Updated: Oct 13, 2021
It’s 8 pm and your little one has been fussing and crying for the past 3 hours. Your little one is screaming like she’s in pain and you have tried everything to calm her down but nothing is working. If this sounds familiar then it is possible that your little one is suffering from colic.
No one really knows what is causing it but it is defined as extreme periods of fussiness and crying for at least 3 hours, more than 3 times a week, and for longer than 3 weeks. Episodes of Colic are often described as the so-called ‘witching hour’ as the periods of extreme fussiness and crying often start in the late afternoon/early evening.
Colic usually starts around 2 weeks after birth and the crying peaks at around 6 weeks of age. Then around 3 months it just stops just like an off switch. It is interesting to note that premature babies don’t usually get colic before their due date. Also, colic does not discriminate between bottle-fed or breastfed babies and affects about 20% of all babies.
It is important to note that colic is not to be confused with reflux. Colic and reflux are often mentioned together but it is important to note that colic is not caused by reflux. Reflux is a medical condition and thus requires a medical diagnosis by your doctor and can usually be treated with medication. Despite what numerous marketing campaigns would have you believe, colic can not be cured with medication.
What causes colic?
Even though no one really knows what truly causes colic there are some theories as to what makes your little one so upset.
Some doctors believe that colicky babies suffer from tummy pains caused by gas, constipation, food sensitivities, or allergies.
Immature nervous system
Others believe that the baby’s immature nervous system is to blame for colic and that babies are simply overwhelmed by all of the new sights, sounds, and smells.
Again others believe that your baby’s sensitive or passionate temperament is to blame for the fussiness.
While these possible causes of colic sound quite plausible the problem with those theories is that all of them fail to explain why the extreme fussy periods only start a couple of weeks after birth and usually stop by 3 months of age.
What really causes colic and the absence of colic in some cultures
According to Dr. Harvey Karp, the true reason for colic is the missing fourth trimester. He states that babies are born 3 months too early and truly seek the calming environment of the womb for the first 3 months of life. Karp notes your baby sleeps a lot the first 2 weeks of life to deal with the new environment and tends to get overwhelmed as she starts to wake up more to the world. This would explain why colic often starts from 2 weeks of age and stops around 3 months.
It also explains how colic is absent in some cultures where infants are usually carried and nursed 24/7. In those cultures, the womb-like environment is replicated in the outside world. Karp further states that the reason why not all babies get colic is that most babies ‘have mild temperaments and good self-calming abilities, which help them handle being born too soon’.
Strategies to help calm your colicky newborn
Even though colic cannot be treated with medication there are strategies you can apply to help you cope. And if we are to believe that the true cause of colic is in fact the missing fourth trimester the most straightforward solution in dealing with colic is to mimic the womb-like environment as much as possible. Not only will these strategies help with the crying they will also help you in settling your baby to sleep as colicky babies often struggle with sleep.
The 5 S’s
Swaddle baby tightly in the torso area, ensuring to leave enough room for the hips. This makes them feel calm and helps to reduce their arms and legs flailing around. Some babies will fight the swaddling but this does not mean that your baby doesn't like to be swaddled. Your baby is fighting it because they cannot control their flailing arms. Swaddling alone is often not enough to calm down your baby but it will be enough for them to pay attention to the next S.
Putting your baby on their side can turn on the calming reflex as it makes them feel like being back in the womb and avoids setting off the moro reflex (falling reflex, switched on when your baby is startled). Very important to move your baby on their backs when they are ready to sleep.
Shushing is so effective in calming down your baby because it mimics the sounds of the womb which is a very noisy place. Shush next to your baby’s ear and ensure it is louder than the baby’s crying. Never shush directly into your baby’s ear and ensure that you match the volume of the shushing to your baby’s cry. Once your baby starts to calm down, lower the volume of the shushing.
Swaying also mimics the sensation of the womb and in order to calm your screaming baby the motion will have to be quite vigorous at first (fast, tiny jiggles) and once your baby starts to calm down gentle swaying from side to side will be sufficient. Best to do this while your baby is positioned on their side in your arms.
The last of the 5 S's is sucking and is the cherry on top of calming your crying baby and helps to keep the calming reflex turned on. You can use a dummy, bottle or mum's breast if breastfeeding.
Strategies to help YOU cope
According to Dr. Weissbluth, ‘depression, anxiety, exhaustion, and relationship problems are likely consequences when your baby has colic', so it is very important to also look after your mental health. Reach out to friends and family to ask for help, whether that is coming over to hold the baby, cooking dinner, cleaning, or just having a chat.
Try taking a relaxing bath with your baby and incorporate baby massage into your bedtime routine. Further try to create a relaxing atmosphere in your home as much as possible in the early evening when colic episodes usually start (dim the lights, turn off electronic devices, turn on white noise, avoid stimulating activities).
Sometimes trying to get your colicky baby to stop crying at all costs can make the crying spells worse so try to avoid taking your little one out into the bright lounge room and vigorously bouncing them around. Instead, try using the 5 S to calm your baby. Also, try to avoid tag teaming (passing baby from one parent to the other constantly) as much as possible as this can further stimulate your newborn. Best to only switch parents if one of you desperately needs a break.
Lastly and most importantly don’t be afraid to put your little one in a safe place and walk away for a few minutes so you can compose yourself (shower, a cup of tea, screaming into a pillow). Listening to your little one cry for hours on end can be mentally draining and exhausting and sometimes walking away for a few minutes is necessary for you to calm down yourself.
Also if you are a breastfeeding mother it might be a good idea to have your partner give your newborn baby a bottle of expressed milk or formula at least once every 24 hours so you can get a break and catch up on lost sleep.
Overtiredness is often mistaken for colic
True colic starts around 2 weeks of age and stops at around 3 months of age and is often accompanied by difficulty settling to sleep. An overtired baby can easily be mistaken for a colicky baby as they get more and more upset as the day drags on. By late afternoon overtired babies just can’t take it anymore and will often be quite upset, hence why they are often labelled as colicky babies.
It is important to watch out for your little one’s tired signs (eye rubbing, bored or distant look, grizzling, jerky arms, and legs, etc.) and watch those awake windows to ensure your baby does not get overtired. However a baby suffering from colic will cry and fuss regardless of how tired they are.
How to deal with sleep issues after colic?
According to Dr. Weissbluth ‘post-colic children are more likely to develop a difficult temperament, shorter sleep times and frequent night wakings’. So what can you do to help your baby sleep better once colic is gone?
It is important to start weaning your baby off the sleep associations created (walking, rocking, feeding to sleep) and teach your little one to self-settle. There are lots of different strategies to help you do this and there is a settling strategy that will match your parenting philosophy and more importantly your child’s temperament. Establishing a good nap routine, early bedtime, and extensive wind-down ritual will also help in improving your baby’s sleep.
Watch out for your baby’s tired signs and start the wind-down ritual at the first sign of tiredness to avoid overtiredness. It is important to remember however that it is only a problem if it is a problem for you. If you are happy to continue rocking or feeding your baby to sleep, you can continue doing so. Just know that these strategies can stop working as your baby gets older.
It is not your fault!
The most important thing to remember is that it is not your fault. In the words of Dr. Martin Stein, “colicky infants are born, not made.”
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Karp, H, 2015, The Happiest Baby on the Block, Bantam Books, New York
Weissbluth, M, 2003, Healthy Sleep Habits, Happy Child, A step-by-step programme for a good night’s sleep, Ballantine, USA