Linda,

While much has been written and usually assumed by parents, that "colic" is
a GI problem, not much research has actually shown this to be the case.
Breastfed babies can have colic and formula-fed babies can have colic
(regardless of the type of formula). I tell parents that many studies have
been done on colic and that there is no universal answer other than time
(usually about 3 months). It is hard to say why a baby is crying: it could
be hunger (good option), fatigue, boredom, pain (could be anywhere, I don't
know why we have this big focus on the GI system).

I look the baby over carefully to be sure everything looks OK for my
re-assurance and the parents. I point out how well their baby is growing (if
appropriate, which it usually is). I also tell them that all babies cry and
the peak of crying is at 6 weeks. So to some extent, this is normal behavior
on the baby's part. What I've seen is that rather than the amount of crying
the baby's doing, it seems to depend more on the parent's nature and level
of anxiety as to whether or not they come in the office for help with the
colic. Because of this I try to focus on coping techniques for the family.

While we don't know if different foods (per mom or baby) are making the baby
colicky (ie, GI problems), we do know that a crying baby (for whatever
reason) will swallow air and then be "gassy". Because of this and the
parents desire to "do something", I tell them if they want to use
simethicone to relieve some of the gas bubbles, they may. I don't worry too
much about it since it is a fairly benign medicine (much better than
anti-cholingergic anti-spasmotics). I tell them that while simethicone won't
hurt, it may not help either and I explain its mechanism of action. I do not
prescribe anti-cholingergic anti-spasmotics and if the baby is already on
them I strongly recommend to the parents to discontinue this medicine which
also has not been shown to be effective and can be dangerous.

If the mom feels that certain foods in her diet could be contributing, she
can certainly eliminate them. I don't recommend that a mom routinely change
her diet. This can be a big (and usually unnecessary hassle). I feel that it
is unlikely that the baby is reacting to the mother's diet. I don't want the
mom to stop breastfeeding because her diet has become a huge hassle or
deprivation. On the other hand, chocolate (?theobromine)/caffeine can pass
into the breastmilk and have effects on the baby. So the mom may want to
monitor these substances.

My feelings on colic come from more of a developmental perspective. I tell
parents that when we were living in the woods thousands of years ago, if the
baby was laid down by itself, it was in danger (lions, and tigers and bears,
oh my! though I am not very graphic about this with the parents). While our
circumstances are different now than several thousands of years ago, babies
brains are still working the same way. So babies self-protectively cry when
they are laid down.

Similarly, over thousands of years, babies were carried constantly and fed
according to early feeding cues. Because babies brains are still working the
same way (not too much deliberation and thought-processing yet, mostly
survival and learning trust), babies firmly believe that they are meant to
be constantly carried by a someone (usually mom) and fed whenever they are
ready. While some babies will tolerate a wider spectrum of practices from
their parents, some babies (I think these are the colicky babies) won't.

I generally show the mom how to swaddle the baby, discuss motion (sling,
snuggly-carrier, swing, car-rides, etc.), white noise (sound of the shower
running was great for my daughter-- we even taped it). I talk about being
sure that the baby is getting the hindmilk. I encourage feeding to be an
early option even if the baby has "just nursed 20 minutes ago".

Sorry this is sooo lengthy and a bit beyond the scope of your questions.
Sorry I couldn't address your second question-- there any research out on this?

Mari Douma, DO, FACOP, FAAP
Lansing, Michigan