Ask the baby expert #17: “How do I know if my fussy baby has colic, reflux or allergies?”
Who here knows a fussy baby, or two? Ah, everyone in the audience is raising their hands. 😉
This “Ask the Baby Expert” question comes from the worried mom of a patient I’m seeing in the clinic.
He was referred to me by his pediatrician at 4 months old for torticollis, which means he has tight muscles on one side of the neck causing a head tilt or a preference to looking only one way. (Which then caused flat head syndrome.) The tightness in his neck seemed to be preventing him from lifting his head or trunk in tummy time. Then she told me “He hates tummy time!” I was not the least bit surprised.
Read more about torticollis here:
But…there are many reasons a baby may not like tummy time. After I asked her a few more questions about tummy time, eating and sleeping habits, mom reported that he “cries every night, all night long!” Go figure.
What does torticollis, tummy time and excessive evening crying have in common, you say?
EVERYTHING! Just follow along, you’ll get it! But for now, let’s talk about fussy babies in general.
If I have a “fussy baby,” how much crying is too much?
Many moms (new moms, especially) are dismissed by health care providers and well-intended mother-in-laws when they complain about their baby’s excessive crying. They are told, “babies cry” or “you’re a new mom, you’ll get used to it.”
Ooohhhh…that boils my blood! I was that new mom 7 years ago! My concerns were dismissed by my pediatrician, the nurse, other pediatric therapists who are my friends and colleagues, and my own mom and sister! Not cool, people!
I tell you this because, after 11 weeks of crying and no-sleeping-HELL, she was diagnosed with severe reflux. But not until my mom had to sit in a rocking chair with my poor baby for 3 hours straight without a single break in crying until I got home. Then someone believed me. And boy did that little thing have some lungs! She was touted to be the loudest baby in the NICU during her stay. Ha!
She was finally prescribed medication for reflux and two days later my mom admitted out loud, “this is a completely different baby. I’m so sorry no one believed you.”
The moral of my story is that we must advocate for our babies, and in turn our sanity! We all know and tolerate sleep-deprivation as mom’s of young babies, but there is actually some research that shows an increase in postpartum anxiety and depression with parents of babies that are unusually fussy. Another no-brainer. 😉
So, what is a “Normal” amount of crying?
This graph is a representation of “normal” amounts of crying in the first 5 months of life. It illustrates the fact that babies do cry, and some of them cry a lot. According to this research, even when 2-month-old babies cry 5-6 hours a day, it’s considered “normal”.
But if a 5-month old baby cries for 5-6 hours a day, this is not normal and we should ask more questions to determine the cause and treatment, if any.
According to Dr. Barr and some other pediatric providers, “colic” is considered normal and might account for the “High Crier” group in this graph. This camp believes that colic is not a diagnosis per se and does not need to be treated with medication. If you’re curious about Dr. Barr’s perspective of normal crying, go to this website to learn more: Purplecrying.info
(Disclaimer: My professional and personal beliefs about colic are not necessarily “aligned” with Dr. Barr’s concepts. Which means I don’t necessarily agree or disagree with his perspective. But I like how he simplifies the information with the ‘PURPLE’ acronym. You may or may not find this helpful.)
What is colic?
The general consensus among reliable research-based sources like Mayo Clinic and the NIH is that colic is normal. Well, sort of normal.
Colic is defined as increased severity or duration of ‘normal’ crying in the first 5 months.
More specifically, colic is diagnosed when a baby cries for more than 3 hours a day, more than 3 days a week for at least 3 weeks in duration. This correlates somewhat with the top dark blue curve in Dr. Barr’s graph above.
The key is that colic is not associated with any other infant health conditions, like illness, reflux or allergies. Babies with colic often have predictable “fussy” times of the day, but there seems to be no explanation or solution for their crying. Colic typically resolves around the age of 5 months, and colicky babies go on with life without any lasting complications.
