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.

Babies That Go Waaah in the Night

My wife tells the story of how two of her nephews screamed non-stop for their whole first year of life.  Her sister and her husband were getting so crazy that she offered to watch the kids for a weekend so they could get a break.  My wife only half-believed that babies could cry that much but sure enough, the only time those babies didn’t cry all weekend was when they took a bottle, or were in the swing.  And in those days of wind-up swings, the spring only kept them rocking for twenty minutes before needing rewinding.  Thus at night no one got more than twenty minutes of sleep at a time!

All babies cry.  Occasionally a baby is brought to us in Emergency because the baby is crying too much and parents want to know why.  More importantly, they want it to stop.  They are ready to tear their hair out with frustration because they have been to their pediatrician several times, have tried several treatments, and baby still cries all night.  Often that means baby has colic.

Colic is a common baby problem- almost one-fifth of all babies have it.  These are babies who cry for more than 3 hours per day for more than 3 weeks, in the first 3 months of life.  Often they cry most in the evening.  That much crying can make parents crazy with worry and frustration, listening to the screaming and not being able to comfort baby.  Sometimes parents get so worked up that they are afraid they might hurt baby to stop the crying.

Pediatricians try some easy fixes early on.  They may advise that formula-fed babies change formulas, in case of milk intolerance.  They may give medicines for gastric reflux, if they think that heart burn from reflux is the reason for pain.  Sometimes these things work, but for colic they don’t. 

One of the most frustrating things about colic is that in this day and age of cancer cures and antibiotics and MRIs, science still is not sure what colic is or what to do about it.  It seems like a gas problem when babies cry and cramp up, pull up their legs, grunt, and pass gas.  However, anti-gas medicines don’t help much.  There is some research in intestinal bacteria and probiotic treatment, but this is very preliminary.  People try all sorts of alternative medicines like fennel tea, chiropractic manipulation, herbal medicines, but none of that seems to help much either.

Here is what we do know to help.  Breast feeding makes colic less common.  Swaddling baby in a blanket, rocking them, and pacifiers seems to help.  The ultimate way to calm a fussy baby is still a car ride in the car seat.  Swings and white-noise makers (like fans, clothes dryers, and purpose-made white noise makers) also often calm colicky babies. 

If baby is really driving you nuts and you think you might hurt baby- get help!  Get a neighbor or relative to watch baby for a while so you can calm down.  If you can’t do that, put baby in a safe place (baby bed, buckled into a car seat or swing) and get out of hearing range to calm down.  Letting baby cry won’t hurt them or give them a “complex.”  Heck, you haven’t been able to stop the crying anyway, so why not give yourself a break?  As my mom said, she had no baby-crying problem that wasn’t fixed by two closed doors between me and her.  And me and my brothers seemed to have turned out okay (but that is just our own opinion- others may differ). 

As always, call your pediatrician before going to Emergency for crying.  Most crying is not an emergency and your doctor can help you decide if it is.  Do you have a colic story or cure?  If so, send me a comment.  You might know something about colic that science doesn’t!