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Expert Q&A

	By David L. Fay, M.D. Family Physician Associate Director, Waukesha Family Practice Residency Program

Could you give me some advice on how to prevent colic in newborn babies and how to deal with it when it occurs? I have a 1-week-old son, and I wish to avoid this distressing condition if at all possible. I am successfully breastfeeding my baby.

Colic is poorly understood, despite numerous studies. It occurs spontaneously in infants 3 weeks to 3 months of age, appearing suddenly and resolving just as suddenly. Many feel it is related to intestinal spasm, although this has never been shown. There are many recommendations for its treatment, ranging from dietary changes to opioid analgesics (drugs similar to morphine), but none has been shown to be effective. There is no known prevention. Ask 10 doctors and 10 experienced mothers what to do for it and you'll get 35 different answers.

What I generally tell my patients is:

• This will be a very challenging time for you. You will become frustrated, angry and tired. Have another adult who can help you when you've had enough, to avoid the possibility of abuse (if you're saying to yourself, "I would never feel that way!" you haven't had a child with colic).
• If you're breastfeeding, avoid foods which can cause gas (even if they don't cause you a problem, they can for the baby). While colic is not "gas pain," gas can worsen the problem. Avoid greens, beans, dairy products, caffeine, peppers and anything you know causes you a problem.
• Holding the child close to you may help.
• Simethicone drops may help. Avoid paragoric and other intestinal preparations. Infant Tylenol (acetaminophen) is OK.
• Rest when you can. Colic is worse at night, and you may be in for six to nine weeks of sleepless nights.
• If you're concerned this may be more than colic, call your physician. Other, more serious conditions can masquerade as colic.

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