The Happiest Baby on the Block: Causes of Colic

The Happiest Baby on the Block: Causes of Colic. The causes of colic as outlined in The Happiest Baby on the Blog by Harvey Karp.

Mom with fussy baby

Chapters four and five of The Happiest Baby on the Block discuss top theories of the causes of colic and Karp’s reasoning for why those theories are false, along with this theory for what causes colic.

Neither of my children ever had colic. Kaitlyn never even had a time of day when she cried. I literally never had a time when she cried that I couldn’t console her immediately, and she had reflux. I know, good baby.

Brayden had his period of crying in the evening most days, but that stopped as soon as we started Babywise. So, I won’t pretend to know what colic is like or what does or doesn’t cause colic. Here are some points I took note of while reading these two chapters.

  • Lack of Logic: Overall, I found Karp’s arguments for and against theories lacking. Again, not to say I agreed or disagreed with them, but just that I didn’t find them to be strong enough arguments. His evidence for his thesis just isn’t strong enough. While earning my degree, I conducted many studies. I know how to present a hypothesis and how to support it. I also worked as a tutor throughout college in our Writing Center. I know how to properly write these things. I have studied logical fallacies up and down. These chapters are very weak.
  • Misleading: I could easily see a new parent reading this book and assuming babies don’t cry due to something like gas (theory #1 Karp discusses). He does say it doesn’t cause “colicky crying,” but a frazzled parent, especially a new one, looking for answers might not realize the distinction. Babies certainly can cry from pain due to gas. I know Brayden did.
  • Food Aversions: Pages 39-40. Karp doesn’t believe many babies can possibly be bothered by foods. If a mother in Mexico can eat that food, then it shouldn’t bother an American baby. That argument just doesn’t work. No two adults react the same way to foods, why would two babies? He does concede that it doesn’t hurt to cut foods out of your diet to see if they bother your baby, just in case. In my experience, Brayden didn’t have any noticeable aversions to anything I ever ate. Kaitlyn, however, had extreme aversions to caffeine. I don’t drink it in any form; I just eat it in chocolate. A small piece of chocolate was enough to disrupt her whole day. I had to avoid it completely (hard for me!). So I definitely know that babies do have food aversions.
  • Reflux: Page 42. Karp seems to be one in the camp of belief that reflux can only be damaging/painful to the baby if he cries incessantly (at least 5 hours a day according to Karp). I fully disagree with this belief. I believe it can be damaging even without crying or spitting up (known as silent reflux–which is what Kaitlyn had).
  • New Baby is Hard: Page 46. Karp says new babies are hard. I agree. I thought I should be sure to add something I agree with 🙂
  • Babies Are Just Babies: Ugh. Page 47. I really dislike that statement. Karp says babies can’t sense the feelings of the mother (like anxiety) because babies are just babies. I disagree with both parts of that statement. I believe babies can sense the feelings of the mother. I also agree with Hogg’s take on babies that they are people too. Not “just” babies.
  • Good Self Calmer/Bad Self Calmer: Pages 50-51. Karp talks about the abilities of babies to self-calm. He says some are good and some are not. I agree with this. They all come with a different level of skill to self-calm.
  • Never Been Pregnant: Karp has women imagine what life is like for the baby in the last month of pregnancy. He says, “Imagine your baby bouncing around when you hustle down the stairs” (page 63). I found this funny. I don’t know about any of you, but I certainly never hustled anywhere my last month of pregnancy. 🙂
  • Appeals to Emotions: On page 66, Karp talks about parents now wanting their babies to have “big smart brains” and be born “early” (you know, after 9 months), but don’t want to feed them frequently or carry them around all day. “…parents…denied what mothers and fathers for hundreds of thousands of years had promised to give their new infants” (page 66). To me, this just seems like he is trying to guilt parents into following his plan for babies.
  • Spoiling: Page 69. Karp says new parents avoid holding their babies too much in order to avoid spoiling the baby. Maybe this is true for some, but for me it is to avoid over stimulation and avoid teaching the child to depend sleeping in your arms.
  • The Missing 4th Trimester: In my previous post, I mentioned that Karp calls the first three months of life the fourth trimester and that I have heard it called that. I agree that it is like a fourth trimester in that it is hard, just like pregnancy (at least pregnancy is hard for me). You don’t get any smiles from baby for a while, and laughs usually come after three months. With this difficulty, though, parents develop a deep love for their children. An unconditional love. I call it a Christlike love.Karp states that through evolution, the brains of our babies have gotten larger, and therefore babies are now born three months “too early” because otherwise their heads would be too large and mother and child would die. This is the reason for colic. Well, this isn’t something I believe in the least.In reality, his “missing fourth trimester” is drawn out as an elephant. The five other theories he previously discussed are the elephants legs, stomach, ears, and back (page 71).

