Categories
Pediatric

Colic

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Definition:
Colic is when an otherwise healthy baby cries more that three hours a day, for more than three days a week, between ages three weeks and three months. The crying usually starts suddenly at about the same time each day. This is actually just an arbitrary definition made years ago . By this definition, a surprising number of babies actually would have colic: some experts have even estimated as many as half of all babies!

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If your baby is crying a lot, you should call your doctor. Your pediatrician will want to check your baby to make sure there is no medical reason for the crying. If your baby’s doctor finds no underlying cause, then they will probably say your baby has colic. Colic is perfectly normal, and does not mean there is anything wrong with either baby or parents. Colic can be distressing for both you and your baby. But take comfort in the fact that it’s not permanent. In fact, in a matter of weeks or months — when your baby is happier and sleeping better — you’ll have weathered one of the first major challenges of parenthood.It does not have any lasting effects on the child or the mother in later life.

Signs and symptoms:

The baby’s cry is loud and they may have a red face and a tense, hard belly, because the abdominal muscles tighten with crying. Baby’s legs may be drawn up and fists clenched. This is often just the typical baby crying posture. However, the first time your baby has a long jag of inconsolable crying like this—with a tense, hard belly—you should call your doctor. This can sometimes be a sign of a serious condition that requires medical attention.
A fussy baby doesn’t necessarily have colic. In an otherwise healthy, well-fed baby, signs of colic include:

*Predictable crying episodes. A baby who has colic often cries about the same time every day, usually in the late afternoon or evening. Colic episodes may last anywhere from a few minutes to three hours or more on any given day. The crying usually begins suddenly and for no clear reason. Your baby may have a bowel movement or pass gas near the end of the colic episode.
*Intense or inconsolable crying. Colic crying is intense. Your baby’s face will likely be flushed, and he or she will be extremely difficult — if not impossible — to comfort.

*Posture changes. Curled up legs, clenched fists and tensed abdominal muscles are common during colic episodes.
*Colic may affect up to about 25 percent of babies. Colic usually starts a few weeks after birth and often improves by age 3 months. Although a few babies struggle with colic for months longer, colic ends by age 9 months for 90 percent of babies.

Causes:
No one really knows what causes colic. Researchers have explored a number of possibilities, including allergies, lactose intolerance, an immature digestive system, maternal anxiety, and differences in the way a baby is fed or comforted. This last idea speculates that Baby’s immature nervous system can’t handle the stimuli of everyday life, and that crying is their only way of communicating this “overload.” An opposite hypothesis is that Baby needs more stimulation, and gets it through crying. Colic is mysterious, but not harmful to your baby. et it’s still unclear why some babies have colic and others don’t.

Diagnosis:
Your baby’s doctor will do a physical exam to identify any possible causes for your baby’s distress, such as an intestinal obstruction. If your baby is otherwise healthy, he or she may be diagnosed with colic. Lab tests, X-rays and other diagnostic tests aren’t usually needed.

Treatment:
Colic improves on its own, often by age 3 months. In the meantime, there are few treatment options. Prescription medications such as simethicone (Mylicon) haven’t proved very helpful for colic, and others can have serious side effects.

A study published in January 2007 suggests that treatment with probiotics — substances that help maintain the natural balance of “good” bacteria in the digestive tract — can soothe colic. More research is needed, however, to determine the effects of probiotics on colic.

Consult your baby’s doctor before giving your baby any medication to treat colic.

Risk factors:
Infants of mothers who smoke during pregnancy or after delivery have twice the risk of developing colic.

Many other theories about what makes a child more susceptible to colic have been proposed, but none seem to hold true. Colic doesn’t occur more often among firstborns or formula-fed babies. A breast-feeding mother’s diet isn’t likely to trigger colic. And girls and boys — no matter what their birth order or how they’re fed — experience colic in similar numbers.

