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Infantile Colic
Colic is defined as recurrent, prolonged, unexplained crying episodes in an otherwise well-appearing infant. It is a diagnosis of exclusion. Colic usually begins within the first three weeks of life, and it affects 10-30% of infants. The problem usually resolves at 3-4 months of age. The peak period of crying is usually the late afternoon or the evening, and it is characterized by a loud, high-pitched and colic, kolic, colick, colicky, callic.
Clinical Evaluation
History and physical examination should exclude acute causes of infant crying, such as infection, trauma or
Treatment of Colic
Breast-feeding should be continued because weaning to formula can result in worsening of
Formula Feeding
Cow's milk protein consists of casein and whey. Whey may prolong crying in a small number of colicky infants, and symptoms of colic may decrease when "elemental" formulas (eg, Nutramigen, Pregestimil), which
Allergy to cow's milk protein is rare and occurs in only 1% of bottle-fed infants who present with prolonged crying, persistent diarrhea, and/or positive fecal occult blood. Changing to a soy formula may be beneficial in a few cases; however, 25% of infants who are allergic to cow's milk protein are
Feeding Techniques
Positioning the infant vertically during feeding may reduce colic because it
Correct bottle and nipple size for the infant's age, curved bottles (that allow the infant to
Burping of the infant should be done in an upright position, and the infant should be
Simethicone ( Mylicon) drops, a nonabsorbed antiflatulent with no systemic side effects, is widely used for the treatment of colic. Studies have
Physical Methods
Application of gentle of pressure to the abdomen often relieves colic. The infant can be laid over the knees or shoulder of the parent or the infant is held on the forearm with the
Carrying the infant may be helpful during colicky spells. Backpacks, front carriers, and
Behavioral Management of Colic
A routine schedule for feeding, holding, playing and general care of the infant should be
Excessive stimulation should be avoided because it may prolong crying. Carrying or
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