Infantile colic (colic) as a defined medical condition, is usually arrived at after other explanations for the symptoms have been excluded. According to at least one report1 it affects up to 25% of infants but anecdotal evidence indicates that this figure is much higher. Traditionally, conventional medicine (conmed) ignored infantile colic, referring to it either as a myth, or a transient issue of little consequence. For anyone with a baby suffering from this problem, it’s a reality that causes significant distress to the infant as well as parents, carers and siblings. In more recent times, conmed recognition, albeit limited, has been given to colic. It’s now referred to either as Crying Baby Syndrome or Infantile Colic. A specific cause is as yet unknown and the symptoms involve excessive crying for more than three hours per day for more than three days per week in an infant who is otherwise (clinically) well and thriving. The infant may also have abdominal distension, flatus, borborygmus, a flushed face, clenched fists, may draw their knees up or arch their back, as if in pain. Colic may develop in the early weeks of life, peaking at around 2-8 weeks of age and ceasing by around 12 to 16 weeks but may, in rarer cases, persist for up to 12 months1.
The symptoms may occur at any time but more typically arise in the late afternoon or evening. While fewer than 5% of colicky infants are found to have an organic disease2, it’s important to differentiate colic from other causes of excessive crying such as constipation, infantile migraine, dairy, soy or some other form of allergy (where these may be associated with an aggravation of symptoms), gastro-oesophageal reflux (which may itself be secondary to dairy or soy allergy), or lactose overload / malabsorption (indicated by frothy watery diarrhoea with perianal excoriation). Other causes of persistent crying may include early teething, urinary tract infection, otitis media or raised intracranial pressure. These last three should be excluded as a matter of urgency where other signs or symptoms support their diagnosis.
In addition, it’s useful to be aware that maternal post-natal depression may be a factor in the presentation of colic and if confirmed this should also be addressed. Maternal post-natal depression is also associated with an increased risk of Shaken Baby Syndrome. There are a number of symptoms that, when combined with excessive crying, indicate the need for timely medical attention- these include a change in bowel habits, an abnormal temperature, persistent abdominal distension, an increase in crying frequency or lethargy.
Once serious medical causes for the symptoms have been excluded, where the infant is being formula-fed, dairy-free and/or thickened formula may be worth trialling and a crying diary (for the infant) that includes the maternal diet, sleep and lifestyle events, can be useful in the identification of causative or aggravating factors. Burping should be encouraged after each feed and the infant should be cuddled, kept upright, and wrapped after feeding and feeding itself should be conducted at regular times in a calm and peaceful environment. It’s also just as important for mum to have time-out and support in this situation. As a final note on colic aetiology, birth complications may have a direct impact on the infant. Researchers have found correlations between childbirth complications and infant crying, where more stressful deliveries were linked to more crying3.
Very few medications, either from conmed or from our traditional medicine armory, have consistently been found to be effective for colic and some proposed solutions from conmed, such as dicyclomine, have been found to have serious side effects. In mothers who are breastfeeding, a maternal hypoallergenic diet, avoiding dairy products, eggs, wheat, or nuts, may improve matters. If symptoms are due to a cow milk allergy, switching to a soy or hydrolyzed protein formula may help, although substituting dairy for soy formulae is often unsuccessful as cross-reactivity with dairy proteins occurs in around a quarter of cases. Evidence of effectiveness is greater for hydrolyzed protein formula with the benefit from soy based formula being disputed 4, 5.
The rapid acting and low-risk features of homeopathic medicines can make them ideal for use with infants suffering from colic, and following are some of the most frequently prescribed.
This is one of the most commonly used first-aid medicines for colic. The infant who responds to it will frequently appear to be irritable and easily angered. Characteristically, the colic will cause the child to bring the knees up to the chest. There may be co-existing gastro-intestinal bloating, green spluttery diarrhoea, vomiting and a coated tongue. Symptoms are worse from eating or drinking, if overheated or before a bowel movement, and better from warmth, after a bowel movement and from firm pressure or rubbing .and from being put over the knee or shoulder.
