A fussy and crying infant can be a tremendous challenge for parents. Just when you get past the stress of childbirth, learn how to feed your baby, your newborn’s weight gain, and possibly deal with a jaundiced baby, your infant begins to spend more time awake, often fussing and crying frequently. Is your baby experiencing the dreaded colic or is something else wrong?
Jennifer Bragg, MD
In this Q&A, Jennifer Bragg, MD, Director, Mount Sinai Neonatal Intensive Care Unit Follow-Up Program, and Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, explains colic, how parents can tell if their baby may have it, and what to do to soothe a fussy baby.
What is colic?
“True colic” is defined as at least three hours of unexplained crying or fussing, at least three days per week, for at least three weeks in a row. It often starts around two weeks of age, peaks at four to six weeks, and goes away by three to four months. These hours of crying usually occur at a certain time of day, often in the evening hours. When not crying, the baby is usually happy. The crying is often high-pitched and many babies will pull up their legs, almost as if in pain, or turn red in the face. It is equally common in boys and girls, and slightly more common in first-born children.
What causes colic?
It is not entirely known what causes colic. Some believe it is caused by immaturity of the nervous system, while others believe it is caused by something upsetting the baby’s stomach. The most conventional wisdom is that colic is caused by a combination of the two. What we do know is that colic has no ultimate impact on a child’s temperament and personality later in life. Studies have shown that a colicky baby is no less likely to be a pleasant, happy, and well-adjusted child, teenager, and adult.
My fussy baby does not have “true colic.” What else could cause their constant crying? Should I see my pediatrician?
There are many explainable reasons for crying in a baby. Hunger, fatigue, and a dirty or wet diaper are simple, easily fixed causes. There are also some treatable medical problems such as sickness, fever, or pain. Babies also may be particularly fussy if their stomachs are upset due to a food sensitivity or gastroesophageal reflux disease.
Crying accompanied by a fever, vomiting, diarrhea, or runny nose may indicate that your baby is sick. A food sensitivity may be the culprit if your baby’s stool contains blood or mucus or if there is excessive spit-up or vomiting even after switching formula or, if breast-fed, the mother has eliminated certain items (dairy, caffeine, etc.) from her diet. Gastroesophageal reflux disease may be suspected if the baby is upset and appears to be in pain during spit-up and shortly after feeding; this can be treated with medication. Addressing these potential underlying causes of your baby’s crying should curtail the fussiness.
What can parents do to soothe their baby?
To soothe the fussy baby, it may help to use a method that mimics the baby’s environment in the womb. They are often referred to as the 5 S’s:
- Swaddling, which entails wrapping a baby’s arms tightly to the side
- Shushing, or using white noise to relax your baby
- Swinging or rocking your baby
- Sucking on either the breast or a pacifier may calm your baby
- Holding the baby in the side/stomach position with a small amount of pressure on their belly can also be helpful
There is no evidence that over-the-counter remedies such a simethicone gas drops or gripe water helps, but they are certainly safe to try and many parents find them beneficial.
If the above does not help, it is important to understand that the crying is not a reflection on parenting skills. If possible, take breaks from the task by seeking help from other family or friends. In time, the crying and fussing will get better.
If symptoms cannot be explained by any of the above, and the crying persists for hours per day and for days or weeks straight, parents should make an appointment with their pediatrician.