all you need to know about COLIC

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Colic is frequent, prolonged and intense crying or fussiness in a healthy infant. Colic can be particularly frustrating for parents because the baby’s distress occurs for no apparent reason and no amount of consoling seems to bring any relief. These episodes often occur in the evening, when parents themselves are often tired

Episodes of colic usually peak when an infant is about 6 weeks old and decline significantly after 3 to 4 months of age. While the excessive crying will resolve with time, managing colic adds significant stress to caring for your newborn child.

SYMPTOMS

Fussing and crying are normal for infants, especially during the first three months. And the range for what is normal crying is difficult to pin down. In general, colic is defined as crying for three or more hours a day, three or more days a week, for three or more weeks.

FEATURES OF COLIC MAY INCLUDE THE FOLLOWING:

  • Intense crying that may seem more like screaming or an expression of pain
  • Crying for no apparent reason, unlike crying to express hunger or the need for a diaper change
  • Extreme fussiness even after crying has diminished
  • Predictable timing, with episodes often occurring in the evening
  • Facial discoloring, such as reddening of the face or paler skin around the mouth
  • Bodily tension, such as pulled up or stiffened legs, stiffened arms, clenched fists, arched back, or tense abdomen
  • Sometimes there is relief in symptoms after the infant passes gas or has a bowel movement. Gas is likely the result of swallowed air during prolonged crying.

CAUSES

The cause of colic is unknown. It may result from numerous contributing factors. While a number of causes have been explored, it’s difficult for researchers to account for all the important features, such as why it usually begins late in the first month of life, how it varies among infants, why it happens at certain times of day and why it resolves on its own in time.

POSSIBLE CONTRIBUTING FACTORS THAT HAVE BEEN EXPLORED INCLUDE:

  • Digestive system that isn’t fully developed
  • Imbalance of healthy bacteria in the digestive tract
  • Food allergies or intolerances
  • Overfeeding, underfeeding or infrequent burping
  • Early form of childhood migraine
  • Family stress or anxiety

COMPLICATIONS

Colic does not cause short-term or long-term medical problems for a child. Colic is stressful for parents. Research has shown an association between colic and the following problems with parent well-being:

  • Increased risk of postpartum depression in mothers
  • Early cessation of breast-feeding
  • Feelings of guilt, exhaustion, helplessness or anger

DIAGNOSIS

Your baby’s doctor will do a complete physical exam to identify any possible causes for your baby’s distress. The exam will include:

  • Measuring your baby’s height, weight and head circumference
  • Listening to the heart, lungs and abdominal sounds
  • Examining the limbs, fingers, toes, eyes, ears and genitals
  • Assessing reaction to touch or movement
  • Looking for signs of rash, inflammation, or other signs of infection or allergies

TREATMENT

The primary goals are to soothe the child as much as possible with a variety of interventions and ensure that parents have the support they need to cope.

SOOTHING STRATEGIES

You may find it helpful to have a plan, a list of soothing strategies you can try. You may need to experiment. Some may work better than others, and some may work one time but not another. Soothing strategies may include:

  • Using a pacifier
  • Taking your infant for a car ride or on a walk in a stroller
  • Walking around with or rocking your baby
  • Swaddling your baby in a blanket
  • Giving your baby a warm bath
  • Rubbing your infant’s tummy or placing your baby on the tummy for a back rub
  • Playing an audio of heartbeats or quiet, soothing sounds
  • Providing white noise by running a white noise machine, a vacuum cleaner or clothes drier in a nearby room
  • Dimming the lights and limiting other visual stimulation

TRIAL CHANGES IN DIET

If soothing or feeding practices aren’t reducing crying or irritability, your doctor may recommend a short-term trial of dietary changes. If your baby has a food allergy, however, there would likely be other signs and symptoms, such as a rash, wheezing, vomiting or diarrhea. Dietary changes may include:

Formula changes. If you feed your infant formula, your doctor may suggest a one-week trial of an extensive hydrolysate formula (Similac Alimentum, Nutramigen, Pregestimil, others) that has proteins broken down into smaller sizes.

Maternal diet. If you’re breastfeeding, you may try a diet without common food allergens, such as dairy, eggs, nuts and wheat. You may also try eliminating potentially irritating foods, such as cabbage, onions or caffeinated beverages.

PARENT SELF-CARE

Caring for an infant who has colic can be exhausting and stressful, even for experienced parents. The following strategies can help you take care of yourself and get the support you need:

Take a break. Take turns with your spouse or partner, or ask a friend to take over for a while. Give yourself an opportunity to get out of the house if possible.

Use the crib for short breaks. It’s OK to put your baby in the crib for a while during a crying episode if you need to collect yourself or calm your own nerves.

Express your feelings. It’s normal for parents in this situation to feel helpless, depressed, guilty or angry. Share your feelings with family members, friends and your child’s doctor.

Don’t judge yourself. Don’t measure your success as a parent by how much your baby cries. Colic isn’t a result of poor parenting, and inconsolable crying isn’t a sign of your baby rejecting you.

Take care of your health. Eat healthy foods. Make time for exercise, such as a brisk daily walk. If you can, sleep when the baby sleeps — even during the day. Avoid alcohol and other drugs.

Remember that it’s temporary. Colic episodes often improve after age 3 to 4 months.

Have a rescue plan. If possible make a plan with a friend or relative to step in when you’re overwhelmed. If necessary, contact your doctor, a local crisis intervention service or a mental health help line for additional support. Recent studies show Biogaia (Probiotics) are helpful.

Consult your family physician and or Paediatrician for further help.

Dr. Pargat Singh Bhurji
MD,FRCP ( C ) Consultant Pediatrician Surrery BC

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