The Colicky Baby

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		Home Management Tips & Treatments
				THE COLICKY BABY
		The first thing we need to say about colic is that there is no general agreement among the medical profession about how it is defined. Colic is a term that is often given to a healthy infant under three months of age, who is distressed. A colic infant isn’t easily consoled and cries excessively, which often varies with good and bad days. Some colic infants cry all through the day, while others only cry in the afternoon, however the typical pattern of a colicky infant is one who cries increasingly throughout the day, but mostly in the early evening or late afternoon. It is a condition that varies in its severity, with some babies settling on being held, while others are inconsolable, (this occurs in about 20% of cases) Infant colic is sometimes described as consisting of a colic attack, which usually happens once or twice a day, and lasts for one to two hours. Colic is not associated with illness or hunger, and is not relieved by feeding. Colic should also not be confused with wind. “Wind” usually meaning the bubble of air brought up during, or soon after a feed. With wind, the baby can be calmed by gentle burping and soothing. A colic infant may also often settle after burping or passing wind, but burping does not prevent colic. Failure to burp a baby does not cause colic. Colic is a painful condition that usually peaks at around six weeks and stops around three months of age, although it can persist for up to five months. It includes a variety of symptoms ranging from the pulling up of legs, clenching of fists, tensing of abdomen, bloating, cramps, passing flatus, frequent loose bowel actions and crying. Although the medical profession does not know what really causes colic, some believe it is due to an immaturity of the digestive system that develops as the baby grows. Based on this belief, some experts in colic have developed the following theories: Intestinal spasm caused by wind getting trapped in the baby’s intestines. Minute bubbles of air are swallowed during the feed, which cause pain and spasm further down the digestive tract in the intestines. Internal spasm caused by an immaturity of the digestive tract. Peristalsis or muscle contractions occur all along the the digestive tract. The contractions are repeated in waves to propal the food through our digestive system. It is thought that because the nerves of the intestine are not fully developed, the contractions become uncoordinated and spasmodic. Refer to related article on motility immaturity. Lactose intolerance due to the baby having a deficiency of intestinal lactase to break down the amount of lactose in the feed, resulting in undigested lactose building up in the baby’s intestines. Refer to our article on food intolerance and allergies, for further information. Cows milk protein intolerance thought to be due to a hypersensitivity to cow’s milk protein. Recent research is indicating that this may account for a high proportion of colicky infants. Research has shown that these babies are reacting to the cow’s milk protein in their mother’s diet or in formula feeds. When the breastfeeding mothers removed all forms of dairy foods from their diets, or went to a dairy-free prescription formula such as Neocate, these babies’s colic ceased. Around 50% of these babies have been found to be sensitive to soy protein as well.Refer to our section on food intolerance and allergies for further information. Colic is a symptom of cow’s milk protein intolerance. Stress. For many years colic has been blamed on anxious, inexperienced parenting. There is absolutely nothing to support this theory! Baby’s temperament. An active, awake, busy and tense baby is more likely, according to research, to have colic. Caffeine. Many mothers have said eating certain foods seem to make their baby’s colicky; some babies are especially sensitive to caffeine. Try to eliminate any foods that you think are making your baby upset for a few days to see if there is an improvement. Potential problem foods include wheat, eggs, fish, peanuts, other nuts, chocolate, alcohol, citrus fruit, spices, cola and carbonated drinks in general. Gastro-oesophageal reflux. This is when the baby regurgitates the stomach acidic gastric contents back into the mouth or oesophageaous. Refer to our article on reflux for further information. Spinal functional disturbance. Incorrect positioning of the spine, can interfere with the vagus nerve, which is involved with the workings of the digestive system. This is called a spinal functional disturbance, and can be rectified through a visit to a chiropractor who will apply slight pressure to correct the spines alighnment. Refer to our article on chiropractive treatments for more information. IMPORTANT: Please see your doctor if you think your child has colic to rule out any other causes of the crying. Changing formulas is not a cure for colic, often only having a very temporary effect, and should only be done under the care of a medical practitioner. Breast milk remains to be the safest, least irritant and most nutritious diet for sensitive babies. Stopping breastfeeding is not a cure for colic and should only be done under the advice of a paediatric gastroenterologist. A paediatric gastroenterologist specialises in colic and may also be of assistance in better managing this condition. Top of page Management tips & Treatments Home

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		Back		Colic Management Tips & Treatments
		Management Tips Rule out other causes of crying, change the babies nappy, feed if hungry etc. Offer the breast or a dummy as sucking can relax and distract the baby. For breast fed babies, posture feed so that the baby has to suck milk up, by e.g.feeding with the baby lying on your tummy. This will help slow down the milk flow, and is especially effective with the morning feed. For bottle fed babies, try using a smaller holed / anti colic teat or narrow neck bottle, to slow down the milk flow. Burp your baby after a feed. Give your baby a cuddle, or try a sling or baby carrier. Try calming your baby with movement, such as rocking, driving, walking with your baby in a pram or even an electric powered swing. ( Some councils hire out these swings for babies) Music, relaxation tapes, womb sounds for newborn babies, may all help relax your baby. Experiment and see. Rhythmical or continuous noise such as the washing machine, dryer or vacuum cleaner is also soothing. A deep warm relaxation bath, or gentle massage may work. A warm towel wrapped around the baby’s stomach, or wheat bag placed on their stomach, can relax them. Let your baby lie on your stomach, the warmth of your body combined with your heart beat and rhythm of your breathing, will all help to relax and comfort your baby. Wrap your baby snugly in their cot blanket or bunny rug with their arms and legs inside the rug. Some babies like to have a hand free for sucking. Try laying your baby in different positions, the colicky baby is often happiest when held in a position which puts some gentle pressure on the stomach, such as tummy down over an arm or knee. When sleeping try laying your baby on her left-hand side. Some mothers found their babies slept best in this position, although it must only be attempted whilst using sleep safe device available from department stores or the Royal Children’s Hospital Safety Centre. It is important to follow the manufacturer’s instructions to prevent your child from rolling over. Remove or add clothing if hot or cold, to make sure the baby is comfortable. Move your babies legs in a bicycling action, as this may help expel bowel gas. Let your baby sit in the crook of your arm with his knees drawn up and body flexed forward. It may be of some benefit to stay at a mothercraft hospital. Refer to helpful addresses. These units have had some success in managing colicky babies, through establishing routines in feeding, sleeping and playing times. Refer to attached listing. Treatments Some medical practioners may prescribe drug therapy in an effort to treat colic and these generally consist of three types: Wind medication – Containing a chemical that causes the small bubbles of gas in the infants stomach to join together into one large bubble which can be easily expelled. Eg: Simethicone (InfaCol ‘Wind Drops’). Anti spasmodics -The digestive system contains glands that secrete mucus, which aids the wave like contractions of the digestive system(perstalsis) in propelling food along the digestive tract. This range of colic medication has a drying effect on the glands of the digestive system, causing the peristalsis of the digestive tract to slow down.Eg: Atropine (Donalix colic mixture). Sedatives – This has a sedating effect on the infant. Eg: Phenobarbitone. Usually taken in a liquid form, Phenobarbitone is actually an oral barbiturate designed as a treatment for epileptics. It works by partially blocking the transmission of nerve impulses in the brain, thus controlling epileptic fits. One of the side effects of the drug is that it acts as a sedative, which is the main reason it is prescribed today in the treatment of a distressed child, in an effort to calm the infant down. Please note that The Royal Children’s Hospital no longer supports the use of Phenobarbitone as a treatment for colic. Refer to our article on Phenobarbitone for further information. Top of page Back Home

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