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Infantile colic

Also listed as: Colic - infantile

• Signs and Symptoms
• What Causes It?
• What to Expect at Your Provider's Office
• Treatment Options
• Following Up
• Special Considerations
• Supporting Research

Colicky babies cry constantly and hard at about the same time each day at least 3 days a week. About one in five babies develops colic. It is more common in boys and in firstborn children. It usually begins at about 2 weeks of age and goes away by the fourth month.

Signs and Symptoms

• Your baby cries for more than 3 hours on at least three occasions a week, but is otherwise healthy.
• Your baby kicks a lot, pulls his or her legs up close, and makes tight fists.
• Your baby's tummy seems hard, and they burp and pass gas often.
• The crying sounds like your baby is in great pain.
• Your baby spits up frequently after feeding.

What Causes It?

Abdominal discomfort appears to be present, but one knows what actually causes colic. Possible causes include one or more of the following.

• The baby's nervous or digestive system may be immature
• The baby needs comforting, or is over- or under-stimulated
• Swallowing air, especially when feeding
• Reaction to something in the mother's diet (if the baby is breast-fed)
• Allergies to some foods, such as milk (if the baby is on formula)

What to Expect at Your Provider's Office

Your health care provider will ask if the baby is eating well and gaining weight or has diarrhea, fever, or unusual stools. If you are breast-feeding, your health care provider may ask you about foods you have eaten. If your health care provider decides your baby has colic, you can work together to find ways to relieve your baby's discomfort.

Your provider will also encourage you to take care of yourself, like taking a break or getting help if you are afraid you will harm your baby. Remember that colic usually disappears between 4 - 6 months of age. If the treatments you choose do not work, your baby's provider may check for other problems, such as a digestive problem or allergy.

Treatment Options

• If breast-feeding, nurse on demand, usually every 2 - 3 hours. Avoid caffeine, dairy products, citrus fruits, soy products, and spicy foods. Elevate the infant's head during and after feedings.
• If bottle-feeding, ask your health care provider to recommend a formula that is not based on cow's milk and that is not iron-fortified. Keep the baby in a sitting position when feeding, and massage his or her back to get rid of gas bubbles. Burp after every ounce of formula.
• Do not offer your baby solid foods before age 6 months.
• Try the "colic carry" -- Place the baby, chest down, on your extended forearm with his head supported by your hand and his legs on either side of your elbow. Use your other hand to provide additional support and walk around with him.
• Hold your baby close, offer a pacifier, try rocking or rubbing the back, give your baby a warm bath, take a car ride with the baby, play soft music, or use an infant swing to ease the crying.

Drug Therapies

No drugs are currently recommended, although simethicone, an over-the-counter gas remedy, may be helpful.

Complementary and Alternative Therapies

Eliminating gas-producing foods and using supportive herbal or homeopathic therapies may help reduce or eliminate infantile colic. Colic may be caused by a hidden food allergy and may require switching formula or food. A qualified natural health care provider can help you find nutritious hypo-allergenic foods for your child. If breast feeding, eliminating gas-producing and potentially allergic foods from the mother’s diet may help. In addition, playing soft music, rocking the infant, or using "white noise" (for example, a dryer or even a vacuum cleaner) may be helpful in soothing the infant. Reducing stimuli and placing the infant in a dim, quiet room may help calm the baby.

Nutrition and Supplements

Acidophilus (especially Bifidus spp. ) can be given to both a breast-feeding mother and infant who takes a bottle, whether of breast milk or formula. Use 1 capsule with meals three times per day for adults. Use one capsule per day for infants (break capsule open and add to bottle in divided doses throughout the day). Use acidophilus formulas specifically formulated for infants, such as Baby Jarrow-Dophilus by Jarrow.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Because of the alcohol content, do not give tinctures to infants unless directed by your health care provider. Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 to 4 cups per day.

A tea made from fennel seed (Foeniculum vulgare) may be given directly to the infant (1 tsp. before and after feedings) or drunk by the breast-feeding mother (1 cup three to six times per day). Fennel acts as a gastrointestinal relaxant and helps expel gas.

Teas and liquids made with the following herbs may also help:

• Chamomile ( Matricaria recutita ), vervain (V erbena officinalis ), fennel ( Foeniculum vulgare ), and lemon balm (Melissa officinalis). Give about 1/2 cup of tea up to three times per day.
• Caraway ( Carum carvi) helps reduce intestinal cramping. Combine 1 teaspoon caraway seed with 8 ounces boiled water and steep for 10 minutes. Add 3 ounces of vegetable glycerin. Strain and give 1/2 teaspoon 15 minutes before feeding.
• Other herbs that may help reduce calm the baby or reduce gas include linden (Tilia cordata), catnip (Nepeta cataria), peppermint (Mentha piperita), and dill ( Anethum graveolens ). They can be combined with the teas above.
• Slippery elm bark ( Ulmus fulva ) helps soothe the digestive system and can be used as a tea, or the powdered bark can be combined with water and made into a meal of slippery elm “gruel," similar in consistency to instant oatmeal. Check with your pediatrician first before using slippery elm gruel in your child’s diet.

