10 Questions About Baby Colic

Today, we'll answer your questions about baby colic, which refers to prolonged and repeated crying spells throughout the first months of life.

When your little baby starts crying, everyone pulls the baby colic card out of their sleeve. And then they spout off a series of tips of all kinds and colors, which aren’t always as magical as they promise they’ll be.

It’s important to know that not all crying is synonymous with colic and that no matter how much distress it causes you, you won’t always be able to stop it. However, this is not necessarily something dangerous or harmful for your little one.

Next, we’ll answer the 10 questions that parents ask most frequently about baby colic.

1. What is baby colic?

Infant colic refers to crying and irritability crises that parents can expect and which resolve spontaneously around 3 months of age.

For some authors, these episodes can be understood as an exacerbation of normal behavior in the young baby, as a result of a combination of physical and psychosocial stimuli.

It’s very common and can affect up to 40% of healthy children. However, not all crying is colic and doctors use different clinical criteria to define it.

Wessel criteria

For a long time, this was the most common criterion. According to Wessel, a child’s crying is colic when it meets the following characteristics:

• Starts around the second week of life.
• Lasts more than 3 hours a day.
• Occurs more than 3 times a week.
• Improves spontaneously around the third month of life.

PURPLE crying

The acronym PURPLE is also often very helpful in defining the main characteristics of this type of crying:

• P (peak of crying): The peak of appearance, from the first week of life to 3 or 5 months.
• U (unexpected): Unpredictable.
• R (resist soothing): Resistant or difficult to resolve.
• P (pain-like face): The child has an expression of pain on their face.
• L (long-lasting): Crying can last up to more than 5 hours a day.
• E (evening): It usually occurs during the afternoon or evening.

Rome IV criterion

In 2017, colic fell into the category of functional gastrointestinal disorders, according to the Rome IV criteria. To define them, cases must meet the following conditions:

• Babies under 5 months.
• Crying and prolonged irritability that begins without apparent cause and that recurs.
• The absence of organic disease or developmental disorder.
• The caregiver reports crying for more than 3 hours a day and more than 3 days a week.

2. Why do these episodes occur?

Although this phenomenon has been widely studied, its cause is still unknown. As we mentioned before, the child must be healthy to define this condition as such, so ruling out other health conditions that manifest themselves through crying is essential.

3. When does the infant’s colic disappear?

In general, infant colic peaks at 6 weeks of age and disappears around the third month. In any case, a smaller percentage of infants may present an episode up to and including the fifth month.

4. What should I monitor during a colic attack?

Colic refers to crying episodes that occur due to issues having to do with the baby’s maturation. For this reason, it’s important to note that they shouldn’t be accompanied by any symptoms or signs of disease.

Some red flags of crying spells in a young baby include the following:

• Fever (more than 100 degrees Fahrenheit)
• Noticeable abdominal distension (usually involving stool retention)
• Changes in the child’s general state, with a tendency to a diminished response state (poor feeding attitude, tendency toward permanent sleep, little movement of the limbs)
• Noticeable changes in the appearance of the poop, such as those that are red in color

In the case you notice any of these symptoms, you need to contact your pediatrician so they can carry out a thorough evaluation of the child.

5. Are colic and gas the same thing?

Not necessarily, and this false association is one of the main points of conflict of this condition.

Many times, a baby’s crying can be the result of the retention of gas or stool in the intestine. Other times, prolonged crying favors the intake of an excessive amount of air (aerophagia) and gases are the consequence of colic.

On the other hand, diseases such as lactose intolerance, allergy to cow’s milk protein, or gastroesophageal reflux can cause crying with digestive symptoms. But this crying isn’t due to infant colic.

6. Should I change my baby’s diet if they suffer from colic?

As we stated, colic and gas aren’t the same thing and, in addition, gastrointestinal diseases that cause distention of the abdomen, vomiting, and irritability rule out the diagnosis of colic.

For this reason, neither hydrolyzed formulas nor plant milks nor changes in diet have proven to be capable of modifying the course of evolution.

7. Can the baby’s constant crying harm him?

The baby’s cry is a means of communication and its intensity or characteristics vary depending on the context. In itself, crying for several hours doesn’t harm the baby’s health.

8. Probiotics, pain relievers, and prokinetics, do they work?

Infant colic causes distress and despair in caregivers. Many parents try whatever promising strategy they hear about in order to end the family distress as soon as possible.

However, none of these drugs have proven to be effective and, on the contrary, many can cause unwanted adverse effects.

Probiotics

Some authors have suggested theories about the origin of colic that involve the intestinal microbiota. For this reason, in recent years, multiple studies have taken place to demonstrate the effectiveness of probiotics in the management of colic.

However, at the moment, the evidence in favor of the use of these drugs is insufficient.

9. Do abdominal massages work?

Abdominal massages or relaxing techniques haven’t proven to be 100% effective in managing infant colic. However, they constitute a practice capable of providing comfort and well-being both to those who offer the massage and to those who receive it.

The key to managing colic at home is parental education and counseling in order to reduce the stimuli that the baby receives, as well as to promote relaxation. Some of the techniques suggested for this purpose are baby massages.

10. I go for a walk and the baby stops crying, is this a coincidence?

No, it’s actually extremely common. Just as in the case of infant massage, any situation that favors the relaxation of the child and their caregivers can favor the resolution of colic. But this doesn’t mean that it won’t appear again.

A key to surviving baby colic: Ask for help

Try to seek help in your close environment so that you can rest, eat, and regain energy. This isn’t something you should overlook and it constitutes a fundamental pillar to better accompany your baby in this critical stage.

Remember that this is an expected and physiological stage of maturational development. Despite being annoying, it indicates that the child is growing in the way we expect.