Prescriptions
Infants usually outgrow colic problem
By Landis Lum
Excessive crying is one of the most common and exasperating of problems in a baby's early life. Crying that lasts at least three hours a day at least three days a week for at least three weeks in an otherwise healthy infant is known as "infantile colic," and may be due to an immature digestive system. This condition usually starts at the age of 2 to 3 weeks and disappears by 3 to 4 months. It leads one in six families to consult a health professional.
Colic is most common in the evening. A usually calm infant may scream, draw his knees up to his abdomen, and may pass flatus or feces, at which point the pain is often relieved. An episode can last 30 minutes to 2 hours.
A recent scientific review revealed no treatments to be consistently effective; however, two rather simple procedures do appear to offer some benefit: reduced stimulation and herbal tea!
The reduced stimulation study was inspired by the observation that babies with troublesome crying improve quickly in the hospital. Histories from parents of such babies suggested that much work went into trying to console the children. Perhaps this really did the opposite, leading to excessive stimulation, and perhaps the improvement seen in hospital reflected a reduction in stimulation. Thus, in this 1991 study in the Archives of Disease in Childhood, mothers were advised to reduce stimulation by not patting, lifting, jiggling or providing auditory stimulation to their crying infants. For infants under 12 weeks of age, this reduced crying more than the control group.
There is also limited evidence from one randomized study that herbal tea reduces colic. This study published in the Journal of Pediatrics in 1993 compared a tea containing extracts of chamomile, vervain, licorice, fennel and balm mint in a sucrose solution with a control group of infants given a sucrose solution alone. Parents gave these drinks up to three times daily in response to episodes of colic. At seven days, the herbal tea had eliminated colic in more infants (19 of 33) than did the sucrose solution (9 of 35 infants). However, this study did not address the purity or safety of using herbal teas. For instance, in the January 2001 issue of the journal Nephron, an herbal tea preparation was found to lead to dangerously low blood potassium levels. Additionally, teas from comfrey leaves have been shown to cause liver damage in humans and cancers in rodents. Comfrey has been banned in Germany and Canada, but not in the United States.
For persistent crying, picking babies up and carrying them around or holding and rocking them will usually quiet them. A study of 27 infants found that car ride stimulation for up to one hour did not reduce crying. However, other things you can try are holding an infant close to the body in a front pack, using soothing words, and adequate burping, with avoidance of over- or underfeeding. Holding the baby upright or permitting the baby to lie prone across the lap or on a hot water bottle or heating pad sometimes helps. Allowing the infant to cry is OK and an acceptable option if the above have failed and you have determined that hunger or illness is not present. Since a screaming child can be a major stress, parents should be encouraged to spend some time by themselves away from the baby if at all possible.
The drug Bentyl (dicyclomine) reduces colic, but can also cause adverse effects such as drowsiness, loose stools and constipation; there are case reports of breathing problems, seizures and coma. One systematic review found no evidence that simethicone (Mylicon, Phazyme, and others) reduces colic. Finally, there is not enough data that using soya milk, hypoallergenic milk (casein hydrolysate formula), or low lactose milk in place of cow's milk reduces colic.
Infantile colic can be very frustrating, but the fact that it disappears in the vast majority of infants by 4 months of age and that it does not harm the baby may help parents cope.
Dr. Landis Lum is a family practice physician with Kaiser Permanente, and an associate clinical professor of family and community medicine at the University of Hawai'i's medical school.
Hawai'i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send questions to: Prescriptions, 'Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.
