Colic can be a scary and frustrating ailment for both an infant and their parents. It’s a condition that is multi-faceted, and the causes are not entirely understood. It is important to note that while colic can be worrisome, it’s a common condition that many infants face; it does not last forever and is not harmful. We have some recommendations for non-invasive treatment strategies available that can help your little one if they are experiencing this concern.
SYMPTOMS & DIAGNOSING COLIC
Colic is characterised as inconsolable and persistent crying episodes in an infant who is fed and healthy that can last three or more hours. It affects anywhere from 10 to 20 percent of newborns in the first few weeks of life and is a common pediatric concern. Other key features of the condition include crying episodes without a known cause, crying until the infant’s face is red, abdominal tension, clenched fists, and drawing the legs inward.
Colic is a diagnosis of exclusion, meaning that it’s only diagnosed when other possible conditions and causes for the crying episodes have been definitively ruled out. The diagnostic criteria for colic are known as the rule of three, which includes crying for more than three days per week, for over three hours per day, for more than three weeks. It’s important to understand that colic episodes have a distinct beginning and end and usually include crying that is often described as “screaming” with a level of urgency. Episodes are almost always unprovoked without specific triggers or patterns. It is critical to talk to your healthcare provider about your child’s case before assuming your child’s situation is colic and proceeding with treatment. Your healthcare provider will conduct a thorough physical exam and health history and be able to tell you what mechanism may be at play.
POSSIBLE CAUSES of Colic
Colic still requires more research to determine why it occurs, despite years of research already being conducted in this area. There are several theories as to what may cause the presentation of colic, most having to do with feeding, the gut, and nutrition. Some potential causes for colic include changes in fecal microflora, intolerances such as lactose intolerance, poor latching/feeding, gastrointestinal inflammation, and maternal smoking. Additional contributing factors may be maternal diet while breastfeeding, insufficient burping, under- or overfeeding and gut hypermotility. Some studies have shown that infants with colic have higher levels of gut inflammatory markers, further solidifying the potential connection between colic and the gut.
TREATMENT STRATEGIES FOR COLIC
Parental Reassurance
The first and most important treatment for colic is parental education and reassurance. Parents should be reassured that colic is a self-limiting condition and that it’s harmless to your baby. Counselling parents on what the condition is, the potential causes, and what next steps would be if they wanted to proceed with treatment is the first step to any colic case. If symptoms persist and parents wish to intervene with treatment, strategies will depend on whether the baby is breastfed or bottle-fed.
Allergen Restricted Diet
An allergen-restricted diet may be useful to treat colic in babies who are breastfed. Studies have shown that mothers who introduced a low-allergen diet had less crying time on average than infants whose mothers did not adopt this diet style. The major allergens include:
- Cow’s milk
- Tree nuts
- Wheat
- Soy
- Fish and eggs
Spicy foods and aromatics, such as garlic, can also play a potential role in contributing to colic. It’s important to note that all mothers should work with a healthcare provider to ensure any diet is right for them and to obtain guidance on how to implement one without being restrictive or harming to their own health. If this diet style is adopted, it is usually short-lived, and a normal diet can be resumed after the infant reaches three to six months of age.
Switching Formula
For babies who are formula fed, switching to a different formula may be helpful. Studies have shown that infants who switched to partial, extensive, or hydrolysed formulas had reduced crying time. While a formula switch may be helpful, every baby is different, and this approach may take trial and error. It’s recommended that a formula be tried out for two weeks, and to make the transition easier, it can be mixed with your baby’s original formula incrementally for the first four days of introduction. If the new formula is successful in reducing colic, it doesn’t have to be used permanently, as the original formula can be administered again once the infant reaches the three to six-month range.
Herbs
Some studies have demonstrated that herbs such as peppermint, chamomile, vervain, lemon balm and licorice have decreased crying time. While more research is needed in the area of herbal support for colic, these herbs can be supportive for relaxing the nervous system and relieving gas.
Probiotics
Breastfed babies can benefit from tailored probiotic supplementation in cases of colic. Studies that show benefits have utilised a particular strain known as Lactobacillus reuteri (strain DSM 17938). Supplementing with this probiotic at a dose of five drops per day reduced crying in breastfed infants with colic; however, in bottle-fed babies, it significantly increased fussing and crying, therefore, it’s only recommended that breastfed babies utilise probiotics as a treatment for colic. While the evidence shows bottle-fed infants respond poorly to probiotics, there may be cases where a probiotic is still indicated at the discretion of your healthcare provider.
Physical Therapies
There has been research done on physical supports such as chiropractic support, osteopathic manipulation, massage, and acupuncture. Studies have not shown consistent results, and more research in these areas is required. Out of all the physical therapies, massage has the most consistent evidence of improving symptoms of colic and other gastrointestinal concerns such as bloating and gas, while also being a cost-effective at-home method to try.
Colic is a common condition, and while the cause is still unknown, there are non-invasive and evidence-based approaches that can relieve the struggle and discomfort for your baby. It’s important to note that while colic won’t last forever and is a harmless condition, it is critical you work with a healthcare provider to obtain a definitive diagnosis before implementing treatment strategies. Every case is different, and your child may need additional support in other areas that are not colic-related.
