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Home > Help Desk > Health Concern > Health Concern C > Abdominal Pain (Infants)
Abdominal Pain (Infants)
Colic is a common problem in infants, where the baby is healthy but has periods of inconsolable crying, apparently caused by abdominal pain. Colic usually develops within a few weeks of birth and disappears by the baby’s fourth month.
What are the symptoms of colic?
Colic may cause infants, typically less than four months old, to cry inconsolably. The attacks usually occur in the late afternoon and evening, sometimes lasting for hours. During a colicky period, babies may bring their knees up, clench their fists, grimace, hold their breath, and generally be more active.
How is it treated?
The conventional treatment is to provide comfort for the babies until they outgrow this difficult period. Sometimes, anti-gas medicine containing simethicone (e.g., Di-Gel®, Mylicon®, Phazyme®) helps to reduce symptoms. Feeding babies while they are sitting up or burping them more frequently may help prevent colic if too much air is being swallowed during feedings.
Dietary changes that may be helpful:
Allergies may be responsible for colic in some infants. If the child is fed with formula, the problem may be an intolerance to milk proteins from a cows’ milk-based formula. Switching to a soy formula may ease colic in such cases. Infants who are sensitive to both milk and soy may be given a hypoallergenic formula containing extensively hydrolyzed proteins. However, some children are sensitive even to these formulas.
A true food protein intolerance in infants may result in persistent distress attributed to irritation of the esophagus caused by reflux (partial spitting up). These infants may respond to an amino acid-based formula. In a clinical trial, infants who were intolerant of soy and extensively hydrolyzed formula, and who had failed to respond to various formula changes, were switched to an amino-acid formula (Neocate). After two weeks, all the infants receiving the amino acid-based formula showed less distressed behavior and fewer symptoms of reflux.
If a baby is breast-fed, certain foods in the mother’s diet may provoke an allergic reaction in the baby. Cows’ milk consumed by a breast-feeding mother has been shown in some, but not all, studies to trigger colic. Cows’ milk proteins, which may trigger allergic reactions, have been found at higher levels in milk from breast-feeding mothers with colicky infants than in milk from mothers with non-colicky infants. Changing to a low-allergenic formula or restricting the mother’s diet to exclude certain allergy-triggering foods significantly reduced colic symptoms in the infants in one double-blind trial. A healthcare provider can help determine which foods eaten by breast-feeding mothers may be contributing to colic.
Lifestyle changes that may be helpful:
All infants, particularly those with colic, need to be fed on demand and not by a specific clock schedule. Often a baby’s cry is triggered by discomfort caused by low blood sugar. Unlike adults, infants do not have a carefully regulated ability to maintain healthy blood sugar levels in the absence of food. This physiological shortcoming of infants can be solved only by feeding on demand.
In one trial, parents were taught not to let babies cry unnecessarily but rather to attempt feeding right away in response to the infant’s cry. If that failed, parents were taught to try to respond to the cry in other ways, such as holding the infant or providing the opportunity to sleep. These parents were also given the solid medical advice that overfeeding is never caused by feeding on demand nor will the baby be “spoiled” by such an approach. As a result of this intervention, colic was dramatically (and statistically significantly) reduced, compared with a group of mothers given different instructions.
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