Colic describes the condition in which an infant cries inconsolably for a total of more than 3 hours a day, without an identified illness or infection. It occurs in many infants, especially those fed with cow’s-milk formula. Colic is less common in exclusively breastfed infants.
Infant colic starts in the second to third week of life, lasts until about 3 months of age and usually occurs in the afternoon or evening. In the literature it is also referred to as “three-month colic”.
Colic episodes usually occur at the same time of day. The baby cries loudly, intensely and inconsolably, goes red in the face, has a tight abdomen full of bowel sounds and pulls the arms and legs up towards the tummy. Episodes usually pass on their own, or after a bowel movement, burping or passing wind. Despite the distress, babies with colic feed well, gain weight satisfactorily and do not have a fever.
The exact cause of colic is still unknown. Many factors have been implicated, such as swallowing too much air during feeding, overfeeding, intense hunger, parental anxiety and the baby’s temperament. The diagnosis of colic is clinical and is based on the parents’ description. A careful examination is necessary to rule out other conditions. Colic that persists beyond the third month or is combined with other symptoms should be investigated further. Cow’s-milk protein allergy may first present with colic, but may also be accompanied by vomiting, atopic dermatitis and bloody stools. Gastro-oesophageal reflux, with marked regurgitation of food, may also initially present with colic.
In managing colic, parents should first be reassured about its benign nature, so that they can cope without anxiety and with patience. The pediatrician should first examine the baby to rule out other causes of distress. Detailed guidance on correct feeding technique is essential. Plenty of cuddling, gentle rocking, holding the baby upright or on the tummy (while awake and supervised) and applying warmth to the abdomen can help soothe the baby. The literature reports occasional improvement with simethicone drops, probiotics and herbal extracts.
For appointments and information, contact Dr. Giannis Ritsas, pediatrician Thessaloniki and pediatrician Evosmos.