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Understanding and managing infantile colic

Have you ever wondered why your baby is having persistent episodes of crying during the first three months of life, especially one month after birth? And has this situation caused you and your baby much stress? Don’t worry, Mama, this is a common physiological condition occurring in almost 35-40 % of all new-borns worldwide named infantile colic.

What is it? And Why does it happen?

It’s a condition that presents as crying for no apparent reason that lasts for more than three hours per day and occurs on more than three days per week in an otherwise healthy and well-fed infant less than three months of age, associated with features of increased muscle tone inconsolability (failure to calm down).

The cause of this condition is unknown. It probably represents a final common pathway for numerous contributing factors like gastrointestinal, biological, and psychosocial.

What are the clinical features?

  1. Paroxysms โ€“ Colic’s cry/fuss behaviour generally is paroxysmal. It typically has a clear beginning and end. The infant’s behaviour right before the “attack” and the onset appears to be unconnected. The baby could have been content, agitated, eating, or even sleeping. These crying episodes come on suddenly and frequently in groups throughout the evening.
  2. Qualitative differences โ€“ The colic cry is qualitatively different from normal crying. It is louder, higher, and more variable in pitch and more turbulent and dysphonic than non-colicky crying. When a baby is colicky, it may appear that they are screaming or in agony.
  3. Hypertonia โ€“ Colic episodes may be associated with physical characteristics related to hypertonia (increased muscle tone). These include facial flushing, mouth pallor, hard or bloated abdomen, drawing up of the legs, holding a fist, stiffening, and tightening of the arms, or arching of the back.
  4. Difficulty consoling โ€“ Infants with colic can be difficult to settle, no matter what the parents do. Sometimes, the baby stops crying but continues to be fussy.

Is it harmful?

Colicky crying is not harmful to your infant in the short or long term. However, to stop the attack, parents of screaming babies may turn to physically harm the child. In addition, observational studies suggest that infantile colic is associated with an increased risk of postpartum depression and early cessation of breastfeeding.

How to manage infantile colic?

Management of excessively crying infants is mainly by the caregivers and families. First-line interventions for colic are changes to the feeding; for example, bottle-feeding the baby in a vertical position (using a curved bottle) in combination with frequent burping may reduce swallowed air. Utilizing a bottle with a collapsible bag could likewise lessen air swallowing. A change in the breastfeeding method may also be necessary. However, it is essential to treat breastfeeding issues on an individual basis. A lactation specialist’s advice may be required.

Another solution is soothing techniques; they can be tried in any order or combination. You can try one method for several minutes and move on to the next if it does not work. The success or failure may vary from one episode of colic to the next of each soothing technique listed below:

  • Using a pacifier.
  • Taking the infant for a ride in the car or a walk in the stroller/buggy.
  • Putting the baby in a front carrier or holding it.
  • Rocking the infant.
  • Changing the environment or view (or minimizing visual stimuli).
  • Placing the child in an infant swing.
  • Providing a warm bath.
  • Rubbing the infant’s abdomen.
  • Playing an audiotape of heartbeats or providing “white noise” (e.g., vacuum cleaner, clothes drier, dishwasher, commercial white noise generator, etc.) should be kept as far away from the baby as possible, used only briefly, and played at a moderate volume.

Many unproven treatments and medications are available on the market, like a drug called simethicone which is considered generally safe; however, trials with conflicting results found little proof to support its use in treating infantile colic.

An insight from mamahood

To conclude, all mothers should be patient in that phase and get as much support from family and friends as possible. Remember that it’s not your fault or your baby’s, and it will eventually resolve.

Our References

Mamahood content is written by practicing physicians and healthcare professionals who rely on evidence-based resources, the latest research, and their experience to ensure our users get credible and updated information they can trust.

  • Barr RG, Rotman A, Yaremko J, et al. The crying of infants with colic: a controlled empirical. description. Pediatrics 1992; 90:14.
  • Lester BM, Boukydis CF, Garcia-Coll CT, Hole WT. Colic for developmentalists. Infant Ment Health J 1990; 11:320.
  • Parker S, Magee T. Colic. In: The Zuckerman Parker Handbook of Developmental and Behavioral Pediatrics for Primary Care, 3rd ed, Augustyn M, Zuckerman B, Caronna EB (Eds), Lippi ncott Williams & Wilkins, Philadelphia 2011. p.182. Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016; 387:475.
  • Lehtonen LA, Rautava PT. Infantile colic: natural history and treatment. Curr Probl Pediatric1996; 26:79.
  • Carey WB. The effectiveness of parent counseling in managing colic. Pediatrics 1994;94:333. Baum R. Colic. In: American Academy of Pediatrics Textbook of Pediatric Care, McInerny TK, Adam HM, Campbell DE, et al (Eds), American Academy of Pediatrics, Elk Grove Village, IL 2009. p.1931.

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