Colic

Introduction

It’s no surprise that babies cry from time to time. It’s not always easy to hear your baby cry but it's their way of communicating that they need something (such as a nappy change or feeding).

Sometimes your baby might cry for long periods of time despite your best efforts to soothe them. You might feel helpless and worried that something is wrong but it’s important to know that you’re not alone. Baby colic is a common problem effecting between 10–30 percent of infants worldwide¹.

This article covers what is baby colic, how to tell if your baby has colic, things you can do to soothe your baby, possible causes of colic, self-care tips to help you to cope with the stress of baby colic, and when to get help from a doctor.

What is baby colic?

Baby colic is a term used for babies who cry a lot. It’s sometimes defined as recurrent and persistent crying, fussing, or irritability that starts and stops without an obvious cause and can’t be resolved^2,3.

Colicky crying is different from normal crying. With normal crying usually a feed, a change of nappy or just a cuddle will eventually soothe your baby. With colic your baby continues to cry and any amount of consoling doesn’t work.

It occurs in young babies under 5 months who are otherwise healthy^2,3. The good news is that most babies outgrow colic by the time they’re 4-6 months old^2,4.

How do you know if your baby has colic?

All babies cry, but if your baby cries more than others, it could be a sign of colic.

Here are some baby colic symptoms to look out for:

• Excessive and inconsolable crying that may go on for several hours without an obvious cause⁵.

• Drawing knees up to their tummy or arching their back when crying⁵.

• A red face or clenched fists whilst crying⁶.

• Rumbling tummy noises, and/or a lot of wind⁶.

• Baby is otherwise well with no obvious illness such as diarrhoea, vomiting or fever⁷.

If you think your baby is crying due to an illness or fever, speak to a medical professional⁷.

How to soothe a baby with colic

Remember that lots of babies have colic, and it will pass with time. It might not seem easy at first, but you’ll get used to your baby and what helps them best. There isn’t a quick fix for colic, but there are plenty of trusted techniques to help you soothe your colicky baby. Here are some things you could try:

• Understanding your baby’s signals may help you to recognise pre-cry cues.

• If you’re breastfeeding, ask a midwife or lactation specialist to assess the effectiveness of your baby's latch. A poor latch can lead to swallowing too much air, causing a build-up of wind⁸.

• Burp your baby mid-way and at the end of each feed to help get rid of excess wind^7,8.

• For bottle-fed and breastfed babies, try to keep them upright during feeds as this will reduce the amount of air that’s swallowed by your baby^4,6.

• For bottle-fed babies, make sure that the hole in the teat is the right size for the way your baby feeds. Babies who are sucking hard can swallow too much air and might benefit from a bigger teat size⁷. Read our article on newborn bottle feeding to see the types of teats available to help with colic.

• Holding your baby tightly, using a swaddling technique or giving skin‐to‐skin cuddles can provide lots of comfort whilst they’re crying^4,6,9.

• Gentle motion can have a calming effect (e.g., pushing a pram, rocking a crib or going for a drive)^4,8.

• ‘White noise' (e.g., a white noise machine, vacuum cleaner or hairdryer) can help to soothe a baby to sleep⁴.

• Having a warm bath can help your baby to relax^4,8. Splashing about with bubbles can also act as a helpful distraction technique.

• Gentle tummy massage when changing a nappy or getting ready for bed can aid digestion⁸. Avoid starting to massage whilst your baby is crying as they’re unlikely to want to be touched and this could lead to more tears.

• Try to quieten your surroundings; switch the TV off and dim the lights to create a calm atmosphere⁸.

• If you’re breastfeeding, it is not recommended to make changes to your diet. If you think your diet may be having an effect, you can always note down what you’re eating when your baby’s symptoms occur and discuss with your healthcare professional.⁴.

• Certain types of culture or friendly bacteria may have a role in easing baby colic symptoms in breast-fed babies. Recent research suggests they may help to reduce daily crying time in babies with colic¹⁰.

• If you’re formula feeding, speak to your health visitor, public health nurse or pharmacist about suitable specialist formulas designed for babies with colic.

What causes colic?

Baby colic is very common, however the cause remains unknown. It’s normal to worry about your baby when they’re persistently crying but remember that it’s not your fault and it doesn’t mean you can’t look after your baby. Colic can affect both breastfed and formula fed babies regardless of their gender or age¹¹.

Suggested causes of colic include:

• An underdeveloped digestive system. Your baby’s digestive system needs time to develop. In the early days, your little one might be finding it harder to digest breast milk or formula¹¹.

• Cows’ milk protein allergy or lactose intolerance¹¹. This can be difficult to diagnose, and you’ll need support from your GP, health visitor or dietitian before making any dietary changes if you’re breastfeeding.

• Imbalance of gut bacteria. As adults, we have lots of friendly bacteria living in our gut to help breakdown foods we eat. As a baby’s digestive system is still maturing, the gut bacteria are changing rapidly and may be out of balance. This corrects itself naturally as your baby grows¹¹.

• Excess wind. Colic can be worsened by your baby swallowing air whilst feeding. Ensure your baby is being fed in an upright position if bottle-fed, has an effective latch if breast-fed and is being regularly winded⁷.

• Exposure to tobacco smoke. If you smoked during pregnancy, or if you’re often around people that smoke, this could increase your baby's risk of colic¹¹.

At what age do babies get colic? How long does it last?

Colic usually appears within the first few weeks of a baby’s life and usually resolves by the time your baby is 4-6 months old^2,4. We know it does get better with age but the prospect of several months of persistent crying can be scary. It's important to get as much support for yourself as possible.

When to seek help

Parental instinct should always be listened to. If you’re worried about your baby, you should contact your health visitor, GP or public health nurse. They will assess whether there is anything wrong that is causing your baby to cry and will help to support you. It’s advised to always see a doctor if⁷:

• Your baby has a fever

• Your baby is vomiting more forcefully than usual

• Your baby has very runny or watery stools, or

• Your baby's pattern of crying changes suddenly.

Looking after yourself when your baby has colic

Coping with a crying baby isn’t easy and it can have a big impact on your emotional state. As difficult as it may feel in the moment, hold on to the fact that it will pass. In the meantime, it’s important to look after your own wellbeing. We’ve put together some top tips for self-care to support you through the challenges of baby colic:

• Ask family and friends for support wherever you can⁴. Asking for help does not make you a bad parent. Delegate jobs including cooking dinner or collecting older children from school to create a little extra time for you and your baby.

• Rest and recover when your baby is asleep⁴. Taking a shower or having a hot cup of tea on the sofa provide an opportunity for a much-needed short break.

• If you feel unable to cope with the crying, try putting your baby down in a safe place, such as their cot for a few minutes⁴. Practice some breathing techniques, to allow yourself some 'time out'.

• Ask your health visitor or doctor about support groups in your local area [4]. Shared experiences might give you some helpful techniques for coping.

• Support each other – a crying baby effects the whole family. Try to discuss the areas you’re finding hard as a family and come up with solutions as a team.

• Take your baby for a walk in the pram or a drive in the car. The fresh air will have a calming effect and the motion of the pram will hopefully send baby to sleep.