Your newborn is bound to cry. Crying is the only way for your baby to communicate with you and to grab your attention every time he/she is hungry, sleepy, bored, feeling too warm or cold, wants someone to play with, is wet and needs a diaper change, and for every other reason possible.
Most infants cry anywhere between 1 to 3 hours every day but if your infant is crying excessively, it could bring distress to you and other members of your family. Excessive crying can be due to an underlying cause and your baby might require a check-up.
Colic (Excessive Crying) in Infants
Colic, also known as infantile colic or baby colic, is the medical term used to describe infants who cry excessively for no known reasons, especially during the first three months of their life. It is basically high-pitched crying that occurs in sets or patterns of ‘3s’ - 3 or more hours of crying a day, 3 or more days a week, for 3 or more weeks. Colic is observed either in early mornings, in late afternoons, or early evenings.
The causes of colic are varied and differ from infant to infant. What is making your baby cry excessively might not be the cause of colic in other infants around you.
As a new parent, understanding colic can help you deal with it better and keep you assured that your infant is doing just fine.
Causes of Colic
Interestingly, the word colic has been associated with your baby’s gut (stomach or digestive health). Colic can be due to causes related to your gastrointestinal tract or not related to it.
The gastrointestinal tract (also called the GI tract) is a series of organs starting from your baby’s mouth to the anus that facilitates digestion and absorption of your baby’s food. The other organs that make up your baby’s GI tract are the esophagus (the muscular tube that connects the mouth and the stomach), stomach, small intestine, and large intestine. Gastrointestinal-related factors are those associated with common digestive tract problems.
Gastrointestinal Causes of Colic
Remember that your infant’s gut is immature and sensitive. It can react to certain substances in breast milk (also known as mother's milk, which is the milk produced by mammary glands located in the breast of a human female) or formula milk (top feed).
Milk allergies and lactose intolerance are the most common gastrointestinal causes of colic.
Milk allergies can cause abdominal pain and diarrhea (a condition in which your baby passes loose and watery stools) in your baby. If your baby can’t tolerate cow’s milk and responds to a change in formula, he/she is most likely to have a milk allergy.
Lactose is the only sugar present in milk and milk products. Lactose intolerance is a disorder in which your baby cannot digest lactose, hence, is intolerant to lactose. This can cause discomfort, bouts of acidity, and diarrhea, and result in colic.
Studies have shown that about 40% of babies who are medically diagnosed with colic suffer from lactose intolerance, and this condition is known as “colic associated with lactose intolerance”.
Non-gastrointestinal Causes of Colic
These factors relate to the mother, baby, and environment.
Factors related to the mother include her age, educational background, smoking, alcohol consumption, stress and anxiety, and following poor feeding techniques.
Studies have proved smoking during pregnancy to be a risk factor for colic.
Poor feeding techniques can leave the baby hungry and unsatisfied.
Factors related to the baby include the baby’s temperament (how they react to situations, expresses and regulate emotions), immaturity of the central nervous system (systems that control most functions of the body and the mind), or an early form of migraine (throbbing, pulsating headaches in infants).
All babies have different temperaments. If your newborn takes time to adjust to lights, and loud noises, he/she can become impatient and cry excessively.
Similarly, an immature nervous system of your baby cannot handle a lot of stress, especially if it feels your stress and anxiety and this can cause colic.
Factors related to the environment include lack of family support and family stress.
Your baby can very well sense stress around him/her. A stress response from you or a caregiver can leave your baby unsatisfied and make him/her cry excessively.
Other causes of colic include sensitivity to other foods such as eggs and nuts, overexertion or fatigue due to lack of sleep, body pain due to illness, or a physical injury.
Symptoms of Colic
Intense crying, sometimes in sudden bouts of crying and stopping and then crying again
Fever rising to ≥100.4°F (38°C) at times
Face turning red and flushed due to prolonged periods of crying
Abdominal pain can be identified by a tense abdomen with your baby’s legs drawn towards it
Frequent burping and passing a significant amount of gas
Sleep may be irregular and interrupted with episodes of crying
Your baby might stop taking feed properly since feeding is interrupted by intense crying
Increased restlessness
Diagnosis of Colic
In order to diagnose colic, your child’s doctor will examine your baby and obtain a medical history. Questions might be asked about how long and how often your child cries, if you have noticed anything that seems to trigger the crying and what comfort measures are effective, if any. Blood tests and x-rays or other imaging tests may be done to determine if there are other problems present.
When Can Colic Become Concerning and When to Seek Help
You might want to call your paediatrician if your baby:
Has been crying continuously for more than two hours.
Has had a fall or an injury and is crying continuously.
Has a high-grade fever of ≥100.4°F (38°C).
Does not eat or drink properly, vomits excessively, is not urinating well, passing blood in stools.
Has a change in behavior, including lethargy or decreased responsiveness.
Has a strange-sounding cry.
Home Care for Colic
Home care depends on the cause of colic. It is advisable to consult your paediatrician and follow your doctor’s advice.
If your baby is constantly hungry despite feeding him/her at frequent intervals, discuss with your doctor about a change in feeding times.
Try to touch, hold, talk to your infant and keep him/her in your sight as much as possible. Let your baby watch and play with baby-safe toys to distract or deviate him/her. If you think the crying is due to a lack of proper sleep, wrap your baby firmly in a blanket and put him/her to bed. Make sure the blanket is soft and not too tight to avoid reddening.
Always check:
Your baby’s temperature for fever
Any injuries from head-to-toe
Your baby’s fingers, toes, and genitalia
For a diaper rash (a condition that causes redness and rashes in your baby’s buttocks and genital area)
For loose diaper pins or too tight diapers that can cause discomfort
Excessive crying can cause a lot of distress, exhaustion, and stress in infants, parents, and caregivers. Although normal and self-limiting, if excessive crying continues, consult your paediatrician immediately.
References:
1. Indianpediatrics.net. 2021. [online] Available at: <https://indianpediatrics.net/nov2018/979.pdf> [Accessed 4 February 2021].
2. Kidshealth.org. 2021. Colic (for Parents) - Nemours KidsHealth. [online] Available at: <https://kidshealth.org/en/parents/colic.html> [Accessed 4 February 2021].
3. Healio.com. 2021. [online] Available at: <https://www.healio.com/pediatrics/journals/pedann/2014-4-43-4/%7Bb83ae0b4-1eac-4586-a23f-0421a599b04f%7D/the-excessively-crying-infant-etiology-and-treatment> [Accessed 4 February 2021].
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