Colic

Infant colic (also known as baby colic and three month colic) is a condition in which an otherwise healthy baby cries or screams frequently and for extended periods, without any discernible reason.

The condition typically appears within the first few months of life and almost invariably disappears, often very suddenly, before the baby is eight months old. It is more common in bottle-fed babies, but also occurs in breast-fed infants. The crying frequently occurs during a specific period of the day, often in the early evening.

Since the cause is not conclusively established (see below) and the amount of crying differs between babies, there is no general consensus on the definition of "colic". Having ruled out other causes of crying, a common rule of thumb is to consider a baby "colicky" if it cries intensely more than three days a week, for more than three hours, for more than three weeks in a month.

Causes
There is no commonly accepted explanation for colic.

Traditionally, colic was ascribed to abdominal pain resulting from trapped gas in the digestive tract. This theory is not yet discredited, and some recent scientific evidence seems to support it, yet it is no longer universally accepted as the general cause.

Some doctors claim that it is a combination of a baby's sensitive temperament, the environment, and its immature nervous system which makes it cry easily and without control. Others believe that it originates in problems in the baby's digestive system, specifically because of the buildup of gas which cannot be released. New studies at the Colic Clinic at Brown University demonstrate that nearly half of babies with colic have mild gastroesophageal reflux. Some cases may be the result of lactose intolerance.

Recent research raises a number of hypotheses including the onset of melatonin production by the pineal gland (which does not begin until 12 weeks of age, about the time colic seems to disappear), circadian rhythms, and smoking and stress of the mother in the third trimester.

Treatment
There is currently no generally-accepted medical treatment for colic, and the approach taken by medical professionals varies substantially from country to country and indeed from doctor to doctor. Many believe that the condition is currently untreatable, and is best left to run its course. Other doctors prescribe simethicone, which treats trapped gas; some parents report that this is effective, but for many others it is not.

One study showed a moderate success when infants with colic were treated with dicyclomine, an anti-spasmotic drug commonly found in some anti-diarrheal medications. However, further studies are warranted before its use can be approved.

Colic can be caused by allergies in the mother and/or baby. If breastfeeding, the mother's diet can be restricted: some mothers omit dairy, egg, soy, and processed foods (including spices and caffeine) from their diet, drink only water and increase their intake of other foods and supplements for missing nutrients such as calcium. This will not necessarily “cure” colic, which seems to cure itself after a period of time, but it may reduce the symptoms.

There is general agreement that soothing measures, such as pacifiers and rocking, are often effective in calming the baby during crying periods. Some parents take turns holding the baby upright (which may reduce the pain and crying) to enable the other parent to catch up on sleep. Babies with lactose intolerance or reflux cry harder and longer when left to lie on their backs, but parents are not advised to put the baby to sleep on their front as it increases the likelihood of Sudden Infant Death Syndrome.

Various tactics, such as changes in diet or routine, an increase in fresh air or certain herbal teas, are popularly believed to cure colic. While some of these may help in certain cases, none of them is known to be universally effective. The widespread belief in them may be partly due to the suddenness with which colic naturally resolves itself. Many parents keep trying different approaches until the colic suddenly stops, at which point they presume that the last thing they tried was the cure.

Effect on the Family
Colic can place an enormous strain on parents and other family members. The feeling that they are not providing something their child desperately wants or needs can induce stress, depression, feelings of helplessness and low self-esteem. If crying is prevalent during nighttime hours then these problems can be aggravated by the resulting sleep deprivation or interruption to sleep patterns; exhaustion may also result. Where people live in dense housing such as apartment blocks, persistent crying can also strain relationships with neighbours and landlords.

The stress on parents is often compounded by well-meaning but misguided people who believe that the parents must be doing something wrong. This attitude is quite common among the childless, and also occurs in people who have raised colic-free children themselves. Even those who have had children who suffered from colic, and who found a "cure" (see above), can be reluctant to believe their own suggested approach does not work for somebody else.

In some areas, support groups have been set up for parents of children with colic.