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Colic in infants Causes and Risks:
Colic in infants is common, occurring in about 1 out of 10 babies. First-born infants are affected with colic more often than later children. Often it begins within 10 days to three weeks after birth, lasting until three to four months of age when it generally disappears on its own. In spite of apparent abdominal pain , colicky infants eat well and gain weight normally. The crying episodes may tend to occur around the same time each day, but a few infants will cry almost constantly.
The specific causes of infant colic are not known, but the following factors may play a role: - air swallowed during the process of crying, feeding, or sucking on hands or fingers
- overfeeding with large amounts of formula or breast milk
- family tension and parental anxiety
- intestinal allergies to cow's milk
- esophageal reflux;
Recent research suggests that colic may be related to reflux esophagitis , which is a condition that occurs when the esophagus becomes irritated when acid backs-up from the stomach into the esophagus.
Prevention:
Most cases of colic are not preventable. Avoiding related factors, when possible, may help. For example, changing the way the baby is held when fed, changing the type of formula (if there's a cow's milk allergy ), or other interventions may be beneficial in some cases. Consult your health care provider for other suggestions.
Symptoms:
- excessive crying often of sudden onset and frequently beginning about the same time every day. Attacks of crying may last minutes up to several hours
- apparent abdominal pain manifested by drawing knees to the abdomen
- irritability
Signs and Tests:
A physical examination is performed to rule out other causes of similar behavior. Infants also have been studied in the hospital setting with a pH meter in the esophagus overnight. This procedure is more common in infants whose problem is thought to be from gastroesophageal reflux. The procedure measures the amount of acid refluxed from the stomach up into the esophagus
Treatment:
There are no specific measures to treat colic, however, the following suggestions may be of benefit to alleviate pain and to calm an irritable infant.
Keeping the baby in a slight head-up position may help. Wood blocks may be used to raise the head of the baby's crib. Avoid overstimulating the baby; an overattended baby may not get sufficient sleep. An active baby may respond to being swaddled in a blanket.
If a bottle feeding takes less than 20 minutes, the hole in the nipple may be too large. Avoid overfeeding the infant or feeding too quickly. A pacifier may calm an infant with a strong sucking need who fusses soon after a feeding. Many babies quiet while riding in the car, or to the sound of a vacuum cleaner or hair dryer.
Apply warmth to the abdomen with a hot water bottle wrapped on a soft cloth. Rhythmic movement such as walking or rocking may soothe the baby.
Parents should avoid fatigue and exhaustion and should be encouraged to get a break from the infant by having a friend, grandparent, or baby sitter stay with the infant on occasion. Occasionally a physician may recommend medications. A large variety of medications have been tried ranging from paragoric, smooth muscle relaxants, antacids, anti-gas agents, mild sedatives and antihistamines. Nothing has been demonstrated to be consitantly successful. Parents should not give infants less than six months medications for colic without consulting their physician.
Prognosis:
Colic is a benign condition that the baby usually outgrows at three to four months of age. Excessive crying is not harmful to the baby.
Complications:
There are usually none.
Call Your Healthcare Provider:
Apply home treatment. Call your health care provider if you have concerns. The most important concern is not to misdiagnose a serious condition and call it colic. If you baby's behavior or crying pattern suddenly changes or if the crying is associated with fever, forceful vomiting, diarrhea, bloody stools or other abnormal findings, call you physician immediately.
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