Understanding ColicJune 16, 2014June 9, 2016
Dealing with a colicky infant can be the most frustrating and anxious period of parenthood. The joy and elation of your newborn’s arrival is suddenly replaced by suffering, sleeplessness and even panic. Many parents feel powerless to control or even alleviate baby’s incessant shrieking as if in agony. Feeding, comforting, back rubs, pacing the floor with baby clutched in your arms for hours on end, nothing seems to work. Like the pain of childbirth it is an experience most mother’s would rather forget.
Symptoms of Colic
Infant colic is not a disease but rather a condition characterized by a collection of symptoms. There is no specific test for colic but rather it is the symptoms themselves that indicate a colic diagnosis:
- Baby cries vigorously for long periods, despite efforts to console
- Symptoms manifest around 2 to 4 weeks of age, peak around 2 months and subsides after 3 to 4 months
- Episodes begin and end abruptly around the same of time of day, often after meal times in the late afternoon or evening
- Baby shows signs of gas discomfort and abdominal bloating. Colic symptoms often disappear shortly after a bowel movement or passing gas.
- Baby writhes while crying as if in pain. You may notice that the knees are pulled up to the chest, clenched fists, flailing arms and legs or an arched back.
- Baby shows signs of "pushing" or "straining" as if during a bowel movement. The face may flush or turn red.
- Baby demonstrates irritability, fussiness and difficulty falling asleep
In 1954, a renowned pediatrician named Morris Wessel introduced the modern definition for colic as an "otherwise healthy baby who has paroxysms (i.e. outbursts) of crying, irritability and fussiness lasting for more than three hours per day, more than three days per weeks for a period of three months". This definition is sometimes referred to as the "rule of threes" and is used by pediatricians to this day. Colic is very common affecting roughly a quarter of all babies born in the United States but since babies may experience partial symptoms or express colic symptoms to different degrees it is hard to determine an exact percentage.
It is important to distinguish between a "high-needs" babies who may be very fussy but don’t meet the strict Wessel definition of colic. Another difference is that high needs babies are fussy by temperament whereas a baby with colic appears to be genuinely in pain. High needs babies respond well to consolation and parental attention whereas colicky babies do not. To compare your child’s symptoms to the observations of other parents take our brief symptom survey.
In most cases infant colic resolves itself naturally within 3-4 months but for many parents that can seem like an eternity. In rare cases colic has been known to last for as long as 12 months. Colic is unlikely to cause the child any lasting harmful effects but there are exceptions. The National Center on Shaken Baby Syndrome (NCSBS) estimates that nearly 90% of SBS and abusive head trauma cases are triggered by inconsolable crying which are often the result of colic. While there is never an excuse for shaking a child the seemingly endless wailing can certainly take a toll on the frayed nerves of parents and siblings. Many of our customers swore they would not have even considered having more children had it not been for their discovery of Colic Calm while others assert it saved their marriage.
While there is no scientifically proven cause for colic most experts point to gastrointestinal discomfort as the likely trigger. In fact the word colic is derived from the ancient Greek word pronounced "kōlon" meaning intestine. If babies could talk and tell us the precise location and nature of their discomfort the medical community would have a much more definitive understanding this condition. There are at least nine theories proposed to explain the source of colic, but because colic has no precisely defined cause, but rather is a collection of different symptoms, it is quite likely that colic may be due to different factors in different babies. A multi-causal explanation also makes sense because colic symptoms often manifest in different ways in different babies.
Theory of Colic
1. Trapped Intestinal Gas Due to Immature Digestion
Gas, which is a natural by-product of digestion, can become trapped and baby’s immature digestive system is unable to cope.
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)
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
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)
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.*Colic Calm is not intended to treat the underlying cause of TLD.
5. Food Allergy
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
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
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
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
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.
The most frustrating aspect of colic is the apparently inconsolable nature of baby’s discomfort. While parents often feel helpless, there are steps that may provide you and your baby with comfort and help boost everyone’s sleep. You can not only alleviate your babies suffering but also limit the duration of colic by following some of these tips below but because every baby is different and causes may vary, not every tip will work. Some trial and error is required.
