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Treating Colic

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My baby cries a lot and I can't always calm him down. My mother thinks it may be colic. What do you think? How can I treat it?

A: Colic can happen to as many as 20 percent of young infants, usually between one and three months of age. It's described as lots of uncontrollable crying, often for as many as three hours, in an otherwise healthy baby. Most health professionals don't believe it occurs in infants older than three months of age, although exhausted parents can feel like it is lasting for years. Unfortunately, an exact cause is not known. In some sense, colic is considered a diagnosis of exclusion; we want to know that he doesn't have anything else causing the crying. We first prove that the baby is not sick and is otherwise growing and developing normally.

The perception of parents is that their baby is in pain and the usual things they do, like feeding, rocking, holding, talking with, and changing the diaper, usually aren't the answer. The crying tends to be clustered in the late afternoon and early evening hours. Colic is not a sign of bad parenting and crying alone does not hurt the baby.

Parents tend to need lots of teaching and support in dealing with colic. Positioning maneuvers, formula changes, and even medications have been tried with variable and unproven results. The most popular attempts include placing the baby in a mechanical swing chair, taking the baby out for a ride in the car, swaddling the baby in a blanket, burping him more frequently during feeds, or pacing back and forth while holding the child. Sometimes a breastfeeding mother can cut out certain foods from her own diet like green leafy vegetables, broccoli, cauliflower, nuts, and dairy products, especially cow's milk. Giving the infant an anti-gas medicine called simethicone has been tried, but has not been scientifically proven to work. I never recommend medicines like Phenobarbital, diphenhydramine, or bentyl because of their significant side effects.

As you can see, a discussion of colic is tricky and I would need a bit more information to agree with your mother's diagnosis and to write specifically about your infant. Be reassured that, although colic can be hard to handle, it will subside and disappear on its own. So, hang in there and check with your baby's doctor if you are at your wit's end.

Hank Bernstein
Children's Hospital

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

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