HELP! MY BABY KEEPS CRYING!

Sometimes babies cry for no reason. They can cry for a few hours in a day and can neither be comforted with food nor coaxing. This may be infantile colic.

Say what? Infantile colic sounds serious!

Doctors define infantile colic, or just “colic” for short, as uncontrollable crying for 3 hours or more each day that occurs no less than 3 times a week for at least 3 weeks. Even though by definition, it requires at least 3 weeks of symptoms, many parents seek medical attention for their infants well before that.

The cause of infantile colic is still poorly understood thus far. There are several suggested explanations such as an immature digestive system which is sensitive to certain proteins in food, immature nervous system that is sensitive to certain external stimulation or even just the baby throwing tantrum to get what he/she wants. What we DO know is that there are NO long-term consequences for colic and that the syndrome usually starts around 2 weeks of age and disappears when the infant reaches 3-4 months old.

I can’t tell the difference. How is it different from normal crying?

Usually, infant with colic will have:

• A loud, high-pitched cry
• Knees drawn up
• Fists clenched
• Arms that are stiff and tight
• Arched back
• Belly that is hard and bulging
• Flatus being expelled
• Facial expression that seems like the baby is in pain
• Red face

Furthermore, parents often complain that they are not able to pacify the baby no matter what they try.

Ok, when should I seek medical attention then?

Parents should seek medical attention as soon as possible if:

• The baby has a fever (>38^oC) and is younger than 3 months old.
• The baby cries continuously for more than 2 hours without stopping.
• The baby refuses to eat or drink when not crying, has bloody stools, or is vomiting.
• You think you have accidentally hurt your baby or shook him/her too hard.

Do seek medical attention whenever it is convenient if:

• The baby has diarrhoea (no blood), has changes in bowel movements or spits out a lot after feeding. This may mean that the baby is allergic to the food he/she is given.
• The baby is more than 4 months of age and still having symptoms of colic.
• The baby is not gaining weight normally.
• You are worried about your baby’s cry, don’t know how to handle it, or unable to handle the stress associated with it.

Is there anything I can do to help my baby who is having colic?

To date, treatments that claim to be useful in treating colic is not supported by good scientific evidence. Formulations containing simethicone (medication to reduce stomach wind), dicyclomine (medication to reduce stomach cramps) and paracetamol/acetaminophen (pain-killer) have not been shown to be useful in reducing infant colic even though they are frequently marketed to do so.

Switching to hypoallergenic feeding formulas such as those made from soy may help if the baby also has symptoms that suggest cow’s milk protein allergy. Breastfeeding mothers can try to make a switch in their diets such as avoiding cruciferous vegetables like broccoli and cabbage to see if the baby’s symptoms improve.

Other methods to calm a colicky infant include

• Swaddling
• Massage
• Frequent burping
• Taking a walk or car ride outdoors
• Crib vibrator
• Background noise (e.g. humming of a washing machine in operation)

These methods may be useful but have not been studied extensively. They are routinely recommended as ways to relieve infantile colic because potential harm is minimal.

My baby’s crying is stressing me out! I feel like I am a bad parent!

Having a child is already extremely challenging, especially for first time parents. Dealing with a baby with colic is even worse. It can be frustrating and sometimes a parent may even feel angry towards the baby. Do not feel guilty if you have such feelings. You are only human, and may have negative feelings at times. These feelings are perfectly normal.

If you are feeling particularly stressed out, it is ok to leave your baby in a crib or a safe place while you take a short break of a few minutes. You may also want to call a family member or a friend for help while you take a longer break.

Please take note that hitting, shaking or hurting a baby can cause severe brain damage, which may lead to death. Make sure you take a break when you have to, so that you don’t accidentally hurt your baby.

References

1. Abzug M, Deterding R, Hay W, Levin M. Current diagnosis & treatment pediatrics. New York, N.Y.: McGraw-Hill Education LLC.; 2014.
2. South-Paul J, Matheny S, Lewis E. Current diagnosis & treatment in family medicine. New York: McGraw-Hill Medical; 2015.
3. Patient education: Colic (The Basics) [Internet]. Uptodate.com. 2017 [cited 1 December 2017]. Available from: https://www.uptodate.com/contents/colic-the-basics

Written by

Dr. Gan Pou Wee