In the What To Expect series book titled The First Year, a question from a mother reads: “Sometimes, when I'm rocking the baby through his third hour of colic, and he wont stop screaming, I have this terrible urge to throw him out the window. Of course I don't — but what kind of parent am I to even think such a thing?” This pretty much sums up the plight of a parent handling a baby with colic.
What is colic? Explains Bhaskar Raju, Professor and HoD, Department of Paediatric Gastroenterology, Institute of Child Health and Hospital for Children, Chennai: “Infantile colic is common in otherwise healthy newborns under three months of age, characterised by bursts of inconsolable crying, fussing and irritability. These spells tend to occur in the late afternoon/evening, and are characterised by drawing up of the legs, tension of the body, flushing of the face and, often, a bloated abdomen.”
Each episode could last from several minutes to a few hours. “It typically begins around three to four weeks of age, peaks around six to eight weeks and fades away by the time the child is three or four months old,” he says.
So, how do you know if you child is crying due to colic? Paediatricians talk of a ‘Rule of 3' they use to diagnose the condition — persistent crying for three hours a day for three days a week for at least three weeks.
Why colic occurs is a question that continues to baffle the experts. Dr. Raju attributes it to a variety of reasons, including lactose intolerance — Mother's milk has significantly more lactose than the baby can digest (almost double that present in cow's milk); the extra lactose is meant for the healthy germs in the gut. When they use up the lactose, they release gas and some acids. That distends the colon and causes colic. Also, intestinal motility is still evolving in a new born; and inappropriate contractions of intestinal muscles can occur at random, causing spasms. Low lactobacilli (good bacteria that produce short chain fatty acids that help colon cells to grow) levels in the colon can also contribute to the problem. Which is why it is believed that giving pro-biotics (good bacteria) might help.
Diet and environment also play a major role in colic. According to V. Raghupathy, consultant paediatrician, Apollo Hospitals, infants with colic have difficulty digesting complex proteins such as those in cow's milk. They are also sensitive to allergenic foods in the diet of mothers who breast feed their babies (for instance, cow's milk, wheat, eggs and nuts.).
It is necessary to adopt the correct technique while breast feeding. In the case of bottle-fed infants, too large a hole in the nipple can lead to a lot of air being swallowed, leading to bloating of the abdomen, and pain.
Why do some children have more severe colic than others? Points out Dr. Raju: “Some babies are hypersensitive and perceive normal intestinal activity such as contractions as pain. Also, discord in the family and an atmosphere of disharmony is known to precipitate colic.” In the opinion of Dr, Raghupathy, “Infants with colic seem to have a relatively immature nervous system that makes them more excitable to environmental stimuli. Ensuring the baby is not excited at bed time, and reassuring it by holding and comforting helps reduce crying and irritability. Also, such infants prefer sitting in the lap of the mother, or resting in the crook of the arm — postures that help relieve the distress.”
So, do medicines help prevent the occurrence of colic, or reduce the distress? Says Dr. Raju: “There are medications, but they have limited success. Most commercial preparations for colic contain Simethicone, a de-foaming agent that pushes gas down the intestine and helps reduce colic. Anti-spasmodics are not recommended below six months of age, because of side effects. Once a physician confirms that there is no organic problem causing the colic, safe paediatric sedatives may even be prescribed.”
Tips to reduce distress
Make sure the baby is not crying because of some other cause — mosquito/ant bite, thirst, hunger, heat or cold, ear ache, rashes, soiled nappies, etc.
Cuddle and carry the baby. It helps calm them down.
Play some music or sing to the child to distract it.
In case of breast-fed infants, if there is a history of allergies in the family, modify the lactating mother's diet
Low-allergy formulas may help bottle-fed babies.
Burp the baby after every feed.
