What is infant colic and how to treat it?

Infant colic is one of the most common concerns among parents of newborn babies. It is characterized by episodes of inconsolable crying without an apparent cause and usually appears in the first weeks of life. Below, we explain what it is, its symptoms, diagnosis, ways of prevention and treatment, as well as when it is necessary to visit the pediatrician.

What is infant colic

Infant colic is a benign disorder that affects healthy babies during the first months of life. It is defined by episodes of excessive, inconsolable crying lasting more than three hours a day, at least three days a week, for at least three weeks. Although it does not represent a serious health problem, it can generate stress in parents and caregivers.

The exact causes of infant colic are not completely clear, but it is believed that they may be related to the immaturity of the digestive system, the intestinal microbiota, food intolerances or even emotional and environmental factors.

Symptoms of infant colic

The most characteristic symptoms of infant colic include:

• Episodes of intense, inconsolable crying, mainly in the afternoon or evening.

• Reddened face and expression of pain.

• Leg movements to the abdomen.

• Tense or distended abdomen.

• Difficulty in calming the baby with usual methods.

These episodes may begin in the second or third week of life and disappear spontaneously around three to four months of age.

How it is diagnosed

The diagnosis of infant colic is based on observation of symptoms and application of the 2016 Rome IV diagnostic criteria: crying for more than three hours a day, at least three days a week and for one week. The pediatrician may also perform a physical examination to rule out other possible causes of crying, such as infections, gastroesophageal reflux or food intolerances.

In most cases, further testing is not necessary unless other underlying conditions are suspected.

How to avoid infant colic

While there is no sure way to prevent infant colic, some strategies can help reduce its frequency and intensity:

• Avoid overfeeding: Offer frequent feedings and adequate amounts to avoid gas buildup.

• Encourage a calm environment: Reduce noise, bright lights and stressful situations at home.

• Correct feeding position: Keep the baby in a semi-vertical position to minimize air ingestion.

• Encourage expulsion of gas: Take breaks during breast or bottle feeding to burp the baby.

Adaptation of breastfeeding and probiotics may contribute to symptom improvement in some infants.

Treatment

Treatment of infant colic is focused on relieving symptoms and improving the well-being of the infant and family. Some recommended strategies include:

• Calming techniques: holding the baby, using rhythmic movements, swaddling the baby in a blanket, or playing white sounds.

• Abdominal massage: Gently massage the belly in a circular motion.

• Carrying: Carrying the baby in an ergonomic baby carrier helps reduce crying, facilitates digestion by keeping the baby in an upright position and strengthens bonding.

• Skin-to-skin: Direct contact with the parent's body regulates the baby's temperature, heart rate and reduces stress, which helps calm colic.

When to see a pediatrician for infant colic

Although infant colic is not a serious problem, it is important to see your pediatrician if:

• The crying becomes uncontrollable and lasts longer than usual.

• The baby has a fever, persistent vomiting or diarrhea.

• There is weight loss or lack of appetite.

• Signs of food allergy or intolerance, such as skin rash or blood in the stool, are observed.

A proper diagnosis will help rule out other conditions and guide parents on the best strategies to manage the situation.

Infant colic is a difficult but temporary stage. With patience, support and some appropriate strategies, the baby's discomfort can be reduced and the quality of life of the whole family can be improved.

Reviewed by Mª Ángeles Martín