Thursday, February 14, 2008

colic

Colic

Published by BUPA's health information team, healthinfo@bupa.com, November 2007.
This factsheet is for parents or carers who would like information about colic.
Colic is the extreme end of normal crying behaviour. The condition is harmless, but it can be very distressing for parents or carers. About one to two in every 10 babies get colic.

What is colic?

Colic is uncontrollable crying in a baby that has no known cause.

Symptoms

Your baby may have colic if he or she cries excessively over several days. Although this crying can occur at any time, it usually gets worse in the late afternoon and evening. Colic usually appears in the first few weeks after birth and the cause isn't known. It generally lasts for three to four months.

Although colic isn't thought to be due to pain, your baby may look uncomfortable or appear to be in pain. Babies may lift their head, draw their legs up to their tummy, become red in the face and pass wind. Colic is not a serious condition. Research shows that babies with colic continue to eat and gain weight normally, despite the crying. If your baby doesn't, you should see your health visitor or GP.

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

Causes

The cause of colic isn't known. In the past it was thought to be related to the digestive system. Painful wind may contribute to colic, but there is little evidence to prove colic is linked to digestive problems. Intolerance of lactose has also been identified as a possible factor, but evidence is limited.

Another possible cause may be your baby's temperament. This may make your baby highly sensitive to the environment, and he or she may react to normal stimulation or changes by crying. If you smoke, this may also be a factor.

Gastro-oesophageal reflux disease (GORD) is associated with excessive crying in some babies. GORD symptoms include being sick and difficulty sucking, these are not usual symptoms in babies with colic.

Diagnosis

You may be worried about your baby's crying and may want to get advice from your GP or health visitor to make sure there isn't a serious problem.

Before visiting your GP, you should think about what other things may be causing your baby to cry. These could include:

hunger
tiredness
lack of contact - some babies want to be cuddled all the time
startling - due to jerky movements or sudden noise for example
temperature - your baby may be too hot or too cold
pain - there may be an identifiable source of pain, like a nappy rash

If none of these are causing your baby to cry, you may decide to see your GP or health visitor. They will examine your baby and will ask you about your baby's behaviour. By telling them when your baby cries, eats, sleeps and their pattern of bowel movements, they may be able to find out the cause of the crying.

Treament

There is no single medicine or proven cure for colic, but there are measures that may help. Different babies are comforted in different ways, and you may need to try a few methods to see what works.

Self-help

To soothe crying babies, the following techniques may be helpful.

Carry your baby in a front sling or back pack.
Keep your baby moving in a baby swing.
Try to soothe your baby with continuous noise or vibrations from household appliances like the dishwasher, vacuum cleaner or washer-dryer.
Take your baby for a car ride or a walk outside.
Give your baby a dummy to suck on.
Bathe your baby - the warm water may be comforting.

Elimination diets

There are some dietary changes that may help some babies, but none are proven to treat colic.

It's thought that some babies may not be able to digest proteins called lactose very well, but this improves as they get older. If you put breast milk into a bottle or use formula feed containing cow's milk, you could try adding lactase before feeds to see if this helps. This can be purchased from a pharmacist. Lactase breaks down lactose in the body and can improve symptoms in some babies in the first few months. Some mothers may find using low lactose milk formula useful. If, after a one week trial, either method helps your baby, you can carry on feeding them in this way until they are 12 weeks old. The baby should then be slowly weaned onto normal milk over a period of one week.

There are other methods that may help if a low or non-lactose diet doesn't work for your baby. If you are breastfeeding, you could stop eating dairy products, or try feeding your baby a hypo-allergenic formula containing whey or casein hydrolysate which your baby shouldn't be allergic to. If eliminating dairy from your diet or hypo-allergenic formulas feeds work, you should talk to your GP about a referral to a specialist as your child may have an intolerance to cow's milk. However, there is limited evidence that non-dairy breast milk and hypo-allergenic formulas are effective at reducing colic.

A substance found in soya products called phytoeostrogen can affect the development of your child. Speak to your health visitor and GP before using soya-based formulas.

Medicines

There is limited evidence that simeticone (eg Infacol), may improve symptoms. This treatment is used to relieve trapped wind. You may also consider trying colic drops or gripe water, which are available without a prescription.

Complementary therapies

Chiropractic spinal manipulation therapy or cranial osteopathy may relieve symptoms. However there is limited evidence that these treatments are effective.

Aromatherapy and tummy massage using lavender oil may help relieve the symptoms of colic. Always ask the advice of a qualified practitioner as some herbal remedies can be harmful to babies.

Help and support

Caring for a baby with colic can be very stressful, frustrating and challenging for any parent or carer, particularly if it's your first child. If you feel overwhelmed, you should take a break if at all possible. Ask a partner or friend to take over for a while, even for just an hour or two.

Further information

CRY-SIS. Helpline for families having difficulty with a crying baby
0845 1228669
www.cry-sis.org.uk

Sources

Birth to Five: Your complete guide to parenthood and the first five years of your child's life. The Department of Health, March 2006
www.dh.gov.uk
Colic - infantile. NHS Library for Health. Clinical Knowledge Summaries.
http://cks.library.nhs.uk
accessed 22 January 2007
Colic. National Childbirth Trust
www.nct.org.uk
accessed 19 January 2007
Colic - infantile. Management issues. PRODIGY
www.prodigy.nhs.uk
accessed 22 January 2007
Infant colic update 2004. Bandolier
www.jr2.ox.ac.uk
accessed 22 January 2007
Infantile colic. BMJ Clinical Evidence
www.clinicalevidence.com
accessed 08 August 2007