Colic

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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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The wonderful day you have always dreamed of has arrived! Your beautiful, healthy baby has come home. Grandmother comes over for a first visit and feels compelled to tell you, in dreadful detail, about the horrible colic that the baby's father had as an infant. The terror on her face raises your already high anxiety. You recall seeing several articles in Working Mother magazine on colic and wish you had read up on the topic. And sure enough, at 6 p.m. on the dot, your little angel launches into a three-and-a-half-hour episode of uncontrollable screaming. Grandmother has long ago left with a knowing smile on her face, and you are left with this burning question...

Infantile colic has been around for a long time. In 1954, Dr. Morris Wessel, a well-known New Haven pediatrician, defined an infant with colic as "one who, otherwise healthy and well-fed, had paroxysms of irritability, fussing, or crying lasting for a total of three hours a day and occurring on more than three days in any one week for a period of three weeks." It is also important to remember that not all fussy babies suffer from colic. Most infants normally cry two to three hours per day, but this is usually spread out during the 24-hour period.

The crying or fussing most frequently begins suddenly and often after a feeding. The cry is loud and continuous, and the spells last from one to four hours. The baby's face often gets flushed or red. The belly is sometimes distended or prominent, the legs alternating between flexed and extended straight out; the feet are often cold and the hands clenched. The episodes, while they can occur at any time of the day or night, typically begin in the late afternoon or early evening, just when parents or caregivers are most exhausted. There are some babies who are more prone to infantile colic than others. It is generally believed that if one or both parents were colicky, their baby is more at risk. Infantile colic typically begins at about 2 to 3 weeks of age, reaches its peak at 2 months, begins to subside by 3 months, and is gone by 3 ½ to 4 months of age. But the frustrating fact remains that although one in four babies has colic and much research has been done on the topic, there is no one proven cause of colic. In some studies, no discernable cause was found for one-quarter of those babies who suffered from colicky episodes. This is very frustrating for most parents.

It is certainly known that amongst all colicky babies, there are factors that may worsen the colic symptoms:

1. overfeeding in a futile attempt to lessen the crying;



2. feeding certain foods, especially those with high sugar content, for example, undiluted juices may increase the amount of gas in the intestine and worsen the situation;



3. the presence of excessive anger, anxiety, fear, or excitement in the household;



4. probably a multitude of other factors as yet unknown.