Colic Remedies

Chapter 14 is all about other colic remedies you can turn to other than the 5 S’s. The first of these is massage.

Karp discusses a 1986 study done by Tiffany Field. Field found that premature babies who were massaged for 15 minutes, three times a day gained 47% more weight than expected and were able to go home almost a full week earlier than babies who weren’t massaged. I realize a week doesn’t seem like a long time, but if you have ever had a baby in the NICU, you know how long a day is.

In a follow-up study, Field found these massaged babies had a higher IQ at one year than those who weren’t massaged. She also found that full-term babies who were massaged for 15 minutes a day cried less, were more alert, were more socially engaged, gained weight faster, and had a lower level of stress hormones (page 195). See this label for more on massage: massage

The second colic remedy is walks outside (page 197). This is pretty self-explanatory.

The third colic remedy is warming your baby up. Here are some ideas of how to warm baby (pages 198-199):

  • Warm bath
  • Warm blanket
  • Warm hat
  • Warm hot-water bottle
  • Warm socks

If you choose to try to warm your baby, be sure to monitor baby so she doesn’t get too hot. Watch her ears, fingers, and toes. If they are red and hot and her armpits are sweaty, she is probably too warm (page 199).

Karp goes on to say that 10-15% of colicky babies are colicky because of a tummy trouble (which I found odd considering that he stated tummy troubles were not the cause of colic earlier in his book…). The first is food allergies.

To test if your baby has a food allergy, you need to eliminate food from your diet, or if baby is formula fed, switch baby’s formula. It takes 2-4 days of the change before you can expect the crying to get better, so be patient (page 200).

Many moms I know who are testing foods basically eliminate everything they thing could be the culprit. They then wait several days. If things have improved, they might start to slowly introduce foods one by one, waiting several days between each new food. Karp suggests you wait until your child has been less colicky for two weeks before re-introducing. Personally, if I were sure it was what I was eating, I would never reintroduce it just to see :). The most common food babies are allergic to is dairy (page 200). I will say that for sure at least 10% of the babies I know are allergic or have an aversion to dairy.

The second tummy problem that Karp lists as a cause of colic is constipation (page 201). If you suspect this with your baby, consult with your doctor for constipation cures.

The third tummy problem would be because baby isn’t getting enough milk. Baby should be calm and relaxed after a feeding. Baby should be peeing enough and gaining weight normally. Babies typically gain 4-7 ounces per week (page 203).

If you are breastfeeding and have a milk supply problem:

  • First, find out the reason for this problem. It could be flat nipples, thyroid, fatigue, poor nutrition, or insufficient breast tissue. It could also be that your baby isn’t sucking hard enough or is even tongue-tied (pages 203-204).
  • Second, increase your supply. Eat well, get enough rest (as much as you can 🙂 ), empty your breasts at feedings, you can also pump after a feeding (though Karp recommends pumping before a feeding), get comfortable while nursing/pumping to increase production, use fenugreek or Mother’s Milk, and/or talk to your doctor (pages 204-205).
  • Third, you can use an SNS system, which gives your baby supplemental formula. Consult with your doctor and/or lactation consultant first, though (page 205).

The fourth medical cause of colic is baby gets too much milk (page 205). Your baby might not know when to stop or you might have an over active letdown. If you bottlefeed, the nipple might be too soft of have holes that are too big. If your baby struggles, coughs, or pulls away when she starts to nurse, it might be wise to express a couple of ounces before the feeding (page 205). Also, there are many support groups online for moms with over active letdown, so that might be of use to you.

The fifth medical cause of colic is reflux. Karp says keeping a baby upright following a feeding is a “dead-end” treatment (page 206), but I have never heard a parent say that didn’t work for their child.

He says laying on the stomach is a position that will help baby’s reflux, though for Kaitlyn it made it worse. When I say that, I don’t mean that every baby with reflux will not benefit from tummy position; I know many if not most do. But some do not. Karp said also the left side is a good position for a baby with reflux.

Be sure to burp a baby with reflux well and often. Also be sure your baby isn’t overeating. If your baby has reflux, consider eliminating dairy from your diet since for some babies, reflux is a sign of a milk allergy (page 207). Your doctor might prescribe medication to help with the reflux.

>>>Read: Babywise and Reflux

Many Questions

I have many questions about his conclusions. Starting on page 73, he starts to list the 10 clues of colic and why his theory fits but not the other five. Number one is that colic doesn’t start until two weeks of age.

For every other theory (gas, reflux, temperament, immature brain, premature, etc.) he used this to prove that those can’t be the cause of colic because, for example, a baby’s temperament is the same at two weeks as it was at birth, or food aversions and allergies are present at birth if they are present at two weeks (though many doctors have told me aversions and allergies can suddenly appear), etc.

