Colic is a term used to describe infants who cry a lot without any apparent reason during the first 3 months of age. It is one of the most distressing event of infancy.
His cause is not well understood, but usually resolves by itself by three to four months of age.
Definition
For “excessive crying” we mean a cry that lasts more than three to four hours a day for 3 days a week. It is a common situation and occurs in up to 40% of infants, and usually begins between the third and sixth week after birth and ends when a baby is here to four months of age. There is not difference in base to the sex, breast or bottle feeding, full term or preterm infants.
Colic
It is normal infants cry a lot in the first three months of life, but we can say he has a colic when:
- A cry that lasts more than 3 hours a day
- The crying episode usually starts suddenly in the evening hours and in the same way stops
- The cry is more intense, louder, and high pitched than normal crying. It seems the infant is in pain
- The infant with colic has typical symptoms that usually start always at a typical time during the evening hours (predictable time)
- Infants are difficult to soothe, and crying can end if the infant passes gas or a bowel movement
- It is a temporary problem and resolves in 90% of infants by 4 moths of age
Other causes of excessive crying
- Hunger- try to feed the baby to see whether hunger is the problem
- Pain- check to see if the baby is uncomfortable because of illness or physical injury, feel the skin for fever and if you see any skin rash or pain to the movement
- Fatigue or overstimulation- babies can cry when they are tired or overstimulated from playing or being handled.
- Food sensitivities- it can exist an allergy or sensitivity to foods present in their mother’s diet or in their formula. Usually in this case there can be : spits up, diarrhea, vomiting, eczema, blood in the stools.
Once excluded all these items you can think to a colic, a condition without a serious underlying medical problem
Diagnosis
- Does the cry start at the same time every day?
- What seems to trigger an episode of crying?
- What the cry sounds like
- Does the child seem always hungry?
Colic management
Babies do not cry to manipulate you, it is not possible to spoil babies by holding or comforting them, rice cereal does not improve colic and even drugs commonly used for colic do not work (simethicone, lactase).
Parental support- parents, when babies have colic, feel often frustrated, angry, guilty and tired. It is normal and it doesn’t mean that you are not worthy of caring for your child. It is even normal to need a break when you care for an infant who cries excessively. Sometimes the break is necessary to prevent you from potentially harm your child. It is well known that shaking, smothering, or slapping can seriously injure a child (shaken baby syndrome).
Dietary and feeding technique changes can sometimes help. For example, if you are bottle feeding your baby you can try to use devices (nipples, bottles) done to decrease the amount of air swallowed during feeding. It doesn’t seem to work to change the formula passing to a soy based or hypoallergenic one.
For the mothers who are breastfeeding, with a familiar story of allergies can be useful to follow a hypoallergenic diet excluding at turn eggs, milk, nuts , wheat from their diet and even to lessen sweeties.
Inconclusive studies have been done with probiotics.
When should I call a doctor?
- The baby has cried for more than two hours
- The parent is afraid he or she cannot stand the situation anymore
- The crying started after a fall or an injury
- The baby has a fever > 104.4 F or 38 C, in this case you should call your health care provider or go to an emergency department immediately
- The infant refuses to eat or drink anything for more than a few hours, vomits, is not urinating well, has bloody stools or has a change in behavior, including lethargy or decreased responsiveness.
