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INFANT COLIC - a parent's guide
Dr Peter Nobbs - Paediatrician
What is colic?
Colic is frequently used in the sense of being a diagnosis
but strictly speaking it is a one word clinical description
of a crying, fussing, irritable infant without any obvious
cause for this behaviour.
This is a common condition and is estimated to occur in
10 - 15% of newborns.
A medical assessment and examination should always be
done to check for other conditions which may cause similar
symptoms.
Key features:
Typically occurs late afternoon and early evening.
Very difficult to placate once symptoms develop. Feeding
usually does not relieve distress.
Infants often have legs drawn up and back arching during
crying episodes.
Generally abates spontaneously by around three months
of age.
Equally likely between breast and bottle fed infants.
Generally otherwise healthy and gain weight at an appropriate
weight.
Long term outlook - excellent.
Diagnosis:
1. The importance of a family history of allergy needs
to be noted. It is estimated that 10% of infants who are
labelled as having 'colic' are in fact intolerant of dairy
milk protein either in terms of a reasonable dairy intake
the mother is having if breastfeeding or in being on a cows
milk protein formula.
2. Possible urinary tract infection. This is not an infrequent
condition in infants and may present with a clinical picture
mimicking that of colic. It is therefore reasonable for
a urine check to be done on all infants who are suspected
of having colic. Similarly if there is anything else on
the physical examination or history that suggests an underlying
medical history, then this does need to be explored.
What is the treatment?
1. If there is a suggestion of intolerance of cows milk
protein in either a breast or a formula feeding infant,
then steps to reduce or eliminate this from the diet are
worth considering. For a breastfeeding mother, this would
mean eliminating dairy products from her own diet. For a
formula fed infant, the approach would be to try either
a goats milk or soya milk formula to see if this provides
relief.
2. Other dietary changes do not commonly produce a substantial
improvement although a heavy caffeine load in a mother's
diet can sometimes produce this pattern of irritability
and it is therefore worth considering reducing or eliminating
coffee or tea from the diet to see what changes occur.
3. If a urine test shows a urinary tract infection or
if there is evidence of another medical problem, clearly
this will need to be treated in any event and often will
substantially improve the irritability.
4. Various physical approaches have been tried with reasonable
success rates in children who are displaying colicky behaviour.
Motion of one kind or another often seems to provide some
sort of relief. There are different ways of doing this.
For example:
a) Taking the infant for a car ride. Most infants seem
to settle with the motion of car movements.
b) Kangaroo care with carrying the infant in a front pack.
This also seems to provide relief or at least some degree
of soothing for irritable infants.
Surviving colic
Helping parents cope with this frightening situation is
one of the key points in surviving this condition. The infant
will certainly survive it but parents may need assistance.
Key points for parents:
Try to avoid sleep fatigue by catching up on sleep where
possible.
Accept what offers of help are available to look after
the infant for a while.
Talk to other parents of infants who have been or are
similarly affected.
Both parents should try to spend some time together outside
home without their infant for 2-3 hours at a time.
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