science of us

My Baby Cried More Than Yours, and No One Knows Why

Photo: Brosa/Getty Images

I’ve taken countless videos of my daughter since she was born, but there’s one I can barely stand to watch. In it, she is 5 weeks old and screaming. Her face and tiny fists are tomato-red. Her gums are bared and her eyes are squeezed shut, and her head is twisting back and forth like she wants to climb out of her own skin. At the end of each breath she trails off into a jagged bleat and then keeps screaming silently.

I promise: My husband and I tried to help her. Our lives revolved around attempts to soothe her screaming fits, which happened predictably every evening and unpredictably during the day. I developed a habit of hugging her close and shushing straight into her ear, so she could hear me over her own screeches; meanwhile, I feared something was deeply wrong. We had made a terrible mistake already in our parenting, or passed on faulty genes, and she would be tortured forever. Our friends with newborns seemed tired but — bafflingly — happy.

We felt so alone then, but now I know we weren’t. Because no one — not doctors, not scientists — knows for certain how to help babies like my daughter, who are healthy by all measures but can’t stop crying. That means parents are mostly on their own as they fight through conflicting information and useless remedies. But recent research is starting to cut through the din.

Colic is a misleading term because it sounds like a real disease — something old-timey, maybe, like scurvy. Really it’s just crying at the extreme end of the spectrum. A 1954 paper on infantile colic, or “paroxysmal fussing,” first used the now-common definition: Colicky babies are otherwise healthy but spend more than three hours a day crying, on more than three days a week, for longer than three weeks. The authors suggested allergies or “family tension” might be to blame. Anywhere from 5 to 25 percent of infants meet the criteria today, depending on your source.

“It’s really just symptoms,” says Jeremy Johnson, a family physician with the U.S. Army and lead author of a 2015 review paper on treatments for colic. Johnson started researching colic after his own run-in with the condition 14 years ago. “I was frustrated with [my] inability to help my child,” he says. He thinks its symptomatic nature is one of the reasons researchers haven’t come up with a cure for colic, or even a good explanation. He compares colic to the symptom of chest pain in adults, which could signal anything from acid reflux to a heart attack. Likewise, there’s probably not one single cause for nonstop crying in babies.

Beyond that, the blessing and the curse of colic is that it’s fleeting. The very people who are perhaps most motivated to understand it are also the ones in the throes of it. But then the baby grows out of it, and life moves on. To borrow the medical term, colic is a “self-limiting” condition, meaning that the problem eventually goes away on its own. Researchers can’t justify trying invasive procedures or tests on an infant they know will be fine eventually. Most colicky babies are at their worst around six weeks old, but they usually age out of their inconsolable crying around three or four months.

It sounds like a short time. Unless you’re the one listening to the baby.

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Our daughter followed the mysterious patterns of most colicky newborns: They concentrate their crying in the evening. Their little faces and bodies will often turn a deep, angry red. Their wailing sometimes takes on a frantic, crazy-making pitch that you swear it didn’t have during the day. Almost nothing makes them stop.

My husband and I started to call 5 p.m. “scream o’clock,” because the baby was eerily punctual. At 4:50, she might be napping in my arms as peacefully as one of those calendar infants inside a watermelon — but at 5, her face would abruptly contort, and the screaming would start before she even opened her eyes. She’d keep going, with a few breaks to pass out and regain her strength, until around 9.

I felt dread as every evening approached. When my husband got home from work, I’d push our already apoplectic child into his arms and scrape together some dinner. We ate in shifts, one person gulping down forkfuls while the other tried to soothe the baby. As the colic crescendoed week by week, I wondered how we would all survive to four months.

We held, wore, swaddled, vibrated, patted, and shushed her. We rocked her in the dark, lifted her up to lights, held her next to a running shower, bathed her, massaged her, took her outside, and supported her body in tricky ways that are supposed to calm babies. My husband liked to put her across his lap and drum continuously on her back. We walked endless circles around our apartment while bouncing her over one shoulder and singing.

What worked for a night or two would soon stop working. When one of us lost patience, we’d hand her off and go sit in another room with the door closed.

Each night’s screaming period ended when she finally accepted a meal. But getting her to that point was difficult, because she wouldn’t nurse normally in the evenings. She’d suck frantically for a few seconds, then break away to cry again, leaving my milk dripping everywhere. She refused bottles at all times, so my husband couldn’t help. I tried various creative positions and PG-13 acrobatics to coax her to eat. The best solution I found was nursing while walking. After making sure our blinds were drawn, I cradled her at my breast and paced the apartment with bouncy steps while she (slowly, eventually) ate and calmed down. When I got bored I walked backward or did grapevines. I only cried on some nights. Spatters of dried milk dotted the floors of every room, like constellations.