- Keep a Colic Diary: By documenting your babies colic episodes you may be able to help yourself and your pediatrician anticipate episodes and even pinpoint the cause. A colic diary should contain a record such as the time of day the episodes started and their duration, sleeping and eating patterns, what soothing strategies you’ve already tried and their effect, the sound of baby’s cry, your baby’s behavior, body posture during episodes and smell and color of stool and urine.
- Gripe Water: For over a hundred years, gripe water has been a trusted remedy for colic used by pediatricians, nannies and millions of parents all over the world. The best quality of gripe water should be FDA listed for safety and efficacy, contain all-natural ingredients and be manufactured according to strict FDA regulations for good manufacturing practices (GMP) for homeopathic medicines. Colic Calm® is the only gripe water that meets this high standard, and it works quickly; usually within five minutes or less, providing safe and effective relief with no side effects. Many parents simply describe Colic Calm as the miracle medicine.
- The Colic Hold: – The colic hold uses gravity to apply gentle pressure to your baby’s abdomen. This may help baby expel gasses and increase motility in the gut. Carry baby face down with baby’s tummy resting on your forearm, baby’s legs straddling your elbow and baby’s chin resting in your hand. You can give baby a gentle back rub for additional pressure. A similar result can also be achieved by putting baby face down on your leg, whilst you are seated. Alternately try the neck nestle; where baby’s head is placed in the groove between chin and chest and lean back slightly whilst holding baby upright to place gentle pressure on the tummy area.
- Herbal Tea – Lukewarm herbal teas are an old "folk remedy" for colic. There is some evidence that fennel tea in particular may help.
- Sound: Background sounds from the womb can be simulated using a white noise from a hair dryer, vacuum cleaner, tumble dryer, radio static or shushing.
- Music: Recorded lullabies or just singing to your baby may work at least by distracting baby’s attention from discomfort, not to mention soothing the frayed nerves of mom and dad.
- Motion: A gentle rocking, vibrating motion or slow dance can soothe an upset baby. You can hold baby in your arm, a cradle, swing or even take baby for a car ride. You can also sit on an exercise ball to create the bouncing motion many babies love.
- Probiotics – Babies treated with a special type of oral probiotic available for infants, such as Lactobacillus reuteri have been shown in studies to have reduced crying episodes when compared to a placebo group.
- Massage – A gentle stomach massage has been known to help some babies relieve the digestive discomfort associated with colic and to improve the motility of trapped gas.
- Cuddling, Swaddling and Holding: Keeping your baby close in your arms, swaddled in a blanket or in a sling may help calm your fussy baby. This creates a warm and confined environment more like the womb.
- Simethicone: – This drug it referred by some doctors as a remedy for gas. While simethicone is relatively safe there is also no evidence that it actually works any better than a placebo and studies have actually shown it to be completely ineffective.
- A Warm Bath – May relax baby especially if combined with aromatherapy (such as with scented soap or bath oils).
- Pacifiers – Can help baby calm down by triggering the sucking reflex.
- Increase Frequency of Feedings – Shorter and more frequent feeding may help placate your baby if hunger is a factor in the fussiness and the sucking reflex certainly has a calming effect on infants. Be careful not to overfeed as this could actually worsen symptoms. If breastfeeding empty one breast completely before switch sides as the hindmilk has less lactose which could trigger increased gassiness.
Try keeping a colic tips checklist like the one below to determine what worked best for your baby and discuss with your child’s pediatrician or health care provider.
* Disclaimer: The information on this website is not a substitute for professional medical care for the prevention, diagnosis, or treatment of your child’s condition. Please consult with your child’s doctor or pharmacist before trying any medication (prescription or OTC) or following any treatment plan mentioned. This information is provided only to help you be as informed as possible about your child’s condition. You should consult your child’s physician if you are concerned about symptoms as your doctor may be able to identify or exclude certain causes of your child’s discomfort.
