Colic
Colic is very common in newborn babies, up to 20% of infants suffer, and it may continue for the first three to four months after birth. Both breast-fed and bottle-fed infants get colic and it affects boys and girls equally, but there is some evidence that it is more common in infants whose mothers smoke. Although it is often distressing for parents, colic does not harm your baby in the long term and babies with colic should continue to feed and gain weight normally.
The main problem with colic is the stress and anxiety it causes. Parents and other family members often find it difficult to cope with the constant crying.
How will I know if my baby has colic?
It is often difficult to work out whether your baby is ill or is simply hungry, cold, tired or in need of a nappy change. The most common colic symptom is a high-pitched inconsolable crying which typically occurs in the late afternoon or evening, often repeated at a similar time each day. You may also notice some or all of the following:
- A flushed appearance
- Drawing their legs up to their chest & clenching their fists as if in pain
- Passing wind frequently
- Passing stools with difficulty.
- Disrupted feeding and sleep routines due to bouts of crying
Colic can be milder in some babies and periods of restlessness in the evenings may be all that is noticed. Familiarity with your baby's temperament and behaviour can be invaluable in helping you to recognise a more serious problem.
If you and your doctor are sure that there is no other medical reason for the baby's distress, then colic may be diagnosed.
What else might it be?
Other common causes of excessive crying include:
- Poor feeding technique - don't be afraid to speak to your midwife or health visitor if you need advice.
- Hunger
- Cold
- An itch
- Parental problems (e.g. excessive anxiety or depression).
What causes colic?
The cause of colic in babies is not known for sure. Common belief is that it may be due to trapped wind distending the stomach. Other theories include:
- Poor digestion. It is thought an immature digestive system may be the cause of pain as milk passes through it. Colic usually disappears before weaning onto solid food begins.
- Lactose intolerance - lactose is a sugar found in breast milk, cow's milk and most formula milks which some babies may be sensitive to.
- Cow's milk - Although babies under twelve months should not be given cow's milk, most formula milk is based on cow's milk and so contains cow's milk and some babies may be sensitive to it. Mums who breast feed and who include dairy products in their diet can also pass cow's milk proteins to their baby through their breast milk so don't automatically rule this out if you're breast feeding. However remember to find another source of calcium to replace the dairy you cut out, to ensure you are still getting sufficient calcium while breastfeeding.
Some parents worry that they are responsible for their baby crying a lot, but all babies cry - until they get older it's their only way of communicating that they need something! Colic is simply an extreme version of this, and has nothing to do with bad parenting.
How to treat?
Many parents learn by trial and error how to soothe their baby's crying, and how to recognise what it is their baby wants. Try to avoid over-stimulating your baby and remember to take 'time out' to relax yourself. If you are tired and stressed, you may find it harder to cope with the situation.
There is no treatment to prevent colic, but there are things you can do to reduce the distress to your baby that is caused by colic. The following measures may help to soothe a crying baby:
- Ensure you keep your baby upright whilst feeding to prevent them from swallowing air. Always burp your baby after a feed. Sit your baby upright or hold it up against your shoulder to do this. Gently rub their back and tummy until they burp - sometimes they may vomit a small amount of milk when you do this, this is normal.
- If you breastfeed, try reducing the amount of tea, coffee, and other caffeine containing drinks you have. Some women also find that spicy food and alcohol in their diet can aggravate colic.
- You could also try cutting down on vegetables which can encourage wind production (such as cabbage, broccoli and cauliflower).
- If you are bottle feeding your baby check the holes in the teat are large enough. Small teats may increase the amount of air swallowed along with the milk. 'Fast-flow' teats are available and may be a good alternative.
- Babies like gentle movement, so pushing them around in their pram or pushchair, or going for a drive can be comforting.
- Some babies find a low level background noise soothing and preferable to silence. Try the sound of a washing machine or vacuum cleaner but not too loud!
If you do feel your baby needs something more your pharmacist can advise you on the options available, such as lactase drops or gripe water to release trapped wind, or low lactose/hypoallergenic formula milks. However there is little compelling evidence that any of the available treatments are effective.
Sequential one-week trials of removing lactose and then cow's milk protein from the infant's diet may be worthwhile, just in case the symptoms are due to an intolerance. To remove lactose from the diet, lactase (an enzyme that breaks down lactose) may be added to the infant's usual milk, or a low-lactose milk formula may be tried. To remove cow's milk from a breast-fed infant's diet, the mother has to stop consuming dairy produce. For bottle-fed infants, the usual formula milk can be replaced by hypoallergenic milk. Remember to speak to a healthcare professional such as your midwife before making significant changes to your baby's diet.
