Colic is fairly common and it affects 15-40% of babies from the second week of life and subsides when they are 3-4 months old.

It presents as recurrent inconsolable fits of crying for at least three hours a day, three days a week and for at least three weeks (Garrison & Christakis 2000).

The cause of infantile colic is unknown but is thought to be caused by multiple factors:

• There may be a temporary intolerance to lactose or cow’s milk protein or both.
• Another possible reason is that there is a build up of air in the intestines and this causes the gut to go into painful spasm. The baby cries and the intake of air from the crying is also thought to make the problem worse. Sometimes gurgling of gas can be heard within the abdomen.
• Parental anxiety has also been mentioned as a possible cause.
• Maternal smoking during pregnancy is mentioned in some studies.
• Infantile colic is found in both breast fed and bottle-fed babies.

When does it start?
Typical infantile colic starts in the first few weeks after birth and disappears by the time the baby is three to four months old. It starts in the early evening and the baby has a high pitched cry, flushed face, drawing up of the knees and abdominal distension. The baby may pass wind and have difficulty with bowl movements. Infantile colic can be a very distressing experience for parents but it is time-limiting and babies grow out of it by 3-4 months and come to no harm.

What is the best treatment?
There is no one effective treatment but the following suggestions may be of benefit depending on the severity of the crying and the colic:

• A physical examination by the Doctor to rule out other causes for crying such as
• Acute intestinal conditions such as hernia
• Gastro-oesophageal reflux
• Adequate weight gain will rule out hunger
• Symptoms not associated with colic are: raised temperature, vomiting and diarrhoea
• A change in feeding technique might help breast or bottle-fed babies.
• Making sure that in breast feeding the baby is latched on properly. Requesting help from a Health Visitor to observe a feed may be helpful.
• In bottle-fed babies the bottle should be tipped up sufficiently so that the teat is full of milk to prevent the baby sucking air.
• Sitting the baby upright while feeding and winding frequently may help
• Changing the milk in bottle fed babies may help. Hypoallergenic Milk Formulas are available by prescription on the NHS By your GP. There are two kinds
• Casein based milk formula: Nutramigen1 and Pregestimil
• Whey based milk formula: Pepti & Pepti Junior
• Soya based infant milks are not recommended for infants under six months. This is because they have a high phytoestrogen content which may pose a risk to future fertility and sexual development.
• For breast feeding mothers it is not recommended to eliminate dairy products from the diet unless under the supervision of a dietician.
• Fennel and peppermint teas taken by the mother are sometimes effective in breast fed babies
• Sometimes the use of anti-flatulent's can help. There are several suitable products available over the counter e.g. Infracol. They act by reducing the surface tension of bubbles in the stomach, which help to dissipate them so that they are more easily expelled.
• Gripe water has been used for generations. Gripe water contains sodium bicarbonate, sugar and sometimes dill or spearmint oil
• Homeopathy offers a product called Colocynth. Follow the instructions on the bottle and give your chosen remedy 4-7 days to work.
• Baby massage may help some babies. Health Visitors will know about Baby Massage classes in the area
• Sometimes rocking the baby in the cradle helps
• Carrying the baby in a sling may also help
• Swaddling may have a successful outcome for some babies
• Babies can sometimes be soothed by music a baby soother tape ‘Sound Sleep for Babies’ by Dr Elizabeth Scott from www.crs-records.com is worth a try.
• Support from Health Visitors has also proved effective in helping parents to cope during the weeks of colic
• Support from Family and friends is also effective in giving the mother ‘time out’
• CRY-SIS – a support group for families with children who cry excessively is a useful contact. The help line is open every day from 9-10pm Tel: 020 7404 5011

Frances Byatt-Smith - Health Visitor

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