Dr Chris Steele

Colic

What is colic?
The colic that affects babies is a condition where there appears to be an episode of abdominal pain, occurring more often in the evening between 5pm and 10pm. During the day the baby is usually not in pain, feeds well, sleeps well and is otherwise a fit, healthy baby. During the attack the baby appears to be in intense pain, crying or screaming as he draws his legs up to his tummy. His face is often red and he is obviously very upset!

The pain can last 2 or 3 hours and then wears off. The condition is harmless as it clears up by the time the baby is four months old, but it is very disturbing for the parents during that period of time.

Who gets colic?

Colic is common in babies up to the age of 3 - 4 months, it is often referred to as 'three-month colic'. It is not a condition of older children.

• It is more common in bottle fed babies.
• It is more common in babies who are given cow's milk.
• It is more common in babies who are given solids very early.
• It is more common in the babies of smoking mothers.

What causes colic?
Despite colic being a common condition affecting so many young babies, we still do not know the real cause of this complaint. It is thought to be a spasm of the baby's intestines, maybe due to an irregularity in the intestines which have not yet learned how to function correctly.

During the baby's development in the womb, there was no feeding through the mouth and there was, therefore, no great activity in the baby's bowels or intestines.

After the birth the baby starts taking in nourishing feeds every few hours, and it is thought that along with the feed, the baby swallows substantial amounts of air into the stomach and intestines. The bowel tries to cope with this new experience as best it can but does not 'get its act together' and is not able to coordinate correctly its complex actions of gently moving on the contents of the intestines in a smooth and regular fashion. So air and gas get trapped in parts of the bowel and the intestines contract down in a haphazard and often painful manner in an attempt to move the contents on in the best way possible. As the intestines mature and learn to act smoothly (and painlessly) through their daily contact with air and food, so the condition gradually settles.

Can you prevent colic?

• Whether your baby is breast or bottle fed, always stop halfway through a feed and 'burp' him by sitting him up and patting gently on his back, or rubbing his back as you sit him upright with him facing over your shoulder. A hungry baby will greedily feed on breast or bottle and often swallow a lot of air along with the milk. That swallowed air may cause him some colicky discomfort later. If your baby does not bring up any wind within a couple of minutes put him back to feed, otherwise he may start crying, get upset and swallow air, thus producing more colic!
• Try to breast feed for at least the first three months if you can.
• If you are bottle feeding, make sure the hole in the teat is the right size. Hold the bottle upside down and if the milk drops at a slow steady rate from the teat - that's about right! If not, the hole is too small and if the milk pours out the hole is too large. Always ensure you are holding the bottle at the correct angle, i.e. so that the teat is always full of milk and the baby is not sucking air.
• Do not offer your baby any solid food until he is 3 months old. The baby's immature intestines may find it difficult to cope with the new proteins and substances presented by some solid or semi-solid foodstuffs until he is older than 3 months.

Do NOT give your baby ordinary cow's milk until he is 12 months old.

When you are weaning him you may find that certain baby foods disagree with him and may cause colic. In that situation avoid the offending foods - there are plenty more to choose from.

How should you treat colic?
Yourself:

• Wind or burp him to see if that will help.
• Try to soothe your baby by:
  • Rocking o Cuddling
  • Walking to and fro, whilst cuddling
  • Walking him in the pram o Singing
  • Playing gentle music
  • Bathing
  • Taking him for a drive

Gripe water sometimes helps, but to be honest, there is no scientific evidence that this has any effect upon infant colic.

Once your doctor has made sure that nothing more serious is happening there is little he can do from the medical point of view. The only preparation that I know of that is officially indicated for use in the treatment of infant colic in babies under 6 months is a liquid called Infacol. Give between 0.5ml to 1 ml just before each feed. This can be bought over the counter and is also available on prescription. It can safely be used in babies under 6 months.

A baby older than 6 months that is having bouts of colic may be helped with a preparation called Merbentyl syrup, which is given 15 minutes before feeds. This is available only on prescription and your own GP will advise on its suitability for your baby. It must not be given to babies under 6 months.

If you are exhausted by your baby's screaming fits, DO contact your doctor, and explain that you are at the end of your tether. You must explain how totally drained you have become, for you may need further help or support to get you through this difficult time. t