Infantile colic
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Infantile colic

Also listed as: Colic - infantile

Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Treatment Options
Following Up
Special Considerations
Supporting Research
  

Colicky babies cry constantly and hard at about the same time each day at least 3 days a week, but they are otherwise healthy. Often, nothing you do seems to help them feel better. Although colic can be upsetting for both you and your baby, it won’t last too long. It usually begins at about 2 weeks of age and goes away by the fourth month. About one in five babies develops colic.

Signs and Symptoms

All babies get fussy sometimes, but not all have colic. It may be colic if

  • Your baby cries for more than 3 hours on at least three occasions a week over the course of at least 3 weeks, but is otherwise healthy.
  • Your baby kicks a lot, pulls his legs up close, and makes tight fists.
  • Your baby's tummy seems hard, and the baby burps and passes gas often.
  • The crying sounds like your baby is in great pain.
  • Your baby spits up frequently after feeding.

What Causes It?

Babies with colic often look like their stomach hurts, and some stop crying after they pass gas or have a bowel movement. But no one knows what actually causes colic. Possible causes include one or more of the following:

  • The baby's nervous or digestive system may be immature.
  • The baby needs comforting, or is over- or under-stimulated.
  • The baby swallows air, especially when feeding.
  • The baby may be reacting to something in the mother's diet (if the baby is breastfed).
  • The baby has allergies to some foods, such as milk (if the baby is on formula).

What to Expect at Your Provider's Office

The health care provider will ask if your baby is eating well and gaining weight or has diarrhea, fever, or unusual stools. If you are breastfeeding, the health care provider may ask about foods you have eaten. If the doctor thinks your baby has colic, you can work together to find ways to make your baby feel better.

The health care provider will also encourage you to take care of yourself, like taking a break or getting help if you are afraid you will harm your baby. Remember that colic usually disappears between 4 - 6 months of age. If the treatments you choose do not work, your child's pediatrician may check for other problems, such as a digestive problem or allergy.

Treatment Options

  • If breastfeeding, nurse whenever your baby seems hungry, usually every 2 - 3 hours. Try avoiding caffeine, dairy products, citrus fruits, soy products, broccoli, cauliflower, cabbage, and spicy foods. Elevate your infant's head during and after feedings.
  • If bottle-feeding, ask your baby's pediatrician to recommend a formula that is not based on cow's milk and that is not iron-fortified. Keep the baby in a sitting position when feeding, and massage her back to get rid of gas bubbles. Burp after every ounce or two of formula.
  • Try the "colic carry" -- Place your baby, chest down, on your extended forearm, with his head supported by your hand and his legs on either side of your elbow. Use your other hand to provide additional support and walk around with the baby.
  • Hold your baby close, offer a pacifier, try rocking or rubbing your baby’s back or stomach, give your baby a warm bath, take a car ride with the baby, play soft music, or use an infant swing to ease the crying.

Drug Therapies

No drugs are recommended, although simethicone (Mylicon), an over-the-counter gas remedy, may be helpful for some babies.

Complementary and Alternative Therapies

Eliminating foods that cause gas and using supportive herbal or homeopathic therapies may help your baby’s colic. In some cases, colic may be caused by a hidden food allergy and you may need to switch formula or food. A qualified natural health care provider can help you find nutritious hypo-allergenic foods for your child. If you are breastfeeding, eliminating foods that may cause gas or allergies from your diet may help. In addition, playing soft music, rocking your baby, or using "white noise" (for example, a dryer or even a vacuum cleaner) may help soothe your infant. Placing your baby in a dim, quiet room may help calm the baby. Use alternative therapies only under the supervision of a trained health care provider, and always keep your baby's pediatrician informed of any dietary changes or therapies you may be considering. If you are using any supplements for your infant, make sure they are from a trusted source and a brand the doctor is familiar with.

Nutrition and Supplements

Probiotics -- Some research suggests that these “friendly bacteria” may help reduce symptoms of colic, although more study is needed to know for sure. Acidophilus (especially Bifidus spp.) can be given to both a breastfeeding mother and a bottlefed baby. For a baby, make sure you use acidophilus formulas specifically formulated for infants; do not use adult formulas. Some acidophilus products may need refrigeration. Read the label carefully and follow the directions, and talk to your baby's pediatrician.

