Understanding Colic | 9 Causes and 14 Remedies

1. Trapped Intestinal Gas Due to Immature Digestion
Food and liquids are pushed through the gut by special muscles in a wave-like motion called peristalsis. The digestive system is regulated by a complex nervous system and babies nervous systems by definition are immature. Their digestions are literally learning to function.

Gas, which is a natural by-product of digestion, can become trapped and baby’s immature digestive system is unable to cope often causing baby to strain and cry.

When painful gas pressure builds up in the intestines it can also cause an intestinal blockage which in turn can cause baby to reflux. Hence some babies display the symptoms of reflux and gas in combination.

Colicky babies often display signs of intestinal bloating, a hard distended abdomen and signs of "pushing" or "straining" as if during a bowel movement.

Colic symptoms often disappear following a bowel movement or passing gas.

A baby’s gas discomfort can be relieved through natural gas relief remedies such as Colic Calm, tummy massages, more frequent burping and a variety of other techniques. See our section on infant gas relief for more information.

2. Gastroesophageal Reflux (GER)
In his book "Colic Solved", pediatrician Bryan Vartabedian postulates that undiagnosed infant reflux is the most common cause of colic. While almost all babies have a tendency to spit-up, not all babies are able to clear the acidic gastric juices that reflux. When acid remains in the unprotected esophagus it leads to heartburn pain and discomfort.

Dr. Vartabedian points to the similarities between colic symptoms and infant reflux and cites data points such as; 65% of 4-month olds of infants have GER, and nearly 70% of babies between 4 – 6 months of age spit up at least once per day.

However, other clinical studies suggest that reflux drugs have little or no beneficial effect on colic and that reflux is only a factor in a small minority of cases. According to Dr. Eric Hassall, a pediatric gastroenterologist at Sutter Pacific Medical Foundation; the results of at least four clinical trials now show that these drugs work no better than a placebo in treating infants with reflux.

There is a growing trend of treating infant colic with prescription reflux drugs such as PPIs and H2 antagonists that suppress the body’s production of stomach acid. Unfortunately synthetic reflux drugs have side effects because they disrupt the body’s natural digestive process. Stomach acid is essential for proper absorption of certain nutrients such as calcium, folic acid and vitamin B and it also helps protect the gut from infection.

Colic Calm is a natural and side effect free alternative to reflux drugs and unlike synthetic drugs does not require regular dosing. Colic Calm does provide quick symptom relief upon onset of reflux and can be kept on-hand and applied only upon symptom occurrence.

If baby suffers from reflux it is usually advisable to prop up the baby on an incline during sleeping and feeding as this may prevent spit-ups and reflux. Some parents use a specially designed wedge.

Visit our reflux page for more information about reflux.

3. Milk Protein Allergy
Casein and whey are the most abundant proteins in milk. When baby’s immune system reacts negatively to milk protein an irritation and inflammation of baby’s intestines may form. You may notice trace amounts of blood or stringy mucus in the diaper of an infant with this condition. Diarrhea, reflux, congestion or rashes are also possible symptoms of a milk protein allergy. Studies suggest up to 5% of babies have some form of milk protein allergy.

Increased quantities of gas and other forms of gastrointestinal discomfort from milk protein allergy are similar to the symptoms of colic.

Consult your pediatrician promptly if you suspect a milk protein allergy.

4. Transient Lactase Deficiency (TLD)
Despite the apparent similarity to milk protein allergy above, these are in fact completely different issues. Lactose is a sugar contained in all types of milk. The lactose intolerant baby is unable to produce sufficient quantities of the enzyme lactase required to break down and digest this sugar properly. Instead, bacteria in the gut feast on undigested lactose causing excess quantities of gas, bloating and even diarrhea.

Increased quantities of gas and other forms of gastrointestinal discomfort from lactose intolerance are similar to the symptoms of colic.

If baby is formula fed, a lactose free formula may help. Suggestions on our gas relief page may also help alleviate discomfort from gas.

