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Colic is an attack of crying and what appears to be abdominal pain in young infancy.
It is a common condition and is estimated to affect up to 1 in 5 infants during their first few months.
All infants cry for various reasons, including hunger, cold, tiredness, heat, or because the diaper needs changing.
However, an infant may cry even after being fed, cleaned, and well cared for. If an infant has repeated episodes of inconsolable crying but appears to be healthy and well, they may have colic.
Fast facts on colic
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.
- It generally only lasts a number of weeks.
- 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.
Colic usually appears a few weeks after birth and carries on until the infant is about three to four months old. Even though they may cry a great deal, colic is neither dangerous nor harmful.
Experts say that colic has no long-term effects and an infant with colic will gain weight and feed normally.
Colic is relatively short-lived.
This article will focus on colic in infants, but there are a number of other types, such as:
- Renal colic: This is abdominal pain generally caused by kidney stones. The pain can be constant or come in waves.
- Biliary colic: This is pain caused by a gallstone obstructing the cystic duct as the gallbladder contracts.
- Horse colic: This is a symptom of a number of diseases in horses.
- Painter’s colic: This can be caused by lead poisoning.
The following symptoms will appear in an otherwise healthy and well-fed infant:
- Intense crying: The infant cries intensely and furiously, and there is not much the parents can do to comfort them. 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
- Changed 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 infants, symptoms are mild, and the baby may only experience periods of restlessness.
If you think the baby’s crying may be the result of an injury or fall, seek medical attention. If you notice any change in the baby’s general behavior, eating habits or sleeping patterns that concern you, ask your doctor or nurse for advice.
It is suggested that wind or indigestion may be involved in colic, but the causes are largely unknown.
Some wonder whether the infant’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 infants 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 infants are equally likely to have colic.
A 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 visit a doctor.
As colic is a normal part of some infants’ 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 no single substance that cures all cases of colic. However, the following treatments have been shown to help.
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. The infant may continue being allergic to milk.
Simethicone drops: Simethicone is an anti-foaming agent that reduces the amount of trapped wind. It brings together small bubbles of gas that are trapped in the stomach contents when an infant swallows air.
As the bubbles group together and become larger, 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.
Typically, an infant will be given a 2.5 milliliter (ml) spoonful after each feed. It can be added to the infant’s bottle or given directly into the mouth, either with a spoon or an oral syringe.
There is a range of simethicone drops available for purchase online. Be sure 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 to prevent this.
Sometimes lactase drops help infants 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. Lactase drops are available for purchase online.
Therapies to avoid
There are some treatments for colic that could pose a risk to an infant.
Dicycloverine, or dicyclomine: This is 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.
Do not use these treatments.
There are not many treatments for colic. However, there are things a parent can do when calming an infant with colic.
Comforting them is often a question of trying out various methods and pursuing the ones that work – infants respond differently to comforting when they have colic.
The following suggestions may help:
- Wrapping an infant firmly in a blanket during a crying episode may help.
- Some infants respond well to being held.
- Sit the baby upright when feeding. This makes it less likely that air is swallowed.
- More frequent, 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 might improve conditions. This is a diet that excludes dairy, eggs, wheat, or nuts.
- 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. There is a range of bottle teats available for purchase online.
- Make sure you have burped your baby after a feed. Sit the baby upright or hold them against your shoulder with the neck and head supported. Rub their back and stomach you air comes out. It is normal for the baby to bring up some milk.
- Sometimes picking up and putting down an infant 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 feels better, leave them in the crib 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 – an infant sling may make it less tiring on the arms.
- Sometimes a background noise, such as that made by a washing machine or vacuum cleaner, helps settle infants.
- A warm bath or gentle massage may also help
Colic can be exhausting for parents, but it causes little in the way of long-term health problems.
Written by Christian Nordqvist