Colic is a descriptive, subjective diagnosis : it only means that your young baby is crying excessively in the first few months of life. The crying could be associated with clenching of the fists, pulling up the legs and passage of a wind. It is a diagnosis of exclusion : colic can only be diagnosed by your doctor once other causes of crying in a young baby have been excluded. No quick answer over the phone, unfortunately. Your baby is not the only one, however : 25% of normal babies have colic.
Although there are theories surrounding the cause of colic, we actually don’t understand why it happens. Theories include :
- Temporary cow's milk protein allergy (some babies respond to maternal dairy exclusion if breastfed or to switching to an extensively hydrolysed formula like Pepticate if formula-fed)
- Temporary intolerance to a maternal diet containing cauliflower, cabbage, broccoli, bok choy, brussels sprouts, onion or chocolate (if breastfed)
- Excessive gas in the bowel (fermentation due to bacterial overgrowth in the colon/ inability to effectively pass winds)
- Temporary lactose intolerance (some colic medications contain lactase, which breaks down lactose)
- Dysbiosis (the theory that different types of bacteria populating the young gut may lead to inflammation, poor digestion, excessive gas production or neuro-behavioral problems). The probiotic strain Lactobacillus Reuteri DSM 17938 has shown promise in the prevention of colic.
- Incorrect feeding technique (underfeeding, overfeeding or infrequent burping)
- Psychosocial and neurodevelopmental theories : Missing the warmth, sounds and body orientation inside the womb environment/struggling to adapt to the external environment, parental anxiety and depression (in part due to parental disillusionment on how a baby should behave), prevalence of a parental rearing belief that they may "spoil" the baby if not allowed to self-soothe. Some babies just want to be wrapped close (even skin-to-skin) to mom. White (background) noise can help soothe a baby.
There is no solid medical treatment available that consistently alleviates crying in all babies with colic. My experience has taught me :
- Looking for the perfect colic mixture is probably a wild-goose chase. The evidence for their efficacy and real-world experience in their abililty to decrease crying time is not convincing. If you do however choose a colic drop/mixture, try one which contains fennel, chamomile or lemon balm (try Spasmopep Junior or Colic Calm) - there are at least some evidence for these ingredients.
- Don't discount the role of alternative approaches like chiropractic therapy (or even acupuncture!)
- Antispasmodics (like Buscopan/Scopex/Hyospasmol) allmost never makes a difference
- Antacids (like Infant Gaviscon or Nexiam) is overprescribed and current literature does not support their widespread use in the crying baby
The cloud has a silver lining though : One can rest assured that it is a temporary phenomenon – babies with colic stop crying between 3 and 4 months of age.
1. Tu Mai MD, et al. Infantile colic : New insights into an old problem. Gastroenterology Clinics of North America 2018; 47:829-844.