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Alternative NamesInfantile colic
Definition Return to top
Almost all babies go through a fussy period. When crying lasts for longer than about three hours a day and is not caused by a medical problem (such as a hernia or infection), it is called colic. This phenomenon occurs in almost all babies. The only thing that differs is the degree.
Causes Return to top
Colic usually strikes toward the end of a long day, when your baby is just about at the age when your sleep deprivation has really begun to set in. Your baby stops being the quiet, peaceful, miracle baby and begins screaming every evening. It is no wonder that parents can become frustrated, discouraged, and depressed.
The child with colic tends to be unusually sensitive to stimulation. Some babies experience greater discomfort from intestinal gas. Some cry from hunger, others from overfeeding. Some breastfed babies are intolerant of foods in their mothers' diets. Some bottle-fed babies are intolerant of the proteins in formula. Fear, frustration, or even excitement can lead to abdominal discomfort and colic. When other people around them are worried, anxious, or depressed, babies may cry more, which in turn makes those around them even more worried, anxious, or depressed.
About 20% of babies cry enough to meet the definition of colic. The timing varies, but colic usually affects babies beginning at about 3 weeks of age and peaking somewhere between 4-6 weeks of age.
Colic will not last forever! After about 6 weeks of age, it usually begins improving, slowly but surely, and is generally gone by 12 weeks of age. When colic is still going strong at 12 weeks, it's important to consider another diagnosis (such as reflux).
Symptoms Return to top
Colic frequently, but not always, begins at about the same time every day. For most infants the most intense fussiness is in the evening. The attack often begins suddenly. The legs may be drawn up and the belly distended. The hands may be clenched. The episode may last for minutes or hours. It often winds down when the baby is exhausted, or when gas or stool is passed.
In spite of apparent abdominal pain, colicky infants eat well and gain weight normally.
Exams and Tests Return to top
Colic is usually diagnosed by the parent's description of the crying. A careful physical exam is wise to be sure the baby does not have a hernia, intussusception, a hair tourniquet, a hair in the eye, or another medical problem that needs attention. If the diagnosis isn't clear, further testing may be needed.
Treatment Return to top
Helping a child with colic is primarily a matter of experimentation and observation. If you can identify and eliminate a trigger for the colic, that is best. Even if you can't, learn which measures most comfort your baby.
People often hear that breastfeeding moms should avoid broccoli, cabbage, beans, and other gas-producing foods. However, there is not much evidence that these foods are a factor.
TIPS FOR COMFORTING THE BABY
Different children are comforted by different measures. Some prefer to be swaddled in a warm blanket; others prefer to be free. Try many different things, and pay attention to what seems to help, even just a little bit.
Take breaks. Each of you can take charge and relieve the other. Time for oneself is an important part of the new family dynamic. You will be able to pay more loving attention to your baby when you've had a chance to get refreshed.
Outlook (Prognosis) Return to top
Colic is a benign condition that the baby usually outgrows at three to four months of age.
Possible Complications Return to top
There are usually none.
When to Contact a Medical Professional Return to top
Call your health care provider if you have concerns. The most important thing to keep in mind is not to misdiagnose a serious condition and call it colic. If your baby's behavior or crying pattern changes suddenly or if the crying is associated with fever, forceful vomiting, diarrhea, bloody stools, or other abnormal activity or symptoms, call your doctor immediately.
Do not be afraid to seek help immediately if you feel overwhelmed and are afraid that you may hurt your baby.
Prevention Return to top
A fussy period is likely no matter what prevention techniques are undertaken. However, good feeding techniques (as advised by a lactation consultant, if you are breastfeeding), good burping, and early identification of possible allergies in the baby's or mother's diet may help prevent colic. Try different comfort techniques before colic develops to identify your baby's needs and desires. This can help stop the fussy period from becoming so intense.
References Return to top
Barr R. Colic and crying syndrome in infants. Pediatrics. 1998; 102(5): 1282-1286.
Garrison M, Christakis D. A systematic review of treatments for infant colic. Pediatrics. 2000; 106(1): 184-190.
This article uses information by permission from Alan Greene, M.D., © Greene Ink, Inc.Update Date: 7/26/2007 Updated by: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, New York University School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.