Colic is when a healthy baby cries for a very long time for no apparent reason. This is most commonly observed in the first 6 weeks of life. It usually resolves on its own by 3 to 4 months of age. Generally speaking, colic is a condition associated with age-related functional disorders of the digestive tract in infants, accompanied by crampy abdominal pain.
Intestinal colic manifests with symptoms such as infant crying, incessant shrieking, restlessness, straining, facial redness, and abdominal bloating.
During the first half-year of life, infants often experience various functional disorders of the gastrointestinal tract (regurgitation, intestinal colic, functional diarrhea, and constipation). According to various studies, intestinal cramps, or colic, occur in 55-75 percent of newborns.
Intestinal colic can disrupt a newborn's feeding and sleep schedule, as well as cause emotional stress and anxiety in young parents.
Pediatricians, pediatric gastroenterologists, and neurologists are involved in comprehensively addressing the problem of intestinal colic in newborns and infants during the first months of life.
Causes of colic
The mechanism of intestinal colic development in newborns involves a disturbance of the digestive tract's motor function and increased gas production in the intestines, causing acute localized spasms and distension of the intestinal walls. The primary etiological factors of intestinal colic in newborns may be directly related to the child themselves or their mother.
Morphological and functional immaturity of the gastrointestinal tract in the newborn, decreased enzymatic activity of the digestive tract, hydrochloric acid deficiency, lactase deficiency, disruption of intestinal microbiocenosis, and neuroendocrine regulation disorders cause intestinal colic.
Intestinal colic in newborns occurs due to the anatomical features of the intestinal structure and the development of the nervous system, a condition that usually lasts up to 12-18 months.
Violations of feeding technique, such as breastfeeding from an empty breast or feeding the baby with a small amount of milk when there is an insufficient milk supply, as well as excessive swallowing of air (aerophagia) in premature infants, lead to the development of intestinal colic.
Age-related and individual underdevelopment of enzymatic systems and intestinal dysbiosis in newborns lead to the inadequate breakdown of fats and carbohydrates, resulting in increased gas production.
The development of intestinal colic in newborns may also be associated with a deficiency of certain substances that regulate the motor and secretory functions of the gastrointestinal tract. Intestinal colic can also be caused by hypoxia and asphyxia experienced by the child before or during childbirth.
It has been established that the lower the gestational age and body weight of the newborn (i.e., the greater the degree of prematurity), the higher the risk of developing intestinal colic. In premature infants, intestinal colic is usually clinically more pronounced and lasts longer.
Allergic reactions (the gastrointestinal form of food allergy during the transition from breastfeeding to formula feeding, the presence of food additives in formulas, etc.) can also cause intestinal colic in newborns. Congenital anomalies (cleft lip, cleft palate) are also sometimes the cause of intestinal colic in newborns.
Maternal factors that trigger the development of intestinal colic in newborns mainly include a complicated obstetric-gynecological history (gestosis), improper breastfeeding, bad habits of the nursing mother, errors in complementary feeding (early introduction of cow's milk, very fatty foods, gas-producing foods), feeding methods (overfeeding, improper preparation of formulas), emotional instability in the family, and stress.
Symptoms of colic
Colic appears during the first 3–4 weeks of a child's life and lasts until the age of 4–6 months, and sometimes even up to 3 years. Attacks of intestinal colic in newborns usually begin unexpectedly, without any apparent reason, at the same time of day, mostly during or after feeding.
Symptoms of intestinal colic last for 3 hours or more per day, recur at least three days a week, and continue for three consecutive weeks.
In newborns, intestinal colic is accompanied by loud screaming, shrill crying, and infant distress; the child twists their legs and pulls them up to their abdomen. Additionally, hyperemia (redness) of the facial skin, as well as distension and tension of the anterior abdominal wall, are observed. A single episode of intestinal colic can last from 30 minutes to 3 hours.
As a result of severe intestinal colic in newborns, the child's appetite worsens, and digestive system disorders, abdominal tension, vomiting, irritability, and sleep disturbances occur. Relief from intestinal colic occurs after passing gas or defecation. Between episodes of intestinal colic, the newborn's general condition is not impaired, no pain is felt upon palpation of the abdomen, a good appetite is maintained, and weight gain is age-appropriate. In newborns, intestinal colic can be accompanied by conditions such as constipation, dyspepsia, and gastroesophageal reflux.
Treatment
Treatment is carried out by a pediatrician and a pediatric gastroenterologist. Each child's body is naturally unique, and therefore treatment is aimed specifically at eliminating the underlying cause of this condition in the child and correcting motor and functional disorders of the gastrointestinal tract.
Certain cases of intestinal colic can be prevented if the breastfeeding mother follows a diet. Products containing cow's milk and beef are excluded from her diet, and the consumption of fat-rich foods, as well as those that increase gas production (raw and pickled vegetables, fruits, legumes; fresh bread and kvass), chocolate, sweets, and pastries, is limited.
Before each feeding, the child is placed on their stomach for 5–10 minutes, followed by gently massaging the abdomen in a clockwise direction to improve bowel movement and gas release. To soothe the child when intestinal colic occurs, you can warm the newborn's abdomen with a warm cloth or hold the baby in your arms; pressing the baby's abdomen against the mother's abdomen is also helpful.
To prevent aerophagia, it is important to monitor feeding techniques, try to breastfeed in the correct position, limit pacifier use, hold the baby in an upright position for 10-15 minutes after feeding, and, when formula-feeding, choose an appropriate formula. If a child has a gastrointestinal form of food allergy, they are switched to formulas based on protein hydrolysate (casein or whey), and if lactase deficiency is observed, to low-lactose or lactose-free formulas.
In newborns, especially in premature babies, frequent use of suppositories and enemas without medical indication is not advisable due to the vulnerability of the intestinal mucosa.
In cases of significantly pronounced colic, carminative and relaxing phytotherapeutic products (fennel, chamomile, mint, dill) may be recommended, and a doctor may prescribe simethicone-containing preparations, antispasmodics, and sorbents. Probiotics are used to correct dysbacteriosis.
