Three months' colic

Abstract

The term 'three months' colic' is reserved for a clinical entity in which the baby, in the first three months of life, has rhythmical screaming attacks in the evenings, which are not stopped when he is picked up, and for which there is no obvious explanation, such as hunger. The great ease with which crying can be ascribed to colic when in fact it is due to some readily correctable cause such as hunger is emphasized. Severe forms, however, are felt to be so characteristic that they cannot be confused with anything else. The literature on the subject is reviewed. A controlled investigation of colic was carried out, 50 babies with colic being compared with 50 who had no colic. It is shown that the mothers of these two groups of babies differed in no way as regards their age, parity or pregnancy history. The babies differed in no way as regards their sex, birth weight, feeding history, family history of allergy, signs of allergy, incidence of posseting, number of stools, or weight gain. They appeared to be well, normal babies apart from their attacks of pain in the evenings, and when followed up they continued to be normal. In 33 out of 49 babies the colic began in hospital. In 44 of the babies it began in the first 15 days. In 47 of the 50 babies it began at 5 p.m. or later in the evening. The average age at which the colic disappeared was 91/2 weeks. Fifty-four per cent had lost it by the end of two months, 85 % by the end of three months, and all by the end of four months. The cause of colic, in the light of the above findings, is discussed. It is felt that it is not due to underfeeding, overfeeding, or other errors of feeding technique. It is not due to mismanagement or spoiling, to allergy, hypertonia, swallowed air or to foods taken by the mother. X-ray studies taken during an attack of colic did not show an excess of gas in the bowel. The most likely explanation of colic is thought to be the local obstruction to the passage of gas in the colon by local spasm or kinking of uncertain cause.