DESCRIPTION
Colic appears in newborn babies usually at three weeks of life and generally disappears by the time they are 4 months old. During the first three months of life, a normal infant cries as little as forty minutes per day or as much as two hours. The infant with colic cries much more than this.

Normal crying usually peaks at six weeks of age and is seen more often in the afternoon and evening. At six weeks, most infants will decrease the amount of time they spend crying. However, infants with colic may continue their level of crying until 3 or 4 months of age.

The infant with colic has a cry that is higher pitched and sounds very urgent. It is often more grating and frustrating to the parent or caregiver. The crying period may be accompanied by tensing of the abdominal muscles, and flexing of the legs while the infant attempts to lift his or her head. The infant may appear to be in pain. The baby may have a reddened face and may pass gas. This is not always related to stomach distress but is a problem of adapting to his or her surroundings. The infant who is more irritable and cries much of the day tends to have restless sleep.

Colic normally starts during the first weeks of life and ends at about the age of four months. You cannot spoil an infant during the first 3 to 4 months of life.

IMPORTANT FACTS

• Infants with colic grow and gain weight despite crying
• Colic is seen equally in males and females
• Colic affects breast and bottle fed infants equally
• Colic is not the result of bad parenting
• Colic is not caused by abdominal pain
• Colic is not due to excessive gas
• A crying infant with or without colic normally draws up his or her legs when crying
• Simethicone is an over-the-counter medicine that allows gas bubbles to disperse and be released (this medication may or may not be helpful in the infant with colic)
• Infants with colic often have a difficult time stooling
• Colic may be seen in infants with a more sensitive temperament or with a caretaker who is feeling stress.

• Starting solids early does not decrease crying
• A cows' milk allergy may be suspected if an infant has diarrhea, vomiting, wheezing or family history of milk allergy
• Special formulas may be helpful - do not change formula without consulting your child's physician.

• Try to learn your infant's cues to prevent a severe episode
• Set up a bedtime routine
• Bathe the infant in the evening (this is soothing and relaxing and could be followed by a feeding and then rocking to a sleepy state before placing in the crib)
• Always place the infant in the same area to sleep
• If the infant is crying and will not settle, after five to 10 minutes, pick the baby up and try one of the recommended soothing techniques
• Provide structure and repetition as much as possible
• Allow your infant to cry for several minutes before falling asleep.

COMFORT TECHNIQUES
Each of these activities should be used for no less than five minutes to allow the infant time to react and settle:

• Skin to skin contact between parent and infant by placing the infant in a vertical position chest to chest
• Walking with the infant over the shoulder (the baby's abdomen should be near to resting on the adult's shoulder and the adult should walk very slowly about one step per second)
• Stand in one place and rock from one foot to the other at the some slow rate providing a soothing rhythmic activity (do not jiggle or bob the baby up and down)
• Place infant in a carrier strapped to the caregiver
• Bathe infant in a warm bath
• Massage with oil or lotion
• Swaddle the infant with arms folded toward the chest
• Place infant in a wind-up swing, vibrating chair or stroller ride
• Use "white noise" such as a blow dryer, vacuum cleaner or running water (parents have even made 20 minute tapes of these sounds to be played when needed)
• Use a pacifier as much as the baby likes
• Use a bottle with a collapsible bag or a vented nipple to help prevent the swallowing of air
• Avoid bright lights and strong noises, which can be disruptive to the sensitive infant
• Allow the baby to wake on his or her own (try not to interfere with daytime sleep such as awakening for a feeding).

CONCLUSION
Infants with colic can be difficult to care for, so it is important to keep these facts and comfort measures in mind. Parents need time alone away from their babies, with or without colic. Try to seek assistance from friends or family members and make sure those caretakers are comfortable with caring for an infant with colic. Remember that colic will resolve. It may happen slowly with the baby having less and less fussy periods, or it may occur overnight.