When a baby cries for a long time without any obvious cause parents are often told their infant has colic. This is a “catchall” description for when a baby cries incessantly for around three hours a day and cannot be comforted. The crying generally happens in the afternoon or evenings. It often starts in the early weeks and usually stops by about four months.
It can be extremely distressing for a mother to listen to her baby crying without knowing what is wrong or what to do to comfort her child. It’s easy to start to wonder if breastfeeding is to blame, particularly if others suggest it might be.
What causes colic?
Sometimes the cause of colic is never uncovered and may be related to the baby’s own personality or temperament. Some babies are more sensitive than others and need more comforting. It’s not unusual for a baby to cluster feed in the evening both for comfort and to increase milk production, and crying which is labelled as “colic” may simply mean that the baby needs to nurse again.
For other babies, the discomfort can be traced to overabundant supply of milk, overactive letdown, reflux or occasionally allergies. Sometimes a baby is still feeling discomfort from the birth process.
Positioning and attachment
Colic-type symptoms can appear if a baby is having problems latching onto the breast. A shallow latch can lead to babies taking in a lot of air which then causes discomfort. The birth process can sometimes leave babies with tension in their jaw and neck, which makes it hard for them to open their mouth wide enough.
This article gives a lot of suggestions on how to encourage a deeper latch and finding a position which may be more comfortable.
Tongue-tie can also cause difficulties with latching and positioning and can be distressing for both mother and baby. You can find more information in this article:
The baby may be gaining weight well,but seems fussy at the breast. She may pull off the breast spluttering and a mother may see a forceful milk flow. The baby cries and wants to nurse,but seems angry and arches away. Her poo may be green and frothy, rather than yellow, and she seems windy and unhappy.
This article explains the causes of oversupply and gives a lot of suggestions on how to improve things.
Reflux
Reflux and colic are closely related and are often confused. Reflux can also be caused by oversupply and both are more often a problem when a baby is given large feeds with long gaps in between. A baby who has reflux often spits up milk and cries more when he is lying down or is in a car seat.
This article talks about identifying reflux and offers ideas to help.
Allergies
Mothers with a fussy baby often wonder if something in their diet is to blame. Some cultures whose diet includes spicy foods have a special, milder diet for nursing mothers for the first month or so. Most babies are not bothered by any foods their mother eats, but if a baby comes from a family with allergies and seems fussy, it can help to keep a food diary just to see if any particular food triggers discomfort.
One study by Ronald Barr, a paediatrician at McGill University in Montreal, Canada, looked at infant crying patterns.[i] It suggested that some crying is normal, but it may be prolonged by modern practices such as longer intervals between feedings. Dr. Barr compared the results of a study on the !Kung of South Africa[ii] with the typical ways in which American and European infants are handled and fed. The !Kung carry their babies with them constantly and feed them whenever they cry. Babies may be fed three or four times an hour for a minute or two at each feeding.
Dr. Barr asked some mothers to carry their babies for at least three hours a day and these mothers reported that their babies cried only half as long as babies who were not carried for the extra three hours.
What can I do for my unhappy baby?
Many fussy babies are more settled if they are kept close to their mother and can nurse whenever they need to. Offering the breast calms many a crying infant, especially if his mother has been trying to limit feeds because of sore nipples or to try to space nursing.
If that doesn’t work, then just holding him and carrying him may help. Especially for babies with reflux, being held upright is much more comfortable than lying down. All babies have wind and many aren’t particularly bothered by it, but if it is making him uncomfortable an upright position can help move gas bubbles that are causing him pain.
A useful phrase is “contact, carry, walk and talk”: research has shown that these steps, used in a sequence as needed, can significantly reduce crying in many babies.
Many mothers have found the following ideas mentioned in The Womanly Art of Breastfeeding[iii] helpful:
Respond right away. If a baby is picked up and comforted before he gets too distressed it is usually easier to calm him.
Try to use a soft baby carrier as much as possible. A baby likes to be close to his mother and being upright is often more comfortable. It is easier to respond when he needs to feed. Going out for a walk may be relaxing for you both.
