Colic, Fussiness, and the Unsettled Infant
Few things are more stressful for new parents than a baby who cries for hours and cannot seem to be comforted.
They have tried everything. Fed the baby, changed the diaper, checked for fever, tried rocking, bouncing, swaddling, and white noise. They are pacing the floor at 2 a.m., exhausted and desperate, and their baby is still crying.
Eventually, someone tells them, “It’s just colic. They’ll grow out of it.”
And while that is often true, it doesn’t answer the question that stays with most parents long after that conversation: why is my baby so uncomfortable in the first place?
Colic is traditionally defined as crying for more than three hours per day, more than three days per week, for more than three weeks in an otherwise healthy infant. Most babies improve significantly by three to four months of age. That is reassuring information. It is also cold comfort when you are in the middle of it.
Modern medicine has not identified a single cause of colic. It appears to be a collection of symptoms with several possible contributing factors. Some babies have digestive discomfort. Others have difficulty regulating their nervous system. Some are sensitive to stimulation. And some are carrying physical tension in their bodies that nobody has thought to look for.
This is where I think osteopathic medicine has something important to offer.
Birth is one of the most physically demanding events a baby will ever experience. During labor and delivery, an infant’s head and body must twist, compress, and adapt to pass through the birth canal. Even uncomplicated deliveries place real forces on a newborn’s body. Cesarean births have their own stresses, particularly when labor was prolonged or delivery required significant assistance.
Most babies handle this remarkably well. Others arrive carrying areas of tension and restricted motion that quietly contribute to discomfort in the days and weeks that follow.
Because infants cannot tell us where they hurt, they communicate through behavior. A baby experiencing physical tension may prefer turning their head to one side, arch their back frequently, seem uncomfortable lying flat, resist being held in certain positions, struggle with feeding, or cry inconsolably even after every basic need has been met. These are not character traits. They are clues.
One of the most interesting connections in infant osteopathic care involves the vagus nerve, which plays a major role in regulating digestion, swallowing, intestinal movement, and the body’s ability to shift into a calm and restful state. The vagus nerve exits the skull through an opening near the base of the head. When there is significant tension in this region, it is reasonable to consider whether that tension is contributing to symptoms like feeding difficulties, reflux, excessive fussiness, or an inability to settle.
Osteopathic treatment for infants looks nothing like what most people imagine. There is no cracking, no forceful twisting, nothing dramatic. Treatment is gentle hands-on work aimed at identifying and reducing areas of restriction throughout the body, commonly in the head, upper neck, diaphragm, rib cage, abdomen, and pelvis. Many infants sleep through their treatment. Others visibly relax on the table.
Research in this area continues to grow. Several studies have suggested that osteopathic manipulative treatment may reduce crying time and improve symptoms in infants with colic. More high-quality research is still needed, but the evidence we have, combined with decades of clinical experience, supports its use as a valuable addition to the care of these babies.
I want to be clear: osteopathic treatment is not a cure for colic. And any infant with excessive crying should first be evaluated by their pediatrician to rule out infection, gastrointestinal disease, feeding problems, or other conditions that require medical attention.
But not every crying baby has colic. Not every fussy infant has reflux. Not every unsettled newborn simply needs to grow out of it.
Sometimes a baby is uncomfortable, and with a little help, we can do something about that.
Parents know their babies better than anyone. If something feels off, trust that instinct. A gentle osteopathic evaluation may uncover exactly what has been making those early weeks harder than they needed to be.
Dr. Anna Ekstrom, DO, MPH, The Osteopathic Pediatrician, is a board-certified pediatrician and osteopathic physician specializing in the care of infants, children, and adolescents. The content of this article is intended for educational purposes and should not be used as a substitute for medical advice, diagnosis, or treatment from a qualified healthcare professional.
