Colic: what is it?

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In one recent Australian study 60% of parents reported that their babies had suffered from colic. The fact that it is so common is little consolation for parents faced with a baby who is crying, fussing, irritable for no apparent reason, and who cannot be settled. It is very distressing for parents and other family members, and often exasperating for doctors and nurses as well.

There have been scores of articles and research reports published over the years, yet still little is known about the cause of colic or what to do about it.

Cause

The vast majority of babies have no clearly recognisable cause for their difficult behaviour.

There are many opinions about what causes colic, ranging from medical conditions in the baby to maternal anxiety.

Recent research confirms what some authors have been saying for many years – there is no such thing as colic. Repeated studies suggest that infant crying and fussing is a normal part of development and that it gets better with time, whatever you do.

Crying has been blamed on:

• feeding techniques – too little or too much milk, or milk given in the wrong way
• emotional problems in the mother
• a difficult temperament in the baby
• too much wind, though this has never been proven to cause crying. It is more likely that ‘wind’ is the result rather than the cause of crying – crying causes the baby to swallow air.

Some of the medical reasons given include:

• gastrointestinal (gastroesophageal reflux, excess gas)
• infections (ear or urinary tract)
• hernias (inguinal, umbilical)
• nerves (irritable nervous system, neurological immaturity)
• allergy (mother’s diet, cow’s milk given to baby)
• nappy rash and other sources of irritation.

It is probable that a very small proportion of babies who are said to have colic suffer from an identifiable medical problem. However, the common ‘diagnoses’ of too much wind or milk allergy are made far too frequently, with very little evidence that they represent real conditions in this age group.

Younger babies cry because of their temperament, sleeping cycles, and feeding patterns (‘expressive crying’). Later, the crying and fussing is more likely to be about something in their environment, or a way of communicating with carers.

Stressed or anxious parents do not cause crying and fussing, but can make it worse. It is perfectly natural for mothers and fathers to worry about their baby’s crying. You might manage to cope with it, knowing it is a phase that the baby is going through and that it will pass. Or you might worry that a crying baby means you are a bad parent. Crying is very common in infants and it has little or nothing to do with how good you are at parenting. The most confident, calm and competent parents will also have babies who cry all the time.

What are the symptoms?

If you have a baby, you probably know the symptoms: crying and fussing. At some stage after your baby arrives home – sometimes a few days, sometimes a few weeks – the crying starts.

Your baby is restless, irritable, and does not seem to settle into anything resembling a predictable routine of sleeping and feeding; on the contrary it is the unpredictability which many parents find so difficult. Your baby may feed hungrily, but soon after a feed seems to be hungry again. Some babies do not feed well, often fighting the breast or bottle. They may spend long periods fussing or grizzling, but may also scream loudly. During this crying period they may draw their legs up, as if suffering from pain. It is very difficult to settle or console them. The crying and fussing may seem to go on for hours, and is often worse in the evening.

Studies show that the normal baby cries and fusses on average for almost three hours a day (and some for a good deal longer than this). The crying reaches a peak at about six weeks of age, and then gradually lessens as the baby gets older. Most of this crying and fussing seems to take place in the late afternoon and evening, although there is considerable variation from day to day. As babies get older and their crying becomes more communicative, it is more likely to be spread throughout the day.

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