Herbs

Herbs are a way to strengthen and tone the body's systems, although many herbs that may be safe for adults may NOT be suitable for infants. As with any therapy, you should work with the baby's health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas) or glycerites (glycerine extracts). Because of the alcohol content, do not give tinctures (alcohol extracts) to infants unless directed by your health care provider.

Never give any herbs to an infant unless your pediatrician tells you to.

  • Fennel (Foeniculum vulgare) tea is a traditional remedy for colic, and some research suggests that fennel tea may help reduce colic symptoms. A breastfeeding mother can drink it. Fennel helps relax the gastrointestinal tract and get rid of gas.
  • Slipper elm (Ulmus fulva) helps soothe the digestive system and can be used as a tea. You can also combine the powdered bark with water and make a slippery elm "gruel," similar in texture to instant oatmeal. Check with your child's pediatrician first before using slippery elm gruel in your child's diet.
  • Teas and liquids made from chamomile (Matricaria recutita), fennel (Foeniculum vulgare), and lemon balm (Melissa officinalis) may also help. Some people can be allergic to chamomile. Some supplement manufacturers will make products specially formulated for infants with these herbs. Ask your child's pediatrician to determine the right dose for your child. Do not give these herbs to your child on your own.
  • Other herbs that may help calm the baby or reduce gas include linden (Tilia cordata), catnip (Nepeta cataria), peppermint (Mentha piperita), and dill (Anethum graveolens). They can be combined with the teas above. Ask your child's pediatrician to determine the right does for your child. Do not give these herbs to your child on your own.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. However, a professional homeopath may recommend one or more of the following treatments for infantile colic based on their knowledge and clinical experience.

Viburcol, a proprietary homeopathic medicine often used in Europe, can be very effective for acute colic. It contains Chamomilla, Belladonna, Dulcamara, Plantago major, Pulsatilla, and Calcium carbonicum Hahnemanni.

  • Aethusa -- for infants who cannot digest milk, who vomit, and have diarrhea.
  • Belladonna -- for colic with spasms that come and go quickly. The abdomen may feel warm to the touch and symptoms may coincide with constipation. Bending forward may relieve pain.
  • Bryonia -- for pain worsened by movement and pressure. This remedy is most appropriate for irritable infants who lie still with knees drawn up.
  • Carbo vegetabilis -- for colic with a distended abdomen and burping or belching. The face may be pale, and hands and feet feel cold.
  • Chamomilla -- for excessively irritable and screaming infants who are relieved by constant holding and rocking. Infants for whom this remedy is appropriate are often teething and have green, foul-smelling diarrhea.
  • Colocynthis -- for restless, irritable infants whose symptoms of colic are relieved by firm pressure. In these infants, diarrhea and pain may occur after eating fruit. Infant tends to bring knees up to their abdomen.
  • Lycopodium -- for infants who cannot stand pressure on the abdomen (even diapers must be worn loosely). Symptoms tend to worsen between 4 and 8 p.m., and then again after midnight.
  • Magnesia phos -- for infants whose symptoms of colic are relieved with gentle pressure or warmth applied to the abdomen, or while they are bent over. Belching does not relieve pain.
  • Natrum phos -- for colic with no other distinguishing symptoms.
  • Nux vomica -- for colic that occurs when a breastfeeding mother eats rich food, drinks alcohol, or coffee. The infant may arch its back and appear angry.
  • Pulsatilla -- for infants with bloated abdomens after eating, and constipation alternating with diarrhea. May be aggravated by warm rooms, heat, or if the diet of the breastfeeding mother includes fruits, fats, pastries, or ice cream. Relieved by rocking.

Chiropractic

Although there is only preliminary scientific evidence that chiropractic may lessen crying in colicky babies, chiropractors frequently treat colic with a form of gentle spinal manipulation specially modified for infants. Usually treatment lasts three to four visits over a period of 2 weeks.

Physical Medicine

Warm baths may help relax and soothe colicky infants. Add three to four drops of essential oil of lavender or lemon balm to the water. Take great care not to get undiluted essential oils on the skin or in the eyes, mouth, or nose.

