Diseases of the stomach and intestines in young children are among the most severe areas of domestic pediatrics. There are two large sections of diseases of the digestive system in children: organic and functional. Organic diseases are associated with structural changes in organs, that is, there is damage to organs and tissues. Functional diseases are characterized by the absence of damage to organs and tissues, but there are disturbances in the regulation of the functioning of these organs. It is worth noting that changes in the regulation of internal organs are characterized by the appearance of symptoms that are very similar to symptoms in organic pathologies. This is the difficulty in diagnosing and treating children.
In 2021, an improved classification and new criteria for diagnosing functional disorders of the digestive tract in young children were developed - the Rome Diagnostic Criteria IV. This group includes infant colic. Next, we will consider this pathology in more detail, analyzing the main manifestations and methods of treating this disease in a child.
What is intestinal colic
Intestinal colic is a sharp, sudden (for no apparent reason) restlessness, prolonged crying or screaming in a baby, usually in the first four months of life. Infant colic begins approximately two to three weeks after birth and reaches its peak by the sixth week. After the eighth week, their intensity and frequency gradually decreases. Most often they are observed from birth until three to four months. Sometimes up to five or six months. It is worth noting that 60-70% of children have severe colic , which negatively affects the psychological state of parents.
Parents need to be prepared for a difficult period, because 60-70% of children have severe colic.
When medical attention is needed
Medical attention may be necessary when the following are added to the symptoms of colic:
- temperature, fever;
- vomit;
- diarrhea;
- convulsions;
- weight loss;
- blood in urine or stool;
- signs of intestinal obstruction, volvulus or intussusception, strangulation of the umbilical hernia, which were mentioned earlier.
These symptoms indicate serious illnesses, some of which can even be fatal. Therefore, you should not delay your visit to the doctor.
Even if there are no listed symptoms, if you suspect colic, it is still better to consult a pediatrician. Only he will be able to determine the cause of the baby’s anxiety by collecting anamnesis, conducting a visual examination and conducting laboratory and instrumental diagnostic methods.
To summarize, we can conclude that colic appears in most newborns in the first month of life and lasts up to 3-4 months. Parents should not panic, because their emotional state is bad for the baby. Colic is not a disease or pathological condition; it is a temporary and safe phenomenon that needs to be waited out.
Causes of intestinal colic in children
The main reasons leading to the development of colic in children include:
- Unformed nervous regulation of the baby’s intestines.
- Increased gas formation due to a lack of enzymes in the gastrointestinal tract.
- Intestinal dysbiosis, that is, a violation of the intestinal microbiota. To put it in more accessible language, this means an imbalance between the microorganisms that inhabit our intestines.
- Poor nutrition for nursing mothers.
- Gallbladder dysfunction.
- One of the most studied causes of intestinal colic is currently intolerance to cow's milk proteins.
As stated earlier, the main cause of functional diseases is a violation of the nervous or humoral regulation of the functioning of internal organs. In this case, there is a violation of the regulation of intestinal activity in a newborn and infant.
Treatment according to Dr. Komarovsky
Dr. Komarovsky does not recommend treating colic with potent chemical drugs. He does not recommend using a gas outlet tube either. An enema can damage your baby's intestines. If there is a need to use it, you need to choose modern models for 2021. They have a soft tube that cannot be pushed deep. Before use, you must make sure of the need, so as not to perform a traumatic procedure just like that.
Gases accumulate when a child eats more than he can digest. As a result, leftover food begins to rot, releasing harmful substances, the accumulation of which causes abdominal pain. Therefore, instead of using enemas or medications, it is better to increase the time between feedings or the amount of food eaten.
If after the first use there is no positive result, you need to stop installing gas outlet tubes.
What to do with colic in a newborn Komarovsky says this: to help the baby, it is necessary to eliminate or reduce the impact of provoking factors. Use safe methods to alleviate the child’s condition: laying on the stomach, rocking, drugs with natural composition to facilitate the passage of gases, massage.
About feeding
How to relieve colic in a newborn, Dr. Komarovsky: follow the feeding regime. As stated earlier, if a baby is crying, it does not mean he is hungry. There is no need to try to feed him, this may make the situation worse. This is especially true for mothers who breastfeed or bottle on demand.
If the baby is crying and has eaten recently, it is better to try giving water, changing the diaper, giving a tummy massage, or trying to rock him in his arms.
About mom's nutrition
Dr. Komarovsky encourages mothers not to mock themselves and to eat their favorite foods without fear of harming the child. He says what a woman eats has nothing to do with the quality of her breast milk.
When a new mother eats poorly, it affects her well-being and mood. The newborn feels everything subtly and begins to get nervous, scream and cry more. When a woman is well-fed and satisfied, this has a positive effect on the child.
There is no need to torture yourself with strict diets, listen to others and eat, as they say, “bread and water.”
About motion sickness
Many mothers note that motion sickness really helps relieve the child’s suffering. Dr. Komarovsky says that if the baby is truly colicky, he will not be able to be calmed this way. When a newborn stops screaming in his arms, this indicates a manifestation of character. The baby wants to see his mother, he achieves this by crying.
Of course, you can carry your child in your arms from morning to evening so as not to scream. However, he will quickly get used to it and it will be difficult to wean him off. This will cause a lot of inconvenience for the mother, especially if there is a second child in the family who also needs to be looked after.
About laying on the tummy
In some sources you can find information that sleeping on your stomach helps with colic. This is a misconception that poses a serious danger.
There is such a thing as sudden infant death syndrome. This is when a completely healthy child is put to sleep, but he does not wake up. The cause of this has not been established, but it has been determined that most cases occur in babies who sleep on their stomachs. Therefore, babies under one year old should not be placed to rest with their butts up.
