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Ask Dr. Mom — Calming Down Colic

Q. My beautiful 6-week-old baby girl cries for hours at a time for no apparent reason. During her crying bouts she pulls her up legs as if she's in pain, and I can't console her. It's worse in the evenings, and I'm becoming exhausted and discouraged. Her doctor says she just has colic. What is colic, and what can be done for it? I'm at my wit's end.

A. Even though colic is a benign condition that does go away, it's also one of the more frustrating challenges new parents face. Colic describes excessive and inconsolable crying in an otherwise healthy infant. (Excessive crying usually is defined as bouts that last more than three hours per day and three days a week for a period of at least three weeks.) Colic affects approximately 10 to 20 percent of newborns and generally lasts from the first weeks until 3 months of age.

Although crying patterns vary widely among infants, colicky babies typically cry in intermittent and intense spurts that often come on suddenly. These attacks usually last an hour or more and may escalate around the same time each day, often in the evening, when most parents are depleted of energy and are least able to cope with the stress. As you noticed, your baby may draw up her legs, clench her fists, or grimace as if in pain. She may also stiffen and pass gas during a crying episode. (Even if your daughter displays all of these symptoms, before you decide that she has colic, take her to the pediatrician to confirm that no other medical problem exists.)

Despite their apparent discomfort, colicky infants are generally well fed, healthy, alert, and active, and they are happy between crying spells. The crying is no one's fault, and colicky babies are found in all cultures, races, and social classes. Over the years different theories have been proposed by physicians and parents as to the causes of colic. These include a sensitive temperament, an immature digestive system, excessive intestinal gas, formula intolerance, overfeeding, and a reaction to specific foods in the nursing mother's diet. Yet the only thing that's certain is that no single cause, such as gas pain, explains colic, and no one method of treatment consistently provides relief.

Frazzled by their baby's constant crying, parents are often desperate for a solution. Unfortunately, no medication has proved to be an effective cure for colic. At best, medication (such as over-the-counter gas-relief drops) may temporarily ease symptoms. At worst, certain medicines can be harmful. For example, drugs that slow down the workings of the intestines in order to stop cramping, can lead to constipation, while stronger medicines containing the sedative phenobarbital depress the respiratory system and slow down breathing.

Less invasive ways of managing colic may help you and your baby cope during this time.

Hold your baby. Contrary to popular belief, holding doesn't reinforce crying any more than feeding reinforces hunger. Rather, attending to a crying baby teaches an infant to trust the tall people around her.

Rock or swing your baby. Gentle rhythmic motion, soothing words, or repetitive singing can help calm your baby, as can white noise, like that of a running vacuum in the next room or the whir of a fan.

Swaddle your baby. Wrapping her snugly in a blanket and holding her can help her feel secure. If this works, you may want to invest in a front carrier or a sling so that you can keep your hands free while she's swaddled close to your body for long periods of time.

Avoid overstimulation. Crowds, loud noises, bouncing, jiggling, or jostling may upset your baby. When she starts to fuss, take her to a quiet room with subdued lighting and a minimal amount of stimuli.

Try different holds. Place your baby across your lap tummy down and pat her back, or carry her facedown on your forearm with her legs draped over either side of your elbow. Then pat her back with your other hand while walking or rocking side to side.

Go for a short drive. Countless parents of colicky babies attest to the wonders of a car ride. The motion and the sound of the motor can lull the baby to sleep  -- at least for a while. Another strategy: Take your baby for a stroller ride around the house until she nods off.

Keep a food diary. If you're breastfeeding, examine your diet for foods that seem to be linked with fussy behavior in your infant. Lots of milk, caffeinated beverages, onions, and such cruciferous vegetables as broccoli, cauliflower, cabbage, and Brussels sprouts in your diet may cause irritability in your baby. For a formula-fed infant, colic may subside when the baby is switched to a hypoallergenic, soy, or lactose-free formula. (Talk to your doctor before changing formulas.)

Take a break. When you're feeling especially tense and anxious, ask your mother, your partner, or a close friend to watch your baby. Just getting outside and walking around your neighborhood or running a short errand can help you gain perspective and cope with your baby's crying. If you're alone with your crying baby and you feel you might lose control, place her in her crib, close the door, and leave the room until you've calmed down. Return periodically to comfort your baby, and call someone to help you.

Marianne Neifert, M.D. (Dr. Mom), is a pediatrician, mother of five, and the author of Dr. Mom and Dr. Mom's Parenting Guide.

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