Quieting Colic

Last Editorial Review: 2/28/2005

Colic Cures

By Richard Trubo
WebMD Feature

Reviewed By Cynthia Haines

For many parents, living with a colicky baby can just about bring them to tears. Yes, all babies cry, but when a new mom is anticipating peaceful cooing and babbling from her baby, and instead is jolted by hours of shrieking and screaming, it can turn her excitement over her newborn into feelings that she's going mad. Add to that the well-intentioned but insensitive comments from friends and doctors that "it's only colic!" and it can push many parents right over the edge.

But Harvey Karp, MD, a pediatrician at the UCLA School of Medicine, is convinced that he can deliver parents from the curse of colic. Although some of his recommendations -- from swaddling to using a "white-noise machine" -- aren't new, his own research shows that if five specific techniques are packaged and used together, you can put an end to a baby's sob story faster than you can say "hush!"

The classic definition of a colicky baby is one who meets the "rule of threes": He or she cries three hours a day, three days a week, for three weeks in a row. About 20% of babies fit this profile of inconsolable crying and wailing, usually sometime between ages 2 weeks and 3-4months.

There are plenty of theories on the cause of colic, but no definitive agreement on what's behind those screaming baby blues. Over the years, pediatricians have blamed them on everything from an immature nervous system or feeding/digestive difficulties, to temperament or poor sleeping habits.

"The most common feeding problem associated with colic is gastroesophageal reflux, which occurs when some of the stomach's contents leak up into the esophagus," says Barry Lester, PhD, director of the Colic Clinic at Women & Infants' Hospital in Providence, R.I. These acidic juices, he says, can be irritating and painful, leaving your baby in tears.

But Karp, author of The Happiest Baby on the Block, has one of the most provocative theories on colic's cause: He believes that "babies are born three months too soon," and after nine months of pregnancy, their bodies just aren't quite ready to leave the womb and face the real world. They could benefit, he says, from a "fourth trimester" before making that journey through the birth canal. This would allow them to mature for a few more weeks and equip them to cope better with even small amounts of overstimulation that can trigger bawling.

Karp's constellation of colic-quieting strategies sets off the baby's "calming reflex" or shut-off switch, he says, which can stop the crying in its tracks by recreating the comforting sounds and sensations of life in the uterus.

Karp says it's a crying shame that more parents aren't using what he labels the "5 S's" to extinguish their baby's shrieking. "Depending on how colicky or difficult a baby is, you may need to use all five," he says, noting that layering one on top of another can soothe even the loudest little tear-jerker.

  • Swaddling. Wrap your baby tightly in a receiving blanket to duplicate the feelings of warmth and protection, and the "tight fit," in the womb. Swaddling also stops your baby's uncontrolled arm and leg flailing that can contribute to hysterical wailing. Karp says your baby will be calmer if she's swaddled 12-20 hours a day in the beginning. "Twelve hours may seem like a lot from our point of view, but to the newborn, it's already a 50% cutback on the 24-hour-a-day 'snuggling' in the uterus," he explains.
  • Side/stomach soothing. Lay your baby on her side or stomach, which Karp believes shuts down the baby's "Moro reflex," or a sensation of falling, and thus helps keep her calm. (He adds, however, that a baby should never be put to sleep on her stomach, since this may increase the risk of SIDS, or sudden infant death syndrome).
  • Shhhing sounds. There is a whooshing noise within the womb, caused by blood flowing through the mother's arteries. You can recreate this sound with a "white-noise" machine, a tape or CD with these "white-noise" sounds, a dishwasher, a car ride, or a hair dryer.
  • Swinging. Rhythmic movements in an infant swing, hammock, moving automobile, or baby carrier can keep your baby content.
  • Sucking. Occupy your baby with a pacifier, infant bottle -- or a mother's nipple (which Karp describes as "the all-time, No. 1 sucking toy in the world").

Each of these techniques, says Karp, needs to be done exactly right to trigger the baby's own calming reflex. In his book and in a video by the same name, he demonstrates the ideal way to swaddle a baby, such as keeping his arms straight down at his sides so he can't free himself from the blanket; with each fold, the blanket should be tucked as snugly as possible. As for the "shhhing" sound, if it is done very quietly, it won't be as effective, he says.

If the "5 S's" aren't enough to keep you busy, pediatricians often recommend other approaches as well. Lester says it's important to get your baby on a sleeping schedule. "If babies aren't napping during the day, they tend to be tired, fussy, and irritable by the end of the day," he says. "This is also the time when there might be some family stress if mom is tired after a day of caring for the baby, and dad is just coming home from work. All of this can contribute to colicky episodes in the evening."

For bottle-fed babies, crying can sometimes be provoked by intolerance to milk protein. "Formula changes may help babies who are having a hard time with cow's milk," says Lester. Nursing mothers can try removing caffeine from their diet, and see if it makes a difference. For managing gastroesophageal reflux, some parents find that keeping their baby sitting up in an infant seat helps, or according to Karp, laying baby on her stomach or left side.

If your infant continues to cry herself a river, make sure you don't ignore your own needs as your nerves become frazzled and frayed. "In many ways, I worry more about the parents than the crying babies," says Lester. "Parents, particularly mothers, tend to blame themselves for their baby's crying, and feel guilty and responsible. But they need to understand that they didn't cause it." He recommends parents take a break, having a spouse, friend, or babysitter care for their infant so they can get away for an hour or two.

Karp says that colic must be dealt with effectively for the good of everyone. "Crying babies can be exhausting for parents," he says. "Not long ago, the mother of a 6-week-old baby with colic came to see me. She was clinically depressed, agitated, and unable to sleep, with suicidal fantasies. So this can drive parents to the brink of desperation, leading to marital problems and even to child abuse."

Originally published July 15, 2002.

Medically updated February 2005.

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