Video: Infantile colic
Hi there, I’m Dr Golly. I am privileged to be involved in the delivery of newborns almost every day in my job, and – I’ve had the incredible honour of witnessing the births of my own 3 children.
The birth of a baby is at once miraculous, heart-warming and fulfilling – but it’s also terrifying! Especially if your newborn bundle of joy experiences unsettled behaviour in the first weeks of life.
Today I’m going to focus on unsettled babies and I’ll show you some tips and tricks to get everyone in the family some more hours of sleep!
Colic is a form of pain that typically comes and goes quite abruptly. When babies are particularly unsettled – we refer to this as infantile colic.
It comes from the Late Latin term colicus – pertaining to the colon.
But it is normal for babies to cry – so how much is too much? Let’s jump to the whiteboard and take a look at normal baby crying and what happens in the case of infantile colic.
All babies cry in the first months of life, and it’s normal for most babies to cry for up to 2 hours per day. This crying tends to peak at 8 weeks and settle down by 12 weeks.
Colic is defined by Wessel’s criteria, with episodes lasting for more than 3 hours per day, on more than 3 days of the week, for a period of 3 weeks or more.
But anyone with a newborn will tell you that there’s no way you’d wait 3 weeks to ask for help!
So we tend to look for causes of unsettled behaviour in any baby that is healthy & well fed – with no other apparent cause for their crying.
The causes of colic are mostly broken down into 2 categories: physical and emotional.
Some common causes for physical pain include: trapped wind, under/over-feeding, intolerance to cow milk protein, lactose intolerance and an immature gut. Some of the emotional causes can be due to a baby’s temperament, over-stimulation or parental stress.
We often find signs or other symptoms that may suggest a cause for their crying, and all of these possible causes will be analysed by your GP or paediatrician, with a thorough history and examination.
Remember that babies may also cry if they are unwell and it’s important to have them seen by a doctor if you have any concerns regarding their health or behaviour.
Young babies never cry to try manipulate their parents. If there is excessive crying, there’s usually a good reason for it. So what can you do as a parent, if your child is unsettled? Parents and caregivers should first start by looking for manageable causes of crying.
- Hunger is common and newborns have a particularly chaotic feeding routine, especially during growth spurts.
- Next, ensure your baby is comfortable – this means checking that there’s nothing scratching or irritating them from clothing, they’re not too hot or too cold, there’s no hair or clothing thread that has become wrapped around a toe or finger and that they’re healthy, without any injury or infection.
- Next, consider a breastfeeding mother’s diet or the type of formula being used. Too much dairy in a mother’s diet can pass through the breastmilk and overwhelm a young stomach and certain breastfeeding habits can change the amount of lactose the baby gets with every feed. In this setting, the crying usually comes with mucus or blood in the bowel movements and the skin can often become dry or red. These should definitely be discussed with your child’s doctor.
- Lastly, ensure your baby is not over-tired or over-stimulated. This is very common and often happens from too much awake time, too much play or excessive handling. Let’s jump to the white-board again and try tease out some tired signs.
A 6-week old will usually become tired after being awake for more than 90 minutes at a time. Some signs of tiredness include: jerky movements of the arms and legs, frowning of the face, grizzling and crying. Often these are misinterpreted as hunger signs and they may eat if offered milk, but this is more about comfort than true hunger.
If you start to notice some tired signs; change their diaper to a fresh one, swaddle your baby’s arms, wrap them nice and warm, try get some burps out and put them in their cot or bassinet to sleep.
Remember not to worry about a strict routine in the first 6 weeks of a baby’s life. All babies cry and display unsettled behaviours at different times during the day and night.
But if you think that the crying is excessive, there’s lots of help around.
Maternal nurses, lactation consultants, GPs and paediatricians are here to try find the cause of their colic – and make changes to ensure that your baby – and you – get some well earned sleep!
Thanks for watching – I’m Dr Golly, I’ll see you next time.
Last Reviewed: 09/10/2019
Is My Baby’s Crying Normal or Is It Colic?
Infant crying is a fact of life. It’s the only way our newborns can communicate their needs to us. Fortunately, most of the time even a baby’s most passionate shrieks just mean he’s hungry, wet, soiled or lonely, and he will quiet once you give him what he needs.