What Parents Are Saying
“WHAT A FABULOUS PRODUCT!!!!!!!!!! I tried the gripe water in the stores and it was ok but still didn’t settle my little girl very much. I was a little hesitant to buy Colic Calm because it was a little costly for me and I had never heard of it before. I really like homeopathic solutions compared to all the meds they try to give babies for this and that so…. I tried it and guess what it worked wonderfully. I bought 2 bottles of it and ended up giving the other bottle to a friend of mine since her baby was so colicky… she couldn’t believe how awesome it worked. She had tried everything on her little girl also and after many months of sleepless nights was able to get the baby settled! Thanks again! Cost doesn’t matter when you know there is something good out there that is a natural remedy for a fussy baby!!! Many many thanks. Kelly and friend!!”
“From the first night at the hospital, I could tell my baby was gassy. He fussed only when he had gas, and he didn’t sleep at all that first night (and neither did I). I started him on Mylicon with every meal as soon as we got home, and it helped only a bit. At 2 weeks the reflux symptoms showed up. I could tell my baby was in such pain as he arched away screaming. There is nothing more heartbreaking than knowing that what you’re giving your baby is hurting him physically! We went to the doctor and started from the beginning. Burped often, fed on an incline, kept upright for 30 minutes after eating, given tummy massages several times daily and doing bicycle legs. Then no dairy. Then no beans, acidic foods, soda pop, broccoli, etc. Then Zantac. Then Prevacid. Prevacid finally gave him some relief from the top end. But solving the heartburn was only part of the problem.”
Still, with every nap he would wake up screaming hunching over and straining. We would pick him up and hold him with pressure on his tummy while he cried for a good 20 minutes in pain. Suddenly, with one big release of gas he would go limp, falling immediately back to sleep. Evening spells of crying were common as well, and while I didn’t want to pin "colic" on my child, he definitely had colic-like crying spells. Additionally, feedings were still a struggle even without the heartburn to deal with. It was as if once the milk hit his stomach and got things moving, it immediately cramped up. We rarely made it through a feeding without crying – from the both of us.
When I happened upon your website (baby was 6 weeks at this point) and read the testimonials, I had NO doubt in my mind that your product was my answer. I could hardly wait the 2 days for it to arrive in the mail. From the time that bottle has arrived, we have not had a single unsuccessful feeding or an inconsolable crying spell. My sweet baby has been able to focus on the things around him instead of constantly struggling to fight with the gas blocking his digestive system. He has become happier and more social, as well as more aware of his surroundings. He wakes up in the morning cooing and happy, rather than screaming in pain. I could not ask for anything more.
Finally, I know that some people have mentioned the cost of the Colic Calm as a little steep, but brand name Mylicon is $10 per for a 1 oz bottle and can’t hold a candle to your product. Thank you thank you thank you, Colic Calm. I’ve recommended you to everyone I know, and I owe you endlessly for my baby’s comfort and my sanity.
“This stuff is amazing! My son has had horrible colic/reflux since a few days after his birth. It seemed like all he did was cry (me too!). Cry because he was hungry, then cry because his belly hurt, then cry because it all came back up, then cry because his belly was empty and he was hungry again! And then what little he managed to keep down made him so gassy you could literally feel his little bowels rolling. You truly don’t know a broken heart until your tiny baby looks at you screaming with pain, with tears rolling down his little face hoping you’ll help, and you can’t do anything. The doctors were worried because he wasn’t gaining weight (not from lack of food, but lack of keeping it down!) They ran all kinds of tests and tried several medicines to no avail. Fortunately I found Colic Calm online and we ordered a bottle to try, hoping for a miracle. Within a few minutes of the first dose he stopped screaming and was actually smiling as he drifted off to sleep. And now a few weeks later he’s packing on the weight like he was supposed to! This stuff works miracles! THANK YOU, THANK YOU, THANK YOU!!! “
“This product is wonderful! It is the only thing that helps my daughter. I found it when she had bad colic when under a year old, and it worked better than any product for her gas. Within minutes of a dose she is relieved. She is now 2 and we still use it, she even asks me for it by name when she tells me "tummy hurts, need colic calm mommy". It has also helped my husband. Will continue to buy this wonderful product. It may cost a little more than the kind in the store but it is well worth every penny.”
