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Diagnosis: Colic - [Pregnancy & Newborn Magazine, January 2013]

Diagnosis: Colic - [Pregnancy & Newborn Magazine, January 2013]

January 15,2013 10:43am

How to identify—and survive—your baby’s chronic crying condition.

BY RACHEL REIFF ELLIS
 
Babies cry. As a mom of three, I can attest to that fact. However, when my third baby was about 5 weeks old, my husband and I began to notice that his daily demeanor was taking a turn for the worse. He would fuss pretty consistently in the evening hours, even after we changed him, or fed him, or rocked him in an attempt to get him to go to sleep. And it became next to impossible to put him down —ever. But I remembered that my other kids had gone through a similar patch of unhappiness in their second months, and so I chalked it up to new baby malaise, expecting it to last a week or so and then dissipate like it had with the first two.
But instead of getting better, it got worse. One week of crying turned into two, and then two turned into three, and finally after a solid month of escalating inconsolable crying jags that lasted for several hours every day, I finally conceded to the miserable fact: My baby had colic.
 
Crying by any other name
Looking back, I’m surprised I didn’t figure it out sooner, but the truth is, I hesitated to call the problem colic because I didn’t understand exactly what colic was. How was I supposed to determine when the problem had moved from normal fussy baby behavior to an abnormal condition? Robert Sears, MD, a well-known pediatrician and author in the Sears Parenting Library, who has written and spoken extensively about colic, helps parents get some answers to this frustrating and all-too-common problem. He explains: “There is no real official definition [for colic]. Some doctors use the ‘rule of threes’: crying more than three hours a day, for at least three days a week, lasting more than three weeks. But there is no actual
research that supports this definition. The way I see it, babies are supposed to be happy. They should feed, burp, spit up a little, cry for brief periods for a legitimate reason (like diaper changes, dressing, overly tired, hungry), sleep, and have awake periods where they coo and goo and look at mom and dad. They should not cry nonstop for hours and hours.”
If your baby can’t be calmed for long stretches of time on a consistent basis, chances are, you’re looking at colic. Even if your baby isn’t meeting the “criteria” for colic but you sense something isn’t right, it’s reason enough to see your pediatrician. “Parents have an intuition that something is wrong, [that] their baby is hurting,” says Sears. “Don’t let a doctor tell you nothing’s wrong, and that babies are supposed to cry like that.”
 
Making a list, checking it twice
As irrational as I knew it was, there was part of me that worried we were causing the problem somehow. Or worse, that there was something serious lurking inside making him hurt. We craved answers—or at least a direction that might lead to an explanation—so to the pediatrician we went.
According to Sears, if you bring your baby into your healthcare provider with questions about colic, he or she will want to examine your baby thoroughly to check for any obvious signs of pain. “[The doctor will look for] ear infection (usually the baby would have cold symptoms), fever, throat infection, mouth sores, insect bites, scratched eye (eye will likely be red), hair tourniquet (a piece of long hair wrapped tightly around a finger or toe), broken bone (look for swelling and pain), hernia (swelling of the scrotum) or severe diaper rash. Constipation and bladder infection may also be causes of painful crying.” If baby gets the all clear for these, the next stop in colic troubleshooting is the digestive system.
The most common culprit of intestinal issues in infants involves intake of dairy or other food allergens, which cause excessive gas and other tummy discomfort. “There are three primary causes that I see in my office: cow’s milk protein allergy (from cow’s milk formula or from cow’s milk proteins in a breastfeeding mom’s diet), Transient Lactase Deficiency (TLD, a form of temporary lactose intolerance in which baby can’t properly digest milk sugar), and other food allergies through a breastfeeding mom’s diet,” reports Sears. The way to determine if a substance is aggravating your little one’s system is to remove it from the scene —whether eliminating it from a breastfeeding mom’s diet or switching to a soy-based
formula—and see what happens. If there is no change, your doctor may suggest an over-the-counter treatment of lactase digestive enzymes that breaks down milk sugars in breast milk or formula. “These two steps cover the most common causes of colicky symptoms. If breastfed babies don’t show improvement within another week, I’ll have mom remove other colicky foods from her diet, such as gluten, soy, nuts, eggs and corn.”
 
