PROLONG CRYING IN NEWBORNS – COLIC

Dr Tariq Jagnarine
Fam Med, Endocrinology/ Diabetes

Colic is when your otherwise healthy baby cries for three or more hours a day three or more times a week for at least three weeks. Symptoms usually appear during the first three to six weeks of a baby’s life, and it is estimated that one in 10 infants experiences colic.
A baby’s constant crying can cause stress and anxiety, because nothing seems to alleviate it. It’s important to remember that colic is only a temporary health condition, which usually improves on its own, and is not usually a sign of a serious medical condition.
Call or visit a doctor as soon as possible if colic symptoms are combined with other symptoms, such as high fever or bloody stools.

CAUSES OF COLIC
The cause of colic is unknown. The term was developed by Dr. Morris Wessel after he conducted a study on infant fussiness. Today, many pediatricians believe that every infant goes through colic at some point, whether it’s over a period of several weeks or a few days.

POSSIBLE COLIC TRIGGERS
There is no one known cause of colic. Some doctors believe certain things may increase the risk of colic symptoms in your baby. These potential triggers include:
• Hunger
• Acid reflux (stomach acid flowing upward into the esophagus, also called gastroesophageal reflux disease or GERD)
• Gas
• Presence of cow’s milk proteins in breast milk
• Some infant formulas
• Poor burping skills
• Overfeeding the baby
• Premature birth
• Smoking during pregnancy
• Undeveloped nervous system

SYMPTOMS OF COLIC
A baby is likely having colic if they cry for at least three hours a day and more than three days per week. The crying generally begins at the same time of day. Babies tend to be more colicky in the evenings, as opposed to mornings and afternoons, and the symptoms can start suddenly. The baby might be giggling one moment, and upset the next.
They may start to kick their legs or draw their legs up, appearing as though they are trying to alleviate gas pain. Their belly may also seem swollen or firm while they are crying.

TREATING COLIC
• One proposed way to treat and prevent colic is to hold the child as often as possible. Holding your infant when they aren’t fussy may reduce the amount of crying later in the day. Placing the baby in a swing while you do chores may also help.
• Sometimes taking a drive or strolling around the neighbourhood could be soothing to your baby.
• Playing calming music or singing to your child may also help. You can also put on soothing music or some gentle background noise.
• A pacifier may be soothing as well.
• Gas may be a trigger of colic in some babies, though this hasn’t been shown to be a proven cause. Softly rub your baby’s abdominal area, and gently move their legs to encourage intestinal flow.
• Over-the-counter gas-relief medications may also help with the recommendation of your child’s pediatrician.
• Holding the baby as upright as possible when you are feeding, or changing bottles or bottle nipples, can help if you think your baby is swallowing too much air.
• Make some adjustments if you suspect diet is a factor in the baby’s symptoms. If you use formula to feed the baby and you suspect your baby is sensitive to a particular protein in that formula, discuss this with a doctor. The baby’s fussiness may be related to that, rather than simply having colic.
• Making some changes to your own diet if breastfeeding may help relieve symptoms of fussiness associated with feeding. Some breastfeeding mothers have found success by removing stimulants like caffeine and chocolate from their diet. Avoiding those foods while breastfeeding may also help.
The intense crying might make it seem like the baby is going to be colicky forever, but infants usually outgrow colic by the time they are 3 or 4 months old, according to the National Institute of Child Health and Human Development. It’s important to stay attuned with the baby’s symptoms. If they go beyond the four-month mark, prolonged colicky symptoms may indicate a health problem.

WHEN TO SEEK MEDICAL HELP
Colic is usually not cause for concern, however; but consult a pediatrician immediately if the baby’s colic is combined with one or more of the following symptoms:
• Fever of over 100.4˚F (38˚C)
• Projectile vomiting
• Persistent diarrhoea
• Bloody stools
• Mucus in the stool
• pale skin
• Decreased appetite

COPING WITH BABY’S COLIC
Being a parent to a newborn is hard work. Many parents who try to cope with colic in a reasonable fashion tend to get stressed in the process. Remember to take regular breaks as needed, so you don’t lose your cool when dealing with the baby’s colic. Ask a friend or family member to watch the baby for you while you take a quick trip to the store, walk around the block, or take a nap.
Place the baby in the crib or swing for a few minutes while taking a break, if you feel like you’re starting to lose your cool. Call for immediate help if you ever feel like you want to harm yourself or your baby.
Don’t be afraid of spoiling your child with constant cuddling. Babies need to be held, especially when they are going through colic.