Infantile Colic: Overview and Risk Factors

Infantile colic refers to excessive and persistent crying in a baby less than 3 months old. Although the condition is sometimes attributed to psychosocial causes, this chapter will focus solely on digestive contributors. Criteria developed by pediatrician Morris Wessel in 1954, and used as a diagnostic standard ever since, define colic as crying that occurs in an otherwise healthy baby for 3 or more hours a day, on 3 or more days a week, for 3 or more weeks. These criteria are somewhat controversial in that they may not adequately distinguish abnormal crying from normal behavior that occurs around 6 weeks of age.

Colic episodes are usually characterized by increased intensity, duration, and irregularity of crying that borders on screaming; hypertonicity; general inconsolability; and abrupt onset and conclusion.

Symptoms of colic may include flushing, constipation, tense abdominal distention, loss of appetite, and persistent crying and irritability.

Risk Factors

Risk factors for infantile colic are poorly understood. The condition does not appear to be related to gender or gestational age at birth and is not a sign of lactose intolerance. The following list identifies possible risk factors that have emerged in research studies, but whose validity has yet to be established:

• Parental smoking.
• Stressful home environment, including maternal prenatal anxiety and depression.
• Caucasian race.
• Residence in developed nations and/or locations farther from the equator.
• Feeding practices, which include swallowing of air, excessive feeding, and underfeeding.
• First–born birth order.
• Possible nutritional contributors are described in Nutritional Considerations.