But what if your cute little guy keeps blasting even though he’s been fed, has a dry diaper and is being cuddled in your arms? What happens if you feel you've triedeverything and the screaming doesn’t stop? That’s when parents start to wonder if their babymay in fact havemysterious condition called colic, or persistent crying.
Does My Baby Have Colic?
By standard definition, a baby who cries for more than 3 hours a day, at least 3 days a week, and consistently for longer than 3 weeks (and is otherwise healthy) is considered to have colic.
Studies show that colic affects from 10-15% of all babies (and about 50% of crying infants fuss for over 1 hour a day). While certain aspects of colic, from cause to cure, aren’t understood, here’s what we do know:
- Infants with colic usually begin displaying symptoms approx. 2 weeks after being born.
- After the first 3 or 4 months of life, colic generally goes away.
- Gender and feeding style (bottle vs. breast) do not increase a baby’s chances of getting colic.
- The presence of colic in a baby does not indicate that the child will be less intelligent or less healthy that a baby without colic.
Common Misinformation About Colic
For most scientific researchers, colic has been a rather confounding subject. Many factors may lead to the irritation that comes with colic, but no specific “cause” has been identified.
Some often-cited (though incorrect) causes of colic are: lactose intolerance (and the digestive trouble that ensues), gas, overstimulation and heartburn.
Another theory about colic is that it is caused by a baby sensing her parents’ anxiety. That is also completely false.
Babies aren’t little psychologists! They can’t tell if a parent is anxious, irritated or fearful.
In fact, if colic were caused by anxiety, premature babies should have a high level of colic, because their parents are usually extra-stressed. But, premature babies have no more colic than full-term babies.
My Theory About Colic
I believe the key to understanding colic is that that our babies are born 3 months before they're really ready for the world.
And because of that, they are over-stimulated on the one hand and terribly under-stimulated on the other (the latter being the much bigger problem). Life in the womb is one of non-stop sensation. Your baby is held, touched and jiggled, and hears the loud pulsing of blood flow 24/7.
Putting a new baby in a dark, quiet bedroom by themselves is actually sensory-depriving. Some kids can tolerate that, and others just…fall apart!
What I’ve come to learn is that imitating the sensations of the womb doesn't just reassure babies it literally flips a switch—a virtual calming reflex that all babies have at birth.
I developed a method called the “5 S’s” —swaddling, shushing, swaying, side/stomach position and sucking— to turn on an infant’s calming reflex. When done correctly, colicky crying calms in minutes, or less.
Approximately 95% of the time the “5 S’s” fail, it is because they are not done exactly right. Parent can easily master the technique by viewing The Happiest Baby on the Block DVD / streaming video.
There’s also Happiest Baby’s SNOO Smart Sleeper, an innovative baby bed built with smart technology the 5 S’s. It can help calm the even the fussiest colicky baby and stretch his sleep longer.
More on the Mystery
Kids with colic are usually totally healthy. However, if crying persists in spite of the 5 S’s, it’s very important to have your doctor check if illness triggering the colic. Especially if the infant crying is associated with other symptoms poor weight gain, fever, etc.
The most common medical problems associated with colic are milk protein allergy and various types of infections (urine, ear, etc.).
One of the most frequently-diagnosed problems said to cause colic is acid reflux (GERD). However, mounting evidence indicates that GERD is hugely over-diagnosed.
A baby with colic who is growing well and vomits fewer than 5 times a day rarely, if ever, has GERD.
It’s important to consult your doctor before giving ANY sort of medicine to your baby. For example, gas drops made of simethicone, have been shown to be no more effective than water to improve a baby’s colic.
Advice to Parents of Colicky Babies
If you’ve reached your emotional limit and the “5 S’S” are not helping your baby’s colic, lay him down in on the floor or in a safe baby bed and call a friend or a relative to come help you.
It’s normal to feel at wit’s end when a baby cries for hours, but you never want to allow your frustration or anyone else’s to lead to shaken baby syndrome. And finally, if you have a colicky baby, never blame yourself for his cries. Colic may be a mystery, but be confident the cause is not you.
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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.
Hi there, I’m Dr Golly and today we’re talking about HEAD SHAPE in newborns and young children.
With newborns, it’s very common for babies to have oddly shaped heads, due to their position in the womb, instruments used to help deliver the baby, or bruising and swelling from childbirth.
When these occur, most changes resolve spontaneously, within a few weeks. It’s the longer-term changes that we’re going to discuss here.
