Clinical Cases

Infantile Colic in a One-Month-Old Baby Boy

Drs. Aarti. K. Alwani and Sonali. P. Chauhan share a case of infantile colic in a one month old baby. Sensitive to pain and better being carried were among the symptoms leading to the simillimum.

Abstract :

Infantile colic is a condition where an infant otherwise healthy and well fed, cries excessively, frequently for a prolonged duration and is difficult to console by their parents and surroundings. Such a case of a one month old baby came for a homoeopathic treatment and was given a significant relief with a single dose of remedy prescribed on the basis of observed symptoms. Therefore, observation plays an important role in paediatric cases since they are unable to describe their sufferings. Moreover, a correct remedy with a correct posology can bring marvelous results in such cases.

Key Words : Paediatric cases; infantile colic; observational symptoms; posology.

 Case :

A one-month-old baby boy was brought to the OPD on 04.01.2023 for the complaint of crying, moaning, straining and stretching of body during and after feeding at night. All his complaints started after change in milk from packet to formula milk. He cries inconsolably until he is carried and carrying him gave relief for some time.

Case Analysis :

LOCATION SENSATION MODALITY CONCOMITTANT
GIT

Whole abdomen

Colon

Since 10-12days

<Since 1 week

O: Gradual

D: 10-15mins

P: Increasing

I: Moderate

F: 3-4 Episodes

Crying+2

Moaning+2

Stretching and straining+2

Sleep disturbed

Hardness+2

No vomiting

No loose watery stool

No blood in the stool

No fever

No soiling of clothes

A/F : Change of milk+2  (formula feed)

< Feeding after+2

 

< Night+2

> Carrying the baby+2

Not > By burping

 Past History : Nil

Family History : Nil

Medicine History : Colirich Drops; Mextra Drops; Kofarest-PD Drops; Iron, Calcium And Vit D3 Drops

 General Examination :

Weight : 3.27kgs

Temperature : 98 deg F

Heart Rate : 142/min

Respiratory rate : 55/min

Fontanalles : Not Depressed

Skin Turgor : Normal, Well Hydrated

Systemic Examination :

R.S. : AEBE

CVS : S1S2 Normal

CNS : Awake, Playful

Per Abdomen : Soft, Non Tender, No Obvious Distention, No Visible Peristalsis

Investigations :

  • Stool Routine : To rule out milk protein allergy, infection by bacteria, malabsorption of fats, bleeding inside the GIT.
  • X-Ray Abdomen : To rule out dilatation of stomach and colon

Differential Diagnosis :

INFANTILE COLIC / EVENING COLIC /

3 MONTHS COLIC

PYLORIC STENOSIS GASTRIC VOLVULUS
Reference:

The Normal Child – Ronald S. Illingworth

Reference:

Nelson Textbook Of Paediatrics : Volume 2

Reference:

Nelson Textbook Of Paediatrics : Volume 2

•  Pain confined in the evening.

•  No other general cause.

•  Attacks are rhythmical.

•  Loud Borborygmi.

•  Continuous for 2-20mins.

•  Picking him up doesn’t relieve his c/o.

•  Attacks end suddenly but sobbing remains for several minutes.

•  The hall mark of Pyloric stenosis is :

àNon bilious vomiting

àAbdominal pain

àNausea

•  Signs include :

àAbdominal distension

àBleeding from secondary inflammation of the gastric mucosa

•  Diagnosis by palpating pyloric mass which is firm, movable, olive in shape.

•  Triad of :

àSudden onset of severe epigastric pain

àIntractable retching with emesis

àInability to pass a tube into the stomach.

•  Clinical symptoms – non bilious vomiting in infancy.

•  Plain x-ray show dilated stomach.

Final Diagnosis :

Infantile Colic / Evening Colic / 3 Months Colic because there is crying after change of milk, moaning with straining and stretching at night; and after feed.

Hahnemannian Classification of Disease : Dynamic Acute Individual Disease

 Classification Of Symptoms :

  1. A/F: Change of Milk+2 à Characteristic Causative Modality
  2. Moaning <Feeding After+2 à Characteristic Mental Emotion with Characteristic Aggravating Modality
  3. Crying >Carrying the Baby+2 à Characteristic Mental Emotion with Characteristic Aggravating Modality
  4. Straining of Body <Feeding After+2 à Characteristic Physical General with Characteristic Aggravating Modality
  5. Stretching Of Body <Feeding After+2 à Characteristic Physical General with Characteristic Aggravating Modality
  6. Sleep Disturbed <Night+2 à Common Physical General with Characteristic Aggravating Modality
  7. Abdomen Hardness <Feeding After+2 à Characteristic Physical Particular Examination Finding

Acute Totality With Evaluation Of Symptoms :

  1. A/F: Change of Milk+2
  2. Moaning < Feeding After+2
  3. Crying > Carrying The Baby+2
  4. Straining of Body < Feeding After+2
  5. Stretching of Body < Feeding After+2
  6. Abdomen Hard < Feeding After+2

Repertorial Approach :

Kentian Approach because there are qualified mental symptoms, especially those of the P-Q-R-S type.

