Colic is an attack of crying and what appears to be abdominal pain in early infancy (babies). Colic is a common condition and is estimated to affect at least 20% of babies during their first few months.
All babies cry for various reasons; hunger, cold, tiredness, heat, or because the diaper (nappy) needs changing. However, a baby may cry even after being well fed, cleaned, nicely wrapped up and well cared for. If a baby has repeated episodes of inconsolable crying but appears to be healthy and well, they may have colic.
Contents of this article:
Here are some key points about colic. More detail and supporting information is in the main article.
- Colic is characterized by long bouts of crying for no obvious reason
- Currently, colic is not fully understood by medical science
- Only 5% of babies that cry excessively have an underlying condition
- There are a number of different conditions referred to as "colics"
- Colic generally only lasts a number of weeks
- The major symptoms of colic are excessive crying and disturbed sleep
- Smoking during pregnancy might increase the risk of colic
- The diagnosis of colic predominantly consists of ruling out other illnesses
- Home treatments for colic can be effective.
What is colic?
Colic only normally lasts a number of weeks but can be very stressful for the family.
Experts say that colic has no long-term effects and a baby with colic will gain weight and feed normally.
For parents, seeing a baby cry inconsolably can be distressing and upsetting, making them feel that they are either doing things wrongly or letting their child down.
It is important to remember that, if it is colic, it is a common phase which will eventually go away and has nothing to do with bad parenting. Colic is relatively short-lived - in a matter of weeks or months one of the first major challenges of parenthood will be over.
This article will focus on baby colic, but there are a number of other colics. These are listed below to avoid confusion:
- Renal colic: abdominal pain generally caused by kidney stones. The pain can be constant or come in waves
- Biliary colic: pain caused by a gallstone obstructing the cystic duct as the gallbladder contracts
- Horse colic: a symptom of a number disease in horses
- Devon colic: an affliction that struck the people of Devon in the 17th and 18th centuries caused by the lead used in cider making
- Painter's colic: lead poisoning.
Symptoms of colicThe following symptoms will appear in an otherwise healthy and well fed baby:
- Intense crying - the baby cries intensely and furiously, and there is not much the parents can do to comfort him/her. The baby's face will become red and flushed. Crying episodes tend to occur at the same time every day - generally during the late afternoon or evening. Episodes may last from a few minutes to much longer periods. Crying usually starts suddenly and for no apparent reason
- Baby's posture - fists may be clenched, tensed abdominal muscles, knees drawn up, and the back arched
- Sleeping - sleep may be irregular and interrupted with episodes of crying
- Feeding - feeding may also be interrupted and irregular with episodes of intense crying. However, the amount the baby eats each day is not reduced
- Wind - during episodes of intense crying, the baby may pass wind
- Varying intensities - with some babies, symptoms are mild and the baby may only experience periods of restlessness.
Causes of colicExperts suggest wind or indigestion may be involved but nobody really knows what the causes of colic are. Some wonder whether the baby's gut is immature and sensitive to some of the substances in breast or formula milk. Milk allergies and lactose intolerance have similar symptoms to those of colic. These theories are not supported by evidence, however.
Twice as many babies have colic if their mother smoked during pregnancy.
Colic does not occur more commonly among first, second or third born children. Breastfed and formula-fed babies are equally likely to have colic.
Tests and diagnosis of colicA doctor may conduct a physical exam to determine whether anything may be causing the baby's distress, such as an intestinal obstruction. If the baby is found to be otherwise healthy, they will be diagnosed with colic. Laboratory tests or scans are not usually necessary, unless the doctor suspects there may be an underlying cause.
Anybody who suspects that their baby might be unwell should see a doctor. Nobody is more familiar with the baby's behavior and temperament than his/her parents.
Home treatments for colic
A number of home remedies can have some effect on the symptoms of colic.
- Swaddling a baby during a crying episode may help (wrapping him/her up firmly in a blanket)
- Some babies respond well to just being held
- Sit the baby upright when feeding; this makes it less likely that air is swallowed
- Sometimes more frequent - but smaller - feedings may help
- Breastfeeding mothers may find that if they avoid tea, coffee, spicy foods and alcohol the baby's colic symptoms become less severe
- Some evidence suggests that a hypoallergenic diet for the mother i.e. no dairy, eggs, wheat, or nuts, might improve conditions
- A pacifier (dummy) - some parents have found that offering the baby a pacifier helps
- Make sure the holes in the bottle teats are the right size. If they are too small the baby is likely to swallow more air during each feed
- Make sure you have burped your baby after a feed. Sit the baby upright or hold him/her against your shoulder with the neck and head supported. Rub their back and tummy until you air comes out. Sometimes the baby may bring up a bit of milk; this is normal
- Sometimes picking the baby up and putting him/her down frequently may make the crying worse. Comforting the baby in a quiet place with dimmed lighting often works better. When you are sure the baby is OK - fed, clean, not too hot or cold, leave him/her in the cot for a while
- Some people find that going for a walk with the stroller helps settle the baby down, as might a drive in the car. Or anything that keeps the baby in motion - perhaps a baby sling will make it less tiring on the arms
- Sometimes a background noise, such as that made by a washing machine, or vacuum cleaner helps settle babies down
- A warm bath, or gentle massage may also help
- Get someone to help - having someone else help out gives you some private time. This may help calm you and your anxieties, which may result in more peace all round.
Medical treatment for colicAs colic is a normal part of some babies' lives and is not harmful, it is not usually recommended to give medication. If you are concerned, or are finding it hard to cope, talk to your GP (general practitioner, primary care physician).
There is not one substance which sweepingly cures all or most cases of colic. However, some treatments have given a percentage of babies some relief. Examples include:
Excluding cow's milk protein - this means bottle-feeding with hypoallergenic formula if the baby has been bottle-fed, or a dairy free diet for the breastfeeding mother. This should be a one-week trial. If it works, then continue. If it doesn't work, abandon the trial.
If this works it does not mean that your baby is permanently milk-intolerant, it just means the trial worked and the baby may have responded well for many reasons; his/her gut may still be maturing, it might just have been coincidence (the colic was going to disappear anyway at the same time you did the trial), or they may continue being allergic to milk, etc.
Simeticone drops - simeticone is an anti-foaming agent; it reduces the amount of trapped wind. It brings together small bubbles of gas that are trapped in the stomach contents when a baby swallows air.
As the bubbles clump together and become bigger bubbles they are easier to expel by burping or passing wind. Simeticone works locally in the gut and does not get into the bloodstream. It is said to relieve abdominal pain (wind, colic, gripe).
Typically, a baby will be given a 2.5ml spoonful after each feed. It can be given to the infant's bottle or given directly into the mouth, either with a spoon or an oral syringe - read the instructions on the leaflet.
Lactase drops - lactase is an enzyme that breaks down milk sugar lactose into glucose and galactose. People with lactase deficiency in the gut can develop abdominal cramping and diarrhea after consuming milk products - lactase helps prevent that.
Sometimes lactase drops help babies with colic. If your baby responds well, remember that it does not necessarily mean they will need lactase later on; the milk intolerance may be temporary.
In some instances, a dairy-free diet can help ease colic.
Therapies to avoid
- Dicycloverine (dicyclomine) - a medication used for stomach cramps. It used to be commonly used as a colic treatment. However, it has been found to cause breathing difficulties, seizures, weakening of the muscles, loss of consciousness and coma in infants.
- Star anise tea - an herbal tea that used to be popular as a treatment for colic. However, some types are toxic and bad for the baby.
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