From the Guidelines
Infantile colic is typically recognized by episodes of crying, fussing, or irritability that can be accompanied by physical signs such as drawing up the legs, clenching the fists, and a red, flushed face 1.
Common Signs of Infantile Colic
- Crying is a common trigger for child abuse and is the most common trigger of abusive head trauma, with almost all of the parents having sought help for their infant’s crying previously from their primary care physician 1
- The severity and frequency of caregivers’ adverse responses to crying have largely been underappreciated, with almost 6% of parents of 6-month-old infants admitting that they had smothered, slapped, or shaken their infant at least once because of his or her crying 1
- Normal developmental phases that may cause difficulty for some parents, specifically colic, awakening at night, separation anxiety, normal exploratory behavior, normal negativism, normal poor appetite, and toilet-training resistance, can trigger maltreatment 1
Managing Infantile Colic
To manage colicky pain, it is recommended to try non-pharmacological interventions first, such as the "5 S's": swaddling, shushing, side/stomach position, shaking (gentle vibration), and sucking (on a pacifier or the mother's finger) 1.
Important Considerations
- A thorough physical examination and medical history should be taken to rule out other potential causes of the infant's distress, such as gastroesophageal reflux disease (GERD), which can cause symptoms such as feeding refusal, recurrent vomiting, poor weight gain, irritability, sleep disturbance, and respiratory symptoms 1
- If these methods are not effective, a trial of simethicone (Mylicon) 20-40 mg per dose, 3-4 times a day, as needed, can be considered, but it is essential to consult with a pediatrician before giving any medication to an infant 1
From the Research
Definition and Signs of Infantile Colic
The signs of infantile colic in infants can be characterized by:
- Episodes of uncontrollable crying or fussing in an otherwise healthy and well-fed infant less than three months of age 2, 3, 4
- Crying for more than three hours per day, for more than three days per week, and for longer than three weeks 2, 3, 4, 5
- The condition can be very stressful for the family 3
Types of Crying
Three categories of crying have been identified:
- Intense crying
- Non-specific fussing and crying
- Feeding-related crying 4
Diagnosis and Treatment
Infantile colic is a diagnosis of exclusion that is made after performing a careful history and physical examination to rule out less common organic causes 2
- Treatment is limited, and medications available in the United States have not been proved effective in the treatment of colic 2
- Dietary modifications, such as a low-allergen maternal diet or hydrolysed formula, may be beneficial in some cases 5
- A synbiotic mixture has been shown to be efficacious in the management of infant colic, improving quality of life of caregivers and reducing crying episodes and time 6