Colicky Pain In A Baby....
To keep it simple, we will discuss the 4 general categories of colic and how you can differentiate between the types.
This is not a foolproof system – many colicky babies do not fit neatly into a category.
That said, in most cases you will be able to come up with a fairly accurate ‘working diagnosis’.
The colic diagnosis is a little complicated because the list of symptoms is common to all types as well as to other problems:
• Fussy feeding
• Short feeding intervals
• Restless sleep
Nevertheless, by knowing what to look out for, we can get a good idea.
Red Flags - Rule Out Serious Stuff First
Before we get started, it is important to make sure that your baby
has not got a much more serious health issue.
A raised temperature, for example, is not a symptom of colic.
So consider the list below before assuming that your baby has
Hyperthermia - baby abnormally hot
Hypothermia – baby abnormally cold
Respiratory problems and difficulty breathing
Lethargy and poor sucking
Failure to pass urine
Ongoing vomiting – worse than refluxing milk
Cyanosis – blue hands, feet or lips
Excessive Jaundice - Yellow tinge to whites of eyes and body
Throat problems – Choking and lips turning blue when feeding
Abnormal weight loss – greater than 10% of birth weight
NB – Consult your health care specialists if any of these are present.
Gassy or Windy Types of Colic
The vast majority of colicky babies, perhaps around 70%, have
what we call ‘gassy colic’. This is divided into the first two types of colic:
• Cramping – knees to chest.
• Crying spells – anything from a few minutes to several hours
over the course of the day.
• Symptoms start from week two onward.
• Usually worst after and during feeds.
• Moaning and groaning
• Not great burpers, especially in early weeks - can take ages
• When they burp well, they are happier and noticeably more
• If reflux is present, then milky and watery
Somewhere around 30% of colic babies have stomach colic.
Untreated it usually leads to intestinal colic as well. It can be
difficult to distinguish between the two types but this type of colic
revolves largely around feeding issues. Some babies gulp a lot of
air and if they don’t burp it out, they are symptomatic.
Parents may notice that if baby burps well, then they are much
more relaxed and likely to sleep well. Conversely, if the burps don’t
come up they are restless and symptomatic. Too much milk on top
of a gas bubble often leads to reflux (vomiting and spitting up) that
is still milky in texture.
The primary goal is to help baby to relieve gas out the top end. If
you don’t have a good success rate with burping, then learning a
routine for colicky babies will produce the best results in the
shortest time. Breast feeding issues can contribute, as can a bottle
fed baby that takes in too much air.
A recommended 6 position burping routine is taught on our
• Cramping - knees to chest
• Crying spells - few minutes to hours
• Symptoms start from weeks 3-4 onward
• Moaning and groaning for hours, even when asleep
• No particular pattern as to when symptoms appear but often worse in late afternoon or early evening.
• Pushing and straining as if trying to relieve themselves
• May have a bloated and hard abdominal area
• If reflux is present, then of a cottage cheesy texture
• Often a complication of burps that never escaped and have now passed throuh to intestinal tract
Somewhere around 40-50% of colic babies have intestinal colic.
This type of colic affects the lower digestive tract and is
distinguishable by the baby’s attempts to get gas and poop to pass
out the bottom end. They will push, strain and cramp for hours in a
day. The trapped gas leads to bloating and a hardness in the
abdominal area with consequent moaning and groaning. Some cry
a lot, others just push and push.
The longer the problem lasts, the more irritable they get because of
disturbed sleeping patterns and ongoing discomfort. Left for
months, it could even affect personality. Reflux may begin and is
usually thicker and cottage cheesy in texture.
The primary goal is to help baby to relieve gas out the bottom end. Some remedies may help to relax the intestinal tract and make it easier for gas to pass. It is not a good idea to rely solely on medication as symptoms tend to continue and worsen.
Parents can make the greatest impact by learning ‘release’
techniques that help to mobilize the intestinal tract in a way that
releases trapped pockets of gas. These are available on our training section.
Other Types of Colic
• Your baby’s body often feels stiff and tense.
• They are usually symptomatic in the first week after birth
• Cramping, arching and kicking out are common.
• Often don’t like turning head to one side
• Random and sporadic patches of unhappiness.
• They bodies feel quite stiff when awake and relaxed once they
are asleep (generally do not moan and groan when asleep).
• More prevalent in traumatic births and caesarean deliveries
Around 15% of colicky babies fall into this category. Quite often,
they are caesarean deliveries. Because they don’t get ‘stretched
out’ while passing through the birth canal, they remain stiff and
‘curled’ up. In other cases, a vertebrae in the spine may be
subluxated (misaligned), a muscle could be in spasm or they may
have suffered birth trauma (forceps or ventouse delivery).
It could also arise either because of the babies position during pregnancy, eg a breech baby.
Most cases of muscular colic have symptoms that begin in the first
few days. Crying, moaning and groaning are not the main
symptoms. Feeding is usually not a problem. Rather they are stiff, tight and look like they are trying to stretch something out (cramping, arching and kicking legs out).
A key to differentiate between muscular colic and gassy colic is that when muscular colic babies fall asleep, they’re usually comfortable. In gassy colic, moaning and groaning is frequently present even when baby is fast asleep.
If this sounds like your situation (or even if you are unsure), our
stretching techniques for releasing muscular tension (especially
targeting the spine and pelvic muscles) will frequently solve the
problem. Good baby massage techniques can als o make a difference.
These are all available on our training section.
• Your baby will be crying for around five or more hours a day.
This is the extreme form of colic and only around 15% of colicky
babies fall into this category. The hallmark is extreme crying for
many hours a day. All colic symptoms are possible by this stage.
This type of colic is not well understood but is often the 3rd stage of other forms of colic. The baby was often given remedies and
medicines for weeks or months and the cause was never treated. Now they are overwhelmed, overtired, exhausted and in constant discomfort.
In other words, early treatment of the previous types may avoid this
type of colic.
Other symptoms do not matter in order to make this diagnosis. If your baby is crying this much, they are already in the extreme form of colic. They could be overwhelmed, overtired and in constant discomfort. Perhaps they are over stimulated - too many visitors, television, etc.
Or it could be something else entirely – hunger (parent only giving
baby a certain amount of milk) a headache, body pains, a pinched
nerve, allergy, etc.
Make sure that none of the red flags are present.
If your baby has reached this stage, then medication is frequently
required to calm them. This is often a sedative.
A variety of soothing techniques are available and should be experimented with until you find what works. Then be sure that gas and wind is getting out and that they are eating enough.
They often need to be held for long hours and usually are better off sleeping on moms chest.