Chamomilla is also a common prescription here. The child in this case usually hot, thirsty, has red cheeks and wants to be carried, cries inconsolably and may angrily reject things that are offered. In colic the appearance is typically one of vomiting, an arched back, restlessness, anger, and the infant is often teething at the same time. The stools may be green and smell of rotten eggs and there may be great abdominal distension with small quantities of flatus being passed. Symptoms may be brought on by anger and are worse from 9pm to midnight and from heat. Symptoms are better from local warm applications, warm weather, and being carried.
Nux is often associated with nervousness, irritability, anger, as well as hypersensitivity to noise and light. In this instance, colic may arise 1 to 2 hours after feeding, and may be accompanied by retching or vomiting, constipation, flatulent distension of the abdomen, hunger, coating at the back of the tongue, or a stuffy nose. These children like to be kept warm. Symptoms are worse in the morning, on waking or from overeating, from cold, and better in the evening, from rest, strong pressure, from hot food or drink and after stool or a nap,
The Mag phos infant may appear restless, weak and lethargic. There may be muscular spasms or twitching, teething, thirst for cold drinks, belching, constipation, bloating and flatulent colic that causes the child to bend double. Symptoms are worse at night, from cold or from touch, and better from warmth, bending double, firm pressure or rubbing.
In this instance the infant will normally appear to be in severe pain and will exhibit borborygmi. They may be thirstless and have a coated tongue, yellowish diarrhoea and will often belch offensive gas. They will commonly arch their back and may have a history of digestive weakness. Symptoms are worse from lying down, bending forward, and are better from motion, pressure, open air, bending backwards or sitting upright.
The Pulsatilla child is usually sensitive, gentle, weepy and thirstless, despite still wanting the comfort of the breast or bottle, and wants to be held or rocked. They’re frequently seen sleeping with their hands above their heads. Attacks of colic may be aggravated by emotional stress. There may be hiccoughs after feeding, abdominal distension, flatulence, belching, vomiting several hours after feeding, nervous diarrhoea, a fine marbled look to the skin and a history of otitis or nasal discharges. Symptoms are worse from stuffy rooms, heat and during the evening and better in the open air, from motion, cold applications, cold drinks and food.
The pointers here may include symptoms that develop slowly, irritability, an abdomen sensitive to touch, dry mucous membranes, a yellowish or brown coated tongue, constipation or the passing of large, dry stools, lethargy and a thirst for large amounts of liquid. Food or drink may be vomited soon after consuming it and the infant usually dislikes being carried or raised. Symptoms are worse in the morning, from touch, from exertion or the slightest motion, from warm drinks, and better from pressure, rest, cold things, evening, open air and warm weather.
Carbo veg is a common prescription for colic pains associated with bloating, offensive belching, and offensive flatulence. The child may appear weak or listless with a puffy face, the rate of respiration is often increased, the tongue may be coated white or yellowish and the skin may feel cold and have a bluish hue. Symptoms are worse in the evening, from lying down, open air, feeding, and from tight clothing around the abdomen, and better from bending double, or after belching.
This is often indicated where the mother has unresolved grief. The infant in this case may exhibit hyper-acuity of the senses, may be easily excited, apprehensive, moody, rigid and nervous. Spasms and twitches, particularly around the face and lips, and jerking of the limbs, may be noted along with borborygmi and sour belching. Symptoms are worse in the morning, from warmth, after feeding and in the open air, and better from changing position and while feeding.
The Lycopodium infant may appear to be thin, weak, anxious, sensitive and apprehensive. There may be a lack of thirst, the infant is usually hungry and feeds in a hurry, may have a sensitivity to noise and a history of digestive weakness. There may also be abdominal bloating and respiratory catarrh. The extremities may feel cold. Symptoms are worse in the late afternoon or early evening, and better from motion and after midnight.