PEDIATRIC NURSING STUDY GUIDE
COLIC
NURSING CARE MANAGEMENT
What is colic?
Colic is commonly described as a behavioral syndrome in neonates and infants that is
characterized by excessive, paroxysmal crying.
Colic is most likely to occur in the evenings, and it occurs without any identifiable cause.
During episodes of colic, an otherwise healthy neonate or infant aged 2 weeks to 4
months is difficult to console.
The most widely used definition of colic was used by Wessel et al; their definition is
based on the amount of crying (ie, paroxysms of crying lasting >3 hours, occurring >3
days in any week for 3 weeks).
Colic is a poorly understood phenomenon; it is equally likely to occur in both breastfed
and formula-fed infants.
Pathophysiology
The term colic derives from the Greek word kolikos or kolon, suggesting that some disturbance
is occurring in the GI tract.
Researchers have also postulated nervous system, behavioral, and psychologic
etiologies.
A meta-analysis indicated that colic may be a form of a migraine headache rather than,
as has been proposed, a GI condition.
The analysis utilized 3 studies (891 subjects total), one of which indicated that there is a
greater likelihood of colic in infants whose mothers have migraine headaches and the
other two of which indicated that infants with colic are more likely to experience a
migraine in childhood and adolescence.
, Using a pooled random-effects model in their analysis, Gelfand and colleagues found
the odds ratio for an association between a migraine and colic to be 5.6.
In a secondary analysis, which included two additional studies (both of which also
looked at the colic/migraine link but addressed a different primary research question),
the odds ratio for the association between a migraine and colic was 3.2.
Statistics and Incidences
Colic is one of the common reasons parents seek the advice of a pediatrician or family
practitioner during their child’s first 3 months of life.
Colic affects 10-30% of infants worldwide.
Increased susceptibility to recurrent abdominal pain, allergic disorders, and certain
psychological disorders may be seen in some babies with colic in their childhood.
This condition is encountered in male and female infants with equal frequency.
The colic syndrome is commonly observed in neonates and infants aged 2 weeks to 4
months.
Causes
Demonstrated and suggested causes of colic may include the following:
GI causes- GI causes may include but are not limited to gastroesophageal reflux,
overfeeding, underfeeding, milk protein allergy, and early introduction of solids.
Inexperienced parents (controversial) or incomplete or no burping after feeding-
Incorrect positioning after feeding may contribute to excessive crying; note that colic is
not limited to the first-born child, casting doubt on the theory about inexperienced
parenting as the etiologic factor.
Exposure to cigarette smoke and its metabolites- Some epidemiologic evidence
suggests that exposure to cigarette smoke and its metabolites may be related to colic;
maternal smoking and exposure to nicotine replacement therapy (NRT) during
pregnancy may be associated with colic.
Food allergy- Some evidence has linked persistent crying in young infants to food
allergy; an association between colic and cow’s milk allergy (CMA) has been postulated.
Low birth weight- Data from one study suggested an association between low birth
weight and an increased incidence of colic.
Characteristic intestinal microflora-Some reports have focused on intestinal microflora
and its association with colic; lower counts of intestinal lactobacilli were observed in
infants with colic compared with infants without colic.
COLIC
NURSING CARE MANAGEMENT
What is colic?
Colic is commonly described as a behavioral syndrome in neonates and infants that is
characterized by excessive, paroxysmal crying.
Colic is most likely to occur in the evenings, and it occurs without any identifiable cause.
During episodes of colic, an otherwise healthy neonate or infant aged 2 weeks to 4
months is difficult to console.
The most widely used definition of colic was used by Wessel et al; their definition is
based on the amount of crying (ie, paroxysms of crying lasting >3 hours, occurring >3
days in any week for 3 weeks).
Colic is a poorly understood phenomenon; it is equally likely to occur in both breastfed
and formula-fed infants.
Pathophysiology
The term colic derives from the Greek word kolikos or kolon, suggesting that some disturbance
is occurring in the GI tract.
Researchers have also postulated nervous system, behavioral, and psychologic
etiologies.
A meta-analysis indicated that colic may be a form of a migraine headache rather than,
as has been proposed, a GI condition.
The analysis utilized 3 studies (891 subjects total), one of which indicated that there is a
greater likelihood of colic in infants whose mothers have migraine headaches and the
other two of which indicated that infants with colic are more likely to experience a
migraine in childhood and adolescence.
, Using a pooled random-effects model in their analysis, Gelfand and colleagues found
the odds ratio for an association between a migraine and colic to be 5.6.
In a secondary analysis, which included two additional studies (both of which also
looked at the colic/migraine link but addressed a different primary research question),
the odds ratio for the association between a migraine and colic was 3.2.
Statistics and Incidences
Colic is one of the common reasons parents seek the advice of a pediatrician or family
practitioner during their child’s first 3 months of life.
Colic affects 10-30% of infants worldwide.
Increased susceptibility to recurrent abdominal pain, allergic disorders, and certain
psychological disorders may be seen in some babies with colic in their childhood.
This condition is encountered in male and female infants with equal frequency.
The colic syndrome is commonly observed in neonates and infants aged 2 weeks to 4
months.
Causes
Demonstrated and suggested causes of colic may include the following:
GI causes- GI causes may include but are not limited to gastroesophageal reflux,
overfeeding, underfeeding, milk protein allergy, and early introduction of solids.
Inexperienced parents (controversial) or incomplete or no burping after feeding-
Incorrect positioning after feeding may contribute to excessive crying; note that colic is
not limited to the first-born child, casting doubt on the theory about inexperienced
parenting as the etiologic factor.
Exposure to cigarette smoke and its metabolites- Some epidemiologic evidence
suggests that exposure to cigarette smoke and its metabolites may be related to colic;
maternal smoking and exposure to nicotine replacement therapy (NRT) during
pregnancy may be associated with colic.
Food allergy- Some evidence has linked persistent crying in young infants to food
allergy; an association between colic and cow’s milk allergy (CMA) has been postulated.
Low birth weight- Data from one study suggested an association between low birth
weight and an increased incidence of colic.
Characteristic intestinal microflora-Some reports have focused on intestinal microflora
and its association with colic; lower counts of intestinal lactobacilli were observed in
infants with colic compared with infants without colic.
