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DEAR MAYO CLINIC: Our newborn daughter is often inconsolable and sometimes cries for six hours a day. Is there anything that can be done to help a colicky baby? It's difficult to see her so upset.
ANSWER: While it can be very stressful for parents, colic doesn't have any long-term effects on the baby's health or development. Colic typically does not require medical care, nor is it a symptom of a larger medical problem. Fortunately, colic usually improves on its own within several months.
All babies cry and get fussy from time to time. But colic is different than normal fussiness. Babies with colic typically cry more than three hours a day, three days a week for three weeks or longer. The crying tends to come around the same time each day. There appears to be no clear reason for the crying. Babies with colic are otherwise healthy and may cry even when well-fed and clean.
Colic crying is intense. It sounds distressed and is often high pitched. The baby's face may flush. Babies often curl up their legs, clench their fists and have tense abdominal muscles during episodes of colic.
Comfort measures — such as holding, rocking or walking with the baby — usually do not help soothe an infant with colic. But some parents do have success easing colic symptoms by going through a consistent series of interventions. They may include steps such as checking if a diaper needs changing, seeing if the baby is hungry, swaddling, gentle swinging or trying a pacifier.
Mix up your strategies to try to calm the baby.
In most cases of colic, the symptoms get better on their own by about three to five months of age. A medical evaluation usually is not necessary.
However, if colic is causing a significant amount of worry and stress, or if your baby has other symptoms along with colic that may signal another medical problem, make an appointment to see a health care provider. A thorough history and physical examination can confirm that no serious underlying medical concern is causing the baby's persistent crying. Concerning symptoms may include poor feeding, slow weight gain, vomiting, diarrhea, constipation, abdominal distension, blood in stools, fever, irritability, lethargy, breathing problems, poor muscle tone or an unusual rash.
There are a number of options for parents who feel the need to do more than wait for the symptoms to improve. Simethicone, an over-the-counter gas-relief medication, is used frequently. But a randomized, placebo-controlled trial of this medication found no benefits for babies with colic. If a baby is formula-fed, trying a hypoallergenic formula may be helpful. In breast-fed infants, there is some evidence to support mothers eating a low-allergen diet, starting with avoiding cow's milk.
Research also has shown that the probiotic Lactobacillus reuteri seems to reduce the amount of time breast-fed babies with colic cry. Be aware, though, that probiotic supplementation should not be given to an infant whose immune system or intestinal system is compromised, nor should it be used for infants who have indwelling central venous catheters, unless it is provided under a physician's guidance.
Caring for a baby with colic can be exhausting. Hours of crying can be challenging for everyone in the household, but recognize that crying for prolonged periods will not hurt your baby. Ask others for help and support. Call in a friend, relative or grandparent for breaks that are necessary and important. Even an hour or two away can make a difference. Doctors often advise that busy parents of colicky infants try to catch up on their rest when the baby is sleeping.
If you get frustrated or upset, it is OK to put a crying baby in his or her crib for a little while, so you can take time to collect yourself. Never shake a baby. Be sure to reach out to your baby's health care provider if your concerns continue. He or she may be able to offer some useful tips on how to manage colic, as well as reassurance that colic is temporary and likely to fade over time. — Dr. Kara Fine, Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota