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A dummy's guide to colic

Copperfield

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There are some victims of the current over-diagnosis epidemic who are frankly rubbish at articulating their plight. Instead of voicing a cogent explanation of how they are unnecessarily pathologised and medicated, they just shout and blubber and generally poo their pants.

Then again, they are only eight weeks old. And these infants are wondering, as I am, whatever happened to colic? Because not all that long ago, colic was a thing, wasn’t it? Any baby with unexplained persistent/recurrent crying simply had ‘infant colic’, the parents just needed a dose of reassurance and it all settled down given time.

Not any more. Infant colic doesn’t appear to exist nowadays. Why? Well, let me roughly translate that ‘Wwaaaaaaaaaaaaaaaaaaaaaaaeeeeeeeeeeeeuuuuuurrrgh’ emanating from junior. What is actually means is, ‘Look, all I did was burp and I got taken to A&E where a doctor not much bigger/cleverer than me stuck me on an alginate, H2 blocker, a PPI and a cow’s milk-protein free diet then turfed me out without any follow-up.’

Ends up being unnecessarily medicated because of a spurious diagnosis

Because that’s what happens. Now, I don’t want to throw the screaming baby out with the bath water. There may be a few who really are suffering GORD or CMPI. But I’m equally sure there’s a whole lot more experiencing something minor and self limiting which we used to call colic, which needs nothing more than a pat on the head/fontanelle but which ends up being unnecessarily medicated because of a spurious diagnosis.

That’s medication that we GPs are not only continuing, but initiating, too, because indiscriminate hospital prescribing has normalised this spasm of over-reaction. And that’s despite the cost, the side effects and the fact that doing the dosage maths on a stressful day duty in a room full of anxious parents, screaming baby and unrestrained siblings pretty much has me soiling my own nappy.

Enough. Time for some Clinics for Colic, so long as the local Coliclinic is run by a paediatrician more familiar with doses of perspective than omeprazole. In the meantime, I’ll suggest the parents use a dummy. By which I don’t mean the local A&E doc.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (8)

  • Cobblers

    Yup just got through this patch with my six month granddaughter and two anxious parents (daughter and son in law).

    She's a bit of a puker and she did have several colicy sessions a day which lead to fat belly granddad doing the walk whilst calming screaming child. Meantime grandad's head is thinking of the differential GORD, CMPI, Lactose Intolerance, Intussusception to name a few. Rotavirus oral vaccine seemed to worsen it. Infacol, Calpol eventually Colief seemed to help a bit. No logic to this BTW.

    But at other times she was normal cheerful self. Good weight gain. Mum settled. Dad happy. Grandpops wipes his brow with relief.

    All fine now. Settled at 4-5 months. No alginate, H2 or PPI. Needed constant house calls (100m down the road) and reassurance.

    I would agree with Top Cat, a ColiClinic to provide the backup to parents who don't have a retired GP and Midwife (my wife) to call on for help. Which is most of them.

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  • Can someone remind midwives & Health visitors and tell them to stop sending worried mothers for alginates.
    70-85% of infants have reflux symptoms.
    Well over 90% of these do not require any treatment.
    I looked it up after a recent row (consultation). Copy & paste for appraisal folder!

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  • All correct except advising a 'dummy' - the sucking on which results in aerophagy, resulting in gastric distention, resulting in bloating, discomfort, burping et al .......?colic & GERD.

    And a quick wipe on the sleeve after the repeated drops to the floor (the dummy, not the baby) is not very antibacterial.

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  • Dear All,
    And what of the long term effects of PPIs in humans who's immune systems have not yet matured?
    Anyone fancy an epidemic of gastric lymphoma circa 2040?
    I find my musings on what effect these drugs might have is usually a sufficient deterrent.
    Regards
    Paul C

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  • the curious thing about infant colic is that it just stops one day with no change in diet or other explanation. I have always taken this to mean that the infant has got used to the tummy pains and now ignores it. A thorough search of the literature produced no cogent explanation for colic apart from normal gut pains due to peristalsis. When I started as a GP 30 years ago merbentyl syrop cured colic instantly. Then it had a rare side effects so was withdrawn. Our main task as a GP is to keep colic as colic and not let the hospital docs overdiagnose it......

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  • Agree! Over medicalisation of a normal process that kids grow out of.

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  • Cobblers

    Agree with the general consensus. Just to say that whilst you're going through it, it is a real trial. I think my daughter would have gone to the GP had I not been around to talk and walk (talk to parents and walk the baby).

    A ColiClinic drop-in would save a fair bit of over medicalisation and polypharmacy. It might even save money. (Shock Horror)

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  • An endocrinologist diagnosed polyphagia in a patient of mine and wanted me to give a GLP-1 agonist. Sorry, greedy is not a diagnosis. An abuse and misuse of free healthcare at the expense of others.

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