What is colic in babies?
Written by Carolina Vaccari
What is colic in babies?
Infantile colic is a common, self-resolving paediatric condition that usually affects the first few months of a baby’s life. It affects 20% of infants worldwide (NICE, 2022) and is reported equally across both sexes, and amongst both breastfed and bottle-fed newborns.
It consists of repeated episodes of excessive irritability, fussiness and inconsolable crying in babies who are otherwise healthy and thriving. Even though it is not indicative of disease, infantile colic may cause significant carers distress and anxiety. One in six families with a baby refer to a health professional about symptoms associated with colic (NICE, 2022).
- What are colic symptoms in babies?
Colic symptoms usually begin around the first weeks of the baby’s life, improve around four months of age and fully resolve by six months of age.
The signs of infantile colic in babies include:
- Inconsolable crying and irritability that does not follow a specific time pattern, but tends to worsen in the late afternoon and evening
- Colicky babies usually cry for an average of 4-5 hours a day
- Babies with colic typically continue to be distressed and cry, despite using comforting methods such as holding, cuddling and feeding
- Flailing movements of the body, such as:
Arching the back
- Drawing legs towards the abdomen
Clenching fists
What are the causes of colic in babies?
The exact cause of infantile colic is unknown.
Overall, psychological, behavioural and biological elements seem to play a role in the onset of infantile colic. Proposed theories include food hypersensitivity and allergy (such as cow’s milk allergy and intolerance, or reactions to a specific type of formula), gastro dysmotility and intestinal microflora immaturity due to age and poor feeding techniques (Gordon et al, 2018).
Only in a small percentage of babies, colic may represent a sign of other underlying conditions that might need specific medical intervention.
- How long does colic last?
Colic’s symptoms usually start around the first few weeks of a newborn’s life, improve around four months of age and fully resolve by six months of age.
If symptoms are severe or persist beyond four months of age, further investigations are recommended to rule out possible underlying conditions.
- What can relieve colic in babies?
It is important to remember that infantile colic is a common, self-improving condition, which usually self-resolves without intervention by six months of age. The aetiology of infantile colic remains disputed in the medical community, and therefore a consensus on the treatment approach remains debated.
However, dealing with a distressed baby can be difficult and some strategies can help to soothe colicky infants. These include:
- Holding and cuddling the baby when unsettled
- Gentle motion, such as rocking the crib or pushing the pram
- Using some soft, white noise in the background
- Bathing the baby in a warm bath
- Using winding techniques after feeds, if needed
- Holding your baby upright after feeds to avoid them swallowing air
If a food allergy is suspected and the baby is breastfed, changes in the maternal diet can also be beneficial to reduce the symptoms of colic.
If breastfeeding problems are suspected, it is important to ask the health visitor or the lactation consultant for support and advice about the best infant positioning and attachment to the breast. A good feeding positioning will prevent the baby from swallowing air and contributing to colic.
Can anti-colic bottles help babies with colic?
Anti-colic bottles aim to improve the general patterns of bottle feeding.
In particular, they may help control the milk flow and reduce the amount of air swallowed by the baby when feeding.
Even though there are no side effects associated with using anti-colic bottles, there is also no evidence confirming they are useful in treating infantile colic.
Always check with your GP or Paediatrician what the more appropriate and indicated approach is to help your colicky baby.
Can probiotics help babies with colic?
Probiotics are live microorganisms that provide several health benefits by improving and restoring intestinal microflora. The most common probiotics used are Lactobacillus, Bifidobacterium and Streptococcus.
Growing research has shown that the intestinal flora of colicky babies seems to differ from that of healthy infants, and it is hypothesised that probiotics may help to restore balance and create a more favourable intestinal microbiota environment.
Even though there is no clear evidence showing that probiotics are more effective than placebo, daily crying time appeared to reduce with probiotic use compared to placebo (Ong et al, 2019).
Moreover, probiotics’ low cost and easy accessibility make them a possible and valid option to help colicky infants.
Always check with your GP or Paediatrician what the most appropriate approach to help your colicky baby is.
Can anti-colic drops help babies with colic?
It is largely believed that anti-colic drops can help babies with colic. However, there is no scientific evidence confirming their efficacy. Even if it seems to be safe to give anti-colic drops to colicky infants, they may present some rare side effects.
Different brands contain different ingredients, but some anti-colic drops may contain substances, such as alcohol, sugar, sodium bicarbonate, simethicone and/ or lactase that can affect your baby’s health.
Always check with your GP or Paediatrician what the most appropriate approach to help your colicky baby is.
Does a baby with colic need to be seen by the GP?
Even though infant colic is a self-resolving, paediatric condition, which most of the time occurs in healthy babies,promptly seeking medical advice is recommended in some situations.
Parents and carers should contact the GP if:
- They are worried about the baby crying and the cry does not sound normal. Parents and carers are the ones who know their babies best. It is fundamental for them to follow their instinct if they believe there is something wrong with their baby and there are also symptoms supporting that
- Underlying conditions are suspected
- They are struggling to cope with the baby’s symptoms. Several helplines are also available to help parents and carers cope with excessive crying babies
- The baby is not thriving and growing as expected, or is losing weight
- The baby’s symptoms do not improve, or if they worsen after 4 months of age
References:
Gordon M., Biagioli E., Sorrenti M., Lingua C., Moja L., Banks S.S., Ceratto S., Savino F. ( 2018). Dietary modifications for infantile colic. Cochrane Database Systematic Review, 10(10).
National Institute for Health and Care Excellence (NICE), (2022). Colic – Infantile, https://cks.nice.org.uk/topics/colic-infantile/ [last accessed: 23/08/2022].
Ong T.G., Gordon M., Banks S.S.C., Thomas M.R., Akobeng A.K., (2019). Probiotics to prevent infantile colic. Cochrane Database of Systematic Reviews, (3).