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Colic

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Colic



Introduction 

Colic is the medical term for excessive, frequent crying in a baby who appears to be otherwise healthy and well fed. It is a common yet poorly understood condition, affecting up to one in five babies.

Colic usually begins within the first few weeks of life but often stops by the time the baby is four months old, and by six months at the latest.

In most cases, the intense crying occurs in the late afternoon or evening and usually lasts for several hours. You may also notice that your baby's face becomes flushed, and they may clench their fists, draw their knees up to their tummy, or arch their back.

If your baby has colic, they may appear to be in distress. However, the crying outbursts are not harmful and your baby will continue to feed and gain weight normally. There is no clear evidence that colic has any long-term effects on a baby’s health. 

 

Seeing your GP

You should see your GP if your baby cries excessively.

This is so your GP can rule out conditions that may be causing your baby's crying, such as eczema or gastro-oesophageal reflux disease (GORD). GORD is a condition where stomach acid moves back out of the stomach and into the oesophagus (gullet).

If no other cause of your baby’s symptoms can be found, diagnosis of colic can be made (although this is simply a term used to describe a baby that cries a lot). Your GP can advise you about the things you can do to help your baby, including what treatments are available.

 

When to call your GP immediately

A number of signs and symptoms may suggest that your baby is more seriously ill. It is recommended that you contact your GP immediately if your baby:



has a weak, high-pitched continuous cry



seems floppy when you pick them up



takes less than a third of their usual amount of fluids



passes much less urine than usual



vomits green fluid



passes blood in their stools



has a fever of 38C or above (if they're less than three months old) or 39C or above (if they're three to six months old)



has a bulging fontanelle (the soft spot at the top of a baby’s head)



has a fit (seizure)



turns blue, blotchy or very pale



has a stiff neck



has breathing problems, such as breathing quickly or grunting while breathing



has a spotty, purple-red rash anywhere on their body (this could be a sign of meningitis)



 

What causes colic?

The cause or causes of colic are unknown, but a number of theories have been suggested. These include indigestion, trapped wind or a temporary gut sensitivity to certain proteins and sugars found in breast milk and formula milk.

However, there is currently little solid evidence to support these theories.

Colic occurs equally in boys and girls, and in babies who are breastfed or bottle-fed.

Advice for parents 

Having to care for a baby with colic can be distressing for parents, particularly first-time parents. It is important to remember that:



Your baby’s colic is not your fault – It does not mean your baby is unwell, or that you are doing something wrong, or that your baby is rejecting you.



Your baby will get better eventually



You should look after your own wellbeing – If possible, ask friends and family for support as it is important that you can take a break and rest when your baby is asleep.



Support groups, such as Cry-sis, can also offer help and advice if you need it.

 

Tips for helping your baby

There is currently no established method that works for all babies with colic. However, a number of techniques may help your baby, such as:



holding your baby during a crying episode



preventing your baby from swallowing air by sitting them upright during feeding



bathing your baby in a warm bath



gently massaging your baby's tummy



A small number of babies may also benefit from changes to their diet, such as adding drops to breast milk or bottle milk that can aid digestion and release any bubbles of trapped air in your baby’s digestive system.



 



 

Other types of colic

This article focuses specifically on infant or baby colic. Other types of colic include:



biliary colic – caused by gallstones



renal colic – caused by kidney stones



The main symptom of these types of colic is sudden, intense stomach pain.

 

Treating colic 

Colic gets better on its own after a few months. There are not many treatment options for the problem, but the following tips may help.

 

Comforting your baby

There is no 'best' way to comfort your baby or reduce the symptoms of colic. Different babies respond to different methods, so you may have to see what works best for you. The following suggestions may help:



Holding your baby during a crying episode can sometimes help, as can wrapping them snugly in a blanket or baby sling.



Hold your baby in different positions, such as on your shoulder, cradled in your arms or lying tummy-down along your forearm.



Sit your baby upright during feeding to prevent them from swallowing air.



Don't drink too much tea, coffee and other caffeine-containing drinks if you are breastfeeding. Some women also find that spicy food and alcohol can aggravate colic.



Use a 'fast flow' teat if you are bottle feeding, as holes in bottle teats that are too small may cause your baby to swallow air as they feed.



Always burp your baby after a feed. To do this, sit your baby upright or hold them against your shoulder, making sure you support their neck and head. Gently rub their back and tummy until they burp. They may vomit a small amount of milk when you do this.



