Possible Causes of Infant Colic
Your Baby Won't Stop Crying
If your baby has colic, scores of well-meaning friends and family members will offer advice on how to stop your child’s crying. I know this because my first child screamed her head off for over four months—months during which I tried mostly useless remedies.
As a result, I became obsessed with finding the source of my daughter’s screams. Hours of research and countless talks with my pediatrician revealed a sobering truth: No one actually knows what's going on with colicky babies. In fact, the diagnosis of “colic” is simply a way of saying, “Your baby cries a lot, which is completely normal for some babies, but we have no idea why your baby, in particular, won’t stop.”
The official definition of colic is crying "for at least three hours per day, at least three days per week, for at least three weeks.” Pediatrician Dr. Chad Hayes calls this 1954 definition largely arbitrary because it simply lumps babies into two categories: Those who are fussy and those who aren’t.
Since the definition of colic is unhelpful, I prefer to think of colic as excessive infant crying without a readily available physiological cause. A baby who cries a lot and has an obvious ear infection does not have colic. He has an ear infection. Conversely, a baby who cries a lot even after being fed, cleaned, cuddled, soothed, rocked, and examined by a pediatrician has colic.
As you can see, colic is simply a definition of an outcome, rather than a cause. Crying is the outcome, but what causes all this crying?
The Mayo Clinic succinctly says, "The cause of colic is unknown." Similarly, WebMD provides equally bleak information to a new parent: "Colic’s exact cause is unknown, and that's why there’s not a clear way to help it."
This lack of clear medical information causes inordinate stress and confusion. How can we stop our babies from crying if we don't even know why they are crying?
Researchers likely haven't found THE cause of colic because there isn’t one cause. Not all babies with colic are crying for the same reason. This means the parents of a colicky infant have to sift through a number of possible causes.
We don’t have ready-made statistics breaking down which cause is the most common, especially because many infants are misdiagnosed simply because parents and doctors want to come up with a reason, any reason, for the crying.
Nonetheless, I’m going to outline some of the most probable causes by starting with the most likely to the least likely.
1. That's the Way Your Baby Was Born
Although temperament is the most likely cause of colic, parents HATE hearing this. I hated hearing this because it meant I was powerless to stop the crying. Some babies are born with either an oversensitivity to stimuli, an inability to self-soothe, or a still-developing nervous system.
Luckily, most colicky infants adjust to the world and stop the excessive crying around three or four months old. That’s the good news - colic will usually sort itself out. However, that is also the bad news—three or four months of crying is a long freakin' time when you are in the thick of it.
Even if the crying can't be stopped completely, a fussy baby by temperament can still be helped. Dr. Harvey Karp, known for The Happiest Baby books, recommends the "five S’s" to help soothe a colicky baby. I can attest that these five S's are extremely helpful, but they aren’t quite the magic he proclaims. Either way, they are worth a try. Check out his website for more information on swaddling, side-lying, shushing, swinging, and sucking.
2. Your Baby Has a Dairy or Soy Allergy
Some babies with colic have a sensitive tummy, which means the proteins in dairy or soy can make them uncomfortable and irritable. These allergies are not the norm in colicky infants, but they are common enough that breastfeeding moms might want to try an elimination diet. If your baby is on formula, talk to your pediatrician about switching the type or brand. If cutting out dairy and soy, or switching formulas, makes no difference in the crying, then you can rule out an allergy as the cause.
Also, keep in mind, these allergies are rare and often present with other symptoms, such as a skin rash or bloody stools. Many parents, and even pediatricians, rush to diagnosing an allergy without much evidence other than crying. Therefore, try eliminating foods, but don’t obsess about it if you see no difference.
3. Your Baby Has Infant Reflux
Prescribing reflux medication for infants is controversial, and many pediatricians believe they are overprescribed, but this doesn’t mean infant reflux isn’t a real, albeit rare, condition.
Often, infants are given medication based only on the coexistence of crying with spitting up. In some cases this serves as evidence for reflux, but in many other cases this is simply coincidence. A lot of babies spit up excessively, so you could simply have a baby who spits up and also coincidentally has colic. The causal link is hard to make, which is why the topic is controversial, especially because reflux medication is not without risks.
Nonetheless, sometimes colic can be caused by infant reflux, but parents should work with doctors to determine if the benefits outweigh the risks of medication.
4. Your Baby Has Gas Pains
When I mentioned my daughter wouldn't stop crying, most people suggested giving her gripe water or simethicone, over the counter medications to break up gas bubbles. This advice was based on the notion that a gassy tummy is the cause of colic. Unfortunately, not much evidence supports this notion. Indeed, the ever popular gripe water is presumed to be soothing because it is sweet, not because it actually affects the tummy in any way. Scott Gavura from Science-Based Medicine points out that simethicone in particular has “fairly good evidence to suggest it is ineffective.”
Anecdotally, many parents presume stomach pains cause colic because their babies seem to struggle when having a bowel movement or produce excess gas when upset. This anecdotal evidence represents a chicken and egg problem. Is a baby crying because of excess gas? Is the crying (and the swallowed air) creating the excess gas? Are the two things even related?
Either way, the current products on the market can’t do much to soothe a baby’s belly.
A crying baby is stressful. The cause of colic isn't known, but researchers have found that it increases the risk of postpartum depression. Therefore, in between searching for a cause and cure, remind yourself that the crying will eventually stop. In the meantime, take care of yourself, know your limits, and find help if you need it.
© 2018 M Riley