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MEDICAL CONDITIONS

• What is colic?
• What can be done to help?
• Can the doctor help?

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 six 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:

What is colic?

The term "colic" refers to the occurrence on a frequent, usually daily, basis of severe crying, apparently associated with stomach pain. The attack usually begins suddenly, often after a feeding. The cry is loud and continuous. The spells last from one to four hours and the baby's face often gets flushed or red. The belly is sometimes distended or prominent; the legs alternate 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 exhausted parents would like a few quiet hours prior to the middle of the night feedings. No such luck!

Some babies seem more prone to colic than others. It is generally felt that if one or both parents had colic, their baby is more at risk. Colic typically begins at about two to three weeks of age; reaches its peak at two months; begins to subside by three months; and is gone by three-and-a-half to four months of age. But the frustrating fact remains that although one in five babies has colic and much research has been done on the topic, there is no one proven cause of colic.

It is certainly known that amongst all colicky babies, there are factors that can make the colic worse:

1. Overfeeding in a futile attempt to lessen the crying.
2. Certain foods, especially those with high sugar content, like undiluted juices, increase the amount of gas in the intestine and worsen the situation.
3. Intestinal allergy , either to certain foods eaten by the breastfeeding mother or the formula taken by the baby directly.
4. The presence of excessive anger, anxiety, fear, or excitement in the household.
5. Probably a multitude of other factors as yet unknown.

What can be done to help?

First of all, remember you are not alone and since this is such a common problem, talk to other mothers. Also keep in mind that colic generally occurs in big, healthy, active, vigorous babies who are great eaters and who grow very well. Sickly, poor- feeding, unhealthy babies or babies with significant underlying problems may well be cranky, miserable, and unhappy. However, these infants tend to be this way most of the time, whereas the baby with colic generally has episodes at a very predictable ("set your clock by the beginning and end") time of the day.

Try to decrease the factors that tend to make colic worse:

1. Do not overfeed! Stick to your baby's regular feeding schedule of timing and amount of milk taken, as measured in ounces in the bottle-fed baby or in minutes on the breast in the breastfed baby.
2. Breastfeeding mothers should avoid milk products ("you don't have to drink milk to make milk"), caffeine, onions, cabbage, beans, broccoli and other gas-producing, irritating foods. Be sure that if your baby is taking juices, that they are very diluted, or just offer plain water. If babies are really thirsty, they will drink it.
3. In the formula-fed baby, try a completely low-allergy formula (e.g., Nutramigen, Alimentum or Pregestamil). It is worth the expense of a week's trial to see if the formula is at all contributing to the colic.
4. When the anxiety, fear, and tension get to be too much (or perhaps an hour before!), try to have someone else watch the baby, even for an hour, and leave the house. Try to keep a positive attitude.
5. Try walking the baby in a front pouch style carrier with his legs drawn up and pressure off of his belly.
6. Many babies are soothed by rhythmic, steady movements (like rocking gently) or sounds (like running the vacuum, or having the clothes drier within earshot).
7. Wrap the baby firmly in a comfortable blanket ("swaddling").
8. The concept of laying the baby on a hot water bottle or heating pad has frequently been suggested, but extreme caution must be used because of the obvious danger of burning an already-screaming baby!

Can the doctor help?

It is critically important to consult the baby's doctor at the very beginning of the suspected colic symptoms. While there are no tests that can be done where the results come back "COLIC," it is very important to exclude several other causes of sudden-onset screaming in a newborn. These conditions include intestinal blockage or obstruction, abdominal infection, a hernia , a scratch of the baby's eye, an ear infection, a bladder infection, and others. Once the baby is given a clean bill of health, an understanding, supportive doctor is worth his weight in gold! The doctor can reassure you that should your colicky baby's symptoms ever suddenly change, that he will reassess the situation and look for unrelated problems that can arise in any baby. The doctor may recommend an over-the-counter anti-gas bubble medicine for the baby (e.g. Mylicon Drops) or even a prescription anti-cramp medicine (e.g. Levsin Drops). These medications are taken orally. And when it seems that there are as many "cures" for colic as there are grandparents, call your baby's doctor. He can help you put the advice you get from all the "experts" into perspective.

And finally, remember that after the three or four months, and the colic, have passed, you will be left with that happy, healthy, eager-eating baby you dreamed of because there are no long-term problems associated with colic. Good luck!

Colic At A Glance

• Colic is an attack of abdominal pain and crying in infant.
• Overfeeding, undiluted juices, food allergies, and emotional stress can aggravate colic.
• It is important for a baby with new abdominal pain and crying to be evaluated by a doctor who can exclude other more serious conditions.

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