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Strategies for coping with Colic

A “colicky” and unsettled baby, who cries a lot and seemingly can’t be comforted, can deplete the energy reserves of any new parent. Alison Wall draws upon her experience as a health visitor to suggest various ways to cope with and alleviate the stress.

 

Introduction

The first few months with a new baby are exhausting, even with the most settled of infants. However, when a baby appears unhappy, cries a lot and is hard to settle (even after feeding), as is often the case with a colicky baby, some parents can feel isolated, as if they are failing on every single level.

In fact they are not alone. Colic is a common problem, with about 10 to 30% of infants experiencing symptoms of colic between three to 13 weeks after birth1. A continually crying baby can easily knock a parent’s confidence, causing immense parental stress, and although there are various ways to manage colic2 it can be difficult to prove efficacy. Some relief can be provided using products containing simeticone, which allegedly help to dissipate the air bubbles that can become trapped in the immature digestive system.

However, the reason for this remains unclear and some suggest that their use is no more effective than a placebo3.

Other parents may prefer to use homeopathic remedies, believing these are gentler on the digestive system, and an online search of popular forums such as Netmums and mumsnet can source information on remedies that have “worked” for other parents. Massage techniques learned in baby massage classes may also help to settle and relax a colicky baby and many new mothers find this highly beneficial and relaxing for them, too.

Whatever the cause of an individual baby’s colic distress, few would argue with the fact that tired parents will find it harder to cope with the crying, compared to parents who manage to get some sleep. Indeed there is a strong argument that antenatal classes need to provide realistic advice and information about the early days of parenting, so that parents are more prepared. An NSPCC/You Gov poll carried out in the summer of 2012 made this one of its main recommendations4.

This could also have the welcome knock-on effect of reducing levels of postnatal depression, which can sometimes occur as a result of a mother’s struggle to align previously held rosy-tinted expectations of parenting with the reality. This following case history describes a typical scenario of a family initially struggling to cope with a colicky baby and suggests some measures to help alleviate the distress.

 

Key points

  • Colic is very common and is not the parent’s fault.
  • Health visitors should reassure parents that if the cause of the problem is colic, the crying will stop (typically at three to four months) and suggest various methods to help.
  • However, if the crying continues, other possible causes for the crying need to be excluded.
  • Further support for parents can be gained from organisations such as Cry-sis (www.cry-sis.org.uk) and Home-Start (www.home-start.org.uk).

 

Case history

Baby S was born at 39 weeks, weighing in at a healthy 7lbs 4ozs. Her mother (Ms B) was thrilled to have a normal delivery after her stress-free first pregnancy and was expecting that all would go well after the birth. Initially baby S settled well, but after four weeks she would draw up her legs after a feed and cry uncontrollably for at least four to five hours every night. Her parents, who tried everything, including putting her in her car seat and driving round the neighbourhood, became exhausted, and in desperation, Ms B decided to visit her GP to ask for help.

The GP contacted the health visitor, who made a home visit and suggested that Ms B should get showered and dressed every morning, to establish a routine.

She also explained that colic is common and can be due to a number of causes, which are sometimes difficult to pinpoint. An allergy to the cow’s milk protein in milk needs to be considered and possibly medically investigated2. The health visitor should check the baby, including a stool sample, and assess the growth pattern to ensure that the baby is thriving. Essentially colic is a diagnosis of exclusion and if there is any doubt then the health visitor must refer to a medical colleague to eliminate other causes for the crying1,5.

In this case the health visitor listened sympathetically to Ms B, who admitted that, although she lacked confidence in her previous job, she always felt she would make a wonderful mother. However, she now felt she was failing even in this role, feeling incapable of achieving what she considered to be “simple” tasks such as keeping a tidy home and settling the baby in her cot. Her partner was also tired and they argued frequently, as their tolerance levels were so low.

The health visitor explained that dealing with a new baby and adjusting to their demands is a difficult chapter to manage. New parents need to be aware that routines will need to adapt and certain things may need to slip somewhat, for example, someone who usually always cooks meals from scratch may find that being flexible and buying a few microwave meals and takeaways alleviates some of the strain. This is not failing, but providing a breathing space that is really beneficial. Equally, friends and neighbours may offer to help and will be delighted when their help is accepted, as they will be able to feel that they too have contributed and supported the new parents.

The health visitor also stressed the importance of both parents keeping the lines of communication open and talking through their feelings, acknowledging that crying is draining for anyone but especially so for new parents at such an emotional time in their lives. The need to support one another emotionally is essential.

In addition, the health visitor also encouraged the mother to meet other new mothers by directing her to suitable groups in the community to prevent her from becoming socially isolated and help her realise that she is not alone.

Gradually Ms B started to make more friends and by sharing ideas on how to manage the periods of crying she learned not to panic every time her baby cried. She also began to be proactive and set a structure to the day. Babies love structure, routines and predictability so this calm new approach also appeared to ease the crying periods. Ms B discussed what she had learnt with her partner – this enabled him to participate and not feel he was on the periphery. The health visitor called again when baby S was three and a half months old. Ms B informed her that the crying had stopped and life was so much better. The health visitor left, feeling delighted that this mother had overcome the challenge of a crying colicky baby and had grown in confidence as a result.

  1. Marks, Archbold, Augstburger et al. A Systematic Approach to the Differential Diagnosis and Management of Infant Colic [online]. eGuidlines. Available at: http://www.eguidelines.co.uk/eguidelinesmain/guidelines/summaries/gastrointestinal/wp_infant_colic.php [Accessed Jan 2013]
  2. National Collaborating Centre for Primary Care, National Institute of Health and Clinical Excellence. Routine Postnatal Care of Women and Their Babies. CG37 [online]. NICE.2006. Available at: http://www.nice.org.uk/nicemedia/pdf/CG37NICEguideline.pdf [Accessed Jan 2013]
  3. Garrison M, Christakis DA. A systematic review of treatment for infant colic.Paediatrics. 2000;106(6):184–90
  4. NSPCC. New Mums Struggling to Cope Warns NSPCC [online]. 2012. Available at: http://www.nspcc.org.uk/news-and-views/media-centre/press-releases/2012/12-05-11-new-mums-struggling/new-mums-struggling_wdn89327.html [Accessed January 2013]
  5. NHS. Clinical Knowledge Summaries: Colic – infantile [online]. 2011. Available at: https://cks.nice.org.uk/colic-infantile#!topicsummary [Accessed January 2013]