Repertorial Totality (Reference: Repertory Of Hom. M.M By J.T. Kent) :

Sr. No. Symptoms Rubrics Remedies Book Page No.
1 Crying >Carrying The Baby Mind- Weeping- Carried When – Is Quite Only When Carried Chamomilla+3, Cina+2 Kent 93
2 Moaning <Feeding After Mind- Moaning- Sleep During Aur+3, Ars+2, Cham+2, Lyco+2, Podo+2, Puls+3 Kent 67
3 Stretching <Feeding After Generalities- Stretching Ars+3, Bel+3, Cham+3,  Puls+3 Kent 1403

Remedy Differentiation :

REFERENCE: LECTURES ON HOMOEOPATHIC MATERIAL MEDICA- J.T. KENT
CHAMOMILLA CINA
•      Sensitiveness of mind; Sensitiveness to pain

•      Great irritability; Crying, “piteous moaning, irritable”.

•      The pains seem to be better when the child is carried, so the child wants to be carried all the time.

•      Patient is aggravated by being handled yet he wants to be carried.

•      At first on taking him out of the crib he screams when taken hold of; the first touch aggravates.

•      The child smells sour.

REFERENCE: PAEDIATRICS IN HOMOEOPATHIC – AN APPROACH
PULSATILLA LYCOPODIUM
•      Mild child

•      Piteous cry

•      Making people around feel concerned.

•      Better in open air

•      Basically cranky child.

•      Generally it is indicated by its strong modality <evening (but not necessarily 4-8 P.M.) And flatulence as a strong concomitant.

•      Many times feels better on passing flatus.

•      Better in open air

Final Remedy :

REFERENCE: PRINCIPLES AND PRACTICE OF HOMOEOPATHY- DR M.L. DHAWALE
REMEDY POTENCY DOSE
Chamomilla 200 4 Pills Single Dose
inconsolable crying, during and after feeding, moaning. crying is better when baby is carried. Infants and children are in general highly susceptible and react Well To The medium and higher potencies Minimum force is sufficient to disturb as well as to restore balance.

A homoeopathic physician, therefore, employs a minimum dose and has little use for a maximum tolerated one.

 Auxillary Measures :

(REFERENCE: PAEDIATRICS IN HOMOEOPATHY – AN APPROACH)

  • Feed the baby in propped up position or erect position.
  • Avoid feeding in horizontal position, it will lead to entry of more air into baby’s stomach.
  • Avoid under-feeding/overfeeding.
  • Avoid possible allergic foods in the infants/nursing mother’s diet.
  • No other medicine for colic.
  • Burping for at least 10-20mins after feeding.
  • Providing stable emotional environment.

Follow up :

Date Symptoms >Or< New Symptoms and Examination Interpretation Action
05-01-2023 Crying at night after feeding >60-70% No New Symptoms

O/E:

T: 97.6 degree F

HR: 138/Min

RR: 52/Min

Remedy has acted well based on :

1. Sphere of action

2. Pathology

3. Symptom similarities

Sac Lac 4 Pills OD at night for 1week
Moaning >60-70%
Straining Of Body -0-
Sleep at night slept well
Abdominal Hardness >+2
New traditional medicinal drops were given by granny in high doses
08-01-2023 Crying at night after feeding <+2 Previous symptoms got aggravated

O/E :

T: 98’f

Hr: 130/min

Rr: 48/min

Action of Chamomilla 200 got suppressed due to traditional medicinal drops

(Remedy reaction- short amelioration)

Signs and symptoms evaluated again, after assessing the presentation Chamomilla 200 single dose at night given  for two days.
Moaning >+2
Straining Of Body <+2
Sleep At Night ++
Abdominal Hardness ++
10-01-2023 Crying at night after feeding >70-80% No new symptoms

T: 97.8’F

HR: 142/MIN

RR: 46/MIN

When morbid susceptibility is satisfied with similimum then there will be obvious amelioration Sac Lac 4 Pills OD at night for 1 week.

(Chamomilla 200 Single Dose SOS)

Moaning >70%
Straining of body -0-
Sleep at night GOOD SLEEP
Hardness of abdomen -0-

Summary :

The marvelous result was observed in this case of infantile colic where his morbid susceptibility was satisfied with a single dose of Chamomilla 200. Moreover, the mental state of the patient was modified with this simillimum and child became playful with no significant aggravation from feeding.

 

About the author

Aarti Alwani

Dr. Aarti. K. Alwani;
M.D. (Hom.) (Med.); PG (Hom.) (Lon.);
Reader in Medicine Department at Shree H. N. Shukla Homoeopathic Medical College & Hospital, Bhichari, Rajkot–Gujarat (360003).
Consulting physician at Sadhu Vaswani Hospital; Street No. 3; Gayekwadi; Near Junction Police Station; Rajkot – Gujarat.

About the author

Sonali Chauhan

Dr. Sonali. P. Chauhan - M.D. (Hom.) (Paeds.), PhD Scholar (Paeds.), lecturer in Surgery Department at YMT Homoeopathic Medical College, Kharghar, Navi Mumbai - Maharashtra (410210).

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