It’s not uncommon for newborns to cry. Crying is their only language, after all – a shrill and automatic signal, a biological response to communicate their needs. It could be because they’re hungry, tired, need cuddling, or are suffering discomfort from a dirty diaper. But when the crying seems almost impossible to soothe and instead, becomes more intense over time with each session lasting much longer than the ‘normal’ two hours per day, you might just be facing every parent’s nightmare: colic.

In a survey commissioned by Abbott in March 2013 to better understand the prevalence of infant feeding intolerance issues, it is revealed that colic is the most stress-causing symptom for parents, although it is fairly common among infants. Infantile colic is often a sign as a possible gastrointestinal (GI) symptom, alongside other symptoms such as spitting up and regurgitation, gassiness, constipation, vomiting and diarrhoea. Little do most parents know that GI symptoms might not always be the cause of the incessant crying.

Associate Professor Marion Aw, Senior Consultant, Division of Paediatric Gastroenterology and Hepatology, National University Hospital, reveals the answers to some of the mysteries that surround the frustrating C-word.

What is baby colic?
Infantile colic refers to a collection of symptoms experienced by young babies (as opposed to a medical condition or disease per se). These include fussiness, crying, and irritability in a baby who is otherwise well. Almost all babies experience infantile colic at some point.  It typically begins in the first 1-2 months of life.

This crying and fussiness can be quite distressing, particularly for first time parents. Whilst the majority of babies with infantile colic are medically well, there may be a few where there are underlying medical conditions resulting in the crying and irritability. If parents are in doubt, it would be safer to check with their doctor.

Is it different from abdominal colic?
In a broad sense, it is similar. However, baby colic or infantile colic is presumed to be colic (cramps) arising from the infant’s intestines. Abdominal colic, which in the majority of cases usually refers to cramps from the intestines, can also result from other organs such as the gall bladder (biliary colic) or ureters (pipes that connect the kidneys to the urinary bladder). 

Is colic a sure sign that my child is suffering from GI symptoms?
No, it is not. Whilst the exact cause of infantile colic is not known, the postulated causes include excessive intestinal air, gut dysmotility, or the infant’s immature ability to modulate reactions to internal or external stimuli.

However, if you have any concerns as a parent, it would be safer to get a proper check-up.

For how long would colic affect my baby?
Colic usually gets better by 4-5 months of age. It would be usual for the typical “infantile colic” to persist beyond 6 months of age. If these symptoms persist (crying, fussing, irritability), then it may be important to look for and exclude other causes of that may result in similar symptoms.

It seems that crying, vomiting and spitting up is perfectly normal for infants. How can I tell if these symptoms are truly a cause for alarm?
Almost all babies experience GI symptoms, hence, they are ‘normal’ in that sense. However, the degree to which each baby experiences the symptoms may vary; some babies tend to appear to suffer more from these symptoms compared to others.  Those who have significant symptoms may have an underlying medical problem and parents should seek medical attention.

For example, a baby who regurgitates (vomits) milk several times per day after feeding but is otherwise feeding well, putting on weight, sleeping well and happy in interactions, is a normal baby. In this instance, parents don’t need to worry about the regurgitation.
However, if the baby regurgitates, fusses, cries, refuses feeding and becomes difficult to settle, this would be cause for concern.
Other symptoms that would be cause for concern include:

• Vomiting that has an unusual colour (green vomitus, blood in the vomit)
• Poor weight gain
• Blood in the infant’s stool

Are there any safe ‘home remedies’ that you would recommend to soothe my crying baby?
You may try the 5 “’S” approach:

1. Safe swaddling.
2. Side or stomach sleeping – Whilst sleeping on the back is the only safe position for babies to sleep, it may not be the best position to calm a crying/ fussing infant. Putting baby to sleep on his side may be an option. If it is for a short nap with someone watching, then stomach sleeping may be helpful.
3. “Shh” sound – making a “shh” sound near the baby’s ear.
4. Swinging the baby (carefully) with gentle jiggling movements.
5. Sucking has a calming effect on babies – allow your baby to suck on the breast, finger or pacifier.

Other things that have been tried and found useful may include putting baby in a car seat/ carrier placed on a washing machine whilst it is washing a load, or going for a car ride.

Could breastfeeding instead of using milk formula prevent my child from suffering GI symptoms?
Breast-feeding is always best for babies. Babies easily digest breast milk, and breast-fed babies have a lower chance of getting GI symptoms such as constipation.

What can I do to cope with the stress of having a colicky baby?
Looking after a young baby can be very stressful, particularly if the baby is colicky. It would be important to have help from another person such as your spouse, family member or helper.

In fact, studies have shown that crying in colicky babies reduces if mothers have a one-hour “baby-free” time each day.