anxious, or depressed, babies may cry more, which in turn makes those around them even more worried, anxious, or depressed.

About 20 percent of babies cry enough to meet the definition of colic. The timing varies, but colic usually affects babies beginning at about three weeks of age and peaking somewhere between four and six weeks of age.

Colic will not last forever! After about six weeks of age, it usually begins improving, slowly but surely, and is generally gone by twelve weeks of age. When colic is still going strong at 12 weeks, it's important to consider another diagnosis (such as reflux).

Colic frequently, but not always, begins at about the same time every day. For most infants the most intense fussiness is in the evening. The attack often begins suddenly. The legs may be drawn up and the belly distended. The hands may be clenched. The episode may last for minutes or hours. It often winds down when the baby is exhausted, or when gas or stool is passed.

In spite of apparent abdominal pain, colicky infants eat well and gain weight normally.

Colic is usually diagnosed by the parent's description of the crying. A careful physical exam is wise to be sure the baby does not have a hernia, intussusception, a hair tourniquet, a hair in the eye, or another medical problem that needs attention. If the diagnosis isn't clear, further testing may be needed.

Helping a child with colic is primarily a matter of experimentation and observation. If you can identify and eliminate a trigger for the colic, that is best. Even if you can't, learn which measures are most comforting for your baby.

POSSIBLE TRIGGERS

Call your health care provider if you have concerns. The most important thing to keep in mind is not to misdiagnose a serious condition and call it colic. If your baby's behavior or crying pattern changes suddenly or if the crying is associated with fever, forceful vomiting, diarrhea, bloody stools, or other abnormal activity or symptoms, call your doctor immediately.

Do not be afraid to seek help immediately if you feel overwhelmed and are afraid that you may hurt your baby.

A fussy period is likely no matter what prevention techniques are undertaken. However, 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 prevent colic. Experimenting with the comfort techniques outlined above before colic develops can help you identify your baby's needs and desires, and can help stop the fussy period from becoming so intense.