Question:

Our four-month-old son seems to cry a lot, especially after feeding. How do we know if it’s just gas or if it’s colic? Any tips for either condition so we can stop the crying?

Answer:

As long as I have been practising medicine, I can tell you that colic remains a mystery. Although there are lots of opinions about what colic is, we really are not certain what causes it. According to recent review article by pediatrician Dr. Deshpande, colic is commonly described as a behavioural syndrome. The typical colicky child has excessive crying. Colic is most likely to occur in the evenings, and it occurs without any identifiable cause. Colic however usually happens between two weeks and four months, so given your child’s age, hopefully these episodes will stop shortly. Any family doctor or pediatrician will tell you that colic is a common reason for parents to bring their baby to the doctor.

Fact:

An interesting fact is that colic is equally likely to happen in formula-fed infants and breastfed infants. Colic happens with the same frequency in boys and girls and can affect as many as 30 percent of babies.

See your doctor to make sure that your child is thriving well and there are no other underlying reasons for a baby with excessive crying. When it comes to gas, a large amount of air can enter the baby’s stomach during feeding, but this can also happen if your baby is crying a lot.
If you are breastfeeding, make sure that the baby finishes on one side before switching to the other side. If the baby does not empty one breast, he will not get the fat. As a result, the baby can get fewer calories and take in a lot of milk with increased feeding frequency. The stomach can empty quickly and a large amount of milk sugar (lactose) will empty into the intestine all at once. The enzyme called lactase (which has to handle this lactose load) may not be able to handle that much milk sugar at once. 
The baby might appear to have symptoms of lactose intolerance: crying, gassiness and changed bowel movements. You may have to alter the way you feed.

Other suggested causes of colic include:

  • reflux
  • overfeeding or underfeeding
  • milk protein allergy
  • early introduction of solids
  • stress or anxiety in the parent
  • incomplete burping after feeding
  • exposure to smoke or maternal smoking during pregnancy
  • lower counts of good intestine bacteria called lactobacilli