Expert QA: Crying and Colic

Could your crying baby have colic? What is colic, anyway? And what really works for soothing a colicky, fussy baby?

WebMD went to mother of two and pediatrician Tanya R. Altmann, MD, FAAP, spokeswoman for the American Academy of Pediatrics and author of Mommy Calls: Dr. Tanya Answers Parents' Top 101 Questions About Babies and Toddlers. We talked about colic, what it is, how long it lasts, and what you can do to soothe an upset infant, whether your baby is teething, coping with colic, or just feeling fussy.

What is colic?

Colic is when a baby, for no apparent reason, is really fussy and cries for hours at a time, often at the same time every day. Some parents call it their baby’s witching hour, because they just don’t know why their baby cries at this time.

Does colic occur in newborns? And how long does colic last?

Colic typically starts when a baby is about three weeks old, and usually ends at about three months, so babies do typically outgrow it.

What remedies actually work to soothe a baby who is colicky?

Of course every baby is different, but there are several things parents can try to soothe a colicky baby:

• For the younger infant a good, tight swaddle often helps. Being swaddled makes them feel secure and can calm a fussy baby.
• Babies also tend to like loud, repetitive sounds like radio static or the sound of washing machines, so if you go shhhh-shhhh in your baby’s ear that can work as well.? But you do have to do the "shhhing" loud enough to be heard over the baby’s crying. The reason they like sounds like this is that they remind the baby of the sound of their mother’s heartbeat.
• Another thing I like to try is singing; some babies really respond well to their parents’ voice.
• You can also try turning the baby on their the side when you’re holding them, and giving them something to suck on, like a pacifier or your finger.
• Or try taking the baby out in a stroller. One of my sons really loved being out in his stroller, and he was a very colicky, fussy baby.

You may find that one of these solutions works for a few weeks, and then you may have to try something else. I recommend a DVD based off the book The Happiest Baby on the Block, by Harvey Karp, MD. I especially like the DVD because parents can see the techniques being used, and I think that helps them understand more. I also like the book Colic Solved, by Bryan Vartabedian, MD.

Do you have more tips for soothing a fussy baby, colic or no colic?

Usually the techniques we just talked about will help any fussy baby -- colic is actually one of the extremes of fussiness. It’s always good for parents to learn these techniques, because they’ll also help a non-fussy baby sleep longer and through the night.

Eventually the goal is for your baby to learn how to soothe themselves and sleep all night long -- however, when they’re young they do need you to help them sleep in the beginning, and a lot of these techniques help you do that.

A teething baby often likes to suck, chew, and gnaw on things. Teething rings can help, or often I’ll have parents get a washcloth wet, then twist it or roll it up and put it in the freezer or fridge, and once it’s cold let the baby chew on that. Or you can try freezing a mini-bagel and let them chew on it -- but depending on how young they are you have to be careful, keeping an eye on baby so that they don’t bite off a big piece.

Sometimes I’ll have a parent give a teething baby an appropriate dose of acetaminophen at night, which helps sooth the baby and minimize the pain, so the baby can sleep longer.

I will say to be careful with topical solutions, be careful that you don’t overdo them. I’d recommend checking with your physician before you use them.

When should I let my baby "cry it out"?

It depends on the age of the baby you’re talking about. In the first two or three months of life you just can’t spoil your infant, so by all means pick them up, walk with them, calm them down.

After that you do want to let them start learning how to soothe themselves. If you know they’re not wet, they’re not hungry, and nothing else is wrong, you can let them cry awhile and blow off steam. It’s OK to put them down and leave the room and relax yourself -- it’s OK to leave them and give yourself a break. Just leave them in a safe place and take a break and give them a little time.

What do I do if my baby cries so hard they seem to stop breathing?

Crying is not dangerous to your baby. It’s not going to cause brain damage and they’re not going to stop breathing. There is, however, something called breath holding spells, where a baby may cry so hard that they stop breathing for a moment or two and then start breathing again. If this happens, you do want to see your pediatrician to see if there’s something go on, but a breath holding spell is all it usually is. If they really seem to stop breathing or turn blue, call your pediatrician, but it could also be that the baby just cried so hard that mucus got stuck in their throat and they didn’t know how to clear it for a moment.

Breath holding usually applies to toddlers. Some hold their breath until they pass out, and of course it really upsets the parents! It’s not very common in babies, but I have seen it. You do need to see your pediatrician and get this evaluated. It’s not dangerous but it can be very scary for parents. Children do grow out of it.

I don’t know that I see many parents making mistakes, but I like to let parents know it’s completely normal to feel helpless and frustrated and at your wits' end when a baby keeps crying. When you feel like that, it may be time to call for help, and hand the baby over to grandparents or friends.

And it’s OK, after awhile, to allow your baby to learn to soothe themselves. I’ve had parents come in with an 8-month-old baby and they say, “I can’t put her down or she’ll cry.” But by about six or eight months, you need to let the baby learn how to be alone and soothe themselves. Don’t be afraid to put a crying baby down -- as long as you know they’re safe, the crying’s not going to hurt them.

Finally, never shake a baby. This is a form of child abuse and it’s very dangerous to the baby. When you’re frustrated and don’t know what to do -- when you get to that point, give yourself a break.