Infants aged below a year vocalise illness or discomfort through loud and continuous crying. This often nerve-racking din can disturb the most stoic caretaker and frustrate parents about ways and means to diagnose and address the pain – Dr. Gita Mathai Most paediatricians divide children with ailments into three groups — infants under age one who cannot verbalise their symptoms; toddlers who can state their symptoms but are unable to localise the pain they feel, and last, young semi-adults who are articulate, lucid and cooperative. In this essay let’s focus on infants and toddlers. Infants below age one vocalise illness or discomfort through loud and continuous crying. This nerve-racking din can disturb even the most stoic caretaker and frustrate parents about ways and means to assess and address the pain and causative ailment. For instance a simple problem such as blocked nose can prompt continuous wailing as the only way the infant is able to breathe is by crying — mouth breathing does not come naturally to new-borns. The most common ailments of infants are colic, ear and abdominal pain. Ear pain can be unbearable and excruciating for new-borns. In such cases if you gently press the ear or pull or tug at it, you may be able to localise the pain, and address it. Colic Infants aged two-four months tend to suffer colic. Typically, colic is identified by loud inconsolable bouts of crying for three hours or more at least three days a week for three weeks or more. The din usually begins in the evening. There are many home and OTC (over the counter) remedies for infantile colic, such as bonnisan, gripe water, simethicone drops and home-made jeera water. It’s best not to use any of them. Some contain opioids, others alcohol and in some, the ingredients are not mentioned. Instead try carrying the baby on your shoulder, and patting her on the back. The colic usually disappears as