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People who didn’t live in our home didn’t seem to understand. “Well, all babies cry,” they kept telling us, as if the problem was that we’d thought we were getting a kitten. Even a perfect stranger delivered this advice to me in a bookstore where I’d brought the baby on a pre-scream-o’clock outing. (Whatever small talk led to this moment has left my memory, but I can still see the woman sitting in front of the coffee bar and informing me, yet again, that all babies cry.) Our kind, near-retirement pediatrician was also dismissive when I asked whether my daughter had colic, as my desperate internet searches were hinting. “Oh no, colicky babies have very bad gas,” he said. My midwife suggested warm baths to soothe the baby’s stomach. At least neither of them suggested the remedies from 1954, which included narcotics or “a little alcohol.”

The idea that gas causes colic is an old one (the word colic comes from colon, and can also mean abdominal pain), and it’s apparently a marketable one, too. You can buy all kinds of concoctions and props based on it — tablets, waistbands, bottle nipples with air vents in them, baby butt catheters — but it’s not clear that any of these will help. “Gas is probably not the main issue here,” Johnson says. Studies have shown that simethicone, the drug sold for adults as Gas-X, doesn’t treat colic any better than a placebo does.

The list of what doesn’t work is long. The acid-reflux drug omeprazole (Prilosec) has no effect. Soy-based formula doesn’t seem to help, either. Herbal supplements and teas don’t have good data behind them. Some parents swear by “gripe water,” a product that includes sodium bicarbonate and other ingredients such as dill oil or ginger, but this remedy also lacks evidence to support it. I read about these remedies with skepticism: As a science journalist, I wasn’t tempted by unproven supplements — and as a parent, the idea of dribbling tea down my daughter’s scream hole was laughable.

Physical treatments like chiropractic manipulation are hard to study well. That’s because in a good study, parents (and providers) should be “blind” to what treatment the baby is getting. But it’s pretty obvious when someone has their hands on your baby. Likewise, Johnson says, studies of acupuncture and baby massage have had mixed results.

But there are a few things that might work.

One is for a breastfeeding mother to drastically change her diet. There’s solid evidence that cutting out cow’s milk, eggs, peanuts, tree nuts, wheat, soy, and fish reduces babies’ crying time. It’s a lot to ask of a new mom, and it’s true that the diet won’t help every baby, but research suggests that this helps babies on average. And if a restricted diet does work, Johnson says, it doesn’t mean the baby has food allergies. The theory is that cutting out these common allergens changes the breast milk slightly and makes it easier for an infant’s immature gut to handle.

For formula-fed babies, studies have shown that hydrolyzed formula can cut down crying time. (This is formula with its milk proteins partially or totally broken down to make them easier to digest.) But hydrolyzed formulas can be expensive. Enfamil’s hydrolyzed Nutramigen formula, for example, can cost two-thirds more per powdered ounce than its basic formula.

Another promising area of research is probiotics. A new meta-analysis in the Journal of Pediatrics found the probiotic Lactobacillus reuteri is an effective treatment for breast-fed babies with colic. Another new study found that 30 days of treatment with Lactobacillus reuteri drops helped colicky breast-fed babies cry less, and reduced a marker of inflammation in their colons.

So far, the treatments that do work suggest that, for at least some babies, colic is linked to the gut. It’s not as simple as that. But at least it’s a start.

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Francesco Savino, a pediatrician at Regina Margherita Children’s Hospital in Torino, Italy, was an author on both of those recent probiotic papers; he’s also worked on several other studies of colic. He thinks the microbiome — the community of bacteria in the gut, which is just settling in during an infant’s first week of life — is a likely player in colic. But he agrees with Johnson that the condition could have several different causes. On average, you need to give probiotics to 2.6 colicky babies to see just one baby get better.

For now, Savino says, there’s no agreement about how to manage and treat colic. And it’s “not easy” to get clear answers, he adds. One challenge is finding objective ways to measure results, rather than relying on subjective descriptions by a baby’s caretakers. Savino hopes to see more research into probiotics, dietary changes, and pain-relieving options for colicky babies in the future.

A lot has already changed since Johnson had his own experience with colic. “It was pretty much gas drops or nothing” back then, he says. Today, he feels much better equipped to give evidence-based advice to parents of colicky babies. For a breast-fed baby, he’d recommend dietary changes first, followed by probiotic drops, which you can buy in stores or online. For a formula-fed baby, hydrolyzed formula. “At least I could give them hope,” he says.

In my own household, scream o’clock is a fading memory. The baby outgrew her colic just when the websites said she would. My husband and I slowly reentered a world where we could take phone calls in the evening, or have conversations. Sometimes we even ate at the same time.

Our daughter is 16 months old now. She loves dancing to music and eating yogurt in fistfuls, and has a four-word vocabulary if you count barking like a dog. Sometimes in the mornings, still pink-cheeked from sleep, she gives me a searching stare that I don’t know how to answer. I’ll probably never know what used to make her scream, either. I can only hope the mysteries still to come won’t leave my ears ringing.

My Baby Cried More Than Yours, and No One Knows Why