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What pharmacy staff need to know about managing colic

What is colic?

Download the Managing Colic poster for your pharmacy here.

All babies cry – this is perfectly normal. But a baby with colic will cry inconsolably and for no apparent reason.1

Colic is a common problem in both breastfed and bottle-fed babies, with 1 in 5 infants aged under one year experiencing it. The exact cause of colic is not fully understood. However, it is thought that it could be due to an immature digestive system or problems with digesting cows’ milk protein or lactose.1-4

Parents/carers may be stressed and anxious if their baby has colic. They may also be sleep deprived if the baby is crying a lot, as this can disrupt sleep for both the baby and the parents/carers.4

 

What are the symptoms of colic?

Colic usually starts a few weeks after birth. The baby may have bouts of inconsolable crying, particularly in the afternoons and evenings.1

Other symptoms can include:1

 

How should colic be managed?

 Parents/carers can be advised on the following practical solutions to soothe infant crying:1,4

 

 

Advice for worried parents

Reassure parents/carers that colic is a common condition that should resolve by six months. Encourage them to look after their own wellbeing by asking family and friends for support. Parents/carers should try to rest when the baby is asleep and should be encouraged to meet with other parents/carers with babies of the same age, to share experiences and access peer support.4

 

When to seek further advice

Parents/carers should be advised to seek advice from a healthcare professional if:1,4

  • colic symptoms are still present or getting worse when the infant is older than four months
  • symptoms worsen or if they are worried about the infant
  • the infant is not thriving
  • they are struggling to cope with the infant’s symptoms.

Go to A&E or call 999 if:1

  • the infant has a weak or high-pitched cry
  • the infant’s cry does not sound like their normal cry.
 

Colic nutritional support

A GP or health visitor may recommend a short-term trial of dietary changes. Food allergies or intolerances, such as cows’ milk allergy, have been suggested as a possible contributing factor for colic.7

For breastfed babies, the mother may be advised to avoid all cows’ milk products and other potential allergens such as wheat, eggs and nuts, if an allergy is suspected.7,8

For infants who are formula-fed, a healthcare professional may suggest a trial of a specialist milk.9

 

References

  1. NHS (2018) Colic. [Accessed January 2020].
  2. Gupta SK. Is colic a gastrointestinal disorder? Curr Opin Pediatr 2002;14(5):588-92.
  3. Kanabar D et al. Improvement of symptoms in infant colic following reduction of lactose load with lactase. J Hum Nutr Dietet 2001;14:359-63.
  4. Nice Clinical Knowledge Summaries (2017) Colic – infantile. [Accessed January 2020].
  5. Lam TML, Chan PC, Goh LH. Approach to infantile colic in primary care. Singapore Med J. 2019;60(1):12–16.
  6. NHS Start 4 Life (2020) Breastfeeding challenges. [Accessed March 2020].
  7. NHS (2019) What should I do if I think my baby is allergic or intolerant to cows' milk? [Accessed January 2019].
  8. Gultom LC, Sjarif DR. Nutritional intervention in infantile colic: mini review. Int J Pregn & Chi Birth. 2017;3(3):266‒272.
  9. Gordon M et al. Dietary modifications for infantile colic. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No: CD011029.
  10. Pärtty A, Kalliomäki M. Infant colic is still a mysterious disorder of the microbiota-gut-brain axis. Acta Paediatr 2017;106(4):528-9.
  11. Gupta SK. Update on infantile colic and management options. Curr Opin Investig Drugs 2007;8(11):921-6.
  12. Savino F et al. Ghrelin and motilin concentration in colicky infants. Acta Paediatr 2006;95:738-41.

 

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