The term colic has been used in various ways by people over the years. Our definition of colic is a condition in which babies, usually less than four months of age, have periods of unexplained, extreme fussiness, but are normal in every other way. Typically, a regular pattern of crying develops in babies with colic. The attacks of fussiness usually occur between the hours of 3:00 p.m. and midnight, when both the infant and parents are most likely to be fatigued.  The attacks are characterized by sudden outbursts of loud and more or less continuous crying. The baby is usually sucking on its fist, wanting to eat every 15 to 30 minutes, passing gas, drawing its legs up to the abdomen, flailing the arms and legs about and turning red in the face. The infant however, is fine in between these episodes of crying. Parents are usually convinced that the baby has a stomach ache or even worse that something is dreadfully wrong with the infant.

The cause for colic is not well understood. Many people assume that the baby is experiencing cramping abdominal pain because the infant is pulling its knees up to its chest. However, babies will demonstrate this same pattern of movement with crying to anything in their environment that upsets them, such as being stuck with a safety pin or being startled by a loud noise. For these reasons, colic is probably a much more complex issue than simple abdominal pain. Possibly, colic is a response of the infant to a constellation of factors, including a baby’s natural temperament (their personality), adjustments to feeding, adjustments to the external environment, fatigue, perceived stress of the parents, possible formula intolerance, and/or other factors. It may be a developmental phase in which the infant becomes more aware and awake. With a problem as poorly understood as colic, you can imagine the treatment is quite varied. In the past, sedatives have been used extensively such as tincture of opium (paregoric) and even ethyl alcohol. We do not recommend these because they are dangerous to the infant.

Colic is a condition that the infant will outgrow, usually by the age of four months (thank goodness). Infants with colic will develop normally and will have no long-lasting psychological or personality defects. The following approaches may be helpful in treating your child with colic.

  1. Check your baby to make sure there is no obvious reason for the crying. This should be done with baby completely undressed. If there is nothing physically wrong, make sure your baby is well fed, adequately burped and appropriately dressed, including a clean, dry diaper. Your infant should have a normal temperature with nothing obviously hurting him.
  2. If the baby is breast fed, you should consider any recent changes in your diet which might be affecting your baby. For both breast fed and bottle fed infants, attempts at frequent burping may have dramatic effects in decreasing the symptoms of colic. If your baby is bottle fed, try changing the type of bottle to a Dr. Brown bottle. Sometimes formula intolerance or food allergy is the cause of colic. You should discuss this with us at the time of an office visit to evaluate this possibility.  Sometimes switching formula from a milk-based product to either a soy-based formula or even a hydrolysate formula is needed. An example of a soy formula is Prosobee. An example of a hydrolysate formula is Nutramigen LGG. Hydrolysate formulas contain a cow milk protein called casein which has been predigested, or broken up into smaller pieces. These smaller protein pieces are more easily digested and are small enough that the body can not make antibodies against them (an allergic reaction). As a first step, you might try Gentlease to see if this helps. Although not hydrolysate formulas, these are gentle on the tummy. Please see the section on allergies for a discussion of this topic. Even more pre-digested formulas based on amino acids are available. Please know that we view infant formulas as medications and something that you should change only on our direct advice. Please call the office prior to changing your baby’s formula.
  3. Simethicone drops (Mylicon) are sometimes helpful in decreasing the amount of gas in the stomach. The dose is one dropperful (0.6 ml) every six hours.  Again, the most effective way of decreasing intestinal gas, however, is adequate burping and this should always be done.
  4. Swaddle the baby. Your baby should be wrapped snugly in a blanket and possibly rocked for several minutes. If your child continues to cry, then place the baby in the crib and leave him or her alone for several minutes. Almost always in a little time your infant will fall asleep and get the rest that he needs. Holding, patting, rocking, jiggling and moving about a baby who is straining, screaming and crying only bruises them, making the muscles sore which intensifies the crying further.
  5. If the above measures are not helpful and your infant continues to scream, it is possible that your child has another problem besides colic. He or she should be brought to the office for an appointment. Unusual screaming which is inconsolable and persists for more than two hours should prompt a call to our office.
Reviewed 3/16/17 by Dr. Byrum