Mind over matter
The chance that I could potentially solve the problem by changing my diet was a motivator for me, and I started by happily tossing all my dairy products out the window. I was told it would take a week at most to see a change, and so when the crying had not abated by day two, I still held out hope. By day five, my optimism started flagging. After seven days of no
change, I drowned my sorrows in a bowl of mint chocolate chip and began feeling a real despair.
At this point it felt as though we had tried everything, including drops to relieve gas, probiotics for me and for him to aid digestion, an antacid prescription in case of reflux, an earlier bedtime to preempt overtiredness, a later bedtime when that didn’t work, babywearing for closeness, “colic holding” to put gentle pressure on his belly, stroller walking to change the scenery, porch swinging for a constant motion, music for distraction, pacifiers for sucking comfort, teething tablets and acetaminophen in case of gum pain, constant nursing to combat
hunger, spaced out nursing in case of overfeeding, bathing for water therapy … the list of our attempts was long. And I was tired.
Also, I was sad. I was sad that all anyone was getting to see of my sweet boy was a scrunched up red face and a look of unhappiness. I worried that no one would want to be around him. Babies are dubbed “good” when they are smiley, quiet, docile. Did that mean my baby was “bad”?
And the crying was taking a toll on me too. More than once I had to lay him down and leave the room, to give my frazzled nerves (and ears) a break from the noise and shed a few tears of my own. Dealing with my baby’s colic was an unrelenting slog, and I was close to coming unhinged.
 
Coming out of the dark
What I know now is that those emotions are completely normal, and it’s important for parents to recognize that dealing with colic is a legitimately stressful experience. “Realize that you may not be able to do this alone,” counsels Sears. “Get some relief from friends and family; let them take baby for an hour or two while you get out of the house—and out of earshot. Set up a relief schedule so you have some time to look forward to.” Don’t beat yourself up over things like a messy house or unanswered emails. Your baby’s wellbeing is important,
and so is yours. Most of all, keep reminding yourself that this is just a phase, and it will come to an end.
We never did receive a definitive diagnosis or figure out a magical solution for our baby’s unhappiness. One day, right around the 3-month mark, he simply stopped crying. Now at 7 months, he is easygoing and happy —a joy to be around. It may be impossible to imagine in the thick of those colicky weeks or months, but it’s true: Colic won’t last forever. So hang in there. Call in reserves. Take a reprieve. Take a nap. And know that better days are just around the bend. P&N
 

What a colicky baby looks like?

  • Spends hours crying as if in pain
  • Pulls up legs, squirms and grunts
  • Passes gas excessively
  • Is unable to be consoled

 

Did you know? 

Colic typically begins around week three and can continue through 4 months of age. Rarely, infants can continue to be colicky through 7 or 8 months.

 

COLIC VS. ACID REFLUX

Many parents wonder if their baby’s colic is actually acid reflux. “Acid reflux involves stomach contents (milk and acid) coming up into the throat, causing painful burning, and spitting up. Colic is irritation down lower in the digestive system—intestines and colon,” reports Sears. An infant with reflux will spit up a lot, fuss more upon lying down, have trouble sleeping due to pain, and find relief from symptoms when held upright. Colicky babies tend to have an easier time sleeping and continue to cry despite their position.
“The causes of reflux and colic can be similar, however,” explains Sears. “So it isn’t always necessary to distinguish between the two. Any baby who has colic symptoms, reflux symptoms, or both, can go through the same treatment options.”
 

Soothing strategies

Priscilla Dunstan, author of Calm the Crying: The Secret Baby Language That Reveals the Hidden Meaning Behind an Infant’s Cry
shares her tips for identifying a colicky cry and for comforting a hurting infant.
 
  • When babies are suffering from colic, you will tend to hear the phonetic sound “eairh” within their cry. This is a forceful cry that can come on rapidly and is often present in the early evening. You will also notice that the baby’s stomach is hard and body is rigid and difficult to hold. When this sound is heard, it’s best to concentrate on holds that help to relieve gas and offer comfort to the stomach area.
  • Try to keep your baby upright as much as possible, and burp your baby whenever he needs it—not just after a feed—especially if the crying regularly starts in the evening or afternoon.
  • When the crying is excessive, relieve gas buildup by using a high over the shoulder hold where baby’s tummy is held high up and pressed against your shoulder.
  • Use the over-the-knee rocking method when it gets to be too much and you need to tune out to recover your patience and sanity. This is as simple as placing your baby over your crossed knee, with his stomach pushed against the top knee and your hand gently rubbing his back.
  • Try a warm bath to soothe and relax your baby. Add in some lower back baby massage to enhance the effect.


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