Colic

Technically, the term "colic" means spasm of the colon. Infant colic, however, is typically defined as prolonged periods of unexplained, inconsolable crying in an otherwise healthy and well-fed infant.


Causes/associated factors
Infant colic can be extremely frustrating, frightening and disruptive for the entire family. It's especially scary for first-time parents. You may be afraid you're not parenting correctly or feel tremendous guilt. You're not alone, however. Colic is the most common reason parents call a baby's doctor. Because colic can interfere with parent-child bonding, cause conflict in a marriage and increase the risk of child abuse, seeking support is essential.
The cause of colic is unknown, but many theories exist. Colic is sometimes blamed on abdominal discomfort from an allergic reaction to formula or sensitivity to something eaten by a nursing mother. Doctors rarely recommend stopping breastfeeding to ease colic, however. Other theories blame a hypersensitive or immature nervous system or gastrointestinal tract. Colic is equally common among infant girls and boys, as well as those who are nursed and fed formula.


Signs/symptoms
Colic usually begins after the second week of life. For up to 20 percent of infants, it lasts until ages 3 to 4 months. Suddenly and without warning, the baby begins to scream and cry so forcefully that his or her body becomes rigid -- legs pull up to the chest, fists clench, arms flex and the abdomen becomes hard. The baby may also pass gas. Each episode may last up to several hours, despite efforts to comfort and console.
The sudden bouts of crying usually follow a regular pattern, often in the later afternoon or evening. They can occur any time of the day or night, however. Before and after each episode, the baby will appear content.

Colic isn't associated with other symptoms, such as fever, vomiting, weight loss, poor feeding or diarrhea.


Diagnosis
Colic is diagnosed based on the baby's medical history and a physical exam to identify or rule out any underlying conditions.

Treatment
There's no sure cure for colic. What works for your baby will be a matter of trial and error -- what works for one child may not be helpful for another.
Look for a source of discomfort. Is your baby hungry? Too hot or cold? Is the diaper wet or soiled? Or, does your baby simply need a change of position or different view? Within the first three to four months, don't worry about spoiling your baby by responding quickly. Some babies need to suck, so try a pacifier. Call your baby's doctor right away if there are any signs of illness, such as fever, vomiting or diarrhea.

Cuddle your baby. Rhythmic activity is often helpful, such as rocking, walking, swinging or strolling. Sometimes, it's helpful to hold the baby in a position that applies gentle abdominal pressure. Try laying your baby across your lap or shoulder. For the traditional colic hold, place your baby belly down along your forearm, with his or her head resting at the bend of your elbow. Or, try the reverse. Lay your baby belly down along your forearm, but support his or her head with your hand. If you're having trouble with any of the holds, consult your baby's doctor. When all else fails, it may be best to bundle your baby in a blanket and allow him or her to "self-quiet" while lying in the crib. Remember, put your baby to sleep on his or her back to reduce the risk of sudden infant death syndrome.

Consider the environment. Is there too much noise or stimulation, especially late in the afternoon? Some colicky babies prefer a calmer environment. Of course, just the opposite may also be true. Some babies need more stimulation. If this is the case, try carrying your baby with you in an infant carrier. It may also help to turn on some music or the television or go outdoors for fresh air and a change of scenery. You may even want to drive your baby around in the car (buckled into a car seat, of course). It may also help to avoid smoky environments. Some studies have indicated that colic is more common when parents smoke.

If you're feeding your baby formula, discuss a possible change with your baby's doctor. There's some evidence that using a hypoallergenic formula instead of a nonhypoallergenic milk-based formula may help some infants. Less often, soy-based formula may be helpful. Lactose-reduced formula hasn't been shown to be effective in reducing colic. Remember, consult your baby's doctor before making any changes in formula.
Using a bottle with a collapsible bag inside may help keep your baby from swallowing excessive air. During each feeding, hold your baby in a vertical position and burp after every 1 to 2 ounces. If you're nursing, burp your baby every five to 10 minutes. Use an upright position, holding your baby over your shoulder or with a gentle chin grasp. (Prop the baby on your lap with your arm across his or her front and your hand gently cupping the baby's chin.) Make sure each feeding is uninterrupted and done at the baby's pace.


If you're nursing, it may help to eliminate certain foods from your diet, such as onions, cabbage, broccoli, caffeine and large amounts of fresh fruit. If the doctor suspects your baby is sensitive to cow's milk, it may help to avoid dairy products.

Take a break. Caring for a colicky baby is exhausting, and even the most patient parents get frustrated. You'll be best equipped to handle the situation when you're well-rested. If the baby senses you're tired and upset, the crying may get even worse. For your sake and your baby's, enlist the help of caring and supportive loved ones or friends. If you're frustrated with the situation and have no support, call your baby's doctor for suggestions. Remember to never shake your baby -- this can cause a serious brain injury.

Consult your baby's doctor before trying any type of medication or herbal remedy. Typically, medications aren't used to treat colic. Those that decrease intestinal gas (such as simethicone) haven't proven to be beneficial. Other medications that affect intestinal activity (such as dicyclomine) may have unwanted and sometimes serious side effects. And more research is needed on the effects of herbal teas, such as those containing chamomile, vervain, licorice, fennel and balm mint. Herbal teas can be poorly regulated, and in some cases may be potentially dangerous.