14 Things About Colic You Might Not Know
When we hear that a baby has colic, most people picture an upset tummy, a fussy baby that is suffering from abdominal pain and gas. But even if your colicky baby does have these symptoms, this is not what ‘colic’ means. Here are fourteen things you might not know about colic.
1.“Colic” Is Not Actually A Condition
Colic is not a diagnosis, nor is it a medical condition. Rather it is a catch-all phrase describing any baby that cries more than others. The word “colic” has been turned into an acronym, “Cause Obscure: Lengthy Infant Crying,” because it refers to all babies that cry a lot, for any and all reasons. Some colicky babies might have more gassy tummies, whereas others might have stiff necks, or sensitive ears, or teething pains, or simply be better at communicating their newborn distress. So even though people often say their baby “has” colic, it’s not really something babies ‘have’ or ‘get’, it’s merely a description of any baby that cries more than average.
2. Animal Colic Is Similar But Different
This is similar for dogs and horses: colic is not a specific condition but a word that covers any source of tummy upset, gas, or bloating. With animals, however, colic is always about the abdomen, and the cause of discomfort can range from benign to serious. Colic describes the symptoms that are in need of a veterinary diagnosis, in case the stomach upset is caused by something requiring treatment. Sometimes the source of the colic is just bad food, and sometimes it is a dangerous contagion. Whereas with infants, the word colic is only used to describe the fussy behaviour in the absence of a specific condition or illness. And unlike with animals, in infants colic is never considered dangerous.
3. All Babies Can Be Colicky
All babies cry a lot, but how much crying is normal? How much is average? How much should we expect a baby to cry? This is very, very individual. Some babies cry much more than others, which could be a sign of greater discomfort, or could be a sign of a more expressive personality. But most babies have what’s called a “witching hour”, which is typically in the evening, when they spend the most time crying. Often this includes episodes of “purple crying” when the baby is highly upset and inconsolable. This can be very difficult for new parents. While any amount of crying can be normal, colic is often defined as any baby who cries for more than three hours in a row, more than three days a week.
4. Colic Is Temporary
Colic usually lasts from approximately 1 week old to 3 months old. Most babies enter into their fussiest phase after the first week of life, and calm down significantly after about three months. Colic doesn’t usually show up for the first few days to a week.The baby is still too brand new; they haven’t really started adapting yet; and your colostrum is so similar to amniotic fluid that their systems feel the familiarity of the womb. But soon, many babies start to cry more, to exhibit new discomforts that they have never before experienced. This is colic. It peaks around 6 - 8 weeks old, and is usually gone or almost gone by 12 weeks. While this is not universal, and your baby’s arc might be different, this timeline is fairly typical.
5. The Three Month Bridge
When babies are first born, they are still briefly attached to the umbilical cord, and many of their systems are still transitioning from foetal to newborn. A huge amount of change happens in the first few minutes, including switching to lung breathing and activating their digestive system. But the following three months also acts as a bridge from womb support to existence on the outside. This is often called the “fourth trimester”. During this time, your baby is experiencing the jarring separation from your body and experiencing their own body in a variety of brand new and scary ways. In utero, your baby was attached to you, part of you, nourished, grown, warmed, and sustained by your body. The first three months earthside involve rapid development and transition as your baby grapples with this physical separation, with every day bringing new and challenging changes, discomforts, and intimidating experiences.
6. Dyschezia
One of the changes commonly associated with colic is called “dyschezia”. This is a condition that is normal and developmental, but can be very uncomfortable for your baby. In the womb, babies don’t use their bowels. They eliminate waste through the umbilical cord and it gets disposed of through the maternal body. Yes, when you’re pregnant you actually poop for your baby! In the womb, the baby’s bowels are blocked with meconium, which needs to be cleared out after the birth so that they can start using their bowels. Your colostrum is a powerful laxative that helps eliminate all the meconium to get your baby’s system ready to consume your milk. This is one of the reasons your milk doesn’t arrive right away–the colostrum needs to do its work first, and clear the route for the digestive process
After the birth, as the baby’s digestive system develops over the first three months, there are times when all their parts don’t yet coordinate. In particular, relaxing the pelvic floor muscles while pushing with the abdomen to successfully empty the bowels requires two actions that many babies cannot yet synchronise. This causes straining, red-faced crying, until the crying itself causes the release of a bowel movement, which brings about instant relief. This is not constipation, it is dyschezia (also sometimes called “grunting baby syndrome”), which is a functional condition requiring no treatment at all. Most babies have some degree of dyschezia, often involving extreme crying and visible discomfort, as the digestive system sorts itself out. This is one of the normal stages of development commonly associated with the word colic.