Popular Myths related to colic?
Let’s debunk some of the popular myths about colic. Here are the facts:

*Babies do not cry to manipulate their parents.
*Holding babies and picking them up when they cry cannot “spoil” them.
*We do not know whether colicky babies are in pain or not, but they sure seem to be, and that can really stress out parents. Keep in mind that your baby may not actually be in pain or distress, but just doing what they need to do for their immature nervous systems.
*Giving rice cereal does not help solve colic.
*Studies have shown that Simethicone (Mylicon) and lactase (the enzyme that helps digest lactose—the sugar in cow’s milk—which is in breast milk if the mother consumes dairy products) do not help colic. ,
*Sedatives, antihistamines, and motion-sickness medications, like dicyclomine (Bentyl) are NOT safe or effective in treating colic in babies. Often grandparents will suggest these medications. They were commonly used years ago, but now we know better.

Self Care:

Your baby’s doctor may not be able to fix colic or make it go away sooner, but there are many ways you can try to soothe your baby. Consider these suggestions:

  • Feed your baby. If you think your baby may be hungry, try a feeding. Hold your baby as upright as possible, and burp your baby often. Sometimes more frequent — but smaller — feedings are helpful. If you’re breast-feeding, it may help to empty one breast completely before switching sides. This will give your baby more hindmilk, which is richer and potentially more satisfying than the foremilk present at the beginning of a feeding.
  • Offer a pacifier. For many babies, sucking is a soothing activity. Even if you’re breast-feeding, it’s OK to offer a pacifier to help your baby calm down.
  • Hold your baby. Cuddling helps some babies. Others quiet when they’re held closely and swaddled in a lightweight blanket. To give your arms a break, try a baby sling, backpack or other type of baby carrier. Don’t worry about spoiling your baby by holding him or her too much.
  • Keep your baby in motion. Gently rock your baby in your arms or in an infant swing. Lay your baby tummy down on your knees and then sway your knees slowly. Take a walk with your baby, or buckle your baby in the car seat for a drive. Use a vibrating infant seat or vibrating crib.
  • Sing to your baby. A soft tune might soothe your baby. And even if lullabies don’t stop your baby from crying, they can keep you calm and help pass the time while you’re waiting for your baby to settle down. Recorded music may help, too.
  • Turn up the background noise. Some babies cry less when they hear steady background noise. When holding or rocking your baby, try making a continuous “shssss” sound. Turn on a kitchen or bathroom exhaust fan, or play a tape or CD of environmental sounds such as ocean waves, a waterfall or gentle rain. Sometimes the tick of a clock or metronome does the trick.
  • Use gentle heat or touch. Give your baby a warm bath. Softly massage your baby, especially around the tummy.
  • Give your baby some private time. If nothing else seems to work, a brief timeout might help. Put your baby in his or her crib for five to 10 minutes.
  • Mix it up. Experiment to discover what works best for your baby, even if it changes from day to day.
  • Consider dietary changes. If you breast-feed, see if eliminating certain foods from your own diet — such as dairy products, citrus fruits, spicy foods or drinks containing caffeine — has any effect on your baby’s crying. If you use a bottle, a new type of bottle or nipple might help.

If you’re concerned about your baby’s crying or your baby isn’t eating, sleeping or behaving like usual, contact your baby’s doctor. He or she can help you tell the difference between a colic episode and something more serious.

How you can help your baby relieve their colic distress?

Colic usually starts to improve at about six weeks of age, and is generally gone by the time your baby is 12 weeks old. While you are waiting for that magic resolution, try these techniques to help soothe your infant:

  • Respond consistently to your baby’s cries.
  • Don’t panic and don’t worry. If you are worried, bring your baby to their pediatrician.
  • When your baby cries, check to see if they are hungry, tired, in pain, too hot or cold, bored, over-stimulated, or need a diaper change.
  • Some parents find that carrying their baby more reduces colic. You can try different baby carriers to make it easier and free your hands. Many parents (and babies!) love slings once they get the hang of them—but sometimes it takes a little experimentation. One study found carrying babies four to five hours a day resulted in less crying at six weeks of age, as compared to carrying them only two to three hours a day. On the other hand, a later study by the same researcher did not find significantly less crying in babies carried more. So your best bet is just to see if it makes any difference with your baby.
  • Vacuum while wearing your baby in a baby carrier.
  • Rock your baby.
  • Change formula. Talk with your baby’s doctor first.
  • Breastfeeding moms can try changing their diets. In a recent study , researchers found that taking out allergenic foods (cow’s milk, eggs, peanuts, tree nuts, wheat, soy and fish) from the breastfeeding mom’s diet reduced crying and fussing in babies under 6 weeks.
  • Play music and dance with your baby.
  • Talk a walk with your baby in the stroller. This can really help with your stress level, in addition to soothing your baby.
  • Get support from family, friends, your religious community, neighbors, etc. Let them help in any way possible.
  • Take care of yourself and manage your stress. Eating a well-balanced diet, getting sleep and exercise, and having people to talk to can do wonders. If the stress or blues become too much, it’s good idea to get professional help. Your or your baby’s doctor might be able to help you figure out where to start.
  • Nurse your baby every 2-3 hours if you are breastfeeding.
  • Don’t smoke, and don’t allow anyone to smoke around your baby. Babies of smokers cry more, and get sick more often, too. Smoker’s babies also have an increased risk of SIDS.
  • Quitting smoking during pregnancy may reduce the likelihood that your baby will develop colic . in addition to all the other benefits to you and your baby.
  • You could try a device that attaches to the crib. It’s designed to simulate a car ride, but it is not clear that the device actually works. The Sleep Tight Infant Soother consists of a vibration unit that mounts under the crib and a sound unit that attaches to the crib rail. Your pediatrician can tell you whether it would be a good idea to try in your baby’s case. The device is not promoted directly to consumers. Some insurance companies may reimburse the cost if you have a physician prescription. You can reach the manufacturer at 1-800-NO-COLIC or 1-800-662-6542. There is no research to prove that the Sleep Tight works, and some parents have been dissatisfied with it.
  • Provide white noise, such as running the vacuum cleaner, clothes dryer, or hair dryer near your baby while in their car seat. (Do not put your baby on top of the dryer—they could fall off!) White noise machines are also available. White noise simulates the whooshing sound your baby heard constantly while in utero. You can also do your own “whooshing” or “shushing” with your voice as you rock or carry your baby.
  • Go for a car ride.
  • Massage your baby. Find out how to do infant massage for colic. Massage has many benefits for both the baby and the giver of the massage.
  • Some parents have found that herbal tea is helpful. The combination of chamomile, fennel, vervain, licorice, and balm-mint was found to be effective in one study. Other traditional herbs for colic tea include anise, catnip, caraway, mint, fennel, dill, cumin, and ginger root. Gripe water, available in Britain and Canada, is made from dill. These remedies are not produced or regulated in the same standardized ways that medications are—so you don’t know exactly what you are getting. These herbs have not all been studied, and therefore it is not certain that they are all safe. More research is needed to be sure these preparations are safe and effective. If you choose to give herbal tea, start by giving only an ounce, and never give more than four to six ounces per day. Babies who fill up on tea don’t drink enough breast milk or formula and then have trouble growing. Please remember that just because something is “natural”, it is not necessarily safe.

Places where you to get more information about colic:
On the Web:

Recommended reading:

  • The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer, by Harvey Karp
    This book teaches you simple techniques based on other cultures where babies do not get colic, and on the idea a baby’s first three months are like a fourth trimester.
  • Check out the chapter on colic in the book, The Holistic Pediatrician (second edition), by Kathi Kemper.
  • Infant Massage: A Handbook for Loving Parents, by Vimala Schneider McClure
  • Crying Baby: Resource List—recommended books about soothing crying babies.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.med.umich.edu/1libr/yourchild/colic.htm
http://www.mayoclinic.com/health/colic/

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