Avoid overstimulating your baby by continually picking them up and putting them down, as some research suggests this may aggravate the crying. Gently comforting your baby in a quiet, darkened room may be more beneficial. If you are satisfied that your baby is not hungry, tired, too hot or cold or in need of a nappy change, it may help to leave them in their cot for a short while.



Babies like movement, so pushing them around in their pram or pushchair or going for a drive can be comforting. Rocking them over your shoulder or carrying them around the house may also be helpful.



Some babies find 'white noise' soothing. This is the background sound of a washing machine or vacuum cleaner.



Gentle stomach or back rubs or a warm bath may also help to relieve colic.



 

Looking after yourself

If your baby has colic, it is important that you do not forget about your own wellbeing. Looking after a baby with colic can be exhausting and distressing, and it is common for parents to sometimes feel depressed, angry or helpless.

You may find the following tips useful:



If you feel you cannot cope with your baby's crying, it is best to put the baby down somewhere safe and take a few minutes as a 'time out'.



Ask your friends and family for support. All parents need a break, and even an hour of rest on your own can help you cope better with the situation.



Try to rest when your baby is asleep.



Talking to other people about your problems can often help. A support group called Cry-sis provides help and advice to families with babies that cry excessively and have problems sleeping.

 

Medical treatment

As colic improves on its own, medical treatment is not usually recommended. However, if you have problems coping, contact your GP for advice about possible medical treatments.

There is little good evidence of the effectiveness of most treatments for colic, although some parents do find them helpful. It may be worthwhile giving the treatments mentioned below a try (one at a time) for about a week or so to see if they help your baby.

 

Simeticone drops

Simeticone drops, such as Infacol, are a supplement that can be added to your baby’s bottle or breast milk before a feed. The drops are designed to help release bubbles of trapped air in your baby’s digestive system, so they may be of some use if indigestion is contributing to their colic.

A one-week trial of simeticone drops is usually recommended. If your baby’s symptoms do not improve within this time, it is usually felt that there is little point carrying on with the treatment.

Simeticone drops are safe for babies to have, and there have been no reports of any side effects from the treatment.

 

Removing cows' milk

It's possible that your baby may have developed a short-term intolerance to proteins found in cows’ milk and other dairy products.

If you are breastfeeding, you can try removing dairy products from your diet for a week to see if your baby’s symptoms improve.

If you decide to continue with a dairy-free diet after this point, you will need to take additional calcium supplements to ensure you maintain good bone health.

If you are bottle feeding, see your GP for advice about switching to a hypoallergenic milk formula. This type of milk has low levels of the protein that may be causing intolerance. Again, you can try using it for a week to see if your baby’s symptoms improve.

Your GP can advise you about the most suitable hypoallergenic milk formula for your baby. The use of soya milk formula is not usually recommended for babies less than six months old because it contains hormones that may interfere with your baby’s future physical and sexual development.

If your baby’s symptoms do not improve after using hypoallergenic milk formula for a week, it is usually felt that there is little point carrying on with it.

 

Lactase drops

Lactase is an enzyme that helps break down a sugar called lactose, which is found in breast and formula milk. Your baby may have short-term problems digesting lactose, which could contribute to their symptoms.

Lactase drops can be added to your baby’s feed to make digesting the lactose easier. As with the other treatments described above, using lactase drops for more than a week if symptoms do not improve is not usually recommended.

Alternative and traditional therapies

There are many alternative and traditional therapies for colic, but there is little evidence that they are effective, and some may harm your baby. Some of these therapies are described below.

 

Dicycloverine

Also known as dicyclomine, dicycloverine is a medication used to control stomach cramps. In the past, dicycloverine was widely used as a treatment for colic. However, it is now regarded as unsuitable for infants under the age of six months because it can cause serious side effects including:



breathing difficulties



seizures



muscle weakness



loss of consciousness



coma



 

Star anise tea

Star anise tea is a herbal tea that has traditionally been used to treat colic. However, its use is no longer recommended because certain types of star anise are highly toxic and could poison your baby.

 

Chiropractic and massage therapy

Some people feel that a series of massages or chiropractic manipulation of a baby's spine may be effective in treating colic. However, medical trials have failed to find any convincing evidence of the benefit of such therapies for colic.

 

Lactose intolerance and cows' milk allergy

If your baby responds to lactase drops or hypoallergenic milk formula, it does not necessarily mean that they have lactose intolerance or an allergy to cows’ milk.

Both of these conditions are rare in babies with colic. Therefore, you should not make any long-term changes to your baby’s diet without first consulting your GP.







Colic