5. Food Allergy
Some studies suggest that mother’s diet may affect her baby. Specific foods contain trace elements that can be passed to the baby through breast milk which, so the theory goes, create reactions in baby’s gut leading to colic. Foods in mom’s diet that have been linked to gassiness in baby include cow’s milk, cruciferous vegetables, beans, peas, acidic foods such as citrus fruits, coffee, strawberries and tomatoes and dairy products, soy and peanuts.

Likewise elements found in formula, such as cow’s milk proteins, may affect formula fed babies.

Increased quantities of gas and other forms of gastrointestinal discomfort from food sensitivities are similar to the symptoms of colic.

If breastfeeding, discontinue suspected foods in your diet to see if symptoms improve. If this happens, gradually reintroduce specific foods until symptoms return. In this way you can identify the culprit, if indeed food insensitivity is the cause.

Formula fed babies may switch to a hypoallergenic formula.

6. The Fourth Trimester Theory
In his book, "The Happiest Baby on the Block", pediatrician Dr. Harvey Karp proposes the missing fourth trimester theory to explain colic.

This theory states that colic is the result of baby’s immature nervous system being disturbed by the nerve signals occurring before a bowel movement known as the gastro-colic reflex. The GC reflex is an autonomic nervous function in the gut that triggers the intestines to begin working as food is processed through the stomach. In addition, Dr. Karp suggests that the absence of rich sensations available in the womb may be causing baby distress.

While Dr. Karp has received some high profile celebrity endorsements, there is limited direct scientific or clinical data to substantiate his theory.

It does appear that the "5 S" techniques work for some children but it does not necessarily follow that the 4th trimester theory is correct.

Dr. Harvey recommends the application of the 5 S’s be performed in combination to calm and sooth babies restlessness; swaddling (i.e. wrapping baby tightly in a swaddling blanket), side stomach position, shushing sounds, swinging, and sucking through the use of a pacifier. The steps are intended to reproduce the reassuring environment that baby experienced in the womb.

7. Immature Nervous System
Overstimulation can be triggered by too much activity, people or stimulation in the household. Other variants of this theory are that babies biorhythms have not yet established in early infancy, baby’s enteric nervous system is learning to function, or that baby is experiencing anxiety due to maternal separation.

While it is true that overstimulation can make a baby more fussy and colicky, there is not much evidence to support these theories as the underlying cause of colic.

A 1991 study concluded that mothers who were coached to carry their colicky baby’s and to be more "responsive" had no reduction in crying.

Since colic is by definition "inconsolable crying" efforts to console will not work.

If baby’s fussing is due to pain and not nervous anxiety then try the tips list at the end of this article.

8. Maternal Anxiety
The postpartum blues affects most new mothers to some degree. While it was believed in the past that colic was caused by a mothers emotional condition this theory is completely unfounded.

However, since babies are sensitive to their surroundings too much stimulation or emotional stress may aggravate baby’s colic if the condition is already present.

While a colicky baby is guaranteed to cause a mother to stress, there is no evidence whatsoever that colic is caused by a mother’s state of mind. Colic is not caused by bad parenting or baby somehow sensing emotions from either parent.

Colic will cause stress for the entire family and especially mom. Talk to a friend or family member and stay positive. Taking action such as the suggestions listed below can help overcome the feeling of frustration and helplessness. If possible try to share the load by enlisting a reliable caregiver such as a friend or family member.

9. Bacterial Imbalance
The importance of probiotics (beneficial bacteria) to the digestive process has been well known for over a century. Probiotics are known for their ability to inhibit toxic bacteria, supplement natural digestive enzymes and help process nutrients in food. Since babies are born with a clear and pristine gut, it takes them several months to accumulate adequate levels of these flora to aid in their digestion of milk and formula.

It is unclear if it is the absence of benevolent bacteria or the simply presence of bad bacteria that cause baby’s digestive discomfort. However, several studies show supplementation of probiotics (i.e. benevolent bacteria) can reduce the duration of colic in infants.

A University of Texas study also linked the Klebsiella bacteria to about half of the colicky babies in their sample.

Supplementing infants diet with probiotic drops, particularly Lactobacillus reuteri, indicated for infants may reduce colic symptoms if performed consistently over a period of several weeks.

Use of Colic Calm as needed should alleviate excess digestive discomfort during the period of multiple weeks that probiotics require to take effect.