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 CONCEPT
Syndrome characterized by excessive and sudden crying, of predominance vespertino, without identifiable cause, between 2 weeks and 4 months of age, and in a nursing one otherwise healthy.
INCIDENCE
Of 10 to 20 % of the nursing normal ones.
CAUSES
The real etiology of the colics of the nursing one is not known, several theories having been postulated:
Hypersensitivity to components of the diet.
Excessive intestinal gas.
Intestinal Hipermotilidad.
Hormonal factors.
- ("Behavioral") not intestinal causes:
"Weeping children".
Psychosocial factors of the parents.
Problems in the interaction parents - children.
CLINIC
1. Age: during the first 3 months of life. Week usually begins in 2ª-4ª, Diminishes of frequency and intensity with the age, up to yielding at the age of 3-4 months. 2. I fit: Inexplicable, daily attacks of crying and irritability, of predominance in the evenings (18.00 to 20.00 h), of approximately 2 hours of evolution. The child shrinks the legs, becomes red and cries. Abdominal distension; later it stops suddenly, remaining calm. Neither diarrhea nor other symptoms exist accompanists. Normality between crisis, with development psicomotor normal.
EVOLUTION
Autolimited and benign. The intensity is maximum at first. It usually disappears concerning 3 months of age.
DIAGNOSIS
1. Principal symptoms:
Crying paroxístico vespertino (more than 3 h/día and more than 3 d/semana).
I worry, bother, irritably, rough.
Knees push-up on the abdomen.
2. Secondary symptoms:
- It seems hungry, but he does not calm down with the meal.
- Habitual constipation.
- Meteorismo, abdominal gases.
TREATMENT
- General norms:
There is no clearly effective medication.
Not to change blindly the feeding, not the habits. To value modifications as evolution on the part of his Pediatrician.
The use of sedatives is not recommended.
"Training of the parents": To try to satisfy 5 needs when a child cries: famine (flexibilizar the captures, it does not go away to malacostumbrar for it), I want of sucking to calm down, want of feeling protected (to take him in arms, does not go away to malcriar for it), I want of playing or that him pay attention (to play with him, to take him to an ambience with sounds), and desire to sleep (calm ambience and without noises).
To send his Pediatrician for control and pursuit.
- Advices:
I rock, to rock the child. Mouth puts the baby to bed below on his knees and massage or give soft clappings in the back.
Rhythmic sounds (TV set, washer, sonorous toys).
To go for a walk with the child in arms.
To go for a walk with him in car (it does not fail!).
Turnarse in the care of the child to rest.
First of all: not to become nervous!
Instructions for the captures: relaxed and calm mother, the child to have time, to prevent from taking quickly (aerofagia), not to put it to bed immediately after the capture, and to help him to throw the air.
- Intervention on the diet:
If breast feeding: regular rhythm of the captures, to suspend medicines and exciting that the mother could take, as well as the milk to the mother if intolerance is suspected to proteins of milk of cow.
If artificial lactation: regular quantity, concentration and frequency, to try not to change the milk, only if IPLV is suspected to value hidrolizados (NUTRAMIGEN ®, PRESGESTIMIL ®).
- Medicines
: In general it is not recommended to use them, or the least possible thing.
Antiflatulent: Dimeticona (AERORED): 0,25-0,50 cc/dosis with the captures every 6-8 hours.
Carminatives: Miscellanies of oil or extracts of of anise + bicarbonate, with or without belladonna.
WHAT DOCTOR CAN TREAT ME?
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CONCEPT 
