Colic is persistent, unexplained crying and discomfort in an otherwise healthy baby between the ages of two weeks and about five months.
Colic affects 10-20% of all infants. It is more common in boys than in girls and most common in a family's first child. Symptoms of colic usually appear when a baby is 14-21 days old, reach a peak at the age of three months, and disappear within the next eight weeks.
Causes & symptoms
Some babies who have colic are simply fussy. Others cry so hard that their faces turn red, then pale. Episodes may occur frequently but intermittently, usually beginning with prolonged periods of crying in the late afternoon or evening. Crying may intensify, taper off, and then get even louder. It can last for just a few minutes or continue for several hours. During a colicky episode, babies' bellies often look swollen, feel hard, and make a rumbling sound. Many babies grow rigid, clench their fists, curl their toes, and draw their legs toward their body. A burp or a bowel movement can end an attack. Most babies who have colic do not seem to be in pain between attacks.
One cause of colic may be the swallowing of large amounts of air, especially during feeding time. Air may then become trapped in the digestive tract and cause discomfort. Other possible causes include:
- immaturity of the digestive system
- food intolerances
- too little or too much food
- lack of sleep
- overheated formula
- overstimulation resulting from too much noise, light, or activity
- stress and tension on the part of the mother and other caregivers
- foods the mother eats, if breast-feeding, which are allergens or irritants for the baby
Colic is suspected in an infant who:
- has cried loudly for at least three hours a day at least three times a week for three weeks or longer
- is not hungry but cries for several hours between dinnertime and midnight
- demonstrates the clenched fists, rigidity, and other physical traits associated with colic
The baby's medical history and a parent's description of eating, sleeping, and crying patterns are used to confirm the diagnosis of colic. Physical examination and laboratory tests are used to rule out infection, intestinal blockage, and other conditions that can cause abdominal pain and other colic symptoms.
Parents should consult their healthcare practitioner before giving any herbal or allopathic medications to very young children. Teas made with chamomile (Matricaria recutita), lemon balm (Melissa officinalis), peppermint (Mentha piperita), catnip (Nepeta cataria), or dill (Anethum graveolens) can lessen bowel inflammation and reduce gas. Slippery elm powder (Ulmus fulva) is soothing and healing for the digestive system. Homeopathic remedies that may be effective for colic include Bryonia 30c every five minutes as needed, and Chamomilla 6c every five minutes for up to an hour. A homeopath can be further consulted for remedies to help strengthen the child's entire constitution. In addition, it is helpful to give the Bach flower essence called Rescue Remedy to the infant and to the caregivers. This will help to calm the situation.
Hands-on treatments are often helpful in treating colic. Squeezing the acupressure point at the webbing between the thumb and index finger of either hand can calm a crying child. Gently massaging the abdomen with a circular motion can also be used. Applying warm compresses over the child's abdomen can also relieve cramping.
Soothing movements may help to calm the baby. Colicky babies cry less when they are soothed by the motion of a swing, a car ride, or being carried in a parent's arms. Taking the infant for a walk may also help with soothing and encouraging sleep. Rocking the baby in a quiet, darkened room can be used to reduce over-stimulation, as well.
Giving small, frequent feedings rather than a few large feedings will be easier on digestion for a bottle-fed baby. For those who breastfeed, food allergens can be transmitted through the milk of the mother. Therefore, foods that cause problems in the infant should be removed from the mother's diet. These are most often likely to be coffee, tea, chocolate, citrus fruit, peanuts, wheat, and vegetables belonging to the cabbage family, including broccoli.
Medications do not cure colic. Doctors sometimes recommend simethicone (Mylicon drops) to relieve gas pain. Generally, parents are advised to take a practical approach, using home remedies. However, a doctor should be notified if a baby with colic:
- develops a rectal fever higher than 101°F (38.3°C)
- cries for more than four hours without relief
- has diarrhea or stools that are black or bloody
- continually loses weight
- continually eats less than normal
Colic is distressing, but it is not dangerous. Symptoms almost always disappear before a child is six months old.
To help prevent air from being swallowed during feedings, the infant's back can be gently massaged to release trapped gas bubbles. Keeping the infant in a sitting position while feeding is also helpful. Bottle-fed babies can swallow air if the nipple holes in the bottle are either too large or too small. This can be checked by filling the bottle with formula, turning it upside down, and counting the number of drops released as the bottle is being shaken or squeezed. The hole should allow the release of formula at the rate of one drop per second. In addition, sometimes a different style of nipple may improve nursing. A pharmacy should be consulted for additional guidance.
Cow's milk can often be disruptive to an infant's digestion. When cow's milk is the source of the symptoms, bottle-fed babies should be switched to a soy protein formula. (Regular soymilk should not be used, as it is not formulated for the nutritional needs of a nursing infant.) Goat's milk is easier to digest than cow's milk, and is also an acceptable substitute. Alternately, a tablespoon of acidophilus liquid or powder can be added to eight ounces of the infant's formula. A tablespoon of yogurt can also be used for this purpose. If an intolerance to cow's milk is suspected in a breastfed infant, the mother should eliminate dairy products from her diet, gradually reintroduce after seven days, and monitor the baby's symptoms. This should be done with any suspected allergen or irritating foods.
Editors of Time Life Books. The Medical Advisor: The Complete Guide to Alternative & Conventional Treatments. Alexandria, VA: Time-Life Books, 1996.
Taylor, Robert, ed. Family Medicine Principles and Practice. New York: Springer-Verlag, 1994.
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American Academy of Family Physicians. 880 Ward Parkway, Kansas City, MO 64114. http://www.aafp.org.
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