Colic

Colic is persistent, unexplained crying in a healthy baby between two weeks and five months of age.

Colic, which is not a disease, affects 10-20% of all infants. It is more common in boys than in girls and most common in a family's first child. Symptomsof colic usually appear when a baby is 14-21 days old, reach a crescendo at the age of three months, and disappear within the next eight weeks. Episodes occur frequently but intermittently and usually begin with prolonged periods of crying in the late afternoon or evening. They can last for just a few minutes or continue for several hours. Some babies who have colic are simply fussy. Others cry so hard that their faces turn red, then pale.

No one knows what causes colic. The condition may be the result of swallowinglarge amounts of air, which becomes trapped in the digestive tract and causes bloating and severe abdominal pain. Other possible causes of colic includean immature digestive-tract, intolerance to certain foods, hunger or overfeeding, lack of sleep, loneliness, overheated milk or formula, overstimulation resulting from noise, light, or activity, and tension.

During a colicky episode, babies' bellies often look swollen, feel hard, andmake a rumbling sound. Crying intensifies, tapers off, then gets louder. Manybabies grow rigid, clench their fists, curl their toes, and draw their legstoward their body. A burp or a bowel movement can end an attack. Most babieswho have colic don't seem to be in pain between attacks.

Pediatricians and family physicians suspect colic in an infant who has criedloudly for at least three hours a day at least three times a week for three weeks or longer; is not hungry but cries for several hours between dinnertimeand midnight; demonstrates the clenched fists, rigidity, and other physical traits associated with colic.

The baby's medical history and a parent's description of eating, sleeping, and crying patterns are used to confirm a diagnosis of colic. Physical examination and laboratory tests are used to rule out infection, intestinal blockage,and other conditions that can cause abdominal pain and other colic-like symptoms.

Medications do not cure colic. Doctors sometimes recommend simethicone to relieve gas pain but generally advise parents to take a practical approach to the problem.

Gently massaging the baby's back can release a trapped gas bubble, and holding the baby in a sitting position can help prevent air from being swallowed during feedings. Bottle-fed babies can swallow air if nipple holes are either too large or too small. Nipple-hole size can be checked by filling a bottle with cold formula, turning it upside down, and counting the number of drops released when it is shaken or squeezed. A nipple hole that is the right size will release about one drop of formula every second. Babies should not be fed every time they cry, but feeding and burping a baby more often may alleviate symptoms of colic. A bottle-fed baby should be burped after every ounce, and ababy who is breastfeeding should be burped every five minutes.

When cow's milk is the source of the symptoms, bottle-fed babies should be switched to a soy-milk hydrolyzed protein formula. A woman whose baby is breastfeeding should eliminate dairy products from her diet for seven days, then gradually reintroduce them unless the baby's symptoms reappear.

Since intolerance to foods other than cow's milk may also lead to symptoms ofcolic, breastfeeding women may also relieve their babies' colic by eliminating coffee, cocoa, citrus, peanuts, wheat, and broccoli and other vegetables belonging to the cabbage family from their diet.

Rocking a baby in a quiet, darkened room can prevent overstimulation, and a baby usually calms down when cuddled in a warm, soft blanket. Colicky babies cry less when they are soothed by the motion of a wind-up swing, a car ride, or being carried in a parent's arms. Pacifiers can soothe babies who are upset, but a pacifier should never be attached to a string.

A doctor should be notified if a baby who has been diagnosed with colic develops a rectal fever higher than 101°F (38.3°C), cries for more than four hours, vomits, has diarrhea or stools that are black or bloody, loses weight, or eats less than normal.

Colic is distressing, but it is not dangerous. Symptoms almost always disappear before a child is six months old.

Many doctors believe that colic cannot be prevented. Some alternative practitioners, however, feel that colic can be prevented by an awareness of food intolerances and their impact.

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