Unconsolable crying or screaming in infants could be more than just cries, warns Dr Vivek Sharma.

An infant crying in the night: An infant crying for the light: And with no language but a cry.                                                                           
— Tennyson

Excessive crying in infants is distressing, for all concerned. It occurs in 10-15 percent of infants, usually between the ages of 3 weeks to 3 months. The condition usually resolves by 4 months of age. Parents need to understand that babies normally cry for as many as 4 hrs/day. It takes time to understand their babies cry and what they mean.

Symptoms

Colic is a common symptom complex which occurs during the first few month of life, Paroxysmal, unconsolable crying or screaming accompanied  by drawing up of the knees takes place several times a day, particularly in the evening. There is no firm evidence that the cause is intestinal, but this is often suspected.

Colic refers to paroxysmal abdominal pain of intestinal origin, but the term is used loosely and includes moderate to severe and otherwise unexplained bouts of cry.

What causes colic?

There is no single cause. Persistent crying signals distress and should stimulate efforts for an explanation. Hunger, swallowed air, milk intolerance or an acute illness must be excluded. The typical pattern is that of a usually calm and placid infant, who suddenly screams draws knees up to abdomen and may pass flatus or faeces. An episode can last 10 minutes to hours. Occasionally, cow's milk protein intolerance or gastro oesophageal reflux may be responsible. The condition is essentially benign, although it may precipitate non accidental injuries in infants already at risk. Babies with colic are fine between bouts of colic. They feed well, grow well, and do not show any other signs of illness.

Helping colic babies and their parents

* Parents should remember that there is nothing that you have done to cause the colic. Also know that colic usually goes away by 3-4 months of age, often much sooner.

* Holding a fussy infant with colic is recommended. Holding the baby close to the body in front and using soothing words are helpful.

* Drugs (sedatives and antispasmodics) are ineffective, and the hazards of overdosing and toxicity are such that use of these drugs is not recommended.

* Underfeeding and overfeeding should be discontinued. Air swallowing may be prevented by altering feeding and burping technique. If the infant is bottle fed, enlarging the nipple holes may help improve flow of milk.

* Sometimes an automobile ride works wonders. Devices that attach to the crib or bed and cause vibrations are of benefit in some infants. 

* Colic happens more frequently when the mother has postnatal depression or feels very down after the baby was born. If this is the case, see your doctor for some help.

* Friends or other family members may be willing to help. However, try to avoid several people fussing at once, as this may cause anxiety. It may be sensible to leave the coping to one person at a time. Take it in turns if you have help. 

* Parents need reassurance that allowing the infant to cry is an acceptable option if all soothing techniques have failed. This simple "giving of permission" may lessen parental anxiety and tensions, resulting in a calmer infant.

*Remember a baby with colic will have spells when they are perfectly fine in between bouts of crying. There are certain other conditions sometimes mistaken for colic.

* If you are unsure about the cause of a distressed or crying baby, then see a doctor.

(The writer is a consultant paediatrician)