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Colic


Question

How do you determine if a baby has colic or is showing signs of gastrointestinal (GI) issues?

Réponse de nos experts

Colic is something that occurs in infants under two months of age. It is comprised of fussiness and frequent crying all day long with difficulty in being consoled. The etiology is unclear; some people think that it is due to feeding problems since some babies have increased gas and stomach discomfort. Methods that help include walking with the baby, rocking the baby while walking, putting the baby in a swing, putting the car seat on the dryer while the dryer is going or taking the baby for a ride. It is a frustrating thing for parents since the baby will be fed, dry, not sleepy and still fuss. The good news is that it always resolves.

Many babies have mild gastroesophageal reflux. These are the babies, who after every meal will spit up a little bit. This is a normal baby phenomenon and occurs in over half of all babies. It is due to the valve between the esophagus and the stomach not being fully "mature" and tending to flop open especially when the stomach is full. Most babies grow out of this by 6 to 9 months. Sometimes it is so severe that they need to be put on medication temporarily. Many pediatricians will recommend thickening the feeds by putting lots of cereal in the bottle, and use positioning of the baby to help control the reflux (head elevated, lying on the stomach). But, if this does not work, they will try the medications. If they do not work, then a referral to a gastroenterologist would be indicated. If signs of reflux start after about 4 months, then it may not be the typical kind, and might need further workup. Most individuals with CdLS (over 90%) will have issues related to gastroesophageal reflux and/or reflux disease.

TK 7-13-10

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Recommandation(s)

Reflux

R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
R33 : La modification de l'alimentation et les inhibiteurs de la pompe à protons (IPP) sont les traitements de première intention du RGPD. Les médicaments anti-reflux doivent être utilisés à leur dose maximale. Les interventions chirurgicales pour les troubles gastro-intestinaux doivent être limitées aux personnes atteintes de SCdL chez qui les traitements nutritionnels et médicaux ont échoué ou chez qui la sécurité des voies respiratoires est menacée.
R34
R34 : Si les symptômes de troubles gastro-intestinaux persistent, l'endoscopie doit être fortement envisagée pendant que la personne atteinte de SCdL est encore sous soins pédiatriques.
R35
R35 : La surveillance de l'œsophage de Barrett doit être discutée et décidée avec la famille, en équilibrant le gain potentiel de santé et le fardeau pour la personne atteinte de SCdL.

Avis juridiquer

Veuillez noter que le service Demandez à l'expert est composé de professionnels bénévoles dans divers domaines d'intérêt. Les réponses ne sont pas considérées comme une consultation médicale, comportementale ou éducative. Demandez à l'expert ne remplace pas les soins et l'attention que peut fournir le médecin, le psychologue, le conseiller pédagogique ou le travailleur social de votre enfant.

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