Think in terms of threes when it comes to suspecting that your baby has colic. Is he or she crying for more than three hours a day, is the crying occurring more than three days a week and has it gone on for more than three weeks?
“This ‘rule of threes’ is usually a good indicator when it comes to knowing whether or not your baby has colic,” says Jenny Dunne, neo-natal clinical nurse specialist at Children’s Hospital Ireland Crumlin.
She explains that colic is defined as excessive and frequent crying in a baby who otherwise appears healthy.
“They are putting on weight, feeding well and there are no other concerns. Colic usually begins around two weeks of age, peaks at six-eight weeks and usually resolves at three to four months, but it can go on for up to six months.”
Keep a diary
While it is stressful for parents who feel unable to alleviate their child’s discomfort, there are no short- or long-term effects for babies, however. “It’s important to remember that colic will pass but at the time it can be very difficult for parents.
We encourage parents to keep a diary as this may identify a pattern or problems associated with feeding. The diary can pinpoint these issues, or it may show that there is no rhyme or reason at all.
Crying tends to be more common in the evening, which can be because of a build-up of wind throughout the day but it’s not always so.”
When it comes to signs and symptoms, along with the excessive crying there may be back arching, fist clenching and posseting (bringing up some milk after feeds).
“The crying can be spasmodic, they might cry and then settle with no apparent reason and then cry again,” she says. “Obviously the important thing is that the baby is healthy otherwise – that there are no signs of fever, illness or failure to thrive.”
There is some speculation that it can be caused by an immature gut
The jury is still out on what causes colic, however. “There is no known cause but there is some speculation that it can be caused by an immature gut.
There can be an increased incidence in colic in premature babies,” the nurse specialist says.
She adds that there is some research at the moment into gut bacteria. “A specific probiotic bacterium called lactobacillus reuteri is being researched to see if it has an impact on colic, but there is no evidence (as yet) that it does.”
From a feeding point of view there are lots of things to consider that might be contributory factors to colic.
“Babies with colic gulp down a lot of air, which creates more wind so giving them a soother may help stop that happening.
There are lots of anti-colic teats and bottles on the market designed to help the baby avoid sucking air too. They can be worth a try, ensuring you use the correct size teat,” she says.
Support for breastfeeding mums
Breastfeeding mums (particularly first-time mums) might need a little more support, she says, in order to avoid their baby having issues with wind.
“A good history can identify if a baby is being overfed (constant feeding to soothe a crying baby) or underfed, due to a possible poor milk supply for a variety of reasons.
Support for breastfeeding mothers is essential, encouraging mothers of the importance of emptying one breast before moving the baby to the other.
This ensures that the baby is receiving the hind milk, which has a higher fat content than the foremilk. This hind milk provides satiety to babies, so they are nice and full.”
Support groups like La Leche and Cuidiú can provide great assistance and reassurance for breastfeeding mothers, online and in person she says, along with one’s public health nurse.
Taking your child to your GP for a review if they have colic is a good idea, she states.
“While colic resolves in time with no treatment, an excessively crying infant may need a medical /GP review to rule out an underlying cause.
A baby with cow’s milk protein allergy will usually display other symptoms besides crying such as a rash, a wheeze, diarrhoea and/or blood in the stool.
“Projectile vomiting or the presence of green/bile requires an urgent medical review with your GP/local hospital to rule out a surgical cause.
A comprehensive GP examination will reassure parents that there are no underlying issues and that the crying will eventually pass.”
Formula for success
Breastfeeding is the recommended way to feed babies, but if you are bottle feeding your baby and he/she has colic, changing their baby milk formula may help.
“There are many different formulas on the market from lactose-free to anti-colic formulas. We don’t recommend any type or brand, but would advise if you are changing from one to another to give it time to assess the effect, if any.
A dietician or paediatrician may recommend a trial of an extensively hydrolysed formula in which proteins are broken down into a more digestible form.
This may be used for a defined trial period but if there is no improvement, the parent returns to the original feed as these can be expensive and are available on prescription only.”
There are a number of treatments for colic available in pharmacies, she adds. One type is a lactase drop that breaks down lactulose in a feed.
“Parents may think their baby is lactose intolerant and that this is causing the colic and they try these drops.
They should be administered into the feed 30 minutes prior to feeding. The other drops are given pre-feed and work in a slightly different way.
They are supposed to break down gas bubbles (be a deflatulent) so that babies naturally expel them, but again there is no proven research to say that either of these are beneficial in the treatment of colic.”
Be wary of herbal remedies
Jenny strikes a note of warning about homeopathic and complementary medicines for colic.
“Caution should be applied with herbal remedies. Breastmilk or formula should never be replaced with herbal teas.
Herbal remedies are not regulated or standardised so you should speak with your doctor or public health nurse before using them. “
Looking after yourself
It can, of course, be upsetting if a baby is difficult to comfort but try to remember that colic will stop eventually, Jenny Dunne adds.
“You need rest and to look after your own wellbeing as a parent. If a baby has colic it is very helpful to have a network of support in place. Being able to rely on the support of family or friends for a break is invaluable.”
So, in the absence of knowing the causes, what can a parent do to help their child who has colic? The first line (of action) is soothing, Jenny states.
Soother or pacifier
“Offering a pacifier or soother is recommended as is the comfort hold – cuddling your baby skin-to-skin. Skin to skin is beneficial in settling babies as they can smell the parent’s scent and hear their heartbeat. Parents shouldn’t worry about spoiling their child. If they are crying, they are crying for a reason.
“Putting the baby in a sling on your body can help too. That closeness and security and smell and sound of your heartbeat may help them settle and the upright position will help with digestion.” A rocking motion and walking up and down are time-tried tactics also.
“Parents often take babies out in the car for a drive. When your baby is crying, you’d do anything you think might help.”
Constant background noise – may help some babies also. “Mobile phones have lots of white noise apps, heartbeat apps and water swishing apps… It’s amazing what parents can have at the bedside or at home.”
Background music may help as well, she adds. “Soothing music may be useful. A quiet environment is important also.
“You don’t want to overstimulate them so avoid crowded rooms, loud noise and dim down the lights.”
Warm bath A warm bath can work for some, too, as can massaging the baby’s tummy in a circular motion between feeds..“This may help with digestion and release trapped wind,” she says.
A warm bath can work for some, too, as can massaging the baby’s tummy in a circular motion between feeds..“This may help with digestion and release trapped wind,” she says.