Medical Theories About Colic
Despite the large numbers of babies affected, there has never been an all-out effort to determine the causes of colic. This is mainly because colic is not an illness, it is a self-limiting condition. In addition, scientific investigation is hampered because of a reluctance to subject basically healthy infants to potentially harmful procedures like x-ray examinations.
Although the cause of colic remains unknown, a multitude of theories have been proposed. At various times in the past 60 years, colic has been attributed to tension in the home, maternal anxiety, faulty reading of signals from the infant, immaturity of the infant’s gastrointestinal tract, spasms in the colon, trapped intestinal gas, a deficiency of the hormone progesterone, allergy, a sensitivity to cow’s milk protein, faulty feeding techniques, and a host of other factors. Today, most researchers believe that several of these factors may be present together in infants with colic.
The most controversial of these theories has been the one linking colic to maternal emotional factors. Some pediatricians observed that mothers of colicky babies seemed to be especially anxious, and they attributed the colic to the mother’s supposed conflicts about accepting the maternal or feminine role. Critics of this theory have pointed out that the anxiety in these mothers may be a result of the colic rather than a basic personality trait. One study found no significant emotional differences between mothers of babies who became colicky and those who did not, but the controversy continues.
A related theory attributes colic to disturbances in the interaction between parents and their infants. Proponents of this theory suggest a mismatch between the infant’s crying behavior and the parents’ expectations and reactions to the crying. For example, frantic parents of colicky babies have been noted to try a series of calming techniques without using any one consistently, thereby over-stimulating the infants. Other parents give up trying and withdraw from their infants. These parental responses lead to a spiraling of parent and infant stress.
Other research has focused on finding a physiologic explanation for colic. One study noted that immediately after feeding, a significant number of colicky babies had violent, apparently painful contractions of the colon. Another researcher believes that kinks or obstructions in the infant’s colon block the normal passage of gas, causing pain. Still another study found that the urine of colicky babies was deficient in the hormone that relaxes the smooth muscle functions of the bowel. This deficiency might cause muscle spasms and abdominal cramps.
A recent promising theory suggests that colicky infants are sensitive to proteins present in cow’s milk. These substances are contained in most infant formulas and are transmitted from the mother’s diet to breast-fed infants. Some researchers have found that colic symptoms in many breastfed babies disappear when their mothers eliminate milk and milk products from the diet; symptoms return when these foods are reintroduced. The validity of this finding is currently being disputed in medical circles, and additional studies need to be carried out. However, individual pediatricians who have suggested formula changes for colicky bottle-fed babies and modifications in the maternal diet for breast-fed babies report encouraging results.
The temperament of the individual infant may also play a role in colic. Newborns differ greatly in degree of tenseness and fussiness, as well as the ease with which they can be consoled. They also differ in sensitivity to stimulation from within their own bodies and from the world around them. Colicky babies may have more difficult temperaments and a lower sensory threshold, causing them to be more affected than other babies by, for example, normal amounts of gas.
As noted earlier, colic probably has more than one cause. Its origins most likely are neither totally organic nor totally emotional. Rather, colic appears to be a complex phenomenon, in which several of the factors mentioned above combine to create the distress. Moreover, the causes probably differ from baby to baby. Parents will only become frustrated if they try to pinpoint exactly what caused their baby’s colic. They should focus instead on ways of easing the infant’s discomfort.
