Gassy Babies?

My wife’s nephew Jordan had colic bad.  In his first months of life he cried non-stop, only quieting in his swing.  His mom was so frazzled from fatigue and frustration that when my wife offered to babysit for a weekend,  she ran far and fast.

My wife soon discovered that the swing had a wind-up motor (there were no electric swings in those days) that lasted 20 minutes.  That weekend she lived her sister’s life of sleeping in 20 minute increments.  She would wind up the spring, Jordan would sleep while rocking, and she would sleep too.  But when that spring wound down and Jordan creaked to a halt, he would snuffle, then squirm, then begin wailing.  My wife would wake up, roll over to the edge of the bed, crank up the spring, and both would go back to sleep for another brief spell.  Being awakened every 20 minutes for one night is bad enough, but imagine a whole weekend.  Or a whole month.

Living with a colicky baby can be miserable and frustrating.  Colic is a phenomenon where baby in the first months of life cries a lot, for no apparent reason.  Babies feed well and grow, they are not sick with coughs or fevers, they poop and pee normally, yet they cry as if in pain.  Colic usually starts in the first few weeks of life, peeks at about one month old, and then slowly goes away.  Babies often start crying in the afternoon, cry all evening, and fall asleep sometime after midnight.  Some babies, like Jordan, cry around the clock.

It’s almost easier to say what colic isn’t, rather than what it is.  Colic looks like gas pain, with babies cramping and pulling up their legs.  But no baby has yet been able to report to us: “Yes, this is gas pain I’m having.”  It isn’t problems with digesting formula; changing formulas seldom makes it better.  It isn’t constipation; baby’s pooping pattern doesn’t relate to the pain.  It isn’t reflux; spitting up doesn’t correlate with pain either, and reflux medication rarely helps.

One thing colic certainly is, is stressful.  Parents worry that something is wrong, and frustrated about how to stop it.  They are sleep-deprived, worse than the usual new parent.  This makes some parents angry: at baby, at the world, at the helpless doctor with few answers.

It’s a common worry for the pediatrician: Parents bring their baby in with a problem like colic, where baby cries and is unhappy.  We listen carefully to their story, we examine baby head-to-toe, looking for clues to why baby is hurting.  When we exhaust the other possibilities- ear infections, diaper rashes, thrush- we diagnose colic.  We tell the parents about colic, what to expect, and what to do about it.  Then comes the parental reaction we all fear, “That’s it doc?  That’s all you got?”

A lot of pediatrics is like that- having to disappoint parents.  Colic, like cold viruses in babies, doesn’t have any snappy answers, any tests that say “Aha, this is it!”  There is no shazam medicine, no miracle antibiotic, that will make baby quit crying.  Many medicines have been tried.  Mylicon, which is essentially baby Gas-X, some swear by.  There are other remedies like deewee, gripe water, chamomile. Science hasn’t shown any of these work.  Like we said above, reflux medicine hasn’t been shown to help either.  The only medicine that may help is Tylenol.

What does help?  First, breast feeding.  Breast fed babies statistically have less chance of colic, and if they do have colic it’s less miserable than that of formula-fed babies. Second, basic baby comfort things like a pacifier or swaddling can help.  The most reliable way to stop colicky crying is a car ride. Something about the vibration and white-noise of the engine makes fussy babies calm.  You can simulate this at home- put baby in a swing with a white-noise maker going, or the vacuum or a fan.

However, if baby is crying with other symptoms- fever, cough, worsening feeding, rash, call your doctor.  Inconsolably crying babies with other symptoms may have more concerning illnesses.  But if baby is feeding well, gaining weight, and well in every other way, then it’s into the car!  Good thing gas is cheap right now.

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