Colic not synonymous with crying —Expert

The reality is, all babies cry. Crying is a baby’s only way of communicating his needs. But it’s also his only way of wielding any control at all over a vast and bewildering new environment. When he cries, the mother comes running to his side.

Though it can safely be said that hours of daily crying doesn’t seem to hurt a baby, it certainly does leave its mark on parents because listening to a baby’s cry can be upsetting and anxiety-provoking. It can take a physical and emotional toll.

In fact, a baby crying excessively can start from simple problems such as hunger, pain, food sensitivities to more serious problems such as infection. However, excessive crying in an otherwise healthy infant that starts suddenly for no apparent reason and resisting every effort to soothe often is termed colic.

Colic is not a disease or diagnosis but a combination of baffling behaviours. Doctors usually diagnose colic based on the “rules of three.” The baby’s crying lasts a total of at least three hours a day, at least three days a week and for at least three consecutive weeks.

Crying often occurs at around the same time every day, usually in the late afternoon or early evening, but it can vary. The baby may pull up his legs, clench his fists and generally move his legs and arms more. Bowel activity may increase, and he may pass gas or spit-up. The baby frantically seeks a nipple only to reject it once sucking has begun, or doses for a few moments only to wake up screaming.

Howbeit, Professor Adebola Orimadegun, a consultant paediatrician, University College Hospital (UCH), Ibadan, Oyo state stated that colic is not synonymous with crying in babies.

According to him, “By layman’s definition of what colic is, it just simply means that the baby is having rhythmic intestinal movements without eating or passing stool because the intestine is moving. We call it gastrointestinal colic. This is a natural movement that is in excess.

“Even when sitting, certain things are moving within our intestine but we are not aware of it. We are not feeling it but for babies, it is part of the process of maturity. Some of the organs within the abdomen were not fully matured, but gaining their function continues even after birth.

“So in the first three months, part of the process of that acquisition of full function is recurrent peristalsis of that intestine and that is what gives the baby or makes the baby twisting and if you put your ears close to the tummy, you will be hearing the sound of the movement, as if the tummy is grumbling. So it is not a disease as it were, that makes the infant baby cry excessively.”

Professor Orimadegun stated that mothers shouldn’t always assume that a child crying excessively has colic because it could be something else.

He added, “crying is not colic, but colic makes children cry. It could be because the body is hot, the baby may be hungry or something may be irritating the child.”

Moreover, a cross-sectional study conducted in Ibadan metropolis study involving 141 and 177 consenting mothers and their children, two sets of twins inclusive, during immunisation clinics, indicated that awareness on colic is high (77 per cent); of this 14.4% could not vividly describe the features and 36.0% attributed it to improper umbilical cord care practices.

According to this study, the experience of persistent inconsolable cries suggestive of infantile colic within three weeks prior to the study was significantly reported more for children with low than normal birth weight and more among those exclusively (49.2%) than those who were not (19.5%) exclusively breastfed.

Commonly administered orthodox medications included: “Nospamin” (53.8%), “Gripe-water” (38.5%) and paracetamol (7.7%). Also, 29.1% of the mothers who reported persistent inconsolable cries suggestive of infantile colic administered herbal preparations to the children.

The paediatrician, however, said no medications have been found to be both safe and effective for colic in infants.

“Drugs such as Nospamin is a waste of money because the muscles of the intestines of infants at that age are not matured enough to respond to that drug. We don’t recommend it. If you see a paediatrician recommend it, it is just to treat the mother and not the baby,” he said.

In the category of “little evidence, lots of anecdotes” is gripe water, touted as a herbal remedy for everything from baby gas to colic. Some parents swear by gripe water, a mixture of herbs and water, as a way to calm a colicky baby, but no reliable studies have shown its effectiveness in relieving colic symptoms.

He stated that some colicky babies find relief by placing the infant face-down on the lap or upright with his tummy against the shoulder when gently rubbing  or patting the baby’s back to make the child belch or try burping the baby at least twice.

The good news is that baby colic doesn’t last forever. Most bouts start when the baby is about two to three weeks old, peak at around six weeks and then typically begin to taper off by 10 to 12 weeks. By three months, most colicky infants seem to be miraculously cured.

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