Infant irritability ('colic') is an extremely common phenomenon, with most babies having some periods of irritability. Physiological irritability of infancy peaks at 6-8 weeks of age and is deemed 'excessive' if the infant cries for more than 3 hours per day for 3 days per week for 3 consecutive weeks.
For a comprehensive assessment and management of infant irritability, please refer to the Royal Children’s Hospital clinical practice guidelines.
- Infant irritability is extremely common and often does not reflect an underlying pathology.
- It does remain important to exclude underlying medical causes for infant irritability (see RCH clinical practice guidelines for further detail), most of which can be done with careful history and examination.
- It is crucial to assess the level of parental distress and coping when dealing with an irritable infant.
- There is no good evidence that anti-reflux medications, colic mixtures, formula changes (except in cases of cow's milk protein intolerance) or spinal manipulation are any better than placebo in the management of infant irritability.
- Ensuring adequate support for the family is important in management of infant irritability - see Referral Pathways below.
- Paediatrician
- Most cases of infant irritability can be safely managed in the general practice setting.
- Referral to paediatric outpatient services is reasonable when an underlying cause for the irritability cannot be determined, or if the irritability is prolonged (not peaking at 6-8 weeks).
- Infants with acute persistent irritability without an obvious cause should be referred for Emergency Department services or discussed with paediatric services.
- Support services
- Maternal Child Health Nurses are an important support for many families with young infants, and Enhanced MCHN services can be accessed for some families.
- The local GP is useful for parental support and further evaluation of possible PND or other mental health concerns.
- Perinatal support services
- Raphael House
- Infant and Child Mental Health Service, Norman Street Ballarat, 53203030
- note - PEHP (Perinatal Emotional Health Program) is no longer funded.
- Louise Shalders (0407323538) - Early Parenting & Infant Health Consultant
- Antenatal & Postnatal Pyschology Network (Angela Gent, 0408062003, website)
- Day stay and Mother-Baby Unit inpatient facilities
- Chisholm Street sleep and settling clinic (day stay)
- Ballarat Mother and Family Unit (MaFU)
- For other Mother-Baby Units please refer to the RCH listing.
- Breast feeding support and lactation consultant
- available as inpatient, outpatient or drop-in.
- see Community Services index for further details.
- Further resources