Colic

Baby colic
Classification and external resources
Crying newborn
ICD-10	R10.4
ICD-9	789.0
MedlinePlus	000978
eMedicine	ped/434
MeSH	D003085

Baby colic (also known as infant colic, three-month colic, infantile colic and colic) is a condition in which an otherwise healthy baby cries or screams frequently and for extended periods without any discernible reason.

The condition typically appears after the first three weeks after birth and almost invariably disappears, often very suddenly, before the baby is three to four months old. It is more common in bottle-fed babies, but also occurs in breast-fed infants. The crying frequently occurs during a specific period of the day, often in the early evening.

Since the cause is not conclusively established (see below) and the amount of crying differs between babies, there is no general consensus on the definition of "colic". Having ruled out other causes of crying, a common rule of thumb is to consider a baby "colicky" if he or she cries intensely more than three days a week, for more than three hours, for more than three weeks in a month.

Causes

There is no commonly accepted explanation for colic. While no longer universally accepted, traditionally colic was ascribed to abdominal pain resulting from trapped gas in the digestive tract. This theory is not yet discredited, and some recent scientific evidence provides support.

There is evidence that the causes are related to variations in the gut flora. Multiple studies that have shown that colicky babies have variable gut flora, which includes a lack of Lactobacillus acidophilus. Some of these studies suggest the administering of a probiotic, such as Lactobacillus acidophilus or Lactobacillus reuteri, will improve the condition. Probiotics have been shown to improve other conditions associated with colic, such as lactose intolerance, necrotizing enterocolitis and gastric inflammation. In addition to that probiotics have been shown to generally improve the health of children who take them. It is worth noting, probiotics occur naturally in breastmilk and furthermore a breastfed baby and a formula fed baby have very different gut floras.

Some doctors claim that it is a combination of a baby's sensitive temperament, the environment, and its immature nervous system that makes him/her cry easily and without control. Others believe that it originates in problems in the baby's digestive system, specifically because of the buildup of gas which cannot be released. New studies at the Colic Clinic at Brown University demonstrate that nearly half of babies with colic have mild gastroesophageal reflux. Some cases may be the result of lactose intolerance or lactose overload (the latter when accompanied by green stools).

Recent research raises a number of hypotheses including the onset of melatonin production by the pineal gland (which does not begin until 12 weeks of age, about the time colic seems to disappear), circadian rhythms, and smoking and stress of the mother in the third trimester.

Treatment

Role of Chiropractic / New Findings

In the past several years, however, studies have been under taken in Denmark and elsewhere, that have shown remarkably good results from Chiropractic Spinal adjustments, and as little as two treatments have resolved severe cases. In the Danish study, now cioted by the US National Institutes of Health, undertaken by the Southern Danish Medical University, in cooperation with the Danish National Health Service and the Danish Chiropractic Association the various medications used around the world were studied, and the majority were found to NOT be even as good as placebo, where only a few were even found to equal the effects of placebos. Only Chiropractic was determined to have statistically superior effect than placebo, and that consequently became the recommendation of their National Health Service for pediatricians in Denmark. Where doctors are not paid "fee-for-service".

Traditional medical treatment

Historically, and until recently colic was often medically treated with paregoric, a camphorated tincture of opium, but this practice has largely discontinued. There is currently no generally-accepted medical treatment for colic, and the approach taken by medical professionals varies substantially from country to country and indeed from doctor to doctor.

Many babies are soothed by gentle bouncing or rocking, which leads to a parasympathetic response, endorphin production, and therefore calming. Other doctors prescribe simethicone, which treats trapped gas; some parents report that this is effective, but for many others it is not, and research suggests that it is not useful. Some studies have found treatment with probiotics such as Lactobacillus reuteri, intended to reduce gas, is helpful. Due to ignorance of Chiropractic methods, many medical people still convince themselves that the condition is currently untreatable, and is best left to run its course.

There is general agreement that soothing measures, such as pacifiers, listening to white noise and rocking, are often effective in calming the baby during crying periods. Some parents take turns holding the baby upright (which may reduce the pain and crying) to enable the other parent to catch up on sleep. Babies with lactose intolerance or reflux cry harder and longer when left to lie on their backs, but parents are not advised to put babies to sleep on their fronts as it is considered a risk factor for Sudden Infant Death Syndrome, or SIDS.

Effect on the family

Colic can place an enormous strain on parents and other family members. The feeling that they are not providing something their child desperately wants or needs can induce stress, depression, feelings of helplessness, and low self-esteem. If crying is prevalent during nighttime hours then these problems can be aggravated by the resulting sleep deprivation or interruption to sleep patterns; exhaustion may also result. Where people live in dense housing such as apartment blocks, persistent crying can also strain relationships with neighbors and landlords.

The stress on parents is often compounded by well-meaning but misguided people who believe that the parents must be doing something wrong. This attitude is quite common among people who have reared colic-free children themselves. Even those who have had children who suffered from colic, and who found a "cure" (see above), can be reluctant to believe their own suggested approach does not work for somebody else. In some areas, support groups have been set up for parents of children with colic.

References

bg:Детски колики