It's 5 pm and like clockwork, your baby starts to cry and no amount of bouncing, rocking, or singing can calm the storm... What is happening?
This was my daily drama for nearly 2 months with my first baby... I would watch the clock with increasing dread, tearfully willing my husband to come home ASAP. Here's what to know about colic:
What is colic?
While crying is a normal part of a baby's wake cycle, colic refers to prolonged crying and/or fussing for no apparent reason in infants under the age of 3 months. The quality of the crying may differ from other crying (ex. when hungry) and may be louder and more high-pitched. While no consistent cause has been agreed upon, most pediatricians agree that it's likely a combination of gastrointestinal (digestive difficulty, food intolerance, acid reflux, gas) and psychosocial (overly stimulated or tired, variations in routine) factors. It usually follows the "rules of three": crying in an otherwise healthy and well-fed infant for 3 hours or more, occurring on at least 3 days a week, and persisting for 3 weeks or more.
When does it start and more importantly, when does it end?
The good news is that this is a self-resolving phase. Parents typically notice colicky behavior starting around age 3 weeks. There is often a sudden onset and end to the period of fussiness and crying which generally cluster during early evening hours. Most are at their peak fussiness by age 6 weeks and most observe resolution of such behavior by 3-4 months of age.
What should you do?
As always, check for the obvious reasons that your baby might be uncomfortable: hunger, soiled diaper, prolonged laying in one position, or fever/illness. Some specific considerations include:
Any changes in what the baby is feeding (breastmilk vs. formula)?
Sometimes transition from breastmilk to formula or vice versa can lead to mild transient abdominal discomfort leading to a fussier behavior for a day or two.
Any changes in the mother's diet if she's breastfeeding?
What the mother eats can affect her baby as the food proteins make their way into her breastmilk. If you notice that your baby seems fussy after you eat a certain food, it would be reasonable to take a break from that food for 3-4 days and then try again. If your baby displays similar fussiness again, your baby may have some sensitivity to the food you are eating and abstaining from that food for 2-3 weeks would be advised. Some foods are also more gas-producing (ex. beans, broccoli, cauliflower, and cabbage) which can affect your baby's level of gassiness if you're consuming them in large amounts. Some babies may be sensitive to maternal dairy intake or even develop milk protein colitis. The latter often presents with mucous and/or blood in the stool, caused by inflammation of the intestines by the milk protein. If you notice blood in your baby's diaper, please contact your pediatrician.
Any arching/stiffening of the body during or following feeding?
Some babies experience acid reflux which can be quite painful as it is for adults. These babies often start feeding normally only to start experiencing pain due to regurgitation of the stomach acid during feeding. This leads to frequent de-latching from the breast or bottle, arching or stiffening of their backs, and crying. It helps to offer smaller volumes of milk more frequently as this overall decreases the abdominal pressure leading to acid being pushed back up. Try to keep your baby upright after feeding for at least 15 minutes to allow the milk to pass through to the intestines faster. If your baby seems to be in severe pain and/or do not seem to improve with the above measures, please contact your pediatrician to discuss further interventions.
Any changes in the day's routine/schedule?
The first few weeks are often filled with well-wishing visitors wanting to get a glimpse of the baby. While we encourage you to share these special moments with your loved ones, it's usually best to keep your day's schedule simple without too many visitors or errands squeezed into one day. Babies can become overly stimulated and have a difficult time settling down which can lead to more crying. It's not harmful for your baby to be overly stimulated time to time but frequent jam-packed days can increase your baby's (and your) overall stress level.
Any fever? Any changes in baby's feeding and urination?
A fever in a newborn up to age 6 weeks is considered a medical emergency and should be evaluated right away. If your baby has not been feeding well and not urinating adequately (at least 6 wet diapers/day), then this behavior may also indicate possible illness and you should contact your pediatrician.
How can you soothe a colicky baby?
Any condition that mimics the womb (tight, warm, swaying) will be calming to your baby. Here are some examples:
Swaddling
Swing, car ride, or rocking
White noise or music
Pacifier to suck
Placing the baby on his tummy (but always put him on his back when asleep)
It's perfectly safe to try an over the counter anti-gas/colic medication such as simethicone (brand names Mylicon, Little Tummies) or gripe water (a homeopathic remedy) which can soothe an upset stomach or gassiness. It doesn't help all but some of our parents swear by them!
Keep in mind…
All infants cry more during the first three months of life than at any other time - some just more than others. How much your baby cries is NOT a reflection of your parenting skills or capabilities! It WILL get better!
Crying typically lasts for two hours at two weeks of age, peaks to three hours by six weeks, and gradually decreases to about one hour at 3 months.
Take turns with your spouse/partner in calming the baby. It can be physically and emotionally trying for sleep-deprived parents to hear so much crying - everyone needs a break.
If you are frustrated or angry, place your baby in a safe place and take a break for 15 minutes or call for help from family, friends, or your pediatrician.
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