Colic

Index

1. What is colic?

2. What are the symptoms?

3. What are the causes of colic?

4. Can it be prevented?

5. What does the treatment consist of?

What is colic?

Colic is a type of abdominal pain that varies in intensity and can be very severe. There are three types of colic:

• Biliary colic: it is caused by distension of the gallbladder, usually due to a gallstone.
• Nephritic colic: it is usually caused by a kidney stone.
• Infantile colic: occurs in some babies during the first months.

What are the symptoms?

This pain may also be accompanied by nausea, vomiting and diarrhea. It can also cause irritability, tension and stress.

Crying and screaming are normal for babies, especially during the first three months. And the range of what is normal crying is difficult to pinpoint. In general, colic is defined as crying for three or more hours a day, three or more days a week, for three or more weeks.

Characteristics of colic may include the following:

• Intense crying that may sound more like screaming.
• Crying for no apparent reason.
• Extreme fussiness, even after the crying has subsided.
• Predictable timing, with episodes often occurring at night.
• Facial discoloration, such as reddening of the face or paler skin around the mouth.
• Body tension, such as straight or stiff legs, stiff arms, clenched fists, arched back, or tense abdomen.

Sometimes there is relief of symptoms after the baby passes gas or has a bowel movement. The gas is probably the result of swallowing air during prolonged crying.

Colic is a type of very severe abdominal pain.

What are the causes of colic?

The cause of colic is an increase, sometimes violent, of the peristaltic movements of the abdominal hollow viscera. In biliary colic, the main cause is the excess of cholesterol, although it can also be produced by the narrowing of the ways through which the bile circulates, by blows in the liver, hypocaloric diets or by fasts of more than eight hours. In the case of nephritic colic, the main cause is the accumulation of salts in the urine produced by pus or a blood clot. As for infant colic, the exact cause is not known.

Can it be prevented?

There are several habits that can be taken to prevent colic from occurring. To prevent nephritic and biliary nephritis, it is recommended to drink plenty of fluids, control the diet and reduce salt intake; to prevent infant nephritis, it is advisable to put the baby in an upright position after eating and tap on the back to eliminate gas, avoid dairy products during pregnancy and keep the baby seated when feeding, among others.

What is the treatment?

There are several medications to combat the spasms produced by colic, such as atropine or papaverine, which prevent the passage of nerve impulses in the affected region.

The main objectives are to reassure the child as much as possible with different interventions and to ensure that the parents have the support they need to cope with the situation.

We can divide the treatment into different changes:

• Soothing strategies: such as:
  • Using a pacifier.
  • Taking the baby for a ride in a car or stroller.
  • Walking with the baby in your arms or rocking the baby.
  • Swaddling the baby in a blanket.
  • Giving the baby a warm bath.
  • Rub the baby’s tummy or turn the baby on his or her stomach to rub the baby’s back.
  • Play an audio recording of a heartbeat or soft, soothing sounds.
  • Make background noise with a white noise machine, vacuum cleaner, or dryer in a nearby room.
  • Dimming lights and limiting other visual stimulation.

• Feeding practices: such as:
  • Giving your baby a bottle in an upright position.
  • Burping frequently during and after feeding.
  • Using a curved bottle will help with vertical feeding.
  • Using a collapsible pouch bottle can reduce air intake.

• Trial changes in diet: such as:
  • Change in formula. If you feed your baby infant formula, your doctor may suggest a one-week trial of an extended hydrolyzed formula.
  • Breastfeeding diet. If you are breastfeeding, you can try a diet free of common food allergens, such as dairy, eggs, nuts and wheat. You can also try eliminating potentially irritating foods, such as cabbage, onions or caffeinated beverages.

• Self-care for parents: such as:
  • Rest. Take turns with your spouse or partner, or ask a friend to take over for a while. Take the opportunity to get out of the house if possible.
  • Use the crib for short breaks. It’s okay to leave your baby in the crib for a while during a crying episode if you need to pull yourself together or calm your own nerves.
  • Express your feelings. It’s normal for parents in this situation to feel helpless, depressed, guilty or angry. Share your feelings with family members, friends and your child’s doctor.
  • Don’t judge yourself. Don’t measure your success as a parent by how much your baby cries. Colic is not the result of bad parenting, and inconsolable crying is not a sign that your baby rejects you.
  • Take care of your health. Eat healthy foods. Make time for exercise, such as a brisk walk every day. If you can, sleep when the baby sleeps, even during the day. Avoid alcohol and other drugs.
  • Remember that this is temporary. Colic episodes usually improve after 3 to 4 months of age.
  • Have a rescue plan. If possible, arrange with a friend or relative to step in when you are overwhelmed. If necessary, call your doctor, a crisis intervention service or a mental health hotline to seek additional assistance.

• Possible future treatments: such as:
• One treatment under investigation is the use of good bacteria (probiotics) to create a proper bacterial balance to improve overall digestive health.
• Treatment with a bacteria called “Lactobacillus reuteri”.