“Our son was born premature at 28 weeks and had bowel troubles from day 1. We were told it was normal for preemies to have gas, irritable bowels, spitting problems, reflux and much more. He started reflux medicine after 1 mo. of life, at the recommendation of the pediatrician. The medicine seemed to help slightly, but I was determined to find a better "natural" solution once we took him home from the hospital. I finally found "Colic Calm" and I am so grateful I tried it. After just one dose our son’s disposition changed and he barely spit up. I started giving him "Colic Calm" daily and what a difference! Hardly any gas, reflux was gone completely and minimal spitting up. I have since told many friends about your product and ALL have had success with "Colic Calm." We just had our second child and ordered "Colic Calm" again so we have it ready when we need it.”
“I was very skeptical at first and was convinced that I was probably going to have the baby it didn’t work on. I had tried other gripe remedies before, but nothing had worked. But being desperate with a colicky baby, you’ll try anything new. I gave it a shot, and I was so happy it worked! It works so well on my baby that within minutes of administering it to him when he is fussy, he is happy and feels better! This stuff is the best! I recommend it to all; this stuff is a miracle!”
“My grandson has been suffering with hiccups and pain while nursing. My daughter was at my house last night and was so upset. I frantically googled infant reflux. I clicked the first thing. Your site came up. I put my finger on the CVS "sticker", we could try this. It was 8:30. I raced across town to get to CVS by 9. There were 4 products on the shelf. I grabbed them all and started reading the ingredients. One by one I set them back on the shelf. They all had something I didnt like in them. I cant even give a reason why, just instinct. Your box was left in my hand. I went over and over the ingredient list. I liked that it was made in the USA. For the price, it was twice what the others cost. I didn’t care, just to mention to others. My daughter took it home.”
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“Oh my Goodness this product is absolutely FANTASTIC. I was a bit leery of trying it out just because you never know what is real and what isn’t but my husband and I were desperate. Our son was diagnosed with acid reflux at 4 months old and he was put on zantac for it. It helped with his spit up but not the pain. He was just in so much pain it got to the point where he associated his bottle with pain and it was a struggle to get him to eat. There were occasions where we had to syringe feed him just so he reached his once requirement. I ordered this product and what a HUGE difference I give it to him before feeding him and he sucks his bottle right down and the pain has subsided. THANK YOU colic calm you have made this household so much more pleasant.”
- Paroxysmal fussing in infancy, sometimes called "colic." – Wessel MA, et al. Pediatrics. 1954; 14:421-435
- Colic Solved – Bryan Vartabedian, M.D.
- Jordan B, et al. Effect of anti-reflux medication, placebo and infant mental health intervention on persistent crying: a randomized clinical trial. – J Paed Ch Health 2006;42:49-58
- Moore DJ, et al. Double-blind placebo-controlled trial of omeprazole in irritable infants with gastroesophageal reflux. – J Pediatrics 2003;143:219-23 CrossRef
- Simethicone in the Treatment of Infant Colic: A Randomized, Placebo-Controlled, Multicenter Trial Thomas J. Metcalf, Thomas G. Irons, Lawrence D. Sher, and Paul C. Young – Pediatrics 1994; 94:1 29-34
- The "Fourth Trimester": A Framework and Strategy for Understanding and Resolving Colic – Harvey Karp M.D. Contemporary Peds 2001; 21:92-114
- Carrying as Colic "Therapy": A Randomized Controlled Trial – Ronald G. Barr, Sara J. McMullan, Heinz Spiess, Denis G. Leduc, John Yaremko, Randy Barfield, T. Emmett Francoeur, Urs A. Hunziker
- Cow’s Milk Proteins Cause Infantile Colic in Breast-Fed Infants: A Double-Blind Crossover Study – Iréne Jakobsson, Tor Lindberg, PEDIATRICS Vol. 71 No. 2 February 1, 1983 pp. 268 -271
- Healthy Child Healthy World – Christopher Gavigan
- Smart Medicine for a Healthier Child – Janet Zand, N.D., L.Ac., Robert Roundtree, M.D., Rachel Walton, MSN, CRNP
- When Your Baby Won’t Stop Crying: A Parent’s Guide to Colic – Tonja H. Krautter, Psy.D., L.C.S.W.
- Understanding Your Child’s Health – Susan K. Schulman, M.D.
- The Fussy Baby Book: Parenting Your High-Need Child From Birth to Age Five – William Sears M.D., Martha Sears R.N.