Could It Be Something Else?

As Amelia's parents discovered, inconsolable crying shouldn't always be chalked up to colic alone. A hidden medical cause for a baby's discomfort is likely if the so-called colic isn't getting better by the time your baby is 4 months old and your intuition tells you that he is in serious pain. Among the possible culprits:

Gastroesophageal reflux (GER). This occurs when a weak muscle valve between the baby's esophagus and stomach allows irritating digestive acids to back up into the esophagus. Your baby may be suffering from GER if he spits up after feedings, experiences painful bouts of night waking, cries after eating, draws his knees up to his chest and arches his back, has frequent respiratory infections, and is happiest when he's upright. GER is confirmed by placing a tiny tube in the baby's esophagus and leaving it there for 12 to 24 hours to measure the amount of stomach acid that's regurgitated. If crying coincides with episodes of reflux, GER is the likely culprit. Holding your baby upright after feedings, giving him smaller amounts more frequently, and administering medications that lessen the amount of acid and accelerate the emptying of the stomach will help alleviate his discomfort.

Food or formula sensitivities. Nursing moms have long noted a connection between their baby's distress and their own consumption of dairy products, caffeine, cruciferous vegetables (such as broccoli and cauliflower), spicy foods, wheat, and corn. Likewise, babies may become colicky if they're allergic to the milk protein in formulas or can't tolerate lactose. Suspect a sensitivity to formula or something in your breast milk if your baby begins to feed but pulls off and cries with pain; seems gassy, bloated, or uncomfortable after feedings; spits up profusely; or has constipation, diarrhea, or a red, circular rash around her anus.

If you're nursing, make a diary of possible "fuss foods." List the foods you eat for a week and see if you notice a link between what you consume and how much pain your baby is feeling. Be objective  -- in your desperation to help your baby, it's easy to pin the rap on food. But if a food allergy is to blame, she'll also show other signs (rashes, diarrhea, runny nose, or wheezing). Eliminate the most suspect foods from your diet for at least a week; then add them back one by one, a few days apart, to see if your baby's symptoms return. If you think that her formula is giving her trouble, ask her pediatrician about switching to a hypoallergenic or lactose-free brand.

Other possible culprits. Many conditions have symptoms that are easily confused with colic, including ear infections, urinary-tract infections, constipation, and a tight rectal opening. The last condition may be the problem if a baby grimaces, gets red in the face, or draws his legs up to a distended abdomen before moving his bowels, cries during bowel movements, and seems greatly relieved after passing a stool. If this is the case, your baby's doctor can perform a finger dilation of his rectum, which enables stools to pass more easily.

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