Colic: Symptoms and relief

Watching a baby experience colic can be challenging and stressful, especially for new parents. Colic is a pattern of repeated, hard-to-soothe crying in young babies who are otherwise healthy and growing normally. Before diagnosing colic, it is important to make sure the baby is not experiencing anything else medically. While there is not a single, identifiable cause of colic, it reflects a developmental mix of an immature nervous system and some challenges regulating all the stimulation coming to the brain.

“I always tell parents that there is a fourth trimester: the first three months after the baby is born,” said Dr. Bryan Vartabedian, pediatric gastroenterologist at Baylor College of Medicine and Texas Children’s Hospital. “The baby is adapting to a completely new world of sensory inputs. The gut has evolved in motility. During this time, the nervous system has to catch up to what’s happening in the world. It’s a clash with the baby’s brain and the stimulus in their world.”

Colic traditionally peaks around six to eight weeks of age and tends to dissipate at three or four months of age. If a baby develops hard-to-soothe crying in the middle of their first year or three-quarters of the way through their first year, it is no longer an immature nervous system or colic. This should be assessed by a pediatrician.

Symptoms

Babies with colic display periods of intense crying. They might clench their fists, fluff their legs or arch their back.

“What is key is between these episodes of crying is the baby tends to feed, grow and generally look well; a period where the baby does remarkably well outside of these episodes of fist clenching, drawing up the knees and face turning red,” Vartabedian said.

Boys, girls, breastfed and formula-fed babies equally experience colic. A certain demographic is not more prone to it, but some data suggests tobacco smoke may be associated with an increased risk.

Soothing

Before soothing a baby with colic, make sure nothing else is medically at play. A fussy baby might have a milk protein allergy or acid reflux, and both issues can be identified in babies.

While there is not an instant cure for colic, parents can try different soothing tactics that work for their baby. Safe swaddling can soothe colic because babies’ nervous systems like being snug and bundled. White noise or background noise neutralizes all inputs of movement and might sooth babies as well. Holding, walking, gentle rocking and background white noise temporarily settle a baby. Babies might do well with riding in the car. Some studies show that certain probiotic strains (Lactobacillus reuteri) can be helpful for some babies.

According to Vartabedian, some research suggests that changes in the microbiome in the intestinal tract could be a cause of colic. Variations in the microbiome in certain babies can predispose them for colic.

“It may be more than what’s happening in the brain. It could be what’s happening in the gut as well. What we understand about colic is evolving and we’re learning more about it,” he said.

Steps for new parents

Parents should make sure their babies are feeding well and are not having breathing difficulties or forceful vomiting. Blood in the stool can be a sign of allergy. Vartabedian suggests monitoring other symptoms and making sure the baby has adequate feeding and burping and that they are changed and dry. Holding, rocking, safe swaddling and white noise can offer some immediate relief.

“Sometimes something as simple as clipping a fingernail too close can cause intense crying. You want to make sure that the simple things are absolutely ruled out. Then, have the baby assessed as a part of normal newborn care,” he said.

By Homa Warren