Does my baby have colic?

Know the signs and get help

Y ou’ve got the checklist to go through when your baby is crying. He’s hungry? Nope. He’s tired. Nope. He needs a nappy change? Definitely not. Could it be a case of colic? It’s a diagnosis that’s often thrown about in the first three months of your baby’s life, but how would your doc go about confirming this condition? Unfortunately, as with your new-mom checklist, it’s a diagnosis of exclusion, rather than confirmation, and it affects between 10 and 30 percent of infants worldwide, says

paediatrician Dr Johnny Lotter at Kidimed. “The definition of colic is extremely broad based and traditionally the definition that any baby crying for more than three hours a day, having these episodes for more than three days of the week, and experiencing the symptoms for longer than three weeks is defined as a colicky baby. Unfortunately most babies do experience symptoms that would define them as having infant colic especially during the first 12 to 16 weeks of age,” says Dr Lotter, due to their immature digestive systems.

It may seem there is no logic to what sets your tot off, but Dr Lotter says babies with true infant colic tend to have crying bouts at certain times of the day and that would include especially late afternoons and an evening hours. “The cause and reason of this diurnal rhythm is not known and is not related to the infant’s sex, or if the mother has other children, or the parents’ economic status, education or age,” he says. Yup, colic is a true leveller! Dr Lotter says you should look out for these patterns or symptoms, to help determine if your baby has true colic:

What does it sound like?

Moms with colicky babies often insist that their have different crying acoustics than babies with regular crying. “They tend to have a more variable and higher pitch and that the crying is more urgent with the babies looking extremely uncomfortable and irritated with no response to the normal consoling,” says Dr Lotter.

When does your baby cry?

Their crying has a diurnal variation, being worse in the late afternoons and evenings, and occurs for no apparent reason.

What does your baby do? “Look for posture changes, pulling and curling up of legs, clenched fists and tense abdominal muscles,” says Dr Lotter.

How do they feed? “These babies often have rapid weight gain due to their excessive feeding in trying to help the cramping episodes,” says Dr Lotter. The parents complain that their baby experiences lots of flatulence and rumbling tummies during and after feeds.

When did it start? The condition often started abruptly after the so-called honeymoon phase, which usually lasts seven to 14 days after birth.

GETTING IT CHECKED You’re panicked, sleep deprived and the last thing you feel like is a visit to the doctor, but Dr Lotter insists a colic diagnosis cannot be made with a telephonic consultation and that all babies that are extremely irritable should be seen by a medical practitioner and a proper history with physical examination should be performed. “Special investigations are not indicated in these babies, so the blood tests, X-rays, ultrasounds and scans are of no value and should be avoided if there is no clinical reason. A simple urine investigation during the office visit might be the only test indicated to exclude a bladder infection,” says Dr Lotter. He says an unhappy baby that is gaining weight well is most likely to suffer from colic, but an unhappy baby that has failure to thrive does not have simple infant colic.

WHAT CAUSES IT?

No specific cause has been identified as yet, but several hypotheses are being investigated, including the association with gastrointestinal conditions, parental anxiety, poorly developed hormonal control of the digestive system, exposure to cigarette smoke, possible food allergy (especially cow’s milk allergy) and lately there is a focus on the association on abnormal intestinal microflora, explains Dr Lotter.

The reason you want to get it checked out is that your baby’s distress could be caused by something more serious, or simple to cure. “Your doctor may consider gastroesophageal reflux disease, leading to pain associated with oesophagitis, or any other motility condition leading to poor absorption. Constipation should be excluded especially in the baby that has failure to thrive,” he says. Other conditions that may be investigated to rule them out are cow’s milk protein allergy, lactose intolerance, infections, a strangulated hernia, testicular conditions in boys or infant dyschezia (where a healthy baby strains and cries to pass normal soft stools). IS THERE A CURE? Brace yourself: everyone from your gran to your hairdresser will have a “remedy” for colic, but Dr Lotter says while there are many benign (unharmful) treatments available, most of them are unproven to work, so try them with care! A trip to a chiropractor may help ease symptoms and this is popular, especially if you have had c-section (the recommended age to perform these manipulations is at three weeks of age).

“It is extremely important for parents to realise that the condition is innocent and the use of medications with potential side effects should be avoided,” he says. Sedatives should never be used, however tempting, but Dr Lotter does recommend the following:

Change your diet – If you are breastfeeding, exclude high allergen forming food from the diet due to the possibility of the baby reacting to these food allergens through the mother’s milk – for example dairy, soy, egg, peanut, wheat and shellfish. “If using formula there are specialised formulas that are formulated for babies with milk protein allergy but they must only be used under the supervision of a paediatrician,” says Dr Lotter.

Probiotics – These have been proven to be safe, but with mixed medical evidence during studies.

Simeticone – This is an agent that decreases flatulence, but it has performed poorly in clinical studies.

Hyosine – This is a smooth muscle relaxant that is commonly used for cramping by decreasing the spasming of the intestine. You may have heard of lactase enzyme, which can reduce flatulence in a lactose intolerant baby. Dr Lotter says that a recent study has shown the use of stomach acid-reducing medication has no role in the treatment of colic. YB

AN UNHAPPY BABY THAT IS GAINING WEIGHT WELL IS MOST LIKELY TO SUFFER FROM COLIC, BUT AN UNHAPPY BABY THAT HAS FAILURE TO THRIVE DOES NOT HAVE SIMPLE INFANT COLIC