Crying is a normal part of an infant’s day. During the first two weeks of life, an infant usually is crying because he is hungry. After three weeks of life, infants may cry for about three hours a day. When your baby cries at this age, it may be that he is hungry, needs his diaper changed, or just wants to be held. Also check his eyes to look for scratches and his fingers, toes, and penis to check for a tourniquet (sometimes a piece of thread can wrap itself around his skin tightly to cut off circulation). Call your doctor if the crying is associated with skin color changes, fever (a rectal temperature over 100.4 degrees Fahrenheit), or a bulging fontanelle (the baby’s soft spot).
Colic describes a subset of babies who cry more than others. The classic definition of colic is infant crying that lasts for more than 3 hrs per day, more than 3 days per week, and lasts longer than 3 weeks. Some parents describe these periods of crying as “sudden”, an “attack”, and “intense.” The babies may have flushed cheeks, distended stomachs, flexed legs, clenched fists, or arched backs. The infants are often inconsolable, often unrelenting until they pass stool or flatus. These attacks often have early morning and/or evening peaks.
Theories abound regarding the causes of colic. Some experts in child development suggest that colicky babies are just at one end of a spectrum of normal infant temperaments. Infant crying is a necessary and healthy way for your baby to discharge the excitement accumulated from a day of external stimulation before nightfall.
Other studies support the theory that infants’ colic is derived from their immature gastrointestinal systems. Infants may not have fully developed their ability to break down lactose and other carbohydrates, leading to a buildup of gas. Compared to other babies, colicky infants also were shown to have a higher level of motilin, a gastrointestinal hormone that makes their system hyperactive, contributing to cramps. Still others think that colicky infants are expressing hunger during a growth spurt. Mother’s breast milk has the least amount of fat in the evening (prove it to yourself by expressing milk at a different time each day, you’ll see that the cream level is lower at night). Infants may be crying for more frequent feedings because they may need more fat at night to support a growth spurt. Try to pump some breast milk after the baby’s morning feed and top the infant off at night with this more creamy milk to see if the increased fat intake alleviates the colic.
Others believe that a small group of colicky babies are really suffering from milk protein allergy or gastroesophageal reflux. These babies may also have loose stools and more frequent spit up.
You should never feel inadequate as a parent of a colicky baby-if anything, pat yourself on the back for the hard work of caring for a challenging infant! Over 90% of infants recover from colic by the age of three months without any intervention. In the meantime, there are some strategies to try. It may take some experimenting to find which one works for your babyâ€”only 30% of the techniques work with any given infant.
Child development suggests that parents try to match the baby’s environment to “fit” the baby’s temperament. Some light or motion sensitive babies may benefit from swaddling and a darkened room to calm themselves at the end of the day. Babies who seem sensitive to sounds may enjoy lying in a car seat on the washing machine or the sounds of a fan or TV on white noise. Other infants thrive on music, rocking, and the voices of loved ones nearby.
Some remedies that address the infant’s gastrointestinal immaturity relate to feeding. Feeding the baby more vertically with frequent burping may help. Breast-feeding mothers should avoid caffeine. Herbal remedies can be used once the infant is two weeks old. Fennel, chamomile, or balm-mint tea (2 oz at room temperature, without sugar or honey) have long been used to help colicky infants. Teas should only be used once or twice a day, so that the infant’s milk consumption does not decrease. A teaspoon of 0.1% fennel seed emulsion oil up to 3 times per day was shown to help colicky infants in a recent study.
Antispasmodics such as dicyclomine are dangerous for infants and should not be used. Although simethicone (Infant Mylicon Drops 0.3 mL up to three times/dy) drops are safe to use in infants over 2 weeks old and can be helpful for gassy babies, they have not been shown to significantly help colicky babies.
Since milk protein allergy does cause colic in some babies, it may be worth a one week trial of a hypoallergenic infant diet. This could be a hypoallergenic, pre-digested formula such as Nutramigen or Alimentum. For a breast-feeding baby, the mother would eliminate milk/dairy/soy/egg/wheat/nuts from her diet. If after one week there is no change, the infant should go back to his previous formula ( and the mother to a regular diet).
And most importantly, make sure that you get some rest as a parent. Let someone else carry her for a few hours so you can enjoy dinner or even get some sleep. You will both be recharged after the temporary separation. Colicky infants (and their exhausted parents) eventually recover from this period, almost all by three months old. Compared to their peers, colicky babies do not have any increased future risk of allergies, asthma, or sleep problems. So both of you will sleep at last!