"I think so-called colic is an extremely difficult subject to discuss due to the fact that there isn't any definite clinical entity that one could describe, such as cystic fibrosis of the pancreas. One could gamble that if he were to ask the members of this seminar what his ideas were of colic, he would get as many varying answers as there are physicians in the group. . . . It should be pointed out that one should be reasonably certain that there is not something physically wrong with the infant with "colic," such as an ear infection, inguinal hernia, or milk allergy. Many mothers and physicians believe this disturbance is due to excessive gas in the intestinal tract of the infant. On roentgen examinations, the stomach of the newborn baby is filled with air 10 minutes after birth, the entire small bowel 90 minutes later, and air reaches the rectum after 6 hours. How can one keep air out of the intestinal tract? It can't be done. . . . It seems to me that crying in the first 3 months of life is just as much a part of the expected behavior of that period as it is for a 2-year-old youngster to dive from one object to another, or for a 3-year-old to have fears of various things. It would seem to be an extremely wise provision on the part of nature to provide the youngster with this ability to cry.
"The stimulus that will call forth a cry in a baby can be minimal. He cries at the drop of a hat and what the stimulus might be is, at times, impossible to ascertain. It might be hunger, thirst, or more often other things. It is a reflex or response which disappears with maturation of the infant. As he gets older and has other means of protection and expression, the symptom-complex is rarely noted. That is the reason for the term 3-month colic.
"Parents often state that their `second baby was so much better than the first.' We realize that it is ordinarily not a difference in the babies, but rather is a change in the parents. The mother and father have become more comfortable and relaxed in the management of infants. . . . I cannot believe that the answer is phenobarbital or the many antispasmodics or other means of therapy used. It may be necessary to use a hypoallergenic milk substitute occasionally. The main reason for so many problems in first babies is that the parents do not know what to expect of the newborn. . . . I don't know what colic is; but I am sure it is not what the term implies, that is, simple abdominal pain. All of us know that most babies have a fussy period once a day and it usually comes late in the afternoon when they cry for 2 or 3 hours. After that they quit and sleep for the rest of the night. It is inconceivable to me that a baby can be sick with indigestion and discomfort for a few hours of each day or night and be free of this difficulty the remainder of the day.
"It is my impression that we as pediatricians must attempt to give parents some idea of what to expect concerning behavior of the neonate before they leave the hospital. As far as I am concerned, crying is one of the expected modes of behavior. It is true that some babies cry more than others. I think if we could help parents to have the same knowledge and attitudes toward this behavior of the neonate as we or our nurses do, we could help make this period a more pleasant one for the parents."
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