Colic is any cramp-like, recurring abdominal pain. Colic has a variety of causes and may occur at any age. Most often, however, people use the term to refer to colic that occurs in infants.

Infantile colic, or “three-month” colic, is a specific problem that bothers 10 to 20 percent of babies. Colic is far more common in bottle-fed babies than in breast-fed babies. Colic starts during the first few weeks of life and lasts one to six months (an average of three months).

Signs and symptoms

The signs of colic are seen in the typical behavior of colicky infants. A baby with colic cries for hours a day, particularly in the late afternoon and evening. The child pulls the legs up, clenches the fists, screams, and turns red. The child may feed briefly but soon stops feeding and returns to crying. Rocking and cuddling also stop the cries only briefly. In other respects, the infant is normal; the baby gains weight well, has normal bowel movements, and doesn’t spit up any more than most infants do.

A variation of this classical form of colic is the infant past two weeks of age who wakes frequently (every two hours or so), cries fretfully, takes one to two ounces of formula or a few minutes at the mother’s breast, falls into a fitful sleep, and wakens later to repeat this pattern.

Home care

First check for obvious causes of crying and discomfort other than colic. Look for diarrhea or constipation; loose nappy pins; severe nappy rash; a trapped arm or leg; whether the baby is too hot or too cold; or signs of illness – fever, nasal discharge, cough, reddened eyes, vomiting, hernia (a lump in the groin), or sores on the body. See whether your baby responds promptly to talking and cuddling and remains comfortable. A baby in pain can be distracted, but only temporarily. If breast-feeding, check that the mother’s nipples are not bleeding. Swallowed blood causes cramps. If a breast-feeding mother drinks too much cow’s milk, this can also cause cramps in the infant.

Offer your baby a feeding. If your baby drinks generously and falls asleep comfortably for several hours, the child was hungry, not colicky. Keep the baby partially upright in an infant carrier between feedings to be sure the baby is not regurgitating food in the oesophagus.

If colic still seems likely, applying gentle heat to the abdomen temporarily relieves the pain. First place a cloth nappy over the infant’s abdomen. Then place a heating pad (turned to “low”) on top of the nappy. Giving the child a pacifier may help. Also try inserting a glycerin suppository or lubricated thermometer to induce a bowel movement.

Precautions

• Make sure the formula is properly prepared.

• When bottle-feeding your baby, be sure that the nipple is kept full; this keeps your baby from swallowing too much air.

• Make sure the bottle’s nipple hole is large enough so that the baby can finish feeding in a reasonable time.

• Carefully burp the baby in different positions after each feeding.

Medical treatment

Your doctor will check for signs of illness, such as sores in the mouth or urinary tract problems. A urinalysis may be ordered. Your doctor also may recommend a change in formula to investigate the possibility that the child is allergic to the formula. A breast-feeding mother may need to eliminate all milk products from her diet to see if this is what is affecting her child. The doctor may also temporarily stop any solids already started to determine if the child may be allergic to certain foods.

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