Definition

Infantile colic refers to the occurrence of excessive crying or fussing in previously healthy infants without any identifiable cause. Typically, colic is characterised by periodic episodes of acute pain that persist for a longer duration. Colic is typically characterised as prolonged crying lasting for a minimum of three hours per day, occurring on at least three days per week, and persisting for at least one week. Episodes of colic are most prevalent in infants who are 6 weeks old and diminish considerably in infants who are older than 3 to 4 months.

Crying or fussing is extremely common in infants, particularly during the first three months of life; therefore, it is extremely difficult to discern whether or not a baby's crying is typical. This can be a source of anxiety for parents, as the underlying cause of the infant's extreme behaviour is frequently obscure. An infant with colic is extremely challenging to calm. However, colic does not necessarily indicate that the infant has a health issue, as it typically resolves itself.

Causes

Identifying the cause of colic can be challenging due to the multitude of potential factors that can contribute to its occurrence. Possible causes of colic include:

• Pain or discomfort from excessive gas or other digestive tract diseases
• Imbalanced intestinal bacterial growth
• Food allergies or intolerances may develop from either formula milk or the consumption of foods by nursing mothers. Typically, infants with food allergies commonly encounter both colic and diarrhea.
• Excessive food consumption, inadequate food intake, infrequent regurgitation or burping
• Insufficient stimulation
• Newborns are delicate and adapt to life outside their mother's body. Babies are still adjusting to lights, loud sounds, and other new things. Every baby adapts differently. Some babies adapt smoothly; others do not. Babies may cry when responding to stress.

Risk factor

The specific cause of colic in infants remains uncertain. Several potential factors include:

• Preterm infants, characterised by an underdeveloped digestive system in newborns
• Infants who do not breastfeed but instead consume infant formula
• Smoking mothers

Symptoms

Colic is a characteristic crying pattern. Generally, infants are healthy, eat well, and develop normally. Colic in newborns is characterised by screaming or fussing that shows the following:

• The sudden, powerful cry resembles screaming or suffering.
• No apparent reason for crying, such as hunger or nappy change
• Crying is difficult to stop.
• Constant fussing after crying
• Colic episodes frequently occur in the afternoon or evening, causing the infant to experience sleep difficulties. Episodes may, however, occur at any time.
• Redness or pallor, especially around the lips
• The newborn has stiff legs, occasionally bowed to the chest, stiff hands, grasping fingers, an arched back, and a stiff tummy.
• Cry babies swallow a lot of air, making their stomachs bloated. Typically, the infant's fussiness calms following the expulsion of flatulence.

Diagnosis

There is no definitive diagnosis of colic. The doctor will inquire about your infant's medical background, crying patterns, and factors that trigger crying. The doctor will also do a medical examination to confirm the absence of any underlying conditions causing the baby's frequent screaming. If there is an indication of disease, further examinations, such as blood tests and radiography, might be performed.

Management

Activities you may involve at home to calm the baby:

• Maintain the infant in the most comfortable position
• Sit the infant while they feed
• Gently relax the infant, particularly after meals.
• Maintain that diapers are always clean
• Provide the infant with a dummy.
• Cradle the infant tenderly. Avoid strongly shaking the newborn since it might result in severe brain injury, potentially leading to mortality.
• Bathe the baby with warm water
• Softly play some music, turn on the TV, or make any other noise to distract the infant.
• Go for a stroll outside
• Continue feeding the infant normally if they are breastfed. Caffeine and chocolate are not good for mothers. Mothers shouldn't modify their eating habits without a doctor’s recommendation.
• Formula-fed Newborns need smaller quantities and more frequent feedings for 20-minute meals. Try to match the milk temperature to the body temperature.

Anti-colic medications and other probiotic supplements are contraindicated and should be administered solely under the supervision of a doctor. If the infant is still crying after these procedures, call your closest family or friends to help you relax. If you can't calm your baby, put him in the bassinet, close the door, and check every 10 minutes. Take 10 minutes to rest, eat, or relax. Don't blame yourself.

Parental considerations when coping with a colicky infant include the following:

• The colic was not your fault; therefore, there's no need to feel guilty.
• As the baby matures (about 3–4 months), the colic will naturally disappear.
• Infantile colic does not necessarily indicate a health problem. It is a common occurrence. Indeed, a quarter of infants experience colic.

If you experience a tendency to cause harm to your infant, immediately transfer the baby to the bassinet and dial the emergency helpline.

Complications

Typically, colic does not result in any complications or notable medical problems for the infant. Nevertheless, colic can indeed induce considerable distress for parents, resulting in problems such as:

• Postpartum depression is a condition that affects mothers and is characterised by feelings of hopelessness, helplessness, and guilt regarding their inability to provide adequate care for their newborn child.
• Stopping breastfeeding due to maternal stress to prevent the production of breast milk.

Prevention

• Since air ingestion is known to cause cramps, having the baby sit up while eating can lessen the amount of air he or she swallows.
• Encourage the infant to relieve by gently patting the infant's back, which will allow excess gas to pass through.
• Avoid overloading. If the infant is breastfed for a minimum of 20 minutes at a faster rate, consider switching to a bottle featuring a smaller teat hole.
• Avoid foods that may induce allergies or intolerances in infants (consult a pediatrician first).

When to see a doctor?

Excessive, uncontrollable crying may indicate colic or another condition that induces nausea or distress in the infant. If your baby has signs of colic, you should have him examined by a medical professional to conduct a comprehensive evaluation. You are advised to seek emergency treatment if your infant:

• Fever (38°C)
• Relatively inactive
• Poor nutrition
• Reduced breastfeeding desire
• Blood in feces or diarrhoea
• Vomiting
• Failure to gain weight
• Weight loss

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