Colic

Question 1

What is colic?

Answer 1

• = unsettled/crying babies >3 hours day for > 3 days/week

Question 2

Is colic normal or abnormal?

Answer 2

• Normal, infants are well and thriving

Question 3

Natural history of colic

Answer 3

• Starts early weeks
• Peaks 6-8 weeks
• usually improves by 3 - 4 months of age• usually worse in late afternoon or evening but may occur at any time
• may last several hours

Question 4

Non-pathological causes of colic

Answer 4

1. Excessive tiredness

2. Hunger

Question 5

Pathological DDx for colic

Answer 5

1. Cow milk / soy protein allergy
2. Gastro-oesophageal reflux
3. Lactose overload / malabsorption

Question 6

Red flags for a presentation of colic

Answer 6

1. Sudden onset
2. Maternal and family psychosocial state
3. suspicious of cow milk/soy protein allergy

Question 7

What are some Mx options for colic?

Answer 7

1. Engage in a partnership with the parents
2. Explain normal crying and sleep patterns
   • Use a sleep / cry diary to explain the infant’s cry / sleep / feeding patterns
   • Work out the amount of sleep over a 24 hour period using theSleep / Crying Diary
   • Encourage parents to recognize signs of tiredness (frowning, clenched hands, jerking arms or legs, crying, grizzling)
3. Assist parents with sleep hygiene
4. Assess maternal and emotional state and mother-baby relationship
5. Provideprinted informationas parents are unlikely to remember much given their state of mind at the time.
6. Referral for early (within days) ongoing support is essential