Previous Post: What is Infantile Colic
What exactly results in a colic, still remains a medical dilemma but few hypotheses have been proposed by researchers, which include-
- Poor feeding technique or any oral restrictions resulting in a shallow latching leading to aerophagia and feeding dominantly of foremilk.
- Alterations in fecal microbiota- Varies with type of delivery (vaginal vs LSCS and type of milk used)
- Intolerance to cow’s milk protein or lactose
- Gastrointestinal immaturity or inflammation
- Increased serotonin secretion #
- Maternal smoking or nicotine replacement therapy
# It has been hypothesized by many researchers* that in the evening, peak serotonin concentration causes intestinal cramps associated with colic because serotonin increases intestinal smooth muscle contractions. Melatonin has the opposite effect of relaxing intestinal smooth muscles. Both serotonin and melatonin exhibit a circadian rhythm with peak concentrations in the evening. However, serotonin intestinal contractions are unopposed by melatonin during the first 3 months because only serotonin circadian rhythms are present at birth. Melatonin circadian rhythms appear at 3 months of age. The cramps of colic disappear at 3 months of age.*
*Infant colic: the effect of serotonin and melatonin circadian rhythms on the intestinal smooth muscle L Weissbluth, M Weissbluth PMID: 1461181 DOI: 10.1016/0306-9877(92)90180-k
Drafted on Inputs from by Dr Mridul Das, Pediatric Gastroenterologist, Formerly at BLK Centre for Child Health.
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