Disclaimer:
This medical
information is designed as an aid only for the
patients of
Drs. Concannon & Vitale.
It is not a substitute for a medical
exam and direct
advice from your physician.
COLIC & FUSSINESS
Colic has been defined as being
present when infants cry 3 or more hours a day, three or more days a
week, for three weeks in a row. Some colicky babies are extremely
difficult and cry for up to 12 hours and often sleep less than 6 hours
a day. About 20% of otherwise normal infants suffer some period
of colic. Colic often peaks by 6 to 8 weeks of age and is said to
resolve in most cases by 3 or 4 months of age. Infants with colic
often develop problematic sleep habits and go on to have sleep problems
or to be described by the parents as poor sleepers. There are a
few rare things that can be serious and confused with colic, so be sure
to have your child examined as necessary for problems that don't fit
the mold of typical colic.
If your baby has been crying and
you've tried feeding, changing the diaper, burping, rocking, etc., it's
okay to give both of you a break by putting the baby down in bed or a
seat and allowing him or her to cry for at least 10 minutes. After this
time, check on the baby and, if still crying, pick the infant up and
again try your comforting routines. If crying persists, it's probably a
good idea to try another 10-15 minutes of allowing babies to soothe
themselves. Car rides are famous for allowing the infant with
colic to fall asleep, but impractical at odd times. Substitutes
can include automatic gentle infant swings, front-pack Snuggli
carriers, or placing the infant in the car-seat atop a running clothes
dryer
For gassiness, try the gas
relieving exercises which involve slow movement of your baby's bent
legs toward the stomach and side to side, while the infant lies on the
back. You may try this a few times per day in order to minimize
gas build-up. While we generally try to avoid medications in
newborns, you may try Mylicon (simethacone) anti-gas drops as a safe
remedy. These are usually used 0.3 ml dropper doses four times a
day. Sometimes we recommend switching to a soy formula such as
Isomil or ProSoBee to lessen any cow's milk protein sensitivity that
may be confused with colic. Expect about four days to go by
before such a switch becomes effective.
Gastroesophageal reflux
disease (GERD) is the movement of food or liquid backwards from the
stomach into the esophagus (swallowing tube). Sometimes this
results in vomiting. Often the stomach contents are acidic and cause
"heart burn". This may lead to feeding difficulty, poor weight
gain and/or irritability in infants. GERD is quite common in
infants in its milder forms. Most infants with reflux outgrow
this condition by 6 to 12 months of age. Treatment of milder
forms includes possible thickening of formula with rice cereal,
elevation of the head of the bed, prone or side lying sleep positioning
and upright posture after feedings. Some children with GERD
require additional medications.
Limit feedings to a maximum of 4
ounces per feeding every 3-4 hours. Burp after every 1-2 ounces
to decrease the amount of air in the stomach. For 20-30 minutes
after each feeding, keep your baby in a semi-reclined position by
putting her in an infant seat, on your shoulder or in bed with the head
elevated. Elevate the head of the bed by rolling a towel or
blanket and placing it under the mattress. Finally, thicken
feedings by adding 1 teaspoon cereal (rice or oatmeal) per 2 ounces of
liquid to bottle. If necessary, crosscut the nipple in order to
allow the milk to flow more easily from the bottle. If
constipation occurs with rice cereal, change to oatmeal. If
constipation persists, you may give 1 or 2 ounces of full strength
apple juice each day.
Infants of colic age usually need
about 20-24 ounces of formula every day to grow. Limit feedings
to a maximum of 4 ounces per feeding every 3-4 hours (approximately 5-7
feedings/day). Do not allow a feeding to continue for more than
30 minutes. Try to wait at least 2 to 2 1/2 hours from the
beginning of one feeding to the beginning of the next. Feed in a
quiet place (preferable not in front of TV) to avoid distractions.
Consider allowing Dad to give a
bottle as the last feeding of the day - after you have retired for the
night. This allows him an important and pleasurable role and the
mom a few more precious moments of sleep.
There are some approaches to
foster good sleep habits and to prevent the development of
difficult-to-treat potential sleep problems such as persistent night
waking, bedtime struggles, and sleeping with the parents.
Newborns usually sleep a total of
16 hours a day with a longest sleep period of 3 to 4 hours. By 4
months of age, the longest episode of sleep should be at least 6 to 8
hours and the average child sleeps 15 hours a day. At 6 months infants
usually have 2 or 3 naps a day and 18 months they usually take only 1
nap a day. Your infant needs to have a regular bedtime, perhaps 8
PM. Develop a soothing, regular routine at bedtime to be done in
your baby's room. This could include a quiet feeding, a bath,
lowering the lighting in the room, singing a lullaby, listening to a
music box or musical mobile, sharing a picture book, rocking and/or
giving a special toy or blanket. Eventually this routine should end
with you baby being placed into bed drowsy but still awake.
It's OK to pat your baby for a
couple of minutes before leaving the room, but remember that you want
the baby to learn to self soothe and put themselves to sleep. If
your baby cries once you leave, try to allow a cry for 10 to 15 minutes
before returning to room. This allows the infant to learn ways to
self-soothe and put themselves to sleep. When the baby wakes at
night, keep feedings "business only", which means to try not to wake
either of you up very much, to feed at the bedside and get the baby
back in bed as quickly as possible. Don't even change the diaper
unless you feel it is necessary.
Limit daytime naps to a maximum
of 2 1/2 to 3 hours each by waking the baby after this time. If
your child naps in an infant seat or swing, consider putting it in a
quiet room to limit distractions.
Consider asking a friend or
family member to babysit for brief periods so you can have a
break. Try to nap, meditate or otherwise relax when your baby
does. It is important to identify at least 30 minutes a day of
"Mom Time" when you can read a book, watch a soap opera or go for a
walk, as you please. It's important for you to try to eat
regularly. Colic is not the result of bad parenting, so don't
blame yourself. Good Luck!
LastRev
10/2005 COLIC.html