Caption: Colic
Text: One of the most common frustrations encountered during the first 3 months of life is late afternoon and nighttime crying, typically referred to as colic. Colic is characterized by crying that is not easily consoled and usually occurs in the evening. The infant flexes the hips and cries as if in pain. These symptoms are frequently associated with, and sometimes seem to be relieved by, the passage of flatus. The precise etiology is unknown, but colic appears to involve multiple factors including gut immaturity, some types of formula or milk intolerance, overstimulation, fatigue, and parental tension. On examination, the child appears well. Sometimes the parents seem overly attuned to the infant's needs and unable to tolerate even brief periods of crying. In this situation the greatest service a clinician can provide is to give permission for the child to cry. Most medications do not affect the crying, and some remedies are potentially addictive and dangerous. Urging the parents to care for the infant's needs and then give him some time to "unwind" by crying uninterrupted for 15-20 minutes can be helpful. Most important, however is the reassurance that the child is normal, the symptoms are temporary, and their occurrence is unrelated to basic parenting skills.