Dear Doctor,

I am only a few weeks away from labour, and this is my first child so I’m really excited. However, I have heard about colicky babies and I’m terrified. At my baby shower, friends told all sorts of stories and downright freaked me out. What causes this colic and how can I avoid it? It is really worrying me because a baby who cries endlessly might make me lose my mind.

Tona, Nyamirambo

Dear Tona

Congratulations. I wish for you to have a healthy baby without any hassle. Colic in babies is a loose term used to describe a baby’s undue, irritable and loud cries. The term applies to any healthy, well-fed infant who cries more than three hours a day, more than three days a week, for more than three weeks. A baby has intermittent bouts of being unduly irritable or crying loudly or being fussy for no apparent reason. This is fairly common among babies, said to begin by two weeks of age and resolve slowly, spontaneously by six months or so. People mostly presume it to be acute abdominal pain or discomfort (hence the term colic), but it is not known for sure why it happens, because a baby cannot tell what is causing the distress.

Usually the problem begins in the afternoon. The baby cries or becomes unduly irritable; aching back, clenching of fists, abdominal distension, tense abdomen, are the other symptoms.

There are various reasons cited for causing colic. A still developing weak digestive system causing muscle spasm as food or milk enters it lacks gut microbes which help in digestion, bloating due to gas, air swallowed while mouth is open, intolerance to lactose present in milk, particularly with cow milk, heart burn due to reflux of milk and acid towards wind pipe causing discomfort, weak developing nervous system which is agitated by much lights or sound, hormones that cause tummy ache or a fussy baby, all these are possible causes.

Breast feeding is ideal for a baby. But if a baby is on top milk and has colic, it is better to change the milk, say from cow to soya milk or formula feed. The baby’s bottle should be very clean, nipple changed frequently. Burping is important after each feed. Put a lukewarm water bottle on the baby’s tummy or put him in a warm bath, these measures will soothe him and relieve any discomfort present. Keep as close to the baby as possible, a baby sleeping close to the mother feels more secure and comfortable.

Ideally, an infant should not be exposed to noise or lights, as the body hasn’t adapted to it. Some people carry their small babies like a toy wherever they go. But this puts the child to much discomfort and also exposes him to risk of infection. If the child is crying unduly or does not respond to these measures, he should be examined for a urinary tract or another infection causing pain and maybe fever.

There are various kinds of herbal and other preparations available to help in infant colic. But ideally, a small baby should be given those only if very necessary, because there is risk of allergy or side effects.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.