7. The Fourth Trimester
You might notice that your colicky baby wants to nurse even when they’re clearly not hungry, or sometimes they need to nurse to calm down. This is because as well as food, they also get growth factors, developmental hormones, and calming & comforting from your milk. Your milk helps bridge the baby’s development as they go through the fourth trimester. Then your “mature milk” comes in, which can be anywhere from a couple days to a week after the birth, but this milk is not static or mature at all. It is changing rapidly, minute to minute, during the first three months. Your milk continues to change forever, based on your baby’s growing needs, but the period of most extreme change is the fourth trimester, when your milk is guiding your baby’s body from foetal to infant. Every time your baby nurses, their saliva sends information to your mammary glands that cause your milk to update to your baby’s current developmental needs. Every time you baby nurses, your milk advances in response, subtly shifting its prescription, so that it is bringing your baby’s body into greater viability with the world outside the womb. Your milk is a bridge, continuing the work your body did in the womb during the 4th trimester. Your milk replaces the umbilical cord until your baby no longer needs it. It completes the development of their systems outside the womb. (Note that colic presents in both breastfed and bottle fed babies, so if you are not breastfeeding, don’t worry! Bottle fed babies outgrow colic at the exact same time.)
8. Circadian Rhythms
Another cause for colic in the early months is that your baby is born with absolutely no circadian rhythms. Newborns have no sense of night versus day. They exist in a moment to moment series of shifting needs, with no sense of time at all. One way they develop circadian rhythms is through your milk. Your milk has wake-up hormones (cortisol) during the day, and sleep hormones (melatonin) at night. As your baby nurses during both days and nights, their body learns circadian rhythms from you. But the day milk versus night milk is not an either/or. The ratio of cortisol to melatonin is in constant gentle flux, so that your 6am milk is different from your 8am milk which is different from your 10am milk. The gradual arc of your days and nights is represented fully and with intricate complexity in your milk, so that the details of your sleep/wake rhythms are imparted to your baby’s body over many months of unlimited nursing at all hours of night and day. Any attempts to restrict or limit this can actually delay the maturation of your baby’s healthy circadian rhythms. Sleep training can undermine nature’s plan, sometimes resulting in a temporary fix that yields sleep issues down the road. (Again, if you’re formula feeding, don’t worry! Babies also learn circadian rhythms from shifting daylight and family routines).
9. Cluster Feeding
In particular, babies tend to want to ‘cluster-feed’ in the evenings as your melatonin levels rise. This is in large part responsible for the highly fussy, colicky behaviour most babies exhibit every evening. It is in response to the sleep hormone’s increasing presence in your milk, because your baby is trying to build their circadian rhythms to sleep more at night. It is very common to mistake this normal evening behaviour for low milk supply, since babies appear to be ravenous again shortly after they’ve finished a feed. However, this is not about milk supply. This is your baby wanting to stock up on melatonin. Most babies in this phase want to nurse almost constantly, in big clusters, every evening around the same time. They are fussy and they cry and they keep wanting to nurse again. This is normal, and actually helps them educate their body about day and night. In the long run, this will contribute to your baby’s good sleep habits.
10. The Learning Curve
Another common cause for colic is that everything is brand new to your baby. In the womb, your baby never experienced hunger, or cold, or thirst, or loneliness. After the birth, your baby doesn’t understand these new, uncomfortable, and scary sensations. They don’t at first know what will solve the feeling or hunger, or of cold, because they have never felt these things before. Every sensation is unfamiliar and frightening. Even when you are trying to feed your baby, a brand newborn might be fussing and crying during the attempt, with no understanding that what you’re trying to offer will fix this unfamiliar feeling. It can be very discouraging and confusing to try to meet a newborn’s needs in the early weeks, because the baby has no idea what they need or what will help. They cry because something just feels wrong, and it can take lots of trial and error to figure out what. This learning curve applies as much to our baby as to our own growth as parents. The only takeaway here, though, is that at least babies’ needs are not complicated. Always offer to feed them, hold, cuddle, bounce, warm them, and they will eventually either feed or fall asleep, or be soothed by your rocking and holding them. Their needs, at least, are mostly about some form of proximity to you.
11. Stiffness And Torticollis
Another issue that can cause colicky behaviour is infant stiffness or misalignment. Sometimes during the birth, a baby can be stuck in a tight or uncomfortable position for a long period of time, which can lead to a stiff neck, or a sore back, just like it would for anyone. Some babies have trouble turning their head one way or the other, or have strong discomfort when they try to bend or move their neck or back. Sometimes a medical intervention such as forceps can cause or exacerbate this problem, or can create soreness or bruising on the baby’s head or neck. Vacuum extraction, caesarean birth, or any challenging presentation in a vaginal birth (such as an asynclitic head, or a nuchal hand) can also sometimes lead to discomfort for the baby, along the lines of the aching, black and blue feeling we might get after some new physical challenge. There is also a condition called torticollis, which can be congenital or can result from the same above causes. Torticollis can be diagnosed and usually benefits from gentle treatment such as craniosacral therapy, infant osteopathy, physiotherapy, chiropractors, or stretches and exercises prescribed by your doctor or midwife. It often presents as the baby tilting their head all the time, or conspicuously preferring to turn their head one way instead of the other. Torticollis is often lumped in with colic, but is not really considered colic since it is a diagnosable condition with mtreatment.
12. Colic Does Not Cause Harm
Colic–the normal kind that involves lots of crying and no real cure– is really difficult. It can be extremely stressful when your baby cries and cries and nothing you do seems to help. The first three months, or fourth trimester, is unquestionably one of the hardest parts of parenting. But it is important to remember that colic itself is not harmful. In fact, some people say it is nature’s way of ensuring a baby's intense need for proximity is met during the early developmental shift when it is most important. Babies’ systems are regulated by body contact. It is very hard to put down a fussy baby, and babies grow best–develop best– when we are holding them. Babies need us for co-regulation. They thrive with as much skin contact as we can provide. So their extreme crying and fussing might result in more holding, more rocking, more feeding, and in some cases even co-sleeping, because this is how babies do best. So as horrible as it is, colic might actually serve a function after all. A quieter, less fussy, baby might be put down more and actually miss out on being held as often.
13. Colic Relief
Despite all this reassurance that colic is normal, doesn’t cause harm, and might help your baby get their needs met, it can be horribly difficult and stressful when you’re living through it. I remember I could almost never sit down as our baby needed constant motion: having to eat meals in turns while walking our baby up and down the hall, and feeling like this was utterly unsustainable. So I am pleased to report that there are some things you can try to relieve the symptoms of colic. None of these is a guaranteed remedy, but people do report success with all of them. Which one (or ones) work best probably depends on what exactly is causing your baby’s own brand of colic. Go ahead and try them all if you’re inclined.
Infant Massage: Massage is great for babies. It helps with their sensory integration, with their growing awareness of their own contours, and with their developing digestive system. For a gassy baby, or one suffering from dyschezia, massage can provide soothing abdominal relief as it helps them process gas and love waste through their intestinal tract. Massage your baby’s tummy gently clockwise, or downwards, or softly pump or bicycle their legs. You can also take your baby to an RMT who treats infants. We have infant massage experts regularly at our Virtual Parenting Circles, if you want to learn some techniques.
Infant Body Work: Some forms of body work, such as craniosacral therapy, osteopathy, and infant chiropracting are very safe and gentle for babies. There is even baby acupuncture, which is usually done through pressure points instead of needles. All of these modalities can help if the colic is caused by alignment issues, torticollis, or stiffness. It can also help with many newborn breastfeeding issues if your baby is struggling with comfort while positioning.
Skin To Skin: Holding your baby regulates all their systems and brings them into homeostasis. Babies are not independent, and cannot regulate themselves without our help. Studies repeatedly show that the more you hold your baby, the less they cry. While skin-to-skin will not eliminate colic, it certainly reduces both the symptoms and the intensity. Even though we have to put our babies down to meet our own needs, from an infant developmental perspective, the more you can hold your baby, the better.
14. Time & perspective
Although there are other things you can do to help your baby through the colicky first few months, the ultimate cure for colic is simply time. This too shall pass. Your baby will continue to cry, of course, as that remains their main form of communication for a long time, but the crazy intense colic usually resolves naturally around 12 weeks, as your baby’s systems all stabilise and adapt to the outside world. Their digestive systems, their musculoskeletal system, their sense of self, their circadian rhythms, and your shifting milk all slow down after three months of rapid, roller-coaster flux. You will notice that your days are more predictable, your baby sleeps in a more regular pattern, and your techniques for soothing your baby are more consistent and reliable.
A lot of people say that their second baby was much easier than their first, and I often wonder if this is actually true, or if it is that our expectations are simply more realistic the second time around, which makes it all seem easier based on familiarity. And the trust that it is normal and it will pass. The first time round it can be daunting, terrifying, overwhelming, and inconceivable how much our babies want to be held and how much they cry if we’re not actively feeding and bouncing them all the time–and sometimes even when we are! But this is usual. Colic is difficult, challenging, stressful and intense, but also universal, normal and transitional. Just like so much about parenting.
Stephanie Ondrack is a Childbirth educator in Vancouver BC whose first baby was by far the most colicky. Or maybe it was just the jarring learning curve of new parenthood. It sure seemed easier the second and third times around.