Colic strikes

“Colic is the medical term for excessive, frequent crying in a baby who appears to be otherwise healthy and well fed. It is a poorly understood yet common condition, and affects around one in five babies…

The crying associated with colic is usually very intense. Your baby’s face will be red and flushed, their crying will be severe and furious, and there may be little or nothing that you can do to comfort them.

You may also notice a distinctive change in your baby’s posture. Your baby may clench their fists, draw up their knees, or arch their back.

Crying most often occurs in the late afternoon or evening and usually lasts for at least three hours a day, at least three days a week, and for at least three weeks at a time.”

– Colic, according to the NHS.

I haven’t had it diagnosed officially, but if you follow the definition above then Elphie has colic. Every other day it seems she will have a screaming fit lasting a few hours. When they are varies, mostly 10pm to midnight, but sometimes later when you think you’ve got away with it of an evening and then it strikes lasting till 3am or one bad night 5.30am; and sometimes earlier, with last night’s screamathon from 5-7pm which was then carefully calmed by MJ, which of course immediately restarted on her departure!

These times are tough – she screams and screams and you try everything but nothing works for more than a few minutes. You know it’s going to be one of those evenings.

The difficulty with colic is that the medical world don’t know what causes it so it’s difficult to treat.

Given that often, during a bout of colic, an infant will scream intermittently, pull their legs up towards their chest and fart a lot, a top theory has been that the cause of colic is gastrointestinal. The underlying cause could be an immature digestive tract, or a sensitivity to certain food types (such as lactose).

With Elphie, the cause certainly appears to be indigestion related – it appears as if she has too much wind in her and is struggling to get it out. Often this seems to be compounded by her being hungry at the same time. When she’s too windy, she struggles to latch, especially to the shields, but the bout of colic tends to end with her finally being able to be fed, often after she has burped and farted enough to clear some space. But that all may be coincidence and cause and effect may not be what they seem.

No single approach works for reducing her colic discomfort – we just try everything and see what helps that evening!

Positions

Although she is supposed to sleep on her back, this seems to be the worst position when she is colicky.

The “magic” colic hold does seem to calm her most of the time.

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Picture credit – Evetsggod

Another position is holding her upright facing outwards against your chest with one arm under her arms supporting her chest and the other through her legs supporting her bottom. This, combined with swaying and vaguely doing the bus stop seemed to work for MJ last night!

She also sometimes likes being draped over one knee when it’s in a crossed position and having her back rubbed.

Another recommendation we have been given is to create a little nest for her and put her on her side. Once cozy, you give her a dummy and gently pat her bum. We have yet to try this one though!

Basically whatever works…

Massage

Other techniques for releasing wind include massaging the baby to encourage farting!

A simple variant is to draw her legs up to her chest and simply bicycle them in the air, gently pumping her knees towards her chest.

A more advanced technique of colic massage is shown in a video at the end of this article from The Baby Checklist. But either my technique is bad or it didn’t work for us!

Medicines

A review in the Italian Journal of Pediatrics from Abdelmoneim E M Kheir summarises the findings for establishment:

“Simethicone, a safe, over-the-counter drug for decreasing intraluminal gas, it is a non absorbable medication that changes the surface tension of gas bubbles, allowing them to coalesce and disperse and releasing the gas for easier expulsion. It has been promoted as an agent to decrease colicky episodes. A randomized, placebo-controlled, multicenter trial concluded that treatment with this agent produces results similar to those of placebo. The perceived improvement may be a placebo effect. Two other RCTs found no benefit for treatment with simethicone.

Dicyclomine hydrochloride is an anticholinergic drug that has been proven in clinical trials to be effective in the treatment of colic. However, because of serious, although rare, adverse effects (eg, apnea, breathing difficulty, seizures, syncope), its use cannot be recommended. Cimetropium bromide, which is widely used in Italy to treat infantile colic, showed a decrease in duration of crying crises in the treated group compared with placebo. The major side effect was sleepiness; there were no reports of life-threatening events.”

Simethicone is in Infacol, the number one colic medicine in the UK. Given the above and the Analytical Armadillo’s withering appraisal of it, I think I might not restock on this once its 28 day use by limit is up.

And there doesn’t appear to be anything using Cimetropium bromide available in the UK.

Alternatives
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The efficacy of gripe water has constantly been challenged but bizarrely, given its popularity, no large studies seem to have been done on it. In theory, even according to the NHS site, the “Sodium bicarbonate neutralises excess acid. Dill seed oil warms and relaxes your baby’s tummy and breaks down trapped air bubbles which are passed out as wind”.

I just wish they did it in smaller bottles. You can only use it for 14 days once opened and as we only use it when despairing of other methods, that meant we had hardly made a dent in it before it had to be thrown. It also has E numbers in it, so is obviously the work of the devil.

Another less ancient alternative medicine is Colic Calm. This is a truly yummy mummy product with its 100% natural ingredients, being FDA regulated, no side effects and £18 price tag. Our attempts at using this would suggest it might lessen the cries and give you some relative peace for a time but it is not a magic cure.

All of these medicines seem to work amazingly for some and not so well for others. They are often criticised for not being any better than a placebo – in fact I am quite tempted to boil some water and pop a syringe of that into her to see if it has the same effect; a placebo effect being better than no effect!

Another option is Cranial Osteopathy… But that deserves a whole post to itself!

Alternative causes

There are other theories on the causes of colic.

A developmental theory sees it as just a normal stage of growing up, which is why it disappears between 3-5 months. Indeed those that have it may simply exhibit crying behaviours in the top 20% of a normal spectrum and it may be this natural variation which is making them react to it more than other babies.

Another view, propounded by Lester and described in a thorough article on colic in The New Yorker, is that some infants are hypersensitive and that they react to their own issues (hunger, pain etc) and to external stimuli (touch, sounds etc.) more extremely than other babies. Hypersensitive babies will not be easy to console via touch as that will make matters worse.

Another theory is that more baby-wearing and responsiveness to cries lessens the effects of colic. The same article explains:
“Ronald Barr, the co-author of the 1997 study on infant cries, has analyzed data gathered by Harvard researchers between 1969 and 1971, during a study of the !Kung San, a tribe of hunter-gatherers in Botswana who practice a version of attachment parenting. “We found that the !Kung San carry their babies upright, have skin-to-skin contact day and night, breast-feed every 13.69 minutes for the first one to two years of life, and respond within fifteen seconds to any fret or whimper,” Barr, who now teaches at the University of British Columbia, told me. “The duration of the crying is fifty per cent less among the !Kung San compared with Western babies, but the !Kung San still have what we call colic, with episodes of inconsolable crying.””

If it gets to much

It is said that recordings of babies crying were used in Guantánamo as a torture method. You can’t underestimate the impact of a constantly crying baby on your psychological health.

Doing a relay between you and someone else can help. As can just walking away for a few minutes of peace. And you can call cry-sis, a helpline set up to support parents of “excessively crying, sleepless and demanding babies”.

I feel awful for Fred as during the day Elphie is normally content, not a lot of screaming, just a general schedule of feeding, burping, gurgling and snoozing. But by the time he comes back from work, she’s in hell-raiser mode and crying all the time. So all he gets to see is a miserable baby and wonder to himself why he ever had children.

Fortunately it is something Elphie will grow out of. For now, we just need to weather the storm.

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