Read this post to learn how to cope with a healthy but colicky baby, and how to reduce the severity and frequency of your fussy baby’s crying:
“How to deal with colic without losing your mind!” (Coming Soon) Sign up below to be notified when this post published:
****Public Health Notice!!!!!
If your baby is having other problems like vomiting, eczema, constipation or excessive crying right after feedings, then it probably is not colic. It’s more likely a food allergy or reflux. Make an appointment with your doctor to discuss your concerns. Talk to the nurse, ASAP if the vomiting persists, if your baby has a fever, or there are less than 3 wet diapers in 24 hours.
(Disclaimer: I am not a medical doctor and I am not diagnosing your baby or giving you “medical advice.” Do not delay seeing your doctor because of something you have read here. Trust your mommy instincts.)
Well, then what is reflux?
The Fancy Nancy word for reflux is Gastroesophageal Reflux Disease (GERD). It’s like baby heartburn. Signs of reflux include, but are not limited to:
- Excessive volumes or frequency of “spit-up” (See this article from the Mayo Clinic about “normal” spit-up.)
- Crying, arching during and after feeds, sometimes tilting and turning their head to the right while arching
- Intolerance to being flat on the floor–back or tummy–after feeds (because there’s no gravity keeping the stomach contents down)
- Waking up crying shortly after going to sleep
- Stopping feeds with crying but acting like they’re still hungry
- Stopping feeds early but demanding short frequent feeds all day and night
If you suspect your baby has reflux, read this post:
“Managing reflux with or without medicine.” (Coming soon. Enter your email here to be notified when this post is published.)
A baby with reflux may often be dismissed as “gassy,” or “fussy/colicky,” or my favorite one, “just a spirited child.”
A baby with reflux is often dismissed as 'gassy' or 'fussy/colicky' or my favorite one, 'a spirited child.'Click To Tweet
Seriously? When we expressed our concerns about my daughter’s fussiness at the 2-month checkup, my pediatrician told us it wasn’t reflux because she wasn’t “projectile vomiting.” He told us it was colic and she’ll grow out of it…or some other “new mom” comment, I’m sure I don’t remember. :-/
I wish I knew then what I know now, and this is why I do what I do, to try to educate all of you!
“Help! I think my baby has reflux. What do I do?”
You can start with signing up for a free, 30-min call with me! I promise I won’t try to sell you anything!
Don’t suffer with your baby when you think something is really wrong! Can you think of anything worse than not being able to console your baby when they are obviously in pain? It may be second only to not being able to get that miserable baby to sleep so you can sleep, too!! Can I get and Amen, Mommas?!?
This is why you need to advocate for your baby. If you are concerned about your baby’s excessive, inconsolable crying and you are also noticing feeding/digesting problems, don’t take “it’s normal” for an answer. If your mommy instincts still have you worried or you want another opinion, see a pediatric GI (Gastroenterologist). They will be able to diagnose and treat feeding/digestive/allergy issues and reduce your baby’s discomfort right away.
(Most states and private insurances allow parents to refer themselves directly to a specialist without having to be sent by the pediatrician, but you’ll have to check with your local pediatric GI office and your own insurance provider.)
But what about food allergies?
Food allergies seem to be the most well-known (or assumed) culprit of “colicky” babies. Remember, though, colic happens to “otherwise healthy babies,” and food allergies don’t cause colic. But they can cause a lot of angst for momma and baby!
Symptoms of food allergies include:
- Crying after feeds
- Abnormal bowels (hard, green, slimy or extra smelly)
- Eczema or rashes on trunk, arms, and legs
*Reflux can be a symptom of food allergies, often because of constipation.*
If you are suspecting food allergies, check out this resource from Veronica Lamb at radiantlifeconsulting.com:
It is a Free Support Package for Breastfeeding Moms with Fussy Babies.
Food & Symptom Journal
Video of Signs of Sensitivities
Symptom Checker Quiz
Feeling a little bit better, Mommas and Dadas? I hope so!
If not, leave a comment below or schedule a FREE 30-minute call with me…I promise I won’t try to sell you anything! ♥