The first bout of colic usually occurs within a few weeks of birth and episodes can continue until around three to four months of age. It can be very distressing and difficult for parents to cope with.
To be classed as colic, an infant must display all of the following symptoms from birth to four months of age:
Symptoms can also include a red, flushed face and babies may clench their fists, draw their knees up towards their chest or arch their back.
The exact cause is unknown, but there are a number of theories:
The first bout of colic usually occurs within a few weeks of birth and episodes can continue until around three to four months of age
Parents need reassurance that colic will resolve itself. If the symptoms are not caused by an allergy, a healthcare professional may recommend a special infant formula milk to manage colic (such as Aptamil Comfort or Cow & Gate Comfort). These products:
To help ease colic, parents can try the following:
Treatment is only necessary if parents are struggling to cope and if the baby is not feeding or not gaining weight. Treatments that may help breast and bottle-fed babies include:
N.B. If a baby has severe colic that has not responded to first line treatment, it may be due to a cows’ milk allergy. In this case, an extensively hydrolysed formula, (e.g. Aptamil Pepti 1), may be recommended by a healthcare professional. Symptoms of diarrhoea, vomiting and a fever of 38ºC or above (if under three months of age) or 39ºC or above (if aged three to six months) are not associated with colic, and in this case, further investigation would be needed.
Colic should be suspected in any baby from birth to around three to four months of age who cries excessively and inconsolably in the late afternoon or evening. Symptoms typically include simultaneously clenching the fists, arching the back or drawing the knees up to the abdomen, and a red flushed face.
Differential diagnoses include:
According to the National Institute for Health and Care Excellence (NICE) guidance on postnatal care, there is little that can be done. The most useful intervention is support and reassurance for parents that colic will resolve. Soothing strategies should be tried first, such as holding the baby during the episodes, bathing, rocking or pushing in a pram, and using white noise as a distraction. Parents should be reassured that colic rarely continues beyond three or four months of age, and encouraged to look after their own wellbeing by asking friends and family for support.
Nutritional solutions for formula-fed infants include partially hydrolysed formula with reduced lactose content and a thicker consistency.
Treatments are only recommended if parents are struggling to cope despite trying the above. A one week trial of simeticone or lactase drops can be tried, but only continued if the baby seems to respond. If the treatment does seem effective, it should be stopped by the age of six months at the latest.
Over-the-counter antimuscarinic dicycloverine is not licensed for those 12 years and younger, and should be used with caution as it can cause side effects such as breathing difficulties and coma.