COLIC IN INFANTS

General Information

DEFINITION--Repeated episodes of excessive crying that cannot be explained. Crying ranges from fussiness to agonized screaming.

BODY PARTS INVOLVED--Possibly the lower intestinal tract.

SEX OR AGE MOST AFFECTED--Both sexes, but more common in boys. Colic affects infants up to 5 months old and is most common in a first child.

SIGNS & SYMPTOMS--

Excessive crying with the following characteristics:

• Crying bouts usually occur in late afternoon or evening.
• Crying bouts usually begin at 2 to 4 weeks and last through 3 or 4 months.
• The infant's abdomen may rumble, and the child may draw up the legs as if in pain.
• No specific disease, such as an ear infection, hernia, allergy or urinary infection, can be discovered.

CAUSES--Unknown. Colic may be related to physical pain or emotional upset. Some likely possibilities include: hunger; insufficient sleep; milk that is too hot; overfeeding; food allergy; reactions to tension in the home; loneliness; or tiredness.

RISK INCREASES WITH--No known risk factor.

HOW TO PREVENT--No specific preventive measures. Remove any causes that can be identified.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's treatment (occasionally).

POSSIBLE COMPLICATIONS--None expected.

PROBABLE OUTCOME--All babies cry, and many have fussy periods. Crying is an important activity and means of communication. Colic is a distressing, but not dangerous, condition. The symptoms can sometimes be relieved. When they can't, the colic will disappear after the 4th or 5th month.

How To Treat

GENERAL MEASURES--

• Be patient and tolerant. Since colic is not the parents' fault, do not blame yourself.
• Don't feed the baby every time he or she cries. Look for a reason, such as: a gas bubble; cramped position; too much heat or cold; soiled diaper; open diaper pin; or a desire to be cuddled.
• During an attack of gas, hold the baby securely, and gently massage the lower abdomen. Rocking may be soothing or other movement (car ride, swing or stroller).
• Offer the baby a pacifier.
• Playing music may help.
• Allow the baby to cry if you are certain everything is all right (not hungry, not soiled, no fever, no open pins) and you have done all you can. Colic is distressing, but not harmful.
• Keep the baby warm.
• Get someone to care for the baby for at least an hour or two each day. The tension can get to you and you need some relief.

MEDICATION--Medications are usually not helpful for colic. Simethicone (for gas) may be prescribed.

ACTIVITY--No restrictions.

DIET--

• Cow's milk in the diet of a breast-feeding mother may cause colic. Avoid drinking it if your baby has colic.
• Interrupt bottle feedings after every ounce and burp the baby. Interrupt breast feedings every 5 minutes.
• Allow at least 20 minutes to feed the baby. Don't prop the baby for feedings.
• Nipple holes should not be too large. A vigorous baby may require blind nipples in which you can make small, homemade nipple holes.
• For formula-fed babies, try stopping the cow's milk and switching to soy-milk/hydrolyzed-protein formula.

Call Your Doctor If

• The baby's rectal temperature rises to 101F (38.3C) or higher.
• You are concerned about your emotional control.