Is Colic really the problem? No, it's is a symptom.
Updated: Feb 23
So many times when talking to parents about the difficulties they are facing with baby, they tell me that someone told them "It sounds like your baby has colic."
But what actually is colic?
Colic is when a baby cries for hours a day, for weeks at a time, for "no apparent reason."⠀
Many of us believe our baby has colic, or we have been told by family, friends, or other professionals that our baby has colic. And so we just accept that our baby is fussy, cries a lot, and is "difficult." ⠀
But what we need to be asking is... WHY?⠀
WHY is your baby crying for "seemingly no apparent reason?"⠀
Because, I can assure you, there is a reason your baby is crying. It might just be hard to see.
And it's not enough to just write off baby's difficult temperament as "colic." Or to just, "wait and see" if this is a phase.
Because in fact, colic is a SYMPTOM of the root cause. Colic is NOT the cause. ⠀
There are five common, but often overlooked, reasons for why your baby is so fussy. ⠀
1. Your baby is chronically overtired.⠀
2. Your baby has feeding issues.⠀
3. Your baby has GI discomfort/issues.
4. Your baby has tightness in their body.⠀
5. Your baby has sensory processing difficulties.⠀
Or... your baby has any combination or all five of these. Any of these reasons (or combination of these reasons) would absolutely cause your baby to be distressed for most of the day and for weeks at a time. ⠀
BUT YOU DON'T HAVE TO JUST LIVE WITH IT. ⠀
And you shouldn't, because your baby is crying out for help.
So let's dive into these root causes a little more so we can put you on the path to getting you and your baby help from a proper specialist.
1. Your baby is chronically overtired
Newborns and infants need a TON of sleep, and this is an essential function that impacts every part of a baby's development. Newborns (birth- 4 weeks) need an total of 16-20 hours of sleep per day! And young infants (1-3 months) need a total of 15-18 hours of sleep per day! Newborns are waking frequently, but should generally be taking 1-2 hour naps and sleeping 11-12 hours at night (waking often to feed of course). Young infants are starting to develop more consistent sleep/wake patterns. Most naps should be over an hour each, and nighttime should be 11-12 hours (still waking to eat of course). If baby is only taking 20 minute naps, or their total nighttime sleep is consistently under 11 hours, baby can quickly become overtired. And we all know what being overtired feels like! As adults we can feel crabby, short-tempered, foggy, and disorganized. Babies who are chronically overtired feel the same way. They are never caught up on sleep, so are always fussing. This can easily cause feeding and developmental issues, because baby is too tired to function at his fullest potential.
If your infant is struggling to meet her daily sleep needs, our online course Baby's Best Start will teach you all about infant sleep, and how to get your baby to love to sleep using easy, practical techniques that align with your own beliefs and needs. No need to cry it out!
2. Your baby has feeding issues
Along with sleeping, feeding is a basic building block of infant development. And if baby is having difficulty with feeding, you can expect that to affect baby's temperament. Sometimes, newborns and infants can have feeding issues. These are common issues, but they are not normal and they warrant attention. A few examples may be: shallow latch, weak latch, uncoordinated oral motor patterns, tethered oral tissue (tongue, lip, or buccal tie), or feeding aversion. All of these issues can cause poor milk transfer, excessive gassiness, reflux, and/or fatigue, which in turn causes baby to cry and fuss often. So many times when a baby is labeled as "colicky", we find that baby has an underlying feeding issue. Once that feeding issue has been resolved, baby's temperament suddenly changes, and baby is able to thrive.
If you suspect your baby has any feeding issues, do not wait to ask for help. You may need to seek out 1 on 1 help from a specialist such as a: lactation consultant, pediatric speech therapist, pediatric occupational therapist, pediatric physical therapist, chiropractor, and/or dentist to address your infant's individual needs and concerns. In our online course, Baby's Best Start, our feeding expert (Laura = pediatric speech therapist and lactation consultant) teaches you all about infant feeding, correct/incorrect latching, how to bottle feed properly, and how to tell if your baby is struggling with feeding issues.
3. Your baby has GI discomfort/issues
It's not uncommon for babies to experience some GI discomfort as they are just getting used to eating breastmilk or formula. Some gassiness is common and typical. However, it becomes problematic when babies develop things like reflux or excessive gassiness that causes them to be uncomfortable for most of the day or after every feeding. Babies can also have food intolerances like dairy or soy that can upset their system and cause them discomfort.
