Sun
19
Apr
Colic
The mere thought of a colicky baby is often enough to strike fear in the
heart of the parents of a newborn child. A baby with colic may cry for hours
despite the parents attempts at consolation; although the colicky phase will
eventually end, it may seem like an eternity while it continues.
Colic is often defined as excessive (frequently inconsolable) crying that lasts for more than 3 hours on at least 3 days per week, continuing for at least 3 weeks; additionally, there must be no medical problem causing the crying. Other symptoms frequently associated with colic include pulling the knees up towards the stomach, a hard and/or swollen stomach, and excessive gas. Crying occurs most often in the evening. Colic typically ends by the age of 4 to 5 months.
Colicky babies may be at an increased risk of abuse at the hands of exhausted and frustrated parents. Additionally, the parent may not properly bond with the child because of feelings of inadequacy and anger, leading to the child developing behavioral problems as he or she grows.
No one knows for sure what causes colic, although there are many theories. One view attributes it to painful digestive cramps and/or excessive gas caused by allergic reaction to foods (such as milk). Another theory suggests that some babies may simply have a sensitive temperament, possibly compounded by a parental inability to respond to the infants needs. Finally, what we call colic may just be an extreme version of normal infant crying, or an increased perception of normal crying by parents with less tolerance for it.
The antispasmodic and sedating drugs dicyclomine and dicycloverine appear to be effective for colic, but they can have dangerous side effects in infants and are not recommended. The gas-relieving drug dimethicone is also sometimes recommended, but evidence suggests that it does not work for colic.
Colic is often defined as excessive (frequently inconsolable) crying that lasts for more than 3 hours on at least 3 days per week, continuing for at least 3 weeks; additionally, there must be no medical problem causing the crying. Other symptoms frequently associated with colic include pulling the knees up towards the stomach, a hard and/or swollen stomach, and excessive gas. Crying occurs most often in the evening. Colic typically ends by the age of 4 to 5 months.
Colicky babies may be at an increased risk of abuse at the hands of exhausted and frustrated parents. Additionally, the parent may not properly bond with the child because of feelings of inadequacy and anger, leading to the child developing behavioral problems as he or she grows.
No one knows for sure what causes colic, although there are many theories. One view attributes it to painful digestive cramps and/or excessive gas caused by allergic reaction to foods (such as milk). Another theory suggests that some babies may simply have a sensitive temperament, possibly compounded by a parental inability to respond to the infants needs. Finally, what we call colic may just be an extreme version of normal infant crying, or an increased perception of normal crying by parents with less tolerance for it.
The antispasmodic and sedating drugs dicyclomine and dicycloverine appear to be effective for colic, but they can have dangerous side effects in infants and are not recommended. The gas-relieving drug dimethicone is also sometimes recommended, but evidence suggests that it does not work for colic.
Treatment
Proposed Treatments for Colic:
A number of natural approaches to colic have been tried, but none can be considered scientifically proven at this time.
Dietary Changes
Cows milk is thought to be a highly allergenic food. Not only can infant formula—which contains cows milk—produce allergic reactions, but even breast-fed infants may be exposed to cows milk proteins if the mother consumes milk.
Numerous small, open and double-blind studies have evaluated the effects of cows milk in the diet of infants with colic. Most of these found an improvement in crying when cows milk protein was removed from the diet of formula-fed infants, or from the diet of the mothers in breast-fed infants. However, not all studies had positive results.
Many researchers recommend eliminating cows milk from the infants or the mothers diet for 2 to 3 days to see if symptoms improve. If eliminating this milk protein works, and if formula is preferred to breast-feeding, it might be better to try a special hypoallergenic formula based on hydrolyzed casein or whey, rather than soy formula, since it is possible to develop allergies to soy.
If no improvement is seen through eliminating cows milk, it might be worthwhile searching in the breast-feeding mothers diet for other potential food allergens, such as wheat, soy, or eggs. However, it is important to keep nutritional needs in mind: the nursing mother who eliminates certain foods needs to maintain an adequate intake of calcium, protein, and other nutrients.
It should be noted that most infants with colic are able to tolerate cows milk protein as they get older, so neither the mother nor the baby are doomed to life without milk. Researchers propose that this might be the result of an immature digestive system; according to this theory, maturation of the digestive tract is the reason that colic usually disappears on its own in time.
Milk also contains lactose, a form of sugar that many adults cant digest. However, reducing the lactose content of infant formula has not been found helpful in treating colic.
Behavioral Counseling
Many doctors believe that the cause of colic is not physical; rather, that it results from a childs oversensitivity to stimuli in the environment. Overanxious parents might contribute to the problem by adding more stimulation in an attempt to calm their child. Other parents might under-react in the belief that paying too much attention to the infants cries will "spoil" him. Either response could set up a vicious cycle leading to long periods of inconsolable crying.
Based on these theories, some authorities recommend counseling the parents of a colicky infant on appropriate coping strategies, including building a personal support system and occasionally leaving the child with a different caregiver to provide a respite.
Studies evaluating the effects of carrying a colicky child more, or using a motion-simulation device, have not found benefit.
