The first thing we need to say about colic is that there is no general agreement among the medical profession about how it is defined. Colic is a term that is often given to a healthy infant under three months of age, who is distressed. A colic infant isn't easily consoled and cries excessively, which often varies with good and bad days. Some colic infants cry all through the day, while others only cry in the afternoon, however the typical pattern of a colicky infant is one who cries increasingly throughout the day, but mostly in the early evening or late afternoon. It is a condition that varies in its severity, with some babies settling on being held, while others are inconsolable, (this occurs in about 20% of cases)

Infant colic is sometimes described as consisting of a colic attack, which usually happens once or twice a day, and lasts for one to two hours. Colic is not associated with illness or hunger, and is not relieved by feeding. Colic should also not be confused with wind. "Wind" usually meaning the bubble of air brought up during, or soon after a feed. With wind, the baby can be calmed by gentle burping and soothing. A colic infant may also often settle after burping or passing wind, but burping does not prevent colic. Failure to burp a baby does not cause colic.

Colic is a painful condition that usually peaks at around six weeks and stops around three months of age, although it can persist for up to five months. It includes a variety of symptoms ranging from the pulling up of legs, clenching of fists, tensing of abdomen, bloating, cramps, passing flatus, frequent loose bowel actions and crying.

Although the medical profession does not know what really causes colic, some believe it is due to an immaturity of the digestive system that develops as the baby grows. Based on this belief, some experts in colic have developed the following theories:

• Intestinal spasm caused by wind getting trapped in the baby's intestines. Minute bubbles of air are swallowed during the feed, which cause pain and spasm further down the digestive tract in the intestines.

• Internal spasm caused by an immaturity of the digestive tract. Peristalsis or muscle contractions occur all along the the digestive tract. The contractions are repeated in waves to propal the food through our digestive system. It is thought that because the nerves of the intestine are not fully developed, the contractions become uncoordinated and spasmodic.
  Refer to related article on motility immaturity.
  

• Lactose intolerance due to the baby having a deficiency of intestinal lactase to break down the amount of lactose in the feed, resulting in undigested lactose building up in the baby's intestines. Refer to our article on food intolerance and allergies, for further information.

• Cows milk protein intolerance thought to be due to a hypersensitivity to cow's milk protein. Recent research is indicating that this may account for a high proportion of colicky infants. Research has shown that these babies are reacting to the cow's milk protein in their mother's diet or in formula feeds. When the breastfeeding mothers removed all forms of dairy foods from their diets, or went to a dairy-free prescription formula such as Neocate, these babies's colic ceased. Around 50% of these babies have been found to be sensitive to soy protein as well.Refer to our section on food intolerance and allergies for further information. Colic is a symptom of cow's milk protein intolerance.

• Stress. For many years colic has been blamed on anxious, inexperienced parenting. There is absolutely nothing to support this theory!

• Baby's temperament. An active, awake, busy and tense baby is more likely, according to research, to have colic.

• Caffeine. Many mothers have said eating certain foods seem to make their baby's colicky; some babies are especially sensitive to caffeine. Try to eliminate any foods that you think are making your baby upset for a few days to see if there is an improvement. Potential problem foods include wheat, eggs, fish, peanuts, other nuts, chocolate, alcohol, citrus fruit, spices, cola and carbonated drinks in general.

• Gastro-oesophageal reflux. This is when the baby regurgitates the stomach acidic gastric contents back into the mouth or oesophageaous. Refer to our article on reflux for further information.
  
  
• Spinal functional disturbance. Incorrect positioning of the spine, can interfere with the vagus nerve, which is involved with the workings of the digestive system. This is called a spinal functional disturbance, and can be rectified through a visit to a chiropractor who will apply slight pressure to correct the spines alighnment. Refer to our article on chiropractive treatments for more information.
  
  
  
  IMPORTANT: Please see your doctor if you think your child has colic to rule out any other causes of the crying. Changing formulas is not a cure for colic, often only having a very temporary effect, and should only be done under the care of a medical practitioner. Breast milk remains to be the safest, least irritant and most nutritious diet for sensitive babies. Stopping breastfeeding is not a cure for colic and should only be done under the advice of a paediatric gastroenterologist. A paediatric gastroenterologist specialises in colic and may also be of assistance in better managing this condition.