Reflux is often difficult to manage, and baby can also suffer from a type called silent reflux which often goes mis-diagnosed. Food intolerances are also fairly common but are also difficult to diagnose at first unless mom can do an elimination diet, or you can find a formula that doesn't aggravate the symptoms. Most formulas have dairy and soy, so you really should talk with a feeding specialist to discuss different formula options if needed.
There are a number of specialists that may be involved in helping you figure out the causes of baby's GI discomfort. In addition to your pediatrician, you may need referrals to a pediatric gastroenterologist, lactation consultant, pediatric feeding specialist (like speech or occupational therapist), pediatric allergist, chiropractor, or other wellness practitioner.
Know that there are more ways than just medication that can properly treat reflux, including ruling out other causes of reflux like food intolerances and/or tethered oral tissues.
Infant massage and therapeutic handling can effectively calm baby's body to help decrease the pain and tightness resulting from the gassiness, reflux, and GI discomfort.
In our online course, Baby's Best Start, I teach some simple but effective stretches and massage that you can use on any age baby to relieve gas and abdominal discomfort the natural way.
4. Your baby has muscular tightness
Infants can develop tightness quickly and from a variety of reasons – from delivery, hospitalizations, container usage, or from just being held a certain way. Tightness can also occur alongside feeding issues like tongue/lip ties or other latch issues as a way of compensating for weakness or dysfunction in the mouth. Like I mentioned in the previous section, babies with excessive gassiness or reflux also commonly have tightness from guarding/bracing their bodies from pain or discomfort.
Tightness in baby’s body can affect every important function and their future development. ⠀
This is a common scenario that we see frequently...
If a baby has trouble latching because of restrictions on the mouth, then he develops tightness in his shoulders because he is working so hard to latch, then he develop tightness in his abdomen because he is experiencing gas and reflux constantly… and then the tightness continues and prevents the baby from ever developing a proper latch. It becomes a vicious cycle!
Baby now has difficulty relaxing enough to fall asleep, so he only takes 20 minute naps and is up all night. Baby cries all the time and is labeled as colicky, but what really needs to be addressed is the baby’s latch and underlying tightness.⠀If it’s not addressed at an early age, it can impede their motor milestones, preventing them from tolerating tummy time, reaching and grasping, visually tracking toys, rolling over, and so on.⠀
So what do we do about it?⠀
First, you need to do everything you can to prevent tightness. You can do this by avoiding containers, feeding baby appropriately, and allowing baby to be positioned differently throughout the day. And in our online course – Baby’s Best Start – we'll teach you everything you need to know about how to prevent tightness in baby, how to stretch baby safely if they do get tight, how to position and feed baby, and so much more.
If you need individualized support, a pediatric physical therapist will be able to evaluate your baby to assess for muscular tightness. Keep in mind, you may need to look into feeding issues that are causing the tightness if it continues to persist.
5. Your baby has sensory processing difficulties
What I mean by sensory processing difficulties in this case, is that baby may have a hard time self-regulating and calming down on their own. It is difficult to know for sure if your baby has sensory processing issues, but you must first rule out all other causes.
There are many things you can do in the meantime to support your baby's sensory system that are generally easy to do. As therapists, we sometimes suggest swaddling or using a pacifier to support a baby in learning how to calm, but with proper guidance so that these are not later relied on too heavily. Paying close attention to your baby's cues is critical, because often times babies with sensory processing difficulties go from calm to inconsolable in seconds, and they are hard to help regulate back to a calm state. For these situations, you may have to stick more rigidly to a schedule (making sure you don't wait too long to feed them or put them to bed) and being more proactive and preventative until baby has developed more mature self-regulation skills.
If you suspect your baby has sensory processing difficulties, an evaluation from a pediatric occupational and physical therapist would be beneficial. Also, pediatric chiropractors or wellness practitioners may be able to offer support to the baby's nervous system that can help bring the baby back to a calm state.
So if you think your baby has colic, and you don't know what to do, please reach out to us! We can help guide you in the right direction and get you the help that you need.
Gia Mydlo, PT, DPT