Infantile colic

This is the occurrence in a well baby of regular, unexplained periods of inconsolable crying and fretfulness, usually in the late afternoon and evening, especially between 2 weeks and 16 weeks of age. No cause for the abdominal pain can be found and it lasts for a period of at least 3 weeks. It is very common and occurs in about one-third of infants.

Typical features

• baby between 2 and 16 weeks old

• prolonged crying—at least 3 hours

• crying worst at around 10 weeks of age

• crying during late afternoon and early evening

• occurrence at least 3 days a week

• child flexing legs and clenching fists because of the 'stomach ache'

• normal physical examination

Management

Reassurance and explanation to the parents. Advice for the parents:

• Use gentleness (such as subdued lighting where the baby is handled, soft music, speaking softly, quiet feeding times).

• Avoid quick movements that may startle the baby.

• Make sure the baby is not hungry—underfeeding can make the baby hungry.

• If the baby is breast-fed, express the watery foremilk before putting the baby to the breast.

• Provide demand feeding (in time and amount).

• Make sure the baby is burped, and give posture feeding.

• Provide comfort from a dummy or pacifier.

• Provide plenty of gentle physical contact.

• Cuddle and carry the baby around (e.g. take a walk around the block).

• A carrying device such as 'snuggly' or 'Meh Tai Sling' allows the baby to be carried around at the time of crying.

• Make sure the mother gets plenty of rest during this difficult period.

• Do not worry about leaving a crying child for 10 minutes or so after 15 minutes of trying consolation.

Medication

Drugs are not generally recommended, but for very severe problems some preparations can be very helpful, e.g. simethicone preparations.

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