Many experts agree that putting it on the tummy for colic really helps. This can be done for no more than 5-7 minutes and under the constant supervision of adults.
Symptoms of intestinal colic in a child
Parents often ask the question: “How can you tell if your newborn has colic?” According to the Rome criteria for diagnosing functional diseases in young children, intestinal colic begins and stops in children under the age of five months. The main symptoms and signs of colic in a newborn include:
- Regular and prolonged bouts of crying, restlessness and irritability in the baby that appear for no apparent reason. Typically, these episodes last three hours or more per day and occur at least three days a week for at least one week. For convenience, this can be called the “rule of three.”
- Absence of signs indicating a developmental disorder in the baby. Also, such children should not have a fever or signs of other illnesses.
Parents need to carefully monitor their baby's behavior and watch out for warning signs.
It is worth emphasizing that there are so-called “ alarm symptoms ” that can confirm or exclude organic pathology in the baby.
Symptoms of anxiety include :
- Vomiting blood.
- Aspiration. Aspiration is the entry of liquid or food into the respiratory tract. Most often observed in organic pathology.
- Apnea or, in other words, cessation of breathing.
- Difficulty swallowing food and feeding.
- Unusual positions during feeding.
These symptoms exclude the presence of a functional pathology. In such cases, an in-depth examination is recommended to make a correct diagnosis.
The problem of colic in newborns is caused by swallowing air.
The beginning of a potential cause of colic is feeding a newborn. Children who eat actively and greedily suffer most from colic.
Food through the esophagus carries with it almost the same amount of trapped air . However, babies who appear to be eating quietly also swallow air during feeding .
In the stomach, under pressure, it accumulates and bubbles form. Most of the air that enters in the form of bubbles when the baby burps after feeding passes through the oral cavity and esophagus without problems and almost imperceptibly.
But still, some of the bubbles enter the intestines from the stomach . Although they are small, these air bubbles still cause a nightmare in your little one’s small body.
If you've ever felt stomach cramps or bloating, this is exactly the feeling.
The easiest way to deal with colic is to take a short walk or regular exercise after eating.
If the pressure in the intestines is a little stronger, then massaging the abdomen in a clockwise circular motion will help overcome the discomfort . By movement and massage, the air bubbles are divided into smaller bubbles and thus pass more easily through the digestive tract.
Basic advice from Dr. Komarovsky
All that modern medicine knows about infant colic is that such a problem exists. Not a single doctor will tell you the reason why your child has these pains. But the famous doctor gives universal recommendations on how to survive this difficult period in the life of a newborn:
- Do not overheat the baby, do not put a lot of clothes on him, and if you swaddle him, do not do it too tightly.
- Regularly ventilate the room in which the little one is located, make sure that the temperature is comfortable (18-20°C) and the air is not dry.
- Watch your diet, but don't force yourself into strict limits.
- Maintain intervals between feedings and do not overfeed your baby.
- Do not engage in experimental searches for a solution to the problem, especially if this may harm the baby.
- There are no medications that can cure colic once and for all; any medications in this matter help the parents more than the baby.
- Delegate some of your responsibilities to the baby’s grandmothers and father, try to rest.
But the most important thing is not to irritate the child again. All he needs is a calm, content, rested mother and a calm, loving father. Give it to him. The pain will go away regardless of any external factors. The main thing is to maintain the peace of mind of parents during this difficult period.
Symptoms
The main and most distinctive sign of colic is the baby's cry. It is this cry that you will not confuse with a cry of hunger or discomfort, or with whims, or with anything. SO a newborn will cry only and exclusively during colic, mothers with experience understand exactly what we are talking about, and mothers without experience will soon themselves remember the notes and decibels characteristic of this crying.
The second distinguishing feature is that this scream cannot be stopped. Nothing helps. The baby screams with the same “intonation” both in the crib, and lying on his tummy, and in his mother’s arms, and in his father’s, and in his grandmother’s, and after changing the diaper. He yells, despite all your efforts to please him.
In addition, there are specific medical symptoms of this phenomenon in infants:
- the stomach hardens, as if it is bursting from the inside;
- the baby writhes, clenches and unclenches his fists;
- the baby sharply pulls his legs towards his tummy, bending them at the knees, and just as sharply straightens them;
- some children stand tall, arching their backs;
- There are gases leaving all the time and there are quite a lot of them.
Gas leaks in newborns: causes of occurrence
You cannot begin to combat negative phenomena without identifying the sources that caused them. A symptom such as gas in newborns can have a variety of causes. Often the problem lies in improper feeding of the baby, in which he does not receive enough necessary substances. A reaction to the mother's diet is not excluded if the baby is fed breast milk.
Another possible explanation is antibiotics. At the same time, both the drugs that are prescribed to the baby and the drugs that the woman was treated during pregnancy or is being treated pose a threat. Finally, colic in a newborn’s tummy can be caused by increased excitability, stress hormones contained in breast milk, and an unhealthy psychological environment.
Should parents solve the problem themselves or contact a pediatrician? It’s definitely worth showing your baby to a doctor, since seemingly harmless manifestations can turn out to be a symptom of a disease. Self-medication is possible only after consultation with a specialist.
How to use dry heat?
If the above actions do not eliminate gas and colic in newborns, what should you do? A multi-layer diaper is heated with an iron and placed on the sore spot. A folk remedy – flax seed, enclosed in a linen bag – helps retain heat. When heated, it does not cool down for a long time. There is an alternative option - warm potatoes.
Complete relaxation of a tense toddler is facilitated by immersion in a warm bath. Bathing can be combined with massage, light gymnastics, this will enhance the effect. Finally, skin contact is useful, for which the baby without clothes is laid out on the mother's bare stomach. A simple action helps eliminate tension and calms you down. Laying out is also useful for preventive purposes.
