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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 cry.

Clinical Evaluation

History and physical examination should exclude acute causes of infant crying, such as infection, trauma.

Treatment of Colic

Breast-feeding should be continued because weaning to formula can result in worsening.

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).

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.

Feeding Techniques

Positioning the infant vertically during feeding may reduce colic.

Correct bottle and nipple size for the infant's age, curved bottles.

Burping of the infant should be done in an upright position, and the infant.

Simethicone ( Mylicon) drops, a nonabsorbed antiflatulent with no systemic side effects, is widely used for the treatment of colic.

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.

Carrying the infant may be helpful during colicky spells. Backpacks, front carriers.

Behavioral Management of Colic

A routine schedule for feeding, holding, playing and general care of the infant.

Excessive stimulation should be avoided because it may prolong crying.