Try the Magic Baby Hold/colic hold (pictured). This can be a really helpful calming technique, especially for a well-fed but fussy baby. The baby is held with his back against his mother’s chest so both are facing forward. Mother’s left arm goes over the baby’s left shoulder and holds his right thigh. The baby will have one arm either side of his mother’s arm and his mum will have a solid grip on his leg. He can face the floor or be hugged against his mother so he faces outwards or even with mother’s hand (still holding his thigh) on her hip. Mum has her shoulders relaxed, and a hand free if needed. In this position the baby is also on his left side, which some babies find more soothing.
The “baby bounce” can be added to this hold. It can start with simple swaying, then adding a “hitch”. Although the baby’s face is not visible, it’s possible to feel his body’s tension, so if the back of his head starts to wrinkle or his body starts to tense the next things is to turn just a bit so he sees something different. Mostly the baby bounce and change of scene will help.
Burp her.
Change her nappy.
Undress her completely – her clothes may be causing her discomfort.
Swaddle her in a light blanket.
If she is overstimulated, take her to a quiet room.
Rock her.
Sing to her, talk to her, or make loud “shh” noises while keeping her in your arms.
Try different positions such as laying her on her tummy and rubbing her back, or carrying her tummy down across your forearm.
If the baby is being fussy at night and it feels like you are the only ones awake in the whole world, it might help to go outside or look out the window at the moon and think about all the other mothers and babies out there under the same moon.
A nice relaxing bath together can calm both mother and baby, and some babies who are refusing to nurse will naturally latch on in the warm water.
Some babies like a gentle massage (there is one called the “I love U” massage in The Fussy Baby Book by William and Martha Sears).
Go out and about or run errands during the baby’s fussy time to entertain him.
Dance with him.
Put the baby in a sling or blanket “hammock” and swing him gently either head-to-toe or ear-to-ear.
Chiropractic adjustments have been suggested to alleviate colic in some babies.[iv]
If he really wants to nurse, nothing will help but nursing!
Is anything helping?
When a baby cries non-stop and it’s hard to comfort him, it’s easy for a mother to feel she is doing something wrong. She may start to think she doesn’t know how to mother her own child or even that he is doing it on purpose. Well-meaning friends may suggest the baby is manipulating his mother, but babies aren’t capable of this. They don’t understand why they are in pain and just want the comfort of their mother’s arms.
If he continues crying even when held, it can seem to a mother that she is not helping her baby, but it is never a waste of time to cuddle him. In fact, a baby needs his mother more than ever at this time. Even if he doesn’t know why he is unhappy, having his mother close helps him feel safe and loved.
Finding support from others
Looking after a crying baby can be exhausting and stressful. If it gets to the point where a mother feels at her wits’ end, it can help to ask someone else to hold him for a short time while she takes a break and makes a hot drink or has a snack. If she is on her own and really feels like it is too much, then lying him down somewhere safe, just for a few minutes while she goes to another room and takes a few deep breaths, can restore her ability to comfort her little one.[v]
It’s sometimes suggested that a baby be left to “cry it out”, but prolonged crying is physically and emotionally very stressful and may have an impact on the wiring of the brain.[vi] If left, a baby will stop crying eventually but learns that her needs for comfort have not been taken seriously. Responding to a baby’s cries builds security and independence in the future.[vii]
Mothers of crying babies need a lot of emotional and practical support. It is tough having a constantly crying baby but it does end. Lots of fussy newborns grow into relaxed, happy six-month olds. While it is ongoing it can help to find a circle of friends you can complain to. At LLL meetings mothers will be able to empathise, offer suggestions and encouragement during this challenging part of motherhood.
You can find more information here: https://www.laleche.org.uk/unhappy-baby/
Recommended reading:
The Fussy Baby Book by William Sears and Martha Sears
Colic Solved: The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-To- Soothe Baby by Bryan Vartabedian
The Womanly Art of Breastfeeding, 8th Edition, by La Leche League International
Written on behalf of La Leche League GB by Anna Burbidge, March 2018. References
i Barr, RG et al. Feeding and temperament as determinants of early infant crying/fussing behavior. Pediatrics, 1989; 84 (3): 514-521.
ii Konner, M. and Worthman, C. Nursing frequency, gonadal function, and birth spacing among !Kung hunter-gatherers. Science, 1980; 207 (4432): 788-791.
iii La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 383-384.
iv Walters, S. How to Cope with a Crying Baby. New Beginnings, 2007; 24 (1): 30-31.
