Colic

Colic is frequent, prolonged and intense crying or fussiness in a healthy infant. Colic can be particularly frustrating for parents because the baby’s distress occurs for no apparent reason and no amount of consoling seems to bring any relief. These episodes often occur in the evening, when parents themselves are often tired.

Episodes of colic usually peak when an infant is about 6 weeks old and decline significantly after 3 to 4 months of age. While the excessive crying will resolve with time, managing colic adds significant stress to caring for your newborn child.

Symptoms

Fussing and crying are normal for infants, especially during the first three months. And the range for what is normal crying is difficult to pin down. In general, colic is defined as crying for three or more hours a day, three or more days a week, for three or more weeks.

Features of colic may include the following:

  • Intense crying
  • Crying for no apparent reason
  • Extreme fussiness even after crying has diminished
  • Facial discoloring, such as reddening of the face or paler skin around the mouth
  • Bodily tension, such as pulled up or stiffened legs, stiffened arms, arched back, or tense abdomen

Sometimes there is relief in symptoms after the infant passes gas or has a bowel movement. Gas is likely the result of swallowed air during prolonged crying.

Causes

The cause of colic is unknown. It may result from numerous contributing factors. While a number of causes have been explored, it’s difficult for researchers to account for all the important features, such as why it usually begins late in the first month of life, how it varies among infants, why it happens at certain times of day and why it resolves on its own in time.

Possible contributing factors that have been explored include:

  • Digestive system that isn’t fully developed
  • Imbalance of healthy bacteria in the digestive tract
  • Food allergies or intolerances
  • Overfeeding, underfeeding or infrequent burping
  • Early form of childhood migraine
  • Family stress or anxiety

Treatment

The primary goals are to soothe the child as much as possible with a variety of interventions and ensure that parents have the support they need to cope.

Soothing strategies

You may find it helpful to have a plan, a list of soothing strategies you can try. You may need to experiment. Some may work better than others, and some may work one time but not another. Soothing strategies may include:

  • Using a pacifier
  • Taking your infant for a car ride or on a walk in a stroller
  • Walking around with or rocking your baby
  • Swaddling your baby in a blanket
  • Giving your baby a warm bath
  • Rubbing your infant’s tummy or placing your baby on the tummy for a back rub
  • Playing an audio of heartbeats or quiet, soothing sounds
  • Providing white noise by running a white noise machine, a vacuum cleaner or clothes drier in a nearby room
  • Dimming the lights and limiting other visual stimulation

Trial changes in diet

If soothing or feeding practices aren’t reducing crying or irritability, your doctor may recommend a short-term trial of dietary changes. If your baby has a food allergy, however, there would likely be other signs and symptoms, such as a rash, wheezing, vomiting or diarrhea. Dietary changes may include:

  • Formula changes. If you feed your infant formula, your doctor may suggest a one-week trial of an extensive hydrolysate formula (Similac Alimentum, Nutramigen, Pregestimil, others) that has proteins broken down into smaller sizes.
  • Maternal diet. If you’re breast-feeding, you may try a diet without common food allergens, such as dairy, eggs, nuts and wheat. You may also try eliminating potentially irritating foods, such as cabbage, onions or caffeinated beverages.
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