How to treat colic

How is colic treated?

Many colic treatments have been tried over the years however a cure for colic has not been found. There are no truly effective ways of relieving a baby’s symptoms of colic. Fortunately colic eventually (usually by 3-4 months of age) goes away on its own. So treating colic focuses on making baby as comfortable as possible, until the symptoms resolve themselves.

Conservative therapies for comforting baby

Doctors and midwives will most often recommend conservative treatment, which basically means keeping baby as comfortable as possible without using medicines. Try the following strategies:

Cuddling and rocking baby:

• Try holding your baby in your arms, close to your chest and rocking them. Both the close contact and the sound of your beating heart might help soothe your baby.
• Some babies don’t like to be held too closely. If this sounds like your baby, try holding them so that they are facing away from your chest.
• Try not to move around too much, jiggling them doesn’t help.
• Try to avoid picking baby up and putting them down too often or constantly changing your holding position as this might be unsettling for them. Try to hold your baby in the same position and talk or sing to them gently. It doesn’t really matter what you’re saying, it’s the soothing sound of your voice that baby will respond to.

Carrying baby in a sling:

• Try holding your baby a carrier/baby sling and walking around. You can do laps of the house or take a stroll outside if the weather permits.
• Make sure you only use a carrier that meets Australian safety standards and that you can always see your baby’s face while you are holding them in the carrier. The body contact will help soothe your baby. The rhythmic rocking motion can also help soothe a baby and help them fall asleep.
• Be aware that some babies under 4 months old have suffocated while being carried in a sling. This is why it is important that you can always see your baby’s face while they are in the carrier. In addition, while your baby is in the carrier, check that:
  • The carrier is tight enough that baby’s tummy and chest are held close to you.
  • Their head is help upright and their chin does not fall forward to meet their chest. You should be able to see their face at all times and it should be close enough for you to be able to kiss the forehead
  • Your baby’s face is not covered by anything, including the fabric of the carrier.

Rocking baby:

Try holding your baby and rocking them gently from side to side. Be sure not to make any fast or frantic movements, as they’ll probably unsettle your baby and might even be dangerous.

Take baby for a walk in the pram:

Make sure your baby is securely fastened in the harness before you set out. Take a walk outdoors to a calming place like the park, which can help you relax too. The movement of the pram might be soothing for baby. Do not leave your sleeping baby unsupervised in the pram, though.

Put baby in a rocker or bouncinette:

For up to thirty minutes. The gentle rocking or bouncing might help calm them. Make sure you secure the harness and do not leave your baby unattended while they are in the rocker. Never place a rocket or bouncinette on a table or other raised surface. It should only be used on the floor.

Take baby for a drive:

They may find the gentle hum of the engine and the movement soothing. Ensure they are correctly secured in a car restraint that is suitable for their age and meets Australian safety standards.

Sounds/white noise:

Rhythmic or constant sound can also help soothe a baby. If you’re vacuuming or using the clothes dryer, put your baby somewhere they can hear the repetitive noise. However, be aware that it is unsafe to leave your baby on top of a clothes dryer or washing machine. Other white noise that may help sooth your baby include the noise of a fan or music played softly.

Swaddling:

Swaddle your baby using a thin blanket or cloth. Swaddling helps babies feel warm, comfortable and secure. It may also help to keep their room quiet and dimly lit.

Baby positioning:

Lay your baby across your knees on their tummy; this places pressure on their belly. When they are in a comfortable position where they will not fall, gently rub their back. The rubbing and pressure on your baby’s belly may help comfort them.

Use a pacifier/dummy:

Give baby a dummy (pacifier). While not all babies like dummies, for some they provide immediate relief from colic. Be sure to clean the dummy hygienically, every time you use it.

