Infant colic is characterized by severe and paroxymnal crying that occurs mainly in the late afternoon. The infant's knees are drawn up and its fists are clenched, flatus is expelled, the facies has a pained appearance, and there is minimal response to attempts at soothing.
Gastroesophageal reflux is often suspected as a cause of colicky crying in young infants. Undetected corneal abrasion, urinary tract infection, and unrecognized traumatic injuries, including child abuse, must be among the physical causes of crying considered in evaluating these infants.
A colicky infant is healthy and well fed but cries for more than 3 hours a day, for more than 3 days a week, and for more than 3 weeks-commonly referred to as the "rule of threes: The important word in this definition is "healthy." Thus, before the diagnosis of colic can be made, the pediatrician must rule out diseases that might cause crying.
Behavioral states have three features:
(1) They are self-organizing-that is, they are maintained until it is necessary to shift to another one;
(2) they are stable over several minutes; and
(3) the same stimulus elicits a state-specific response that is different from other states.
The behavioral states are (among others) a crying state, a quiet alert state, an active alert state, a transitional state, and a state of deep sleep. The states of importance with respect to colic are the crying state and the transitional state. During transition from one state to another, infant behavior may be more easily influenced. Once an infant is in a stable state (eg, crying), it becomes more difficult to bring about a change ( eg, to soothe). How these transitions are accomplished is probably influenced by the infant's temperament and neurologic maturity. Some infants move from one state to another easily and can be diverted easily; other infants sustain a particular state and are resistant to change. Another factor to be considered in evaluating the colicky infant is the feeding and handling behavior of the caregiver.
SENNA: Is of much use in infantile colics when the child seems to be full of wind. Where the system is broken down, bowels constipated, muscular weakness, and waste of nitrogenous materials, Senna will act as a tonic., constipation with colic a flatulence. Liver enlarged and tender. Stool.--Fluid yellowish, with pinching pains before. Greenish mucus; never-get-done sensation (Merc). Burning in rectum, with strangury of bladder. Constipation, with colic and flatulence. Liver enlarged and tender, stools hard and dark, with loss appetite, coated tongue, bad taste, and weakness.
CHAMOMILLA: This remedy is indicated when a person is hypersensitive to pain. It is especially helpful to colicky babies who desperately scream or shriek and want to be constantly rocked and carried. The abdomen may be distended with gas, and pain can be focused in the navel region. Hot perspiration and facial flushing (sometimes only one cheek) are other indications for Chamomilla.
DIOSCOREA: Abdominal pain that feels better from bending backward often is relieved by this remedy. Babies may arch their backs and try to stay in that position. Pain comes in paroxysms, often with gas and burping, or with nausea.
MAG PHOSPHORICA: Colicky pain that is relieved by warmth and pressure often responds to this remedy. Hot water bottles, heating pads, or drinking something warm can soothe discomfort, and rubbing the abdomen may also help. The person (often a baby) may seem nervous from the pain, and can be irritable or fearful.
NUX VOMICA: This remedy is helpful for tense and impatient people when colicky pains result from overeating or from overindulgence in coffee, alcohol, and other strong or stimulating substances. The abdomen feels tight, and constricting pains press upward, making breathing difficult. Warm applications and warm drinks may bring relief. Infants who need this remedy often arch their backs, and seem impatient and angry.