A BIT ABOUT COLIC

RMacLean
January 2005

Colic can be defined as uncontrollable, extended crying in babies who are otherwise healthy and well-fed.  All babies cry, but when they cry for more than three hours a day, three to four days a week, they are said to have colic.  It's extremely important to rule out reflux as a cause of this crying, as it's becoming widely acknowledged that many cases of colic are actually undiagnosed and untreated cases of reflux.  In these cases, simply treating the reflux may eliminate the colicky behavior.  The following information applies to true colic and assumes the baby has absolutely no symptoms of reflux  and has been thoroughly evaluated for reflux.

About 20% of babies get colic, and generally appears at around two to four weeks of age and can last for three months, or longer.

Symptoms
The main symptom is continuous crying for long periods of time. This crying can occur at any time of day but it usually gets worse at night. It's not believed that colic is caused by pain although a colicky baby look uncomfortable or appear to be in pain.  They may lift their head, draw their legs up to their abdomen, pass gas and become red-faced.  Poor sleep habits is also common.

The main problem with the condition is the stress and anxiety it creates within the home. Parents and other family members may find it difficult to cope with the constant crying, so it's important to have support and to take a break now and then.

Causes
It's not completely understood what causes colic, it used to be thought that it was related to the digestive system although there's little evidence to prove that.

Some now believe it's caused by a combination of the baby's temperament and an immature nervous system.  The baby could be highly sensitive to it's environment The baby's temperament may make him or her highly sensitive to it's environment, taking a little longer to adjust to it's surroundings.  It reacts to this by crying and because it's nervous system is immature, he or she is unable to regulate crying once it starts.

Does Colic Need Treatment?
True colic does not need medical treatment. Deciding whether the baby needs medical treatment or not requires first ruling out all possible causes of the crying.  Do they have other symptoms of reflux?  Other things to rule out can include:

• Are they hungry?
• Are they tired?
• Do they need attention? Some babies want to be cuddled all the time.
• Were they startled due to a jerky movement or sudden noise?
• Is the crying associated with undressing?  Most babies don't like the feel of air on their skin.
• Is the baby too hot or too cold?
• Is there an obvious source of pain or discomfort? (Eg. a diaper rash)

Before calling the doctor, start a journal of when the baby cries, sleeps and everything that goes into (and out of) them and when.  This can help spot a pattern and possible cause of the crying if any.

Many times, a doctor may diagnose colic but parents may believe there is reflux present after spotting many symptoms of reflux in their baby.  In these cases, it can sometimes be difficult for the parents to get the doctor to listen.  See tips for getting diagnosed and getting the doctor to listen to you.

Reviewed By Dave Olson, MD
Fellow, American Academy of Pediatrics
Graduate University of Michigan School of Medicine