Colic is felt to be a gastrointestinal adaptation period, where the enzymes required to break down the newly introduced nutrients through the gut are being developed," explains Dr. Denis Leduc, chair of the community paediatrics committee of The Canadian Paediatric Society.
This makes intuitive sense, since many babies with these symptoms do appear to have abdominal pain and problems with gas. However, it's also possible that long bouts of crying may make babies swallow air, and actually cause the gas. Some experts remain unconvinced that digestive difficulty is the root of the problem.
"What makes colicky babies different is not that they cry more often, but that when they start crying, they're more difficult to soothe," says Dr. Barr, professor of paediatrics and psychology at McGill University and a pre-eminent colic researcher. "It's likely that this difficulty is a normal, individual difference," that may have nothing to do with digestion.
Herbal
Herbal remedies are drugs derived from a plant source," says Dr. Mitchell Levine, director of the Centre for Evaluation of Medicine at McMaster University in Hamilton, Ontario. Levine underscores the obvious because people sometimes forget that like conventional drugs, herbals can have side effects. But unlike pharmaceutical drugs, there are wide variations in quality control in the manufacturing process of herbal remedies.
Some, like St. John's wort for depression, have proven effective in clinical trials, but no such studies exist for colic. However, some practitioners suggest chamomile tea may help soothe its symptoms.
Danielle Wilson, a naturopath in Mississauga, Ontario who teaches women's health at the Canadian College of Naturopathic Medicine, suggests that breastfeeding mothers drink up to three cups of chamomile tea per day. Traces in their breastmilk will provide their babies with a safe dose of the herb. Bottle-fed babies can take a teaspoon of the tea, up to three times daily. The same formula can be used for fennel and peppermint teas, which are thought to aid digestion.
Homeopathic Remedies
Homeopathic remedies are prescribed based on symptoms. For example, chamomilla is used when a baby cries angrily, has a flushed face, and fusses with extra warmth, while colacynthis is given for abdominal cramps that respond to pressure and heat.
But while this system of therapy is well respected in Europe, many physicians and scientists here are skeptical of homeopathic theory, and don't feel it's supported by research.
There are no large randomized controlled trials of homeopathic colic therapies in North American scientific literature. However, parents like Cindy Nathan, of Windsor, Ontario, claim homeopathy helped their children's symptoms.
The risks? Because the concentration of active substances in the remedies should be extremely low, the potential for harm is small. (Nonetheless, some physicians balk at preparations listing belladonna as an ingredient, even in miniscule amounts. Derived from deadly nightshade, belladonna contains chemicals similar to potentially dangerous anticholinergic drugs no longer used to treat colic.) As with herbals, consult a knowledgeable practitioner, and ask for brand recommendations.
Massage
The recommended approach is a daily massage at a regular time rather than in response to fussing. One method: With lightly oiled hands, the parent first massages in firm strokes from chest to diaper area. The second stage involves gently flexing each leg in turn like pedaling a bicycle; the third, a gentle abdominal massage, circling the navel clockwise. An adjunct is a gentle, circular massage of the buttocks, where many people hold tension. Watch your baby for cues - some babies won't enjoy the experience if they're too sleepy, for example.
McNeely explains massage may help move gas through the intestinal tract, improve circulation to the area, relax tense muscles - and serve as a pleasant bonding interlude. She recommends interested parents contact a registered massage therapist specializing in infants for instruction on the finer points before giving massage a try.
Other Strategies
Holding the baby may be the best place to start. A study by Dr. Barr suggests carrying a baby several hours per day (though not in response to fussiness), may reduce the overall amount of crying. (However, a second study, specifically targeting colicky babies found no difference between those who were carried, and those who were not.)
For a very small percentage of breastfed babies, cutting down on cow's milk in mom's diet may provide some relief, say both Leduc and Wilson. However, both stress nursing is still the optimal choice, and switching to formula can cause more problems.
Wilson also suggests 'helpful' bacteria like lactobacillus or acidophilus, used in making yogurt, may reduce discomfort by helping digestion. Marketed in gelatin capsules that can be opened and the contents sprinkled on baby's tongue, these remedies can be used as often as three times daily.
