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Intense crying bouts that occur mostly late in the afternoons and last for several hours, more than three times per week are characterized as colic. It can be hard to figure out if you have a colicky child or the baby is just fussy.

All babies cry when they’re hungry or wet — that’s in their nature. Babies cry when they get too tired and can’t fall asleep. My eight-month old daughter sometimes refuses to fall asleep — one can clearly see that she’s trying so hard to stay awake. I guess the world is that interesting. Babies often get so tired and frustrated that the only thing left is crying.

When we become parents, one of the most important but also most difficult challenges is learning to soothe our crying infants. When it comes to extensive crying, a few guidelines may help you tell if your baby has colicky pain.

How Old Is Your Baby?

Colic is an attack of intense crying that appears to originate somewhere in the abdominal area and affects approximately 20 percent of all babies [1]. It’s hard to determine the exact percentage, but it’s estimated that one in four babies in the US suffer from colic [2].

Crying jags start between two weeks and three months of age, and they’re usually over before the baby is four months old. If they last longer, your baby may be lactose intolerant or have another health condition which has to be examined.

The established peak age for colicky crying in breastfed babies is six weeks, and two weeks earlier in formula-fed babies. One study found that colicky pain occurred in 43 percent of babies compared to 16 percent of breastfed infants. [3]

Bloating And Gas

A colicky baby often looks like they’re trying hard to pass something out of their system. Their face may appear red and the tummy hard. The signs of bloating and gas discomfort often disappear shortly after passing gas or after a bowel movement.

Colicky Cries Are Loud

You’ll eventually learn to recognize and differentiate your baby’s cries. Colicky cries are loud and high pitched — they start and end suddenly. From a playful and a happy-looking baby, your little one will all of a sudden want to cry their eyes out.

If the child cries for at least three hours, more than three days per week, the criteria known as “Wessel’s Rule of Threes” — named after the renowned pediatrician Morris Wessel who introduced the modern definition of colic — you probably have a colicky baby. Crying generally begins around the same time of day.

Nighttime Fussiness Or Colic?

Experts claim that most babies experience colic symptoms to some extent. In those babies with less intense symptoms, the condition is rather referred to as “nighttime fussiness” and all babies will sometimes fuss during the day. The symptoms and peak time of fussy crying are the same as for colic, but colicky babies cry longer and more intense.

With nighttime fussiness, there’s no way to end the frustration easily, and it’s even harder for parents with colicky babies, but there are some natural remedies that you may try to relieve the colicky pain in infants.

Is Colic PURPLE?

PURPLE crying has nothing to do with the color of your crying baby. It’s an acronym; the letters stand for the most common crying properties in the first few months of your baby’s life. It’s basically the same as colic, but Dr. Ronald Barr — a developmental pediatrician who has studied infant crying for a long time — came up with the phrase because he wanted to explain that what most babies go through is completely normal and not a disease, so that parents would know there was nothing wrong with their babies. 

PURPLE stands for:

  • Peak of crying when the child is around 2 months old
  • Unpredictability (crying often comes and goes for no apparent reason)
  • Resistance to almost any kind of soothing that you try (inconsolable)
  • Painful look on the face
  • Long crying periods (often for hours)
  • Evening is the worst (infants cry more in the afternoon hours)

Several studies have shown PURPLE materials beneficial in informing new mothers about the dangers of shaking the baby in response to intense crying bouts. [4, 5]

Does Your Baby Respond To Carrying?

A study conducted on three groups of parents with different parenting styles and responsiveness to crying found that different styles suit different age groups; but colicky babies are mostly unaffected by parenting style. [6]

But don’t hesitate to pick up your crying baby fast! Studies have also shown that babies whose mothers reacted promptly to their crying reduced crying in subsequent months. This breaks the popular myth that picking up a baby as soon as they start crying spoils them. [7, 8]

What Is NOT Colic?

Intense crying in infants older than five months should be further examined as the child may be sensitive or even allergic to the proteins found in milk. The baby will require specific dietary changes and there are plenty non-dairy options available nowadays.

If the baby has high temperature, explosive diarrhea or losing weight, your pediatrician should check it immediately, as these are not the symptoms of colic, but again — might be the symptoms of lactose intolerance.

Rarely the pain is due to undiagnosed infant reflux — not all babies have the ability to clear acidic juices. When acid is trapped in the esophagus, it can lead to pain and discomfort. This has to be well tested, because giving acid-suppressing medications to the infants increases risks of pneumonia and gastroenteritis, and disrupts the levels of essential vitamins and minerals in the body.

The pharmaceutical industry has attempted to over-represent the overall prevalence of GERD in children, and the real prevalence is still unknown. Dr. Eric Hassall, a gastroenterologist at Sutter Pacific Medical Foundation claims that many babies are misdiagnosed with GERD and that acid-reflux medications are overprescribed in infants. [9]

Forty to 70 percent of babies spit up not because they have reflux, but because it’s in their nature to eat more than they can hold. Dr. Hassall suggests, and I agree, that parents should learn how to ease colicky pain in more natural ways such as carrying or rocking. [10] Here’s more about medications your pediatrician may prescribe for colicky pain in infants and which of them you should avoid.

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