Baby love: soothing your fussy and gassy baby

I recently saw a new mom in clinic. Her chief complaint was written out like this:

Baby is gassy and fussy. Mom is worried. Not sleeping well.

When I walked into the room, I saw a visibly tired young mother. Adorable babe nursing happily. Mom was near tears as she started to speak.

Apparently, for the last week, her 1 month old had taken to crying jags. These were described as him being in “pain” with red, crying face and all. He was consolable but the crying had increased in frequency and she was really worried that he was in actual pain.

He was otherwise breastfeeding well, seemed content when not involved in a crying episode, slept well, and was gaining good weight.

I wanted to reach out and give her a hug. New motherhood is hard enough, but now? It seems her adorable baby may be going through some colic. And, if any of you have experienced a colicky baby…you know the helplessness, the worry, the loss of sleep… and the heartbreak of hearing your baby cry so much.

What is colic?

We know that all newborns cry. It’s how they communicate with us. However, in up to 40% of babies, crying can escalate to random bouts of intense crying associated with extending/drawing up legs, facial grimaces, and sometimes the passing of gas. So, they do look like they’re in pain and it’s very concerning for parents. Parents often associate these crying jags as pain due to excess gas.

And, while the true definition of colic is defined by crying for more than 3 hours per day, for more than 3 days per week, for at least 3 weeks…we know that colicky babies run the spectrum. We don’t need these little “fussy” and “gassy” babies brought in by moms on the verge of tears to fit this exact definition to know a colicky baby when we see and hear one.

We also know that these periods of crying typically start between the 3rd-6th week of life and disappear by 3 months of age. So, yes…this too shall pass…but I know, this is not particularly helpful to sleep deprived parents in the throes of colic.

So, what causes colic?

In short, there’s no exact cause known. But, we have a pretty good idea of strong associations that may contribute to colic in babies.

• Gas? Parents are almost certain of the role of gas as it relates to their baby’s crying. However, while it’s true that colicky babies pass a lot of gas; what is unclear is if colicky babies have more swallowed air from crying and thus pas more gas. So although they occur together, gas is not the only culprit here.
• The 4th trimester. Think of your baby’s first 3 months of life as her 4th trimester. Only this time, she’s not in the snug and protected confines of your womb. Immature nervous and digestive systems certainly play a role here. Your baby is sensitive to all the new sights and sounds and her tummy is sensitive as well…adjusting to the whole digestive process.
• Food sensitivities. So, on that note, your newborn may have some food sensitivities causing abdominal discomfort. The most common “fuss” foods? Dairy, soy, caffeine, and wheat. These are foods breastfed babies my be exposed to; and for formula fed babies, the milk protein.
• Temperament. Your baby’s temperament plays a role in everything he does/likes/dislikes, and how he responds to certain physical and emotional challenges. Colic is no different. Some babies are simply more prone to colic than others.
• Reflux. Most babies will have some degree of reflux. However, if more severe, this reflux can cause pain and excessive spit up. This can certainly lead to symptoms of colic with that grimaced face cry. (More on reflux and babies in a future post)

How can I treat my baby’s colic?

If you think your baby may have colic or you’re unsure, the first thing to do is have him checked out by his pediatrician. That way, his doctor can determine which (if any) of the above factors are at play here.

Excess gas? So while this may not be entirely causative of your baby’s colic, we know that it’s certainly not helpful and potentially makes your baby more uncomfortable. Reduce the amount of air that your baby swallows by ensuring he has a good latch while breastfeeding (lips everted around areola and no clicking sounds) and if bottle feeding, make sure he’s latched on at the base, not the tip of the bottle. Also, console your baby whenever she cries. This will decrease the amount of air swallowed by crying.

What about mylicon or gripe water? I’m kind of ambivalent towards these remedies. Many parents try them but haven’t found them to be hugely helpful. A study in the April 2011 Journal of Pediatrics found that while herbal supplements like gripe water may help, the results were inconclusive. So I tell parents, if they are inclined to try them, go ahead. If you don’t notice any improvement, than no need to continue.

For breastfeeding moms, I often encourage a trial of food elimination, starting with dairy then moving on to the other “fuss” foods listed above. Often, these same foods may be reintroduced after the colic has subsided as long as there are no signs of a true food allergy.

If your baby’s doctor thinks reflux is playing a role, then it will be helpful to keep your baby elevated at a 45 degree angle after feeding, feed more frequently with smaller amounts, and your baby may or may not need a medication prescribed for reflux.

Still, even after addressing these above issues, you baby may still have some colic to contend with. Here are some potent baby soothers that will help both you and your baby feel more in control of this (not so little thing) called colic.

Motion. Holding, rocking, walking, vibrating…you get it…move that baby. Colicky babies loved to be held, cuddled and soothed.

Sucking. Breastfeeding and bottle feeding are comforting. But if your baby isn’t hungry, it’s okay to offer a pacifier if she takes it. Sucking is a potent soother, so if the pacifier helps…let it!

Swaddling. Oh I love a good, snug swaddle; and so do babies. Invest in a couple of large swaddling blankets and hone your swaddling skills.

Massage, baby bends, and music. Gently rub your baby’s back and tummy, do the “bicycle” with his legs, and play some soothing music. Find what works for your baby and go for it.

Ask for help and take a break. Colic can be both heartbreaking and frustrating. Ask for help. Go outside for some fresh air. Ask your partner to take the night shift so you can sleep. If frustration combined with sleep deprivation is mounting, remember it’s okay to put your baby safely in her crib and walk away. Take a breather. I know this goes without saying, but never shake your baby. Take care of yourself then come back to your baby with a new and fresh perspective.

I know this is long, and honestly I could write forever on colic, crying, and fussy/gassy babies…so I hope this helps you understand the why of colic (it’s common and not your fault), ways you can help your baby and ultimately know that you and your baby will survive this colicky phase.

It will end.

Your baby will continue to grow and thrive.

At 3-4 months of age, you’ll see that the 4th trimester is truly over and your formerly “fussy” and “gassy” baby has mostly smiles and eyes for only you…his first love.

Did you have a colicky baby? What helped you and your baby? What questions do you have about colic?