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Friday, May 26th, 2017

Colic

Colic is an infant behavior characterized by long periods of inconsolable crying that appears to be related to abdominal discomfort associated with passing gas and stool.  The vast majority of these infants are normal and healthy and will “outgrow” their colic over several weeks to months regardless of any remedies offered.  They are, however, very trying to their parent’s nerves during this period!  The various approaches to treatment of colic would fill an entire book.  There is no one solution for all babies.  Many parents report that use of the OTC product Mylicon provides some relief and is considered a safe thing to try. 

For breastfed babies, it is traditional to speculate that some item of the mother’s diet is the cause of the problem.  Most of the time the culprit is not found.  If you are having a major bout of colic it is not unreasonable to look into this by eliminating caffeine, spicy foods, cabbage, Brussel sprouts, beans and cow’s milk products for 1-2 weeks.  If you notice a major improvement you can add things back gradually trying to pinpoint the precise item that is the culprit. If this initial approach is not helpful there probably is no point in pursuing this further; most mothers do not find a dietary cause for colic. 

In formula fed babies there is often the assumption that a component of the formula or the added iron is the culprit; again this is rarely the case. However, if you are having major episodes on a regular basis it probably is reassuring to try alternate formulas.  The usual plan is to rotate from a cow’s milk based formula such as Similac With Iron to a soy based formula such as Isomil for a 7-10 day trial.  If this is not helpful, a 7-10 day trial of a hypoallergenic formula such as Alimentum is next on the list.  Finally, some babies seem to do better on PediaSure With Fiber (this must be diluted-8oz concentrate plus 4oz of water) in a manner similar to older folks with irritable bowel syndrome improving with extra fiber in their diet. 

Whether babies are breast or bottle fed, it is important to be aware that they can sometimes be overfed during their long periods of crying; the resulting discomfort leads to more crying and an endless loop.  When you have fed, cuddled, burped walked, sung to, and checked for dirty diapers it is sometimes proper to put the baby down for 10-15 minutes to “cry it out” and drop off to much needed sleep.  These periods of being left to “sort things out on their own” often have to be extended as the babies get older.  Each parent varies as to how long they feel comfortable with this process, but it is very important to realize that it is okay to let them cry at times and that constant holding and comforting can lead to an even greater demand for such attention as they get older.  At some point this becomes overwhelming no matter how good one’s intentions are.  Be creative in seeking out what soothes your baby; swaddling, a ride in the car, battery operated swing, massage, music, warm bath, infant seat on top of warm running dryer (vibration and noise similar to a car ride), etc.
If all this seems unhelpful for your baby, please let us examine the child for abnormalities that may be contributing and to give consideration to the use of prescription antispasmodic medications in selected instances.

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