Colic: Symptoms, Diagnosis, & Tips

As parents, we get so much joy seeing our babies happy and content. It brings a smile to our faces and reduces our stress. When our baby cries, we quickly try to figure out what is wrong and fix it. Are they hungry? Do they need their diaper changed? Do they need to burp? Are they sleepy? But, what about those times when we go through our list of what they might need and your baby is still crying and nothing you do seems to help? 

Infantile colic is the main reason for up to 20% of all early visits made by parents and their babies to the pediatrician.(1) Parents explain to their doctor that their baby is crying for several hours and can’t seem to be soothed. The episodes of crying may happen at any time, however, most parents report the crying happens in the early evening hours.

The diagnosis of colic is based on excluding other specific illnesses or reasons for your baby’s crying. It is described as a vague diagnosis and doesn’t pinpoint the exact root cause which then makes it hard to have a clear treatment plan to remedy the colic. The pediatrician will evaluate to make sure the baby doesn't have an infection or injury like a fracture. They check fingers and toes to make sure there is no hair wrapped around creating a tourniquet which can be painful. Colic becomes the diagnosis when there seems no other obvious cause or explanation can be found for the baby’s crying episodes.

Doctors use the “rule of 3” for concluding a diagnosis of colic(2)

  1. Your baby cries for at least 3 hours per day
  2. The crying episodes happen more than 3 times per week
  3. This has continued for 3 weeks or longer and the baby is well-fed and otherwise healthy

Symptoms you may observe in your baby:

  • Crying in the evening hours
  • Clear start and stop of crying with no clear reason why they are crying
  • Baby pulls their legs into their belly
  • High pitched screaming/crying
  • Baby’s face appears flushed
  • Increased gas or burping from swallowing air while crying

Colic affects both boys and girls. Both formula-fed and breast milk-fed babies can have colic. It is reported to affect between 10-40% of all babies.(3) Colic begins around 2 weeks of age, peaks at 6 weeks of age, and seems to resolve by 6 months of age, rarely lasting until 12 months of age.(3) 

Although periods of inconsolable crying and fussiness with no apparent cause have been mentioned throughout history and in most cultures, it was not until 1954 that it was first formally recognized and written about.(4) Different cultures have passed down the lore of what causes colic and various remedies to treat it. 

Most explanations to parents about infant colic include that colic is just one extreme within the normal range of crying. There is research that points to gut health and infant migraine as the strongest potential explanations of a cause for infinite colic. Taking a deeper dive into studies conducted supports the idea of looking at the body as a whole rather than just the symptoms being presented as a way to get to the root of what may be causing your baby’s colic.

Gut health

The research

In a study with babies who had colic and babies in a control group without colic symptoms, there were differences found in gut bacteria. Stool samples of infants were tested for over 1,000 different types of bacteria. Less bifidobacteria was found in the samples of babies who had colic and more bacteria from the proteobacteria group of bacteria. Bifidobacteria is one of the main colonizers in the infant's gut helping to form the baby’s immune system and fight inflammation. Proteobacteria can produce more gas which could be a reason for babies experiencing colic that seems to be accompanied by painful gas or infrequent bowel movements. The researchers also found that babies with colic took longer for their guts to colonize with the “good” bacteria.(5)

What you can do

There is strong evidence for using probiotics for babies whose symptoms seem to fit the picture of gut health being the root cause of their colic. In particular, the strain lactobacillus reuteri was found to reduce the amount of time the baby as a result of colic.(6) Dietary changes need to be made by the lactating parent as well to improve gut function which will impact their milk and the baby's gut health.(7) Having the lactating parent take a probiotic like Lacta-Biotic, can support breast and gut health that gets passed on to the baby. Removing foods that cause sensitivity to the parent and infant along with adding in nutritionally dense foods is a good first step.

Infant migraine

The research

Babies are 2.5 times more likely to have colic if their mother suffered from migraines compared to mothers who did not. If the father had migraines, your baby is 2 times more likely to have colic.(8) Older children who experience migraines were more likely to have had colic when they were babies. Migraines are more common in people with GI symptoms like constipation and reflux. People with celiac disease or irritable bowel syndrome seem to experience migraines more often than people who do not experience GI disorders.(9)

What you can do

When migraine is suspected as the root cause of your baby’s colic, it can be helpful to dim the lights, keep noise to a minimum and reduce possible overstimulation during times of crying. Gentle rocking can help relax and regulate the nervous system, but more vigorous movement may aggregate symptoms. Because migraine is sometimes associated with GI symptoms, addressing gut health may hold a key ingredient to headache help and colic.

Other ways to help your baby with colic

The treatment for colic given by many practitioners is often a wait-it-out approach. It can be very stressful for you and your baby. Adopt ways to reduce stress and have some tools in your toolbox to help at the moment.

  • Learn infant massage - it is relaxing for you and your baby. Certain strokes can help relieve gas and constipation. 
  • Manual therapy like chiropractic care has been shown to reduce symptoms of colic. Gentle pediatric chiropractic manipulation helps balance out structural tension and asymmetry which helps the whole body work better.(10)
  • Bathtime - take a warm Epsom salt bath with your baby. Magnesium helps reduce inflammation and is relaxing, reducing stress and tension.
  • Homeopathic Carbo Vegetabilis for quick relief of gas and bloating
  • Hum to your baby - soft humming can be soothing to your baby and help keep your stress hormones from taking over.
  • Babywearing - babies who are carried and held more cry less.(11)

Colic doesn’t last forever. If you find you are needing help coping, reach out so you can get help reducing the stress that you are experiencing. It is important to talk with your IBCLC and healthcare team about the symptoms your baby has so you can work together to implement strategies to soothe your baby and address underlying issues improving your baby’s overall health now and in the future.

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Footnotes:

  1. https://pubmed.ncbi.nlm.nih.gov/21710185/
  2. https://www.aafp.org/afp/2004/0815/p735.html
  3. https://web.archive.org/web/20170826234735/http://www.aafp.org/afp/2015/1001/p577.html
  4. https://books.google.com/books?id=1CHFjG6fMasC&pg=PA5#v=onepage&q&f=false
  5. https://pediatrics.aappublications.org/content/131/2/e550.short
  6. https://pubmed.ncbi.nlm.nih.gov/24238101/
  7. https://pubmed.ncbi.nlm.nih.gov/21710185/
  8. https://americanmigrainefoundation.org/resource-library/migraine-colic-connection/
  9. https://www.mayoclinic.org/diseases-conditions/migraine-headache/expert-answers/migraines/faq-20058268
  10. https://pubmed.ncbi.nlm.nih.gov/32102827/
  11. https://pubmed.ncbi.nlm.nih.gov/3517799/

Other Resources:

https://www.aafp.org/afp/2004/0815/p735.html

https://www.livescience.com/26312-gut-bacteria-infant-colic.html

https://en.wikipedia.org/wiki/Baby_colic#History

https://wholistickids.com/wholistic-hack-defeat-colic-part-ii/

https://adc.bmj.com/content/archdischild/60/10/981.full.pdf

https://openpublichealthjournal.com/VOLUME/14/PAGE/168/FULLTEXT/

https://parentingscience.com/what-is-colic/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809021/

https://www.hindawi.com/journals/prm/2019/8307982/


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