INFANT COLIC

Infant colic (also known as baby colic and three month 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. 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.

What are the causes of colic ?

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.

Some doctors claim that it is a combination of a baby's sensitive temperament, the environment, and its immature nervous system which makes it 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.

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), circadian rhythms, and smoking and stress of the mother in the third trimester.

What is the treatment for colic ?

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.

One study showed a moderate success when infants with colic were treated with dicyclomine, an anti-spasmotic drug commonly found in some anti-diarrhoeal medications. Another small study found success with probiotics, which were intended to reduce gas. Further studies are necessary before any specific cure should be recommended.

There is general agreement that soothing measures, such as pacifiers and rocking, are often effective in calming the baby during crying periods. Also known as the "cuddle cure", 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. 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 increases the likelihood of Sudden Infant Death Syndrome.

Various tactics, such as changes in diet or routine, an increase in fresh air or certain herbal teas, are popularly believed to 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.