Gently squeezing the acupressure point between the baby’s thumb and finger (on the webbing) may help to calm a fussy child.

Massage

Rubbing your baby’s abdomen may help him feel better and get rid of gas.

Following Up

Use whatever is safe and works, and remember that your baby will outgrow the colic in a few weeks or months. If you need a break, ask someone you trust to watch your baby for a little while.

Special Considerations

Never shake your baby. This can cause serious or fatal brain damage. If you are feeling overwhelmed, try the following steps:

  • Have someone else watch your baby while you get away for a while.
  • Join a support group.
  • Call your baby's health care provider.

Supporting Research

Alexandrovich I, Rakovitskaya O, Kolmo E, et al. The effect of fennel (Foeniculum vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med. 2003;9:58-61.

Crotteau CA, Wright ST, Eglash A. Clinical inquiries. What is the best treatment for infants with colic? J Fam Pract. 2006;55(7):634-6.

Ernst E. Chiropractic spinal manipulation for infant colic: a systematic review of randomised clinical trials. Int J Clin Pract. 2009 Sep;63(9):1351-3.

Gupta SK. Update on infantile colic and management options. Curr Opin Investig Drugs. 2007;8(11):921-6.

Herman M, Le A. The crying infant. Emerg Med Clin North Am. 2007;25(4):1137-59, vii.

Howard CR, Lanphear N, Lanphear BP, Eberly S, Lawrence RA. Parental responses to infant crying and colic: the effect on breastfeeding duration. Breastfeed Med. 2006;1(3):146-55.

Klein K, Stevens R. The clinical use of probiotics for young children. J Fam Health Care. 2008;18(2):66-8. Review.

Landgren K, Kvorning N, Hallström I. Feeding, stooling and sleeping patterns in infants with colic--a randomized controlled trial of minimal acupuncture.BMC Complement Altern Med. 2011;11:93.

Landgren K, Kvorning N, Hallström I. Acupuncture reduces crying in infants with infantile colic: a randomised, controlled, blind clinical study. Acupunct Med. 2010;28(4):174-9.

Perry R, Hunt K, Ernst E. Nutritional supplements and other complementary medicines for infantile colic: a systematic review. [Review]. Pediatrics. 2011;127(4):720-33. 

Pina DI, Llach XB, Arino-Armengol B, Iglesias VV. Prevalence and dietetic management of mild gastrointestinal disorders in milk-fed infants. World J Gastroenterol. 2008;14(2):248-54.

Rosen LD, Bukutu C, Le C, Shamseer L, Vohra S. Complementary, holistic, and integrative medicine: colic. Pediatr Rev. 2007;28(10):381-5.

Savino F. Focus on infantile colic.A cta Paediatr. 2007;96(9):1259-64.

Savino F, Cordisco L, Tarasco V, Locatelli E, Di Gioia D, Oggero R, Matteuzzi D. Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants. BMC Microbiol. 2011;11:157. 

Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, Roos S, Matteuzzi D. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics. 2010;126(3):e526-33. 

Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officialis (ColiMil) in the treatment of breast-fed colicky infants. Phytother Res. 2005;19:335-40.

Savino F, Tarasco V. New treatments for infant colic. [Review]. Curr Opin Pediatr. 2010;22(6):791-7.

Shergill-Bonner R. Infantile colic: practicalities of management, including dietary aspects. J Fam Health Care.2010;20(6):206-9.

Skjeie H, Skonnord T, Fetveit A, Brekke M. A pilot study of ST36 acupuncture for infantile colic. Acupunct Med. 2011;29(2):103-7.

Wade S. Infantile colic. Clin Evid. 2006;(15):439-47.

Wiberg KR, Wiberg JM. A retrospective study of chiropractic treatment of 276 Danish infants with infantile colic. J Manipulative Physiol Ther. 2010;33(7):536-41.

Zwart P, Vellema-Goud MG, Brand PL. Characteristics of infants admitted to hospital for persistent colic, and comparison with healthy infants. Acta Paediatr. 2007;96(3):401-5.


Review Date: 4/4/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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