Definition Colic is a condition that affects some newborn infants. Colic causes intense crying and fussing for which there is no obvious cause.
What is going on in the body? Roughly 20% of infants will exhibit symptoms of colic. It is seen more often in boys than in girls and more often in first-born children than in later ones.
Colic usually begins between 2 and 4 weeks of age. It reaches its maximum intensity at about 8 to 12 weeks of age. The condition usually resolves by 4 months of age, although it can persist for several months longer.
"Colicky" infants typically have periods during the day or night during which they cry and fuss intensely for no obvious reason. These periods often occur at the same time each day. All the usual measures of comforting, such as rocking, feeding or changing their nappies, seem to be of no help. The fussing may persist for several hours despite the best efforts of the parents. It may then end abruptly, with the baby falling asleep. In most cases, the fussy time is in the evening, starting at about 5 o'clock and lasting for several hours.
What are the signs and symptoms of the condition? Intense, prolonged crying is the principal symptom of colic. Infants with colic can also be gassy and have swollen bellies because of all the air they swallow while crying.
What are the causes and risks of the condition? The cause of colic is unknown, and it does not appear to be brought on by something in the baby's environment. Babies with colic tend to respond to stimulation with a lot of intensity. They are also quite sensitive to changes in their environment and are easily "set off" by these changes. Once "set off," they do not seem to have the ability to quiet themselves or to be quieted by others.
Colic does not pose a direct risk to the infant because it is not a disease. The main risks are related to the concern and frustration felt by the child's parents.
What can be done to prevent the condition? There is no known prevention for colic.
How is the condition diagnosed? Colic is what is called a diagnosis of exclusion. This means that before making this diagnosis, a reasonable effort must be made to rule out other causes for an infant's fussiness or crying. Parents of a young infant whose crying seems excessive, and is not readily explained or relieved, should discuss the situation with the baby's doctor. The infant should be taken to the office for an examination. Despite the crying and fussiness, infants with colic usually feed and gain weight normally, with a normal number of wet and dirty nappies.
If other symptoms occur, more serious conditions may be the cause of the crying. For example, vomiting, bloody stools, or nasal congestion with a cough suggest underlying medical problems.
Some infants can have abdominal pain from certain proteins in cow's milk. Colicky infants who are on a formula made from cow's milk may benefit from a different kind of formula. Mothers who are breast-feeding could try eliminating cow's milk and cow's milk products from their own diet for 2 weeks. These options should be discussed with the doctor.
What are the long-term effects of the condition? Colic does not have any adverse, long-term effects.
What are the risks to others? Colicky infants can cause high levels of stress and despair in their parents. This is because of the unrelenting nature of the crying and the frustration parents feel because they are unable to relieve the infant's distress. This can place the infant at risk of being physically harmed by a parent or other caregiver. This is more likely if the caregiver is socially isolated and has little help in dealing with the baby's crying.
What are the treatments for the condition? Since colic has been part of the human condition for a long time, many treatments have become part of folklore. There is no treatment that has been scientifically proven to be effective in a large number of infants.
Generally speaking, drugs are not advised and are not very useful for treating colic. Once they are sure that the problem is colic and not something more serious, parents should trust that the baby is normal and that things will get better with time.
Attention to dietary factors may help. Aside from cow's milk, some breast-fed infants seem to be bothered if the mother eats foods that are spicy or foods that contain onions, chocolate or caffeine. It may help for the breast-feeding mother to experiment with her own diet. She should eliminate only one food item or food group from the diet for several days at a time. If that seems to help, the food can be reintroduced into the diet to be sure that it really is bothering the baby. In general, breast feeding mothers should have a sensible, balanced diet.
Colicky infants are often very sensitive to their environment. It may help to keep the baby's environment relatively quiet and soothing by avoiding sudden or loud noises or vigorous jostling or bouncing.
The baby may be comforted by being securely swaddled in a soft blanket and held or gently rocked. Soft background music may help. The baby may also respond to swinging in a baby swing or going for a walk in a stroller.
The baby will need to be held at times. On the other hand, some infants are overstimulated by handling and may rest better if swaddled and laid down in a cot.
Because the distress a colicky baby can cause may be, at times, relentless for both baby and parents, it is important for parents to develop a support system. This system should provide some brief periods in which the parents can be away from the baby, to recharge their batteries. A trusted, experienced relative or neighbour can often be "on call" to fill in for a few hours when the primary parent feels that he or she needs a break. This not only provides relief for the parent, but also a measure of safety for the baby.
What are the side effects of the treatments? There are no side effects to the above treatments. Making sure the baby is safe while in a stroller or swing is an important safety issue.
What happens after treatment for the condition? Once colic has gone away, no further treatment is needed. A person should call the baby's doctor if symptoms continue despite home care measures.
How is the condition monitored? Parents provide most of the monitoring at home. The infant with colic will gradually get better once he or she is about 3 months old. The colic should end by the age of 4 to 5 months. The doctor should be contacted if the colic seems to be getting worse instead of better. If the baby seems to be in pain, is not thriving and not gaining weight, or there is vomiting or other worrisome symptoms, a doctor should also be contacted.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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