1. Trapped gas and wind
"True" colic refers to trapped gas in the digestive tract. This accounts for the vast majority of cases. The trick to successfully managing the situation is to identify whether gas is getting trapped in the upper or lower digestive tract. Treating the right area will bring much faster results.
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A: Stomach colic
When gas gets trapped in the upper digestive tract, we call it stomach colic. This type of colic is best helped with good burping techniques. Medications that help to get gas bubbles to pop upward in the form of a burp can bring relief. Diagnostic signs of stomach colic:

 

• Symptoms are most noticeable in the hour or two after a feed

• Baby doesn't burp regularly or is hard to burp

• Fussy feeder, doesn't latch well, guzzles milk 

• Can have runny, milky reflux which comes up soon after a feed

• If they release a big burp, they are noticeably more comfortable

 

What to try:
Natural techniques:

Watch videos especially numbers 1-4. Do after each feed and again when they wake. Add these burping techniques to your normal burping routine. 

Medicines and remedies:
Gas drops containing Simethicone can be useful. Examples are Infacol, Wind-eze, WindSettlers, ColicCalm and many others.

 

B. Intestinal colic

When gas gets trapped in the lower digestive tract, we call it intestinal colic. This type of colic is relieved by farting and pooping regularly and by medications that help to get trapped gas to escape downward out the bottom end.

Ideally, repeating the natural techniques below will get the gas moving without need to medicate. Diagnostic signs of intestinal colic:

 

• Symptoms occur throughout the day and even when sleeping

• Lots of cramping, moaning and groaning, pushing and straining

• Can be bloated and hard in the abdominal area

• Can have chunky style reflux which comes up long after a feed

• Most likely to lead to sleeping, eating disturbances 

• Most likely type to cause prolonged crying spells

• As time goes by, body can become quite stiff and tense  

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What to try:
Natural techniques: - From videos below:
Watch videos and do numbers 4,5,6,7,8,10 twice a day, 1-2 hours after feeding.

Medicines and remedies:
Gripe water and herbal concoctions can help - most contain bicarbonate soda, chamomile, dill, ginger, fennel, etc. Examples are Telament, Woodwards, Mommys Bliss and many others.

If baby has been on antibiotics, you might try a probiotic. Talk to your pediatrician about this first.

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2. Reflux

When gas pockets get stuck in the digestive tract, it slows the passage of milk. So reflux is often a symptom of one of the types of gassy colic. This can be harmless or cause milk to start digesting in the wrong place, resulting in acid burn and pain. 

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A. Runny milk - Overfeeding or bubbles in stomach

• Baby throws up runny milk, not long after feeds 

• Spit ups - small amounts

• Doesn't appear to bother baby

 

What to try:

Good burping techniques are essential.
Discourage baby from overfeeding, perhaps by distracting them toward end of a feed.
It's usually that last 10ml that's just too much!
Might also try to stretch feeding interval out so that stomach can properly empty out. 

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A. Chunky, cottage cheesy milk - Milk can't get through

• Throw up mix of runny and chunky milk, anytime and often long after feeds 

• Baby often quite miserable

• Can progress to high pitched screaming spells

• Mostly due to excessive gas in the lower digestive tract  

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What to try:
Treat for Intestinal colic. As long as that continues, you will keep having reflux.
Made need to change formula to an anti-reflux brand

Acid pain can get quite bad so medicine may need to be prescribed by a pediatrician:
eg Nexium, Losec, Gaviscon, Pepcid, Tagamet

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3. Musculoskeletal colic
A significant percentage of fussy, restless babies who are diagnosed with colic, don't in fact have true colic, but rather a muscle spasm or spinal alignment problem. This can be due to position in the womb, birth trauma like forceps or ventouse, caesarean delivery and plain old bad luck. ​Diagnostic signs of musculoskeletal issues:

 

• May be stuck in flexion - legs mostly pulled up - knees toward chest

• Might be bent to one side (banana baby)

• Only favor movement to one side

• One leg frequently pulled up 

• Baby eats well, burps, farts and poops well

• Body seems tight and tense, more than it should

 

What to try:
Natural techniques:
Watch and do videos numbers 9-10 twice a day. 
Baby massage can be useful.

Medicines:

Muscle relaxants are not recommended for babies.

It is rare that the pain would be so severe that you'd need painkillers.

A visit to a Chiropractor who sees a lot of babies may be the answer.

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4. Milk and food allergies
A small percentage of fussy, restless babies who are diagnosed with colic, don't in fact have true colic, but rather are reacting to something in their diet. This can be hard to diagnose and may require further testing by your pediatrician or an allergist. Some signs of an allergy:

 

• Rash, often reddish

• Diarrhea and vomiting

• Runny and blocked nose

• Watery eyes

• Wheezy chest and shortness of breath

• Baby eats well, burps, farts and poops well

• Not common in breastfed babies

 

What to try:
If breastfeeding, mom should try excluding milk and dairy products, gas forming foods, spicy foods and fizzy drinks.

If on a formula, try a hypoallergenic variety.

Examples include Enfamil Nutramigen, Enfamil, Pregestimil, and Similac Alimentum.

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5. Overstimulation
A small percentage of unhappy babies have been overstimulated at some point and their nervous system has become overwhelmed. They eat well and their digestion seems fine but yet they cry a lot and seem miserable. Signs include:

 

• Crying and irritable

• Jerky movements and waving arms around

• Excessive yawning and hiccuping

• Watery or glassy eyes

• May seem listless 

• Baby eats well, burps, farts and poops well

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What to try:
Avoid visitors and passing baby around, especially if it upsets them

Avoid television, loud music, barking dogs, etc.

Spend time in a dark room with baby sleeping face down on your chest 

Swaddling may help as might white noise - calming music, a fan, etc

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6. Hunger
A small percentage of unhappy babies are simply not getting enough to eat. They may seem to be but their brains satiation center is not satisfied and so they manifest with some of the symptoms of colic. Signs include:

 

• Fussy and irritable 

• Underweight for their age

• Seems limp and listless

• Always hungry with decreased feeding interval

• Not much poop coming out

 

What to try:
Are they latching properly? No tongue or lip ties?

If bottle fed, is the opening big enough?

Do they feed on demand and until they've had enough?

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7. Constipation
Lots of babies have constipation at some stage, and in most cases, it is harmless and part of development.

But sometimes, trapped gas can cause the passage of feces to slow down, resulting in a drying out and hardening of the fecal matter. Signs include:

 

• Excessive pushing and straining

• Not much poop coming out

• What comes out is harder than should be for a baby

 

What to do:
Firstly, when did the constipation start?
Was it after medicines or anti-biotics? Could it be because of a formula? Or is it part of the whole colic syndrome and you're not sure why it started.

• If it started when or soon after medical treatment, perhaps a probiotic will help?

• If formula fed, maybe try a different formula and see what happens?

• If the constipation is part of the overall colic symptom pattern, focus on the treatment described above for intestinal colic. In most cases, the exercises taught will help baby to poo.

• Some useful tips: https://www.medicalnewstoday.com/articles/324543

• If feces is very hard and dry, consult your specialist to discuss dehydration concerns or perhaps the need for a suppository. 

If your baby is getting plenty to eat and yet they are still miserable, despite all of the above, please consult your specialist!!​​​​​