Rainbow Pediatrics Knowledgebase
  • Knowledgebase: Information on Specific Illnesses

    Here you will find discussions of specific illnesses and their management.


    60. Colic - Top

    Definition

    A symptom complex of early infancy characterized by loud and excessive crying, apparent abdominal pain, and irritability.

    Causes, Incidence and Risk Factors

    Colic in infants is common, occurring in about 1 out of 10 babies. First-born infants are affected with colic more often than later children. Often it begins within 10 days to three weeks after birth, lasting until three to four months of age when it generally disappears on its own. In spite of apparent abdominal pain, colicky infants eat well and gain weight normally. The crying episodes may tend to occur around the same time each day, but a few infants will cry almost constantly.
    The specific causes of infant colic are not known, but the following factors may play a role:

    air swallowed during the process of crying, feeding, or sucking on hands or fingers
    overfeeding with large amounts of formula or breast milk
    family tension and parental anxiety
    intestinal allergies to cow's milk
    esophageal reflux;
    Recent research suggests that colic may be related to reflux esophagitis, which is a condition that occurs when the esophagus becomes irritated when acid backs-up from the stomach into the esophagus.


    Symptoms
    excessive crying often of sudden onset and frequently beginning about the same time every day. Attacks of crying may last minutes up to several hours
    apparent abdominal pain manifested by drawing knees to the abdomen
    irritability
    Signs And Tests

    A physical examination is performed to rule out other causes of similar behavior. Infants also have been studied in the hospital setting with a pH meter in the esophagus overnight. This procedure is more common in infants whose problem is thought to be from gastroesophageal reflux. The procedure measures the amount of acid refluxed from the stomach up into the esophagus


    Treatment

    There are no specific measures to treat colic, however, the following suggestions may be of benefit to alleviate pain and to calm an irritable infant.
    Keeping the baby in a slight head-up position may help. Wood blocks may be used to raise the head of the baby's crib. Avoid overstimulating the baby; an overattended baby may not get sufficient sleep. An active baby may respond to being swaddled in a blanket.
    If a bottle feeding takes less than 20 minutes, the hole in the nipple may be too large. Avoid overfeeding the infant or feeding too quickly. A pacifier may calm an infant with a strong sucking need who fusses soon after a feeding. Many babies quiet while riding in the car, or to the sound of a vacuum cleaner or hair dryer.
    Apply warmth to the abdomen with a hot water bottle wrapped on a soft cloth. Rhythmic movement such as walking or rocking may soothe the baby.
    Parents should avoid fatigue and exhaustion and should be encouraged to get a break from the infant by having a friend, grandparent, or baby sitter stay with the infant on occasion. Occasionally a physician may recommend medications. A large variety of medications have been tried ranging from paragoric, smooth muscle relaxants, antacids, anti-gas agents, mild sedatives and antihistamines. Nothing has been demonstrated to be consitantly successful. Parents should not give infants less than six months medications for colic without consulting their physician.

    Expectations (Prognosis)

    Colic is a benign condition that the baby usually outgrows at three to four months of age. Excessive crying is not harmful to the baby.

    - Updated: March 5, 2001

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