Infantile Colic

Dr. Parang Mehta, MD.

Some babies cry a lot. There can be a lot of reasons  why babies cry  , and not everything should be attributed to colic. Colic actually means pain in the abdomen owing to muscular spasm of some structure inside. There is no way of knowing whether a baby has pain or not.

What is colic?

An otherwise healthy baby who cries for 3 hours or more a day on at least 3 days in a week is said to have colic. Crying typically occurs in the evening, and the baby feeds and grows normally.

Just because we can define it doesn't mean we know what it is. It is a very common condition, probably affecting 10-20% of all babies. The problem starts in the first few weeks of life, and it resolves by the age of 4-5 months. It is more common in formula fed than in breast fed babies, in first born children, and we do not know accurately what causes such behavior.

Theories abound. The baby may have painful gut contractions. Breast milk contains a high concentration of lactose; inability to digest this may cause discomfort and crying. Cow milk allergy is one theory, and the protein involved can be found in breast milk. The child may have gas, or some other discomfort. Emotional turmoil, anxiety, depression, and household tension are known to contribute to colic. Or, these babies who cry so much may just be at the extreme end of the normal crying behavior of babies.

Do drugs help?

Drugs that have been in use for a long time are anticholinergics. These are drugs that relieve spasm of the gut, and were popular because we thought that the crying was owing to pain in the tummy. One popular drug of this class is dicyclomine. It is effective in some babies, but it can cause sleepiness, coma, constipation, seizures (fits), breathing difficulty, and limpness. These side effects, often serious, have led to the drug being out of favour now.

Simethicone is another drug commonly available, often in a combination with dicyclomine. It reduces the gas in the stomach, but has not been found to have a significant effect on a baby's crying.

Feeding modification

All kinds of dietary changes have been made to cure the crying. The two changes that have some benefecial effects are replacing cow's milk with soya milk, or with whey hydrolysate. Other changes like casein hydrolysate, low lactose milk, etc, do not seem to work.

Home remedies

One study in children with colic tried out a 12% solution (that's 12 grams of sugar in 100 millilitres of water). It did reduce crying somewhat. Unsurprisingly, it was found not to have any harms.

Another substance that has been reported to help sometimes is herbal tea. These herbal teas contain chamomile, vervain, liquorice, fennel, and balm mint. And, of course, all kinds of traditional remedies are given to children. Many of them help, if the parents believe in them. There is a strong placebo effect in the treatment of colic.

For more information:    Why do babies cry?

Last Revision: February 15, 2016

What to do?

Behavior modification

Infantile colic is a harmless condition, and time limited as well. It is neither a disease, nor a manifestation of faulty care. Once the parents and other caregivers realise this, there is often a reduction in the baby's crying. Colic is often a reflection of parental anxiety.

Specific behavioral therapy has also been evaluated. Responding to crying by holding, patting, and putting to sleep reduces crying. Increased carrying of the baby during the day has no effect. Reducing the stimulation of the baby has also been tried -- not lifting, jiggling, or patting, and reducing talking and noise. This is based on the belief that the baby's immature nervous system is unable to take the stimuli of the outside world. No intervention works in all babies, which just shows that not all babies cry for the same reason.

Contact Information

Dr.  Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat, India.     Tel: +91 9429486624.
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