Context: Infant crying can cause parental distress, and colic is associated with low maternal
self-efficacy and heightened risk for depression. Breastfeeding is recognized as an effective
method of calming infants, but the relationship of colic and the use of breastfeeding to remedy
infant crying have not been tested for any effects on breastfeeding duration.
Objective: To evaluate the effects of infant colic (colic analysis) and breastfeeding as a
method of infant calming (calming analysis) on breastfeeding duration.
Design: The authors followed 700 healthy breastfeeding mother–baby dyads from birth to
1 year. Maternal interviews were conducted postpartum, and at 2, 5, 10, 16, 24, 38, and 52 weeks
to ascertain demographic factors, infant crying patterns, comforting practices, physician-diagnosed
colic, and breastfeeding behaviors. Cox survival analyses were used to evaluate the
independent effects of: (a) physician diagnosed colic; and (b) breastfeeding as a comforting
practice on breastfeeding duration. Data from all 700 breastfeeding dyads were used in the
colic analyses. In the calming analyses, to assure that breastfeeding was appropriately established,
data were used from the 617 couplets that had breastfed for at least 2 weeks. Using a
stepwise process, models, adjusted for typical predictors of breastfeeding duration, were developed
for exclusive, full and partial breastfeeding duration. Variables of interest (i.e., colic
diagnosis, breastfeeding for comfort) were then forced into the baseline models to determine
any independent effects.
Results: In the first 16 weeks, parents found that holding (87%), breastfeeding (82%), walking
(67%), and rocking (63%) were highly effective calming practices. Mothers who rated
breastfeeding as highly effective had a higher frequency of breastfeeding at all contacts (p <
0.05). In adjusted analyses the use of breastfeeding to comfort infants was a significant predictor
of longer partial (overall) ([hazard ratio] HR = 0.6, 95% CI 0.4 to 0.9; p = 0.02) but not
exclusive or full breastfeeding duration. By 6 months, 44 mothers (6.3%) reported a diagnosis
of colic. Mothers of infants with a diagnosis of colic were less likely to report breastfeeding
as effective method of infant comforting (p = 0.03). In adjusted analyses the authors found
that a diagnosis of colic predicted shorter full breastfeeding duration (HR = 2.4, 95% CI 1.4
to 4.2; p = 0.001) but not exclusive or partial duration.
Conclusions: Breastfeeding to comfort a crying infant is a strong predictor of partial (overall)
duration and is rated as a highly effective calming method by parents. These data suggest
that parents may benefit from education about normal infant crying patterns and effective
methods of infant comforting, including breastfeeding. However, mothers of infants
diagnosed with colic are at risk for shortened duration of full breastfeeding. Although the
reasons for this are unclear, it may be helpful to specifically address the subject of colic and
infant feeding and encourage mothers to fully breastfeed for the recommended 6 months.