Other Proposed Treatments for Colic:
One small double-blind placebo-controlled study found that an herbal tea eliminated colic in 57% of 33 infants in the treatment group, as opposed to only 26% in the placebo group (a significant difference). The tea contained extracts of chamomile, vervain, licorice, fennel, and lemon balm, herbs with an antispasmodic reputation. However, the safety of this herbal combination in infants has not been established.
Chiropractic spinal manipulation has also been tried for colic. One controlled study compared chiropractic treatments with the drug dimethicone (found ineffective in this study for colic). Fifty infants were randomly assigned one of the treatments for 2 weeks. By the sixth day of treatment, the spinal manipulation group cried significantly less than those on dimethicone. Whether this was a specific effect of the manipulation or a general response to attention and touch has not been determined.
In Britain, a preparation called "gripe water" is widely sold for the treatment of colic. Varying formulations exist; however, all include aromatic oils such as dill, spearmint, or caraway, combined with alcohol, sucrose (sugar), and sodium bicarbonate. There is no scientific evidence to show whether or not gripe water works. It should be noted that at the recommended dosage, the infant would receive the equivalent of five shots of whiskey. That would be enough to calm anyone down.
Other herbs sometimes recommended for colic include cardamom, angelica, peppermint, lemon balm, and yarrow. However, no scientific evidence as yet supports their use.
The use of salt substitutes containing potassium have also been recommended, but they can be dangerous.
A number of natural approaches to colic have been tried, but none can be considered scientifically proven at this time.
Dietary Changes
Cows milk is thought to be a highly allergenic food. Not only can infant formula—which contains cows milk—produce allergic reactions, but even breast-fed infants may be exposed to cows milk proteins if the mother consumes milk.
Numerous small, open and double-blind studies have evaluated the effects of cows milk in the diet of infants with colic. Most of these found an improvement in crying when cows milk protein was removed from the diet of formula-fed infants, or from the diet of the mothers in breast-fed infants. However, not all studies had positive results.
Many researchers recommend eliminating cows milk from the infants or the mothers diet for 2 to 3 days to see if symptoms improve. If eliminating this milk protein works, and if formula is preferred to breast-feeding, it might be better to try a special hypoallergenic formula based on hydrolyzed casein or whey, rather than soy formula, since it is possible to develop allergies to soy.
If no improvement is seen through eliminating cows milk, it might be worthwhile searching in the breast-feeding mothers diet for other potential food allergens, such as wheat, soy, or eggs. However, it is important to keep nutritional needs in mind: the nursing mother who eliminates certain foods needs to maintain an adequate intake of calcium, protein, and other nutrients.
It should be noted that most infants with colic are able to tolerate cows milk protein as they get older, so neither the mother nor the baby are doomed to life without milk. Researchers propose that this might be the result of an immature digestive system; according to this theory, maturation of the digestive tract is the reason that colic usually disappears on its own in time.
Milk also contains lactose, a form of sugar that many adults cant digest. However, reducing the lactose content of infant formula has not been found helpful in treating colic.
Behavioral Counseling
Many doctors believe that the cause of colic is not physical; rather, that it results from a childs oversensitivity to stimuli in the environment. Overanxious parents might contribute to the problem by adding more stimulation in an attempt to calm their child. Other parents might under-react in the belief that paying too much attention to the infants cries will "spoil" him. Either response could set up a vicious cycle leading to long periods of inconsolable crying.
Based on these theories, some authorities recommend counseling the parents of a colicky infant on appropriate coping strategies, including building a personal support system and occasionally leaving the child with a different caregiver to provide a respite.
Studies evaluating the effects of carrying a colicky child more, or using a motion-simulation device, have not found benefit.
Other Proposed Treatments for Colic:
One small double-blind placebo-controlled study found that an herbal tea eliminated colic in 57% of 33 infants in the treatment group, as opposed to only 26% in the placebo group (a significant difference). The tea contained extracts of chamomile, vervain, licorice, fennel, and lemon balm, herbs with an antispasmodic reputation. However, the safety of this herbal combination in infants has not been established.
Chiropractic spinal manipulation has also been tried for colic. One controlled study compared chiropractic treatments with the drug dimethicone (found ineffective in this study for colic). Fifty infants were randomly assigned one of the treatments for 2 weeks. By the sixth day of treatment, the spinal manipulation group cried significantly less than those on dimethicone. Whether this was a specific effect of the manipulation or a general response to attention and touch has not been determined.
In Britain, a preparation called "gripe water" is widely sold for the treatment of colic. Varying formulations exist; however, all include aromatic oils such as dill, spearmint, or caraway, combined with alcohol, sucrose (sugar), and sodium bicarbonate. There is no scientific evidence to show whether or not gripe water works. It should be noted that at the recommended dosage, the infant would receive the equivalent of five shots of whiskey. That would be enough to calm anyone down.
Other herbs sometimes recommended for colic include cardamom, angelica, peppermint, lemon balm, and yarrow. However, no scientific evidence as yet supports their use.
The use of salt substitutes containing potassium have also been recommended, but they can be dangerous.