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Baby colic Classification and external resources
Crying newborn
ICD-10	R10.4
ICD-9	789.0
MedlinePlus	000978
eMedicine	ped/434
MeSH	D003085

Infant colic (also known as baby colic, three month colic, and Infantile colic) is a condition in which an otherwise healthy baby cries or screams frequently and for extended periods without any discernible reason.

The condition typically appears within the first two weeks of life and almost invariably disappears, often very suddenly, before the baby is three to four months old.¹ It is more common in bottle-fed babies, but also occurs in breast-fed infants. The crying frequently occurs during a specific period of the day, often in the early evening.

Since the cause is not conclusively established (see below) and the amount of crying differs between babies, there is no general consensus on the definition of "colic". Having ruled out other causes of crying, a common rule of thumb is to consider a baby "colicky" if it cries intensely more than three days a week, for more than three hours, for more than three weeks in a month.

Contents 1 Causes 2 Treatment 3 Effect on the family 4 References 5 External links

Causes

There is no commonly accepted explanation for colic. Traditionally, colic was ascribed to abdominal pain resulting from trapped gas in the digestive tract. This theory is not yet discredited, and some recent scientific evidence seems to support it, yet it is no longer universally accepted as the general cause.

There is solid and mounting evidence that the causes are related to gut flora, from multiple studies which have shown that colicky babies have different gut flora patterns, which includes a lack of Lactobacillus acidophilus.²³⁴ Some of these studies suggest the administering of a probiotic, such as Lactobacillus acidophilus or Lactobacillus reuteri, will improve the condition.⁵ Probiotics have been shown to improve other conditions associated with colic, such as lactose intolerance⁶, necrotizing enterocolitis⁷, and gastric inflammation.⁸ In addition to that probiotics have been shown to generally improve the health of children who take them.⁷

It is worth noting, probiotics occur naturally in breastmilk and furthermore a breastfed baby and a formula fed baby have very different gut floras.⁹

Some doctors claim that it is a combination of a baby's sensitive temperament, the environment, and its immature nervous system that makes him/her cry easily and without control. Others believe that it originates in problems in the baby's digestive system, specifically because of the buildup of gas which cannot be released. New studies at the Colic Clinic at Brown University demonstrate that nearly half of babies with colic have mild gastroesophageal reflux. Some cases may be the result of lactose intolerance or lactose overload (the latter when accompanied by green stools).¹⁰

Recent research raises a number of hypotheses including the onset of melatonin production by the pineal gland (which does not begin until 12 weeks of age, about the time colic seems to disappear),¹¹ circadian rhythms,¹² and smoking and stress of the mother in the third trimester.¹³

Many parents have also discovered a link between food and colic - and if the child is breastfed, it could include the food ingested by the mother. Dairy products seem to top the list as possibly problematic. It has been suggested that the mother eliminate all sources of dairy from her diet for a week and note any changes in her baby's condition. If it is dairy (or another, less common food relation such as wheat, acid based foods, etc), it will be clearly evidenced within a week. Mothers then can choose to add back to their diets small samples of the suspected offending food a little bit at a time, and note if there are any unfavorable symptoms that reappear in the baby - and go from there. Some babies can tolerate absolutely no dairy (including whey, lactose, etc) - some only are bothered by straight and large concentrations of dairy - such as milk, cheese, etc. The only way to determine this is on an individual basis with the process of elimination and then eventual retrying as the baby ages. Most will begin to become much more tolerant of mother's diet by about 3 months - but some can continue with problems for much longer.^{citation needed}

Because of the links between prenatal stress, birth trauma, maternal stress etc, and colic, it has also been suggested that some 'colic', or excessive crying may actually be a healthy stress release requiring support and facilitation rather than suppression or 'cure'.¹⁴

Treatment

There is currently no generally-accepted medical treatment for colic, and the approach taken by medical professionals varies substantially from country to country and indeed from doctor to doctor. Many believe that the condition is currently untreatable, and is best left to run its course. Other doctors prescribe simethicone, which treats trapped gas; some parents report that this is effective, but for many others it is not, and research suggests that it is not useful.¹⁵

One study showed a moderate success when infants with colic were treated with dicyclomine, an anti-spasmotic drug commonly found in some anti-diarrheal medications.¹⁶

However, dicyclomine has about a 5 percent rate of minor side effects, and a non-zero mortality rate.

Alternative therapies, particularly those that include Fennel, along with dill, chamomile, and other herbs with purported digestive health benefits, have been applied. These are primary ingredients in gripe water, which is believed by some to relieve the symptoms associated with baby colic, teething and baby's gas.^{citation needed} No major scientific study has proven any level of success with these solutions and the United States Food and Drug Administration does not currently advocate their use.