Homeopathy

There have been few studies examining the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for infantile colic based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

Viburcol, a proprietary homeopathic medicine often used in Europe, can be very effective for acute colic. It contains Chamomilla, Belladonna, Dulcamara, Plantago major, Pulsatilla, and Calcium carbonicum Hahnemanni.

• Aethusa -- for infants who cannot digest milk, who vomit, and have diarrhea.
• Belladonna -- for colic with spasms that come and go quickly. The abdomen may feel warm to the touch and symptoms may coincide with constipation;. Bending forward may relieve pain.
• Bryonia -- for pain worsened by movement and pressure. This remedy is most appropriate for irritable infants who lie still with knees drawn up.
• Carbo vegetabilis -- for colic with a distended abdomen and burping or belching. The face may be pale, and hands and feet feel cold.
• Chamomilla -- for excessively irritable and screaming infants who are relieved by constant holding and rocking. Infants for whom this remedy is appropriate are often teething and have green, foul-smelling diarrhea.
• Colocynthis -- for restless, irritable infants whose symptoms of colic are relieved by firm pressure. In these infants, diarrhea and pain may occur after eating fruit. Infant tends to bring knees up to abdomen.
• Lycopodium -- for infants who can not stand pressure on the abdomen (even diapers must be worn loosely). Symptoms tend to worsen between 4 and 8 PM and then again after midnight.
• Magnesia phos -- for infants whose symptoms of colic are relieved with gentle pressure or warmth applied to the abdomen, or while they are bent over. Belching does not relieve pain.
• Natrum phos -- for colic with no other distinguishing symptoms.
• Nux vomica -- for colic which occurs when breastfeeding mother eats rich food, drinks alcohol, or coffee. The infant may arch its back and appear angry.
• Pulsatilla -- for infants with bloated abdomens after eating, and constipation alternating with diarrhea. May be aggravated by warm rooms, heat, or if the diet of the breastfeeding mother includes fruits, fats, pastries, or ice cream. Relieved by rocking.

Chiropractic

Chiropractors frequently treat infantile colic with a form of gentle spinal manipulation specially modified for infants. The duration of treatment is generally brief, consisting of three to four visits over a period of 2 weeks. Studies examining the effectiveness of chiropractic for infantile colic have produced mixed results, however.

Physical Medicine

Warm baths may help relax and soothe colicky infants. Add 3 - 4 drops of essential oil of lavender or lemon balm to enhance the benefit.

Gently pinching or squeezing the acupressure point between the baby's thumb and finger (on the webbing) may help to calm a fussy child.

Massage

Clockwise abdominal massage may help relieve spasm and expel gas. Use 3 - 5 drops of tincture of catnip in 1 - 2 tsp. of almond or olive oil to enhance effectiveness. Apply warmth.

Following Up

Use whatever works, and remember that your baby will outgrow the colic in a few weeks or months. Keep in mind, however, that colicky babies often grow up to have other allergy-related health problems, such as ear infections, asthma, and digestive problems.

Special Considerations

Never shake your baby. This can cause serious or fatal brain damage. If you are feeling overwhelmed, try the following steps:

• Have someone else watch your baby while you get away for a while.
• Join a support group.
• Call your baby's health care provider.

Supporting Research

Alexandrovich I, Rakovitskaya O, Kolmo E, et al. The effect of fennel (Foeniculum vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med. 2003;9:58-61.

Ayllon T. Stopping Baby's Colic. New York, NY: Putnam; 1989.

Boericke W. Materia Medica. 9th ed. Santa Rosa, Calif: Boericke and Tafel; 1927:151.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3 ^rd ed. New York, NY: Penguin Putnam; 1997: 96-97.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 155-156.

Kemper KJ. The Holistic Pediatrician. New York, NY: HarperPerennial; 1996.

Klougart N, Nilsson N, Jacobsen J. Infantile colic treated by chiropractors: a prospective study of 316 cases. J Manipulative Physiol Ther . 1989;12(4):281-288.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:126-128.

Olafsdottir E, Forshei S, Fluge G, Markestad T. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child . 2001;84:138-141.

Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officialis (ColiMil) in the treatment of breast-fed colicky infants. Phytother Res . 2005;19:335-40.

Schiff D, Shelov P, eds. American Academy of Pediatrics: The Official, Complete Home Reference Guide to Your Child's Symptoms, Birth Through Adolescence. New York, NY: Villard Books; 1997.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 60-62.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 171-172.

Wiberg JMM, Nordsteen J, Nilsson N. The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physiol Ther . 1999;22(8):517-522.

Wilen J, Wilen L. Folk Remedies That Work. New York, NY: HarperPerennial; 1996.

• Review Date: 9/1/2006
• Reviewed By: Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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