Colic: When Your Baby Goes Postal

What do you do when your baby cries inconsolably for hours on end? Assuming your pediatrician has determined that the baby is healthy, the answer depends on your baby’s age. In the first three months of life, incessant crying may be colic.

What is colic? Believe it or not, we still are not sure what colic is, although it has been plaguing mankind for centuries. In Medieval times people speculated that colicky babies were possessed. Today, we speculate that these babies may have an immature digestive system. It seems that the pain these babies seem to be experiencing may be related to processing food, but the mechanism is not clear. Gastroesophageal reflux (or spitting up), which is present to some degree in all babies under three months of age, may contribute to colic. This would explain why colic seems to magically disappear around the age of three months.

Most parents go through a mental checklist when their baby starts to cry. Is he hungry again? Maybe he is wet. Did he poop? Is he sick? In pain? Lonely? Bored? The parent then dutifully applies a potential solution to each of these possibilities. The colicky infant may suck vigorously ―sometimes desperately―when offered food but then arch his back and pull off the nipple of the breast or bottle. He may even cry more during feeding. Burping, rocking, changing the diaper, singing, and pacing back and forth may not console him. Motion may help the colicky baby somewhat. Somewhere, right now, there is a desperate parent driving a screaming baby around in the car, hoping for a miracle of silence.

My daughter was colicky as an infant, and I remember walking up and down the streets of our neighborhood constantly. The tires of our stroller actually became bald. We strolled at all hours of the night—that is, until a neighbor complained that he almost ran us over in his car since we had no lights. And what was I doing walking a baby outdoors in the cold in the pitch dark? Any parent with a colicky baby would understand.

Many parents decide that the baby cannot tolerate the formula or that the baby is reacting to dairy or soy that the mother is ingesting. A mother may eliminate all dairy and soy from her diet or switch the baby’s formula again and again, usually with no scientific basis for doing so. If the baby is allergic to cow’s milk protein, then an elemental formula such as Nutramigen or an elimination of dairy by the mother may make sense, but usually these babies have blood and mucus in their stool. What about lactose intolerance? Primary lactose intolerance from birth is extremely rare. Secondary, or acquired lactose intolerance, usually is seen at a much older age or occurs after prolonged diarrhea (usually two weeks or more). If your pediatrician recommends a change in diet or formula, then by all means do so, but following a neighbor’s recommendation is not wise. And it probably will not stop the crying.

Mylicon drops (Simethicone), gripe water (natural herbs), and countless other potions have been tried for colic, usually to no avail. If it works for your baby, then good. (Of course always check with your pediatrician before giving your baby any product—even if it’s marketed as “natural” or sold over the counter.) However, the brightest breakthrough on the horizon is the use of a certain specific probiotic or “good bacteria.” A recent, good, controlled study suggested that a probiotic was better than placebo in relieving colic. So there may be help on the horizon. Until this is widely available, go for a long drive, get a good stroller, or hire a babysitter.

Have you had a baby with colic? What worked for you?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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