Abdominal pain (gas or colic) in infants
Abdominal pain in infants (also called gas or colic) is part of a larger joint called restlessness in infants which I review in detail In another area of this site . But the impression is that the specific topic of flatulence should also be written separately, this is because it is the most common cause of restlessness and abdominal pain in infants.
What is the definition of flatulence in infants:
According to the textbooks this is the definition:
A. Recurrent and prolonged events of crying, discomfort and restlessness that occur for no apparent reason and cannot be prevented or anticipated.
B. Symptoms begin and end before the age of 5 months.
C. The baby without any obvious medical problem in the background such as lack of prosperity, fever or other illness.
D. Addition to definitions for the purpose of research – the duration of the events is over 3 hours for at least 3 days or more during a week.
Another beautiful definition I found is according to Law 3 – a healthy and thriving baby, events that start at 2-3 weeks of life, last at least 3 hours a day, at least 3 days a week, at least for 3 weeks and pass without treatment until 3-4 months of age.
Practically, textbooks have been abandoned, these are babies, usually from the age of a few weeks (but can certainly start earlier), who are restless and sometimes cry for long minutes or hours. Most parents know how to target the abdomen as a source of the child’s discomfort
What is the prevalence of flatulence in infants?
According to textbooks, the incidence of abdominal pain from this source is about 20% of infants.
But in real life there are single families whose babies were abdominal pain free to one degree or another.
What is the cause of flatulence in infants?
The cause or triggers are unknown.
We all say intestinal habituation to food, or expressions like intestinal maturation and the like. This makes sense but has not been proven in any way to be true. Other works even claim that abdominal pain is like a migraine in infants, i.e. a neurological problem.
It seems to me that this riddle will not be solved any time soon. This is a given situation.
What is typical and what should not be missed?
What is typical? Volatility during the day. Most families report worsening of restlessness in the evening or early night. There are families who can tell me that from seven to ten in the evening, at a given time, the gases come. In addition, relief after exit is described.
What not to miss? very important. Flatulence may be one of the most common and benign causes of abdominal pain in infants, but it is not the only cause. It is important to say – this is a diagnosis by way of negation. This means that it is important before diagnosing gases to think deeply and not to miss other important diagnoses.
It must be a baby who is gaining weight well, achieving the developmental milestones, his physical examination is normal, his ejaculations are normal (without blood or mucus for example) and there is no suspicion of disease or other medical condition in the background.
Therefore, if the abdominal pain is severe and you are afraid, go to the pediatrician once, and let him make the diagnosis. And more importantly, rejoice in this diagnosis because there are more terrible things.
What helps gas in babies?
Several things can help:
Relief by touch and repetitive movements – lifting the baby and attaching it to one of the parents, gently massaging the abdomen clockwise and also rocking or riding in a stroller / car can alleviate the discomfort.
Calmness of the system (family in general and parents in particular) – if you parents understand that these are just gases (without underestimating, I also cursed the whole world and his wife when I went with my children from side to side in the living room at two in the morning) and that this is a given situation that will not be dangerous. In this direction the role of the pediatrician is to confirm the diagnosis and sedation.
Regular agenda – proven as an assistant! Maintain set wake-up hours as well as meal and bath time.
Time with yourself – excuse me, but parents of a small baby who are able (physically and mentally) to go out one evening a week, to break away from these frustrating stomach aches, will find that when they return they are more relaxed and contained.
What does not help with flatulence in infants?
Everything you and I tried …
Formula replacement – Although most parents (in families whose babies are not exclusively breastfeeding) will find themselves considering switching to another formula, with a more glittery name, then there is usually no medical reason for such a replacement. Changing a formula gives the feeling that something is being done in an attempt to address the baby’s distress ("a new broom is a good broom") and saves time, but for the most part it does not really help.
Flatulence in infants – Again, nothing really helps in the medium or long term. True, most of these "medicines" that are sold without a prescription have sugar and it calms the baby down a bit for a few minutes but they do not really change the course of these abdominal pains. Just give the feeling that you are doing something.
Homeopathic Remedies – Sure you have a good company that recommends this or that infusion, cabbage oil with watercress or something like that (these are always very beautiful and natural names). In your heart you know it’s nonsense in tomato juice.
Reminds that it is most difficult for a pediatrician to stand in front of a family looking for solutions for a suffering baby and say "there is nothing to do". But the main message to parents "and the most correct" treatment in this situation is to confirm the diagnosis and calm the family.
What about probiotics in the context of flatulence and abdominal pain in infants?
Probiotics is a big name for a variety of friendly bacteria that are given orally in years indications. For the most part most of the probiotic strains tested in the context of gas in infants have no research evidence that can help. However in controlled double-blind controlled trials, including a meta-analysis examining several studies, a specific strain called Lactobacillus Rotary Protectis (L. reuteri DSM 17938 ) Has been shown to improve colic symptoms in breastfed infants.
Therefore, in those breastfed infants (full or partial breastfeeding), it is appropriate to consider trying the individual preparations (or formula) that are sold in Israel and contain this specific type of bacteria.
What about giving painkillers in babies who suffer from flatulence?
On really hard nights, when the frustration increases, I definitely recommend giving the child an age-appropriate painkiller. All parents do, you do not harm the child. Does not suggest starting to continuously treat acetaminophen until the bar mitzvah, but here and there definitely.
A few more words in the larger context of restlessness and abdominal pain in infants:
Restlessness and crying are unfortunately an integral part of raising healthy babies. Crying for example, is one of the baby’s ways to signal to his parents that he needs something. Therefore, it is difficult to determine where the line of good taste passes between normal and pathological restlessness. I would recommend parents to consult a pediatrician for any prolonged restlessness beyond reasonable.
Much depends on you parents – you can not expect stressed parents to raise a calm baby. Precisely the baby who is restless, needs (beyond proper diagnosis and treatment depending on the situation) calm and containing parents, a regular agenda and not a stressful and stressful family.
Easy to say, hard to do, I know. Successfully.