Colic

Tip of the Day: Safe Sleep—Colic
In a study that is getting press today, that has yet to be peer reviewed and published in a medical journal, research-ers in San Francisco surveyed 154 mothers at their babies’ 2 month old well child care visit at pediatric clinics in San Francisco regarding whether or not their infants had colic. The results showed nearly 29% of infants whose mothers had a history of migraine headaches had colic, compared with 11% of those whose mothers did not have migraine headaches. And I am sure all of that crying probably helped trigger more migraine headaches!
This study really spoke to me on a personal level because I had terrible migraine headaches when I was pregnant with my first child, and my baby also had a world record case of colic… he cried so much that both of his grandmoth-ers commented on the screaming baby they heard while exiting the elevator to the maternity section at the hospital on their way to meet him all those years ago, “We hope that is not ‘our’ baby”.
Colic, typically described as the rule of 3’s:
Starts in earnest when an infant is around 3 weeks old Crying goes on for 3 or more hours per day for 3 or more days of the week Lasts until age 3 months (or so)
Although colic affects about 20% of infants, and is usually attributed to a gastrointestinal complaint or milk intoler-ance, the reality is that there is no known reason for colic, and unfortunately there is no “cure” save the tincture of time and lots of loving from parents and caregivers.
This research has implications from a medical reason because the scientists hypothesize that colic may be a mi-graine variant and that children with colic will be more prone to migraine headaches in childhood and adulthood. The research also has social implications for all of us who work in the child welfare realm because many infants who suffer “shaken baby syndrome” are infants younger than six months who are described as chronically fussy or colicky.
As I say all the time, pediatricians are all about the prevention of illness and injury and anticipatory guidance is usually given during a scheduled office visit. But anyone can give guidance to help keep children safe and sound. While screening mothers under Department supervision for substance use, some may report that they have mi-graine headaches that necessitate opiate use (in reality narcotics for headache pain is a rare treatment reserved for occasional use in case of the “worst” headaches). In any event, if a mother reports that she is having chronic mi-graine headaches, anticipate that that child may have a higher than average risk of developing colic.
Fussy babies are more likely to be abused early in life, so an elevated level of concern can be taken into considera-tion if babies in “at risk” households are described as having colic or crying a lot. Please be prepared to have ideas on how to soothe a crying baby to share with parents, because most of the time, a reason for the crying cannot be attributed to an organic medical condition.
Michelle Terry, MD

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