Ritah Ankunda is a mother of a one-year-old baby boy. Being a first-time mother, she was not so familiar with a number of things concerning babies. At two weeks, her baby started crying continuously everyday especially in the late hours of the night.

She could hardly sleep as she had to carry her baby around the house until it slept again. The baby refused to take milk and had to be forced to eat something. At four months the crying was louder and this worried her more. To her, it was a terrible welcome to motherhood though it taught her a lesson that she would use to look after her other children.

Medics say for a baby to cry is normal simply because it is the only way it can communicate when it is hungry, sick, feeling hot or cold. However, crying too much might be a sign of colic. Colic is a situation where a baby goes beyond crying and instead screams, which may last hours.

According to Dr Bwiza Muhire, a pediatrician at King Faisal Hospital in Kigali, colic is a common symptom which occurs during the first few months of life. It is almost resolved by four months of age.

Muhire adds that colic begins at the same time everyday and babies are mainly picky during evening hours.

"If colic starts early, it takes about four months to heal but when it begins a little late, for instance at three weeks, then it heals earlier,” says Dr Raymond Awazi, a pediatrician at Heritage Medical Hospital Park Kagarama, Kigali.

Awazi says the exact cause of colic is not known though it might be due to hyperperisbalpisme, where the movement of intestines in the baby’s stomach is fast. It can also be due to food allergies resulting from the food a mother eats while breastfeeding. For example, babies tend to be allergic to cow milk due to the proteins it contains.

"Theories exist that faulty feeding techniques like swallowing air during breastfeeding, infrequent burping, lactose intolerance, intestinal immaturity and intestinal hyper motility can cause colic,” says Dr Edgar Kalimba, a pediatrician at King Faisal Hospital in Kigali.

Signs and symptoms

"Excessive crying, swelling of the belly, contraction of belly muscles, flexuous legs, baby’s face turning red, and a baby passing out gas can indicate that the baby is struggling with colic,” Awazi states.

He says the baby’s belly tends to get swollen and the crying may last hours, but adds that mothers should not be bothered or worried about it.

Muhire says colic is characterised by paroxysmal, inconsolable screaming often accompanied by drawing up of knees and passage of excessive flatus. These symptoms tend to occur several times a day particularly in the evening.

Treatment

"Healthcare providers should only offer support and reassurance after excluding other possible causes of infants’ crying. Some provide gripe water, but it is of unproven benefit,” says Muhire.

Awazi says there is no specific treatment for colic though some doctors prescribe debridat. Colic is normal but if the baby continues crying unnecessarily after four months, then it should be taken for further diagnosis to ascertain whether it is suffering from another disease.

Muhire adds that the mother should improve on the feeding techniques by helping the infant to swallow some air with a curved bottle and also using a pacifier (keeps the baby sucking on something). "Placing the baby in infant swings, providing a warm birth, pressing a warm water bottle on the baby’s belly to enable it release gas as well as hip healthy swaddling can also help.”

He, however, advises mothers to watch the food they eat while breastfeeding since some food like chocolate, fruits (oranges), eggs, caffeine, wheat, soya, onions, and vegetables like broccoli are not good because they can cause allergy to the baby (through breastmilk) hence worsening the ache in the baby’s stomach.

"Some medicine mothers take while breastfeeding can also be harmful to the baby,” Muhire adds.

Ways to relieve colic

"The baby should lie on the belly, and not the back. Also whenever a baby is crying it should be carried on the shoulder and carried around to make it a little more comfortable,” says Awazi.

Awazi notes that mothers should avoid over feeding or feeding quickly.

"If the baby feeds for about 20 minutes, the nipple holes may become too large and start bringing much milk which might increase the baby’s crying,” he says.

Awazi adds that carrying the baby comfortably and upright helps it pass out the gas from the stomach and also reduces the heartburn. Dr Kalimba says if a mother is breastfeeding, she should try to avoid too many spices in food and tea. Smoking should be completely dealt away with since it can harm the infant, he adds.

He says if symptoms continue, it is good to see a pediatrician to rule out any other causes of the discomfort. Mothers should learn what comforts the baby before colic increases since it would help reduce the tension.