Massage:

Baby massage involves gently stroking your baby’s skin on different parts of their body and typically takes 10-30 minutes. Rub some baby massage oil or moisturiser into your warm hands to start and make sure the room is comfortably warm for baby. Gently stroke:

• The soles of their feet, moving your fingers from heel to toe.
• Their legs, starting at the ankle and stroking your hand up over their knee and along their inner thigh.
• Their chest, by placing your hands on their shoulders and stroking them down and in to the centre of their chest;
• Their arms, starting at the shoulders, while baby’s arms are at the side of their body, and stroking gently along the length of their arm.
• Their stomach, but only at times when their tummy is not full and does not feel hard and only after their belly button has fully healed. Also bear in mind that the stomach is particularly sensitive and some babies may find having it massaged unsettling. Place your open hand on their stomach and move your thumb in a semi-circle to meet the side of your hand.
• Their face, using your fingertips to stroke from the middle of their forehead, down around the side of their face. Then move your fingertips in circular motions, similar to when washing their hair, over their scalp.
• Their back, by placing them on their tummy and running your hands gently down their full length, to finish at their heels.

There is insufficient evidence to determine whether or not massaging a baby helps reduce the symptoms of colic, like crying and it may actually unsettle and overstimulate some colicky babies. However, some babies do seem to respond to massage. It has no harmful effects and may have additional benefits like enhancing parent-infant attachment. So you may want to follow your baby’s lead on whether or not they like it. If they don’t like it, don’t persist.

Changing baby’s feeding habits

Colic may be caused by air bubbles that enter baby’s digestive system during feeds. Feeding baby in particular ways can help reduce the likelihood of this occurring.

Breastfeeding mothers could:

• Ensure their baby is properly positioned at their breast;
• Allow their baby to empty one breast, before changing to feed on the next.

Bottle-feeding parents can help reduce the likelihood of air bubbles in the digestive system by:

• Keeping baby upright during feeds;
• Using a fast flowing teat;
• Winding (burping) their baby after feeding. To wind a baby:
• Hold them in an upright position; and
• Apply gentle pressure to their stomach; or
• Pat them gently on the back.

Mother’s dietary changes for relieving colic

Colic usually affects babies in the first months of life when they are breastfeeding or formula feeding. Mothers that are breastfeeding their babies sometimes worry that the food they eat causes their baby’s colic. Although this is rarely true, there is some evidence that a mother changing her diet can help colic for specific groups of infants. You should seek advice from your doctor if you intend to do this.

Eliminating dairy products for lactose intolerant babies

There is currently insufficient evidence to determine whether removing dairy products from the mother’s or baby’s diet reduces colicky crying. However, when colic is thought to be caused by lactose intolerance or allergy, breastfeeding mothers might consider eliminating cow’s milk from their diet. Formula fed babies could change to a non-cows’ milk formula such as soy based formula, although only after discussion with a healthcare professional. It is recommended that mothers should continue breastfeeding babies with colic.

Other foods

Breastfeeding mothers may also consider eliminating caffeine from their diet as a strategy for reducing their baby’s colic. This means avoiding tea, coffee and caffeinated soft drinks such as Coke, and also foods that contain caffeine like chocolate. Other foods that may be eliminated from the diet of a mother breastfeeding a baby with colic include:

• Onions;
• Cabbage;
• Other foods which the mother is sensitive to.

Dietary changes for babies

Spacing feeds

It is important to space the feeds of a baby with colic so as not to overfeed them. Overfeeding can make colic symptoms worse. Try to wait 2-2.5 hours between feeds the start of one feed cycle to the start of the next feed cycle if your baby has symptoms of colic.

Food that do not appear to influence colic

There is no evidence to support giving babies with colic probiotics (or beneficial bacteria). However probiotics are unlikely to harm a baby, as long as they are administered in the correct quantity, and prepared using cool boiled water.

Medications for colic

No medications have been proven effective in treating colic. Most medicines advertised as treatments for colic are not harmful to a baby if used properly, although there is no evidence they will be of any benefit. If you are interested in trying any of these medicines, discuss the potential risks and benefits with your doctor before starting treatment, and only use medications if they are recommended by your doctor. Medication may interfere with your breastmilk supply, or make it more difficult to recognise symptoms if your baby is ill. If you do use medicine, make sure your doctor has recommended it, and use it only for a short period of time (based on a doctor’s recommendation).