I was curious how he was going to make this first clue fit in with this fourth trimester theory. If the baby is missing his fourth trimester at two weeks, he would be missing it at birth. He fixes that by simply stating that for the first two weeks of life, baby has little alert time, so he doesn’t get over or under-stimulated, and thus delays the onset of colic. If that argument can be used for his 4th trimester theory, then it should be able to be applied to the other theories. Also, his reasoning used sounds more like over/under stimulation is the cause of colic rather than the missing fourth trimester.

According to Karp, preemies don’t get colic until two weeks after due date because they sleep so much. Their immature brains have mastered the sleep state. This lack of alert time fools the baby into thinking they are still in the womb.

If this were true, why wouldn’t “nature” fool the baby born three months too early (missing fourth trimester) into thinking he is still in the womb, also? Why would “evolution” cause us to have babies three months early but make these babies effectively unable to handle the world? Why wouldn’t evolution fix that? Another thing, Karp says to mimic the womb conditions in order to counteract the missing fourth trimester. Kaitlyn was in the NICU. It was nothing like my womb (at least I don’t think so; I haven’t ever actually been in my womb).

Karp says that the fact that babies are happy and healthy between crying bouts proves that it is the missing fourth trimester that is the problem. “…it’s logical to expect immature infants to be healthy and happy until something pushes them over the edge” (page 75).

That actually doesn’t sound logical to me. If the 4th trimester is the problem causing colic, then I would think baby would cry all day and every day. Maybe stop for sleep. It makes more sense that gas, over stimulation, etc. would be the problem because those items aren’t omnipresent.

Further, if it is the missing fourth trimester, why don’t all babies have colic? He says certain cultures that carry their babies all day never experience colic, but how would he explain a baby like Kaitlyn? Why was it she didn’t cry? Is it because she is better at self-soothing than other babies as he mentions earlier in the book? If so, then wouldn’t a lack of ability to self-soothe be the culprit and not the missing fourth trimester? That would be the item the two babies had different in life, not the missing fourth trimester. Kaitlyn certainly wasn’t carried around all day long. I never did any of the 5 S’s on her…

As you can see, I am not really buying into Karp’s theories so far. I could go on, but I don’t need to. Many of you have told me he does have some practical skills that are beneficial to the parent, so I am looking forward to reading about those.

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Reader Colic Comments:

  • Christie said…
    This seems like a really bizarre book:) The whole “evolution giant baby brain head” theory that you cited in Karp’s book is pure silliness. Thank you for reviewing this with us to save me some money on, haha. I did, however, purchase Hogg’s Baby Whisperer for Toddlers and it is ok, but like most of us on here, I believe the more I read, I realize I am a Babywise mom through and through! Thanks again for sharing your thoughts with us!
    January 16, 2009 2:16 PM
    Plowmanators said…
    Christie, it really is bizarre. I just finished the whole thing this morning. Eh. It definitely will not be a book I ever consider buying. I haven’t read that Baby Whisperer for Toddlers book, but it is on my list of books to read some day 🙂
    January 22, 2009 1:42 PM
  • Maureen said…
    This book is starting to make me mad. Thanks for your post and saving me the money. I like the DVD but the book sounds ridiculous. Honestly, I stopped reading your post when I read that he doesn’t think babies have food aversions. What?! Seriously?! William cried non-stop because of lactose intolerance. And I didn’t make that term up. It exists because the condition is real, even in newborns. And we noticed it in the first few days. We didn’t know what was going on, but we knew whatever it was, it wasn’t normal. And I have zero doubt that the cause of his crying/colic was the dairy. A couple days after I cut it out of my diet, he was a NEW baby. I could not believe what a difference it made. Your post makes it sound like he doesn’t truly believe colic exists, like it’s in our heads, as if we want our kids to cry in pain all day long. Grrr!
    January 16, 2009 3:55 PM
    Plowmanators said…
    Maureen, The funny thing about food aversions is that later in the book, he says 10% of babies have food aversions and lists ideas for what to do about it. It makes me wonder who on earth the editor was. Didn’t he/she pay attention and point out the many contradictions?!?!?! Yeah, the book was frustrating to me too. DH kept telling me to stop reading it, but I persevered to the end!
    January 22, 2009 1:44 PM
  • KJackson213 said…
    I wanted to add, that I do believe gas, etc is the biggest reason for ACTUAL colic. However, I read an adult study showing that lack of sleep can result in tummy aches. After reading that I thought to myself, that’s so true bc I always have a stomach ache when Im exhausted. I don’t see why it would be any different with babies!So colic could be blamed on tummy issues, when really, tummy issues are due to lack of sleep.This is a huge reason why I think Babywise babies are less likely to have “colic” then other babies!
    February 10, 2009 6:28 AM
    Plowmanators said…
    Thanks for your thoughts! That is interesting.
    February 12, 2009 2:00 PM

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