Although the skull appears to be one large bone, it’s actually made up of multiple small bones, coming together pieces of a puzzle. If the joining is faulty, or if there’s too much pressure placed on one side of the head, it can lead to an abnormal head shape, or plagiocephaly.
The word plagiocephaly comes from the Greek plagio – which means oblique, slanting or sloping, and cephal meaning head. Let’s jump to the whiteboard and take a look at the puzzle of the human skull and why plagiocephaly occurs.
So the skull is basically made up of 2 frontal bones, 2 parietal bones which make up the sides and roof, then 1 occipital bone which closes off the back and base of the skull.
The reason why we have this jigsaw design is so that the bones of the skull can actually overlap slightly, which can happen during the birthing process, making the head slightly smaller, to fit through the birthing canal.
This degree of flexibility also allows for future growth of the brain, because a baby’s brain will quadruple in the first 2 years of life!
Now, all of these puzzle pieces are held together by a fibrous material, Velcro, which we call sutures.
So where the bones meet, it forms a line, or suture, and where the sutures meet, forms a small gap, which we call a fontanelle, or soft spot.
There are two major fontanelles in a baby’s skull – the anterior fontanelle, and a slightly smaller fontanelle toward the back. There are 2 more, very small fontanelles on either side of the head.
As a paediatrician, you’ll often see me reaching for the front fontanelle of a baby – we call this the paediatrician’s handshake! This is because we can use this soft spot, to get a truckload of information from your baby. In addition to your baby’s heart rate and level of hydration, we can also look for concerning signs, if the soft spot is (pointing to 4 corners of the screen) sunken, bulging, unusually large or closing too early.
It’s normal for the fontanelle to slope down slightly, but a very deeply sunken fontanelle may be a sign of dehydration, especially if your child is unwell with fluid loss, not drinking adequately or overheated.
A bulging fontanelle is normal when babies cry, vomit or lie down, but it should go back to normal when your baby is upright and relaxed.
In terms of fontanelle size and closure, there is huge variability in what is ‘normal’ and it’s important that each baby is properly examined.
Usually the back fontanelle closes by 2 months and the front by 2 years. The sutures only close well into adulthood.
It’s important to be gentle with a fontanelle, but don’t be scared of touching or knocking it. There is a tough protective layer over the brain, as well as the skin, so feel confident to touch the head and wash or brush your baby’s hair.
Did you know that in the first 2 years of life, the brain grows to 75% of its final adult size? This means that the skull is constantly enlarging and changing shape during infancy.
It also means the skull is soft and can be moulded with ease. Flattening of the skull in one area can occur from repeated pressure on that side. That is most often due to a preferred sleeping position, or restricted neck movement.
Let’s jump to the whiteboard and take a closer look.
Flat spots can occur if a baby spends too much time facing in one particular direction during sleep. This can be due to something that grabs their attention when put to sleep, or due to restricted neck movement, called torticollis.
When repeated pressure is placed on one spot of the head, it causes that spot to flatten. When this continues, the front of the skull will start to protrude forward on the same side.
While this doesn’t cause any pressure on the underlying brain, it can be severe enough to change the position of the ears and eyes, making a big change to your baby’s appearance.
Luckily, most babies with mild flattening will resolve by themselves, without any treatment at all. The skull can continue to remodel up to the age of 2 years. So if you see a flat spot on your baby, here are some things you can do to correct it:
- Vary your baby’s head position when they sleep and alter which direction their head is, each time you put them into their cot or bassinet. You can prompt looking in one particular direction by placing a picture on the wall too.
- When awake, encourage as much play time on their tummy as possible. This will improve head control and enable them to vary their own head position during sleep.
- You can also vary the way you hold your baby throughout the day, to ensure they don’t spend too much time in any one position (baby sling, upright, over the arm, etc).
Only a very small number of babies will have a persistent deformity, requiring more treatment, which may be in the form of helmet therapy.
This helps to reshape the skull by taking pressure off the flat area to allow more symmetrical growth, but this is very seldom required.
If you have any concerns regarding your baby’s head shape or appearance, have them seen by your local doctor or paediatrician, sooner rather than later.
So remember, babies’ heads always change shape, and by rotating your baby in their cot for each sleep, you can prevent flattening on one side and ensure a nice, symmetric head shape – which is especially important for us guys — who tend to go bald in older age!
Thanks for watching – I’m Dr Golly, I’ll see you next time.