Colic drops

There are a range of colic drops that can be added to the bottles of formula fed babies, to help release air bubbles. As colic has not been shown to be caused by “wind” there is no scientific reason to use these drops. They have different active ingredients, that have different effects on your baby.

Lactase colic drops breakdown an enzyme called lactose (commonly found in dairy products, and also in breast and formula milk). These drops may help babies who are having difficulty digesting lactose.

However you should talk to your doctor about the potential benefits and risks before giving a baby colic drops. If you are using colic drops and don’t see any improvement in your baby’s symptoms after a week, stop using them.

Alternative therapies for colic

Gripe water

Gripe water is a popular alternative treatment for colic, however it is not recommended. There is no scientific evidence to support the use of gripe water. Regardless, parents have been giving gripe water to their babies since the late 1800s, at which time it contained alcohol and sugar.

Nowadays, gripe water is typically a concoction of herbs such as dill and fennel, in water. In several research studies it has been found to be ineffective. Its use diverges from infant feeding recommendations of only giving infants breast milk or infant formula until they reach six months of age. The additional fluid can cause delay in establishing proper breastfeeding, leading to a reduced milk supply. Giving anything other than breastmilk during the first 6 months of life can introduce bacteria which can cause allergies or irritate the baby’s intestines.

The only benefit that could be reasonably expected from this herbal concoction is the extra fluid the baby gets from the gripe water (as long as it is clean water), or the soothing effect of the sweet taste. The high sugar content of some gripe water preparations may damage infant teeth. In addition herbal treatments cannot be assumed to be safe, and are typically untested.

Natural treatments

It is important for parents to be aware that so-called ‘natural therapies’, including herbal concoctions and dietary supplements, are often untested for use in children. Unlike medicines, they can be sold even when there is no evidence of their effectiveness or safety. Being natural does not exclude the possibility that a remedy can be harmful. For example, star anise tea has traditionally been used to treat colic but is no longer recommended because it sometimes contains toxins that could poison a baby.

The potential harms of untested natural therapies are increased for babies who have much smaller bodies, developing organs and immature immune systems. Parents considering using these therapies should discuss the potential risks with their doctor, before commencing treatment.

Seeking medical care

Ruling out health problems

If your baby is crying because of colic, you can rest assured that the crying will pass by about six months of age. However, if you have not discussed your baby’s excessive crying with your doctor you should do so, to ensure there is not a more serious problem underlying their crying.

When should I take my baby to see a doctor?

Sudden onset of colic

There are some circumstances when you need to consult your doctor immediately, if your baby is crying excessively. These include if your baby:

• Is crying in a high pitched tone or has a weak cry, or cries continuously.
• Suddenly develops colic symptoms, after previously been well settled (especially if crying began after one month of age).
• Has a high temperature (>38oC if they are under 3 months and >39oC if they are 3-6 months old).
• Has a bulge on the top of their head, where the skull is still soft.
• Has a fit (a seizure).
• Skin changes to a very pale or blue colour, or has a blotchy appearance.
• Has difficulty breathing, for example their breathing is too fast or they grunt when they try to breathe.
• Is vomiting and the vomit contains green fluid.
• Has blood in their faeces.
• Is not feeding properly. If a baby stops gaining weight or if their weight gain slows down it is usually an indication they have a condition that needs treatment.

Seeking support

You should also seek professional help if you feel like you need support and cannot get the support you need from friends and family. They may be able to refer you to a support group or other support service.

(Kindly reviewed by Annie McArdle RN, RM, CHN, Master Adv. Prac. (Healthcare Research); Clinical Midwife at Mater Mothers’ Private Brisbane with over 25 years’ experience in parent information and education.)

More information

To read more about infant colic, what it is, causes and how to treat it, visit Infant Colic.

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