Irritable Infant Syndrome or Colic

  Colic is usually de­fined as paroxysmal abdominal pain or cramping in an infant and usually is manifested by loud crying, drawing up of the legs to the abdomen, and extreme irritability. Episodes of colic may last from several minutes to several hours a day. During this time, most efforts to soothe the infant or relieve the distress are unsuccessful. Colic is most common in infants younger than 3 months of age but can persist up to 9 months of age.

Caring for an infant with colic can be frustrating. There is no single etiologic factor that causes colic; there­fore, the treatment of colic is not precise. Many non-medical techniques and pharmacologic preparations such

TABLE 2-3 Assessment of Infection in the Newborn
Evaluation	Data
Are there maternal risk factors?	Premature labor <37 weeks' gestation
	Group B streptococcal colonization
	Premature rupture of membranes (>18 hours
	delivery)
	Inadequate prenatal care
	Low socioeconomic status
	Poor nutrition
	Substance abuse
	Maternal infection or fever
Are there intrapartal risk factors?	Perinatal complications
	Foul-smelling amniotic fluid
	Maternal fever
Are there neonatal risk factors?	Prematurity <37 weeks' gestation
	Congenital anomalies
	Perinatal asphyxia
	Male sex
	Multiple birth
	Concurrent neonatal disease
Are there environmental risk factors?	Invasive diagnostic or therapeutic procedures
	Antimicrobial agent administration
	Nursery environment
Are there general signs of infection?	Poor feeding
	Irritability
	Lethargy
	Temperature instability
Are there skin signs of infection?	Petechiae
	Pustules
	Edema
	Jaundice
	Sclerema
Are there respiratory signs of infection?	Nasal flaring
	Expiratory grunting
	Intercostal retractions
	Tachypnea
	Apnea
Are there cardiovascular signs	Tachycardia
of infection?	Bradycardia
	Hypotension
	Cyanosis
	Decreased perfusion
	Hepatosplenomegaly
Are there gastrointestinal signs	Emesis or residuals from feeding
of infection?	Abdominal distention
	Bloody stools
	Diarrhea
Are there central nervous system signs	Hypotonia
of infection?	Hypertonia
	Poor spontaneous movement
	Seizures
Is the complete blood count abnormal?	Granulocytopenia
	Neutropenia
	Increased ratio of immature neutrophils
	Döhle bodies
	Toxic granules in cells
	Thrombocytopenia
	Anemia

 

as antispasmodics, sedatives, and antiflatulents have been tried. Nonpharmacologic interventions should be at­tempted before administration of drugs. Support of the parents is probably the single most important factor in the treatment of colic. Many times, the mother (or pri­mary care provider) may be afraid to state just how frus­trated she is with her inability to console the infant. An open discussion of this frustration can help the mothers or care providers recognize that their feelings of frustra­tion are normal; frequently, this gives them the added support needed to deal with their infant.