Other studies have found success with probiotics such as Lactobacillus reuteri, which were intended to reduce gas.¹⁷

In addition to herbal teas it is believed that the organoleptic effects of certain herbs can help calm and relieve colic symptoms.

Scientists warn that further studies are necessary before any specific cure should be recommended.¹⁷

There is general agreement that soothing measures, such as pacifiers, listening to white noise and rocking, are often effective in calming the baby during crying periods. Also known as the "cuddle cure",¹⁸ the five S's are known as Swaddling, placing the baby on their Side or Stomach, Swinging the baby, making a Shhh sound in the baby's ear, and giving the baby something to Suck on [2]. Some parents take turns holding the baby upright (which may reduce the pain and crying) to enable the other parent to catch up on sleep. Babies with lactose intolerance or reflux cry harder and longer when left to lie on their backs, but parents are not advised to put the baby to sleep on their front as it is considered a risk factor for Sudden Infant Death Syndrome, or SIDS.

Various tactics, such as changes in diet or routine, an increase in fresh air or certain herbal teas, are popularly believed to cure colic. There is also the theory that rubbing warm olive oil on the hands and feet, then rubbing the stomach with olive oil in a clockwise motion will cure colic. While some of these may help in certain cases, none of them is known to be universally effective. The widespread belief in them may be partly due to the suddenness with which colic naturally resolves itself. Many parents keep trying different approaches until the colic suddenly stops, at which point they presume that the last thing they tried was the cure.

Some breastfed babies have problems digesting milk proteins, or have a milk protein sensitivity(milk allergy) due to the mother's diet. The proteins from cow's milk are able to pass through the mother's milk to the baby. Because baby's intestines are still developing this sensitivity causes gas that is extremely painful. It can also cause the excessive spitting up and reflux. It can be helped with reflux medication, but not cured. The only cure is to have the mother completely avoid all milk products, even foods with traces of milk. Although this has been documented, it is still under debate. This is because La Leche League experts agree that there is already enough stress on a new breastfeeding relationship without having to deal with radical diet changes as well, and blaming the mother's milk for baby's malady puts pressure on mother to wean unnecessarily. Formula may actually be more harmful than helpful in this situation, and will not cure the colic. Some parents attribute colic to "lactose overload" and find that requiring the baby to completely empty one breast before moving on the next helps the problem, or "block feeding" (staying on one breast for 2-3 hours before switching).^19201021.

In cases where 'colic' or excessive crying is possibly the infants innate healing mechanism helping them to recover from birth trauma or other past or current stress, appropriate holding and facilitation techniques may be able to increase the effectiveness of the release process and reduce the overall amount of crying time needed. In any case parents may benefit from learning these techniques, as this can help them to cope better psychologically with their child's distress, and to feel more empowered in the midst of an extremely trying situation. ²²

When choosing caregivers for a colicky infant parents should consider the risk of shaken baby syndrome, a form of severe child abuse, at the hands of inexperienced sitters who respond violently under the stress of a continuously crying baby.

Effect on the family

Colic can place an enormous strain on parents and other family members. The feeling that they are not providing something their child desperately wants or needs can induce stress, depression, feelings of helplessness, and low self-esteem. If crying is prevalent during nighttime hours then these problems can be aggravated by the resulting sleep deprivation or interruption to sleep patterns; exhaustion may also result. Where people live in dense housing such as apartment blocks, persistent crying can also strain relationships with neighbors and landlords.

The stress on parents is often compounded by well-meaning but misguided people who believe that the parents must be doing something wrong. This attitude is quite common among people who have reared colic-free children themselves. Even those who have had children who suffered from colic, and who found a "cure" (see above), can be reluctant to believe their own suggested approach does not work for somebody else.

In some areas, support groups have been set up for parents of children with colic.

References

External links

• Baby Colic Cure- Courtesy of FantasicEproducts
• Infant colic - article at Citizendium
• Baby colic and treatment with lactase enzyme from FoodReactions.org
• WebMd on colic
• Baby Colic Advice
• Melatonin Production in Healthy Infants: Evidence for Seasonal Variations Pediatric Research
• Colic, sleep inertia, melatonin and circannual rhythms on PubMed.com
• Review of Treatments for Colic Article from Fussy Baby
• Do pregnancy and childbirth adversities predict infant crying and colic? on PubMed.com
• Colic Support Message Boards from ColicHelp.com
• Colic articles,Videos from colicbabyshop.com
• Gripe Water Could Help Your Babys Colic from Help Me And My Family - Colic Help

Wikipedia content modification information:

• This page was last modified on 19 November 2008, at 02:46.

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