CRYING AND COLIC

Crying is your baby's only means of verbal communication with you at first. Babies will cry to tell you that they are lonely, wet, uncomfortable, hungry, warm, cold, or have a soiled diaper. In time, you will be able to distinguish between 3 or 4 types of cries indicating specific needs, but until then you may have to check for all of the above when your baby is crying. Also many babies just seem to go through periods of crying for no reason as they get used to their new world. Crying for up to 3 hours a day is considered normal as is crying for 10 to 15 minutes before going to sleep. You can comfort most babies by: using a pacifier, lengthening feeding times, walking while holding him or her, wrapping him or her snugly in a blanket, changing his or her position. If these don't work, try placing your baby in a car seat and placing him or her near or on the clothes drier and turning it on. ENSURE THAT YOU BABY DOES NOT FALL OFF OF THE DRIER. The bumpy or vibrating action of this as well as a car ride often settles even the worst crier. Running the vacuum cleaner or hair dryer sometimes helps also.

COLIC is defined as unexplained crying for more than 3 hours a day in a healthy, well fed infant who is normal in between crying spells, AND you can find absolutely nothing otherwise wrong with the baby. Colic starts between 2 and 4 weeks of age AND WILL GO AWAY by 4 to 6 months of age. No one knows what causes colic, but it is probably many things as some babies respond very well to some treatments and not others. Interestingly, when we started treating gastroesophageal reflux (reflux / excessive spitting up) with strong acid blocking medicines, we seemed to stop diagnosing colic. The worse case of colic I ever saw was crying 18-20 hours a day and not spitting up. We tried an acid blocker as a last resort and the crying completely stopped after a few days on the medicine. Imaging having heartburn without spitting up. Also some babies have extreme reactions to some formulas. Trying a few formulas for a few days at a time might work, but talk to us first so that we can guide you to the best one for your baby.

PLEASE NOTE that all babies tense up their bellies, draw up their legs and turn red in the face when they cry in order to move enough air to cry and this tells us nothing about the cause of the crying.

So what do you do help your baby?

• Ensure that you have a healthy infant by not missing your well baby check ups, keeping his or her immunizations up to date and, if you think your child is sick, then call and make an appointment so that I can examine your baby and rule out any treatable cause for the crying.
• Ensure that you are not overfeeding your child. Please reread the section on bottle feeding as this will tell you how to figure out the exact amount your child should be eating. If you are giving much more than this, then you baby is probably over fed and is crying because the belly is too full. Treat this by limiting you baby to the exact amount needed, feeding no sooner than every 2 1/2 to 3 hours, giving a small amount of water if necessary, comforting your baby however needed until the next feeding and the pain will resolve over the next 1 to 3 days.
• Ensure that the "colic" is not just gas pain. We all have gas, but we only need to do something about it if the gas hurts us. You can reduce your baby's gas by burping your baby often during a feeding (sometimes burping every half ounce is necessary). You can try an anti-foaming agent available over the counter called simethicone drops. Simethicone (a.k.a. Mylicon infant colic drops, Phazyme, or other generics) works by breaking down big gas bubbles into little gas bubbles. This often reduces gas pain as the large bubbles cause muscle spasms in the bowel. Simethicone has been used for decades without any side effects so long you don't overdose your baby. Since simethicone works by breaking up gas bubbles, that means it must be where the gas is to work. If your baby has gas pain now, that gas pain is a few feet down the bowel and if you give it now it will never reach it and not work. This means that simethicone is not an as needed pain medicine, rather it is a medicine that must be given with every meal. This also means that it may take 1 to 2 days to completely work. The dose is .3 to .6 cc with every meal. Before, during, after or mixed in the meal makes no difference, although more may end up where it’s supposed to if you give it before feedings.
• If your baby is bottle fed, try switching to a lactose (milk sugar) free formula called Isomil / Prosobee for a few days and stay on the simethicone.
• There are some mechanical devices that attach to the crib and make car-like noises and vibrations when your baby cries.
• Some babies are still crying after all of the above measures have been tried. For these unlucky parents, I can only reassure you that your child is healthy, normal and will be over the colic by 4 to 6 months of age. Please feel free to consult me when you are worried as I understand how frightening and nerve racking colic can be.
• If your baby acts like they are gagging sometimes, or arches their back a lot when in these crying episodes that might be a sign of reflux.
• By the time you have tried each of the above and have given AMPLE time (2 to 5 days for each step) for each to work the colic should be almost over (4-5 months of age).