A baby comes crying into this world. Crying is also an essential ways of communication by the child with his caregivers. But excessive / fussy crying may become a matter of distress for the baby ,parents and the family.
Baby colic or infantile colic is defined as episodes of crying for > 3 hours a day for >3 days a week for three weeks in an otherwise healthy child.
The episodes start suddenly usually in the evening. It may start at 2-3 weeks of age but peaks around 6 weeks and persists till 6 months. It is seen in about 25% of the normal newborns.
Associated symptoms include flushed face, clenched hands and legs pulled to the stomach.
The exact cause of colic has not been evaluated in-spite of research over years. It has been suggested that it maybe because of immature digestive system.
However 5% of the children may have an underlying disorder like constipation , fissures, lactose intolerance, cow’s milk allergy and even infantile migraine.
Babies require a thorough clinical examination and need no investigations except that if there are “red flag sign” like vomiting , increased body temperature, bloody or mucoid stool , lethargy , poor weight gain, etc.
Management of colic is usually conservative and mostly involves reassuring the parents.
Calming measures using the 5S technique may help-
- Swaddling the baby.
- Stomach / Side- put the baby on side or stomach.
- Sshhh sound to calm the baby.
- Swinging the baby.
- Suckling the breast.
No medication has been really found to be effective. Simethicone is safe but its not really effective. Dicyclomine works but is not considered very safe.
There is no role of alternative medicines like gripe water, heeng/jeera water etc.
Diet changes may be required at times in the baby (switching to hydrolysed protein if formula fed) or taking away allergen (milk, egg,etc) from mother diet.
Gentle manipulation or massage sometimes helps.
Probiotic Lactobacillus rheuteri has been recently studied and is effective in breastfeed babies.
The long term prognosis is good and the colicky babies do well. This too “shall pass” as another parenthood challenge.