Colic

Colic - What It Is And How It Can Be Managed

Colic refers to a state of excessive crying in young infants (less than 4 months old) who are otherwise well. That is, no other medical cause can be found to account for the baby's crying. This condition has also been labelled as "evening colic", "three-month colic", or "infantile colic".

How Is Colic Different From Normal Crying?

All young infants cry to some degree. Normal infants vary in how much they cry, how intense the crying is, how sensitive they are to stimuli and their reaction to being soothed. However, infants with colic typically exhibit periodic crying spells occurring usually in the evenings, which last for up to 2 - 3 hours. This usually begins soon after the baby comes home from the hospital, and may persist till the baby is 3 or 4 months of age.

​Natural History

There have been no preventive measures established as yet for colic. Parental education before the child is born may help to allay parental anxiety. Proper child-soothing techniques and appropriate handling of the crying child may reduce anxiety in the parents and help them in coping with the crying child.

Parents should be aware that evening colic resolves itself spontaneously, without any treatment by 3 - 4 months. Colicky babies do not progress to become impatient or aggressive children or adults.

Causes Of Crying In The Newborn

Most babies cry in one or more of the following situations :

• Discomfort arising from :
  • Hunger. This is the most common cause
  • Wet or soiled diapers
  • Nappy rash
  • Excessive heat or cold
• Sudden stimulation of noise or light
• Unpleasant smell or taste e.g. vomitus
• Loneliness. Most babies cry for company. They need to be loved and carried. A baby will not be spoiled if he is picked up when crying
• Fatigue. Such babies should be left to sleep quietly and not be carried
• Abdominal pain/discomfort due to wind, constipation or bacterial infection of the urinary tract or the bowels, like diarrhoea.

Causes Of Colic

Colic is a poorly understood condition without clear known causes.

Some possible causes that have been suggested by doctors include :

• Psychological. The baby's mother may be too anxious or distressed and is unable to cope with looking after the baby.
• Allergy. The baby may be allergic to certain proteins in the cow's milk formula.
• Lactose malabsorption. The baby's inability to digest certain sugars may lead to poor absorption of these sugars from milk.
• Abnormal gut hormones or excessive secretion of gut hormones such as gastrin, which are normally secreted in the intestines.
• Temperament of the baby.

All these causes listed above are speculative and the actual cause of colic is not known.

​What Can Be Done About Colic?

Consultation with a doctor
A thorough examination is necessary to exclude a medical cause for the excessive crying. Such medical causes are rare and are usually associated with poor feeding, vomiting, diarrhoea or constipation.

Parents should not be unduly worried about the physical examination as it is a normal procedure. With the examination, they will be reassured that no other problem is present.

Techniques to reduce crying

• Soothing the child with a pacifier, playing repetitive sounds like lullabies or soothing music, or placing a warm heating pad on the infant's tummy.
• Most babies respond to rhythmic rocking or pats on the back.
• Some like to be placed on their front.
• Some babies settle with a car ride.
• A quiet environment with minimal unnecessary handling and correction of faulty feeding techniques are helpful. The changing of milk formula is usually not necessary.

Medication
Applying medication for the relief of colic may not necessarily work all the time. Colic drops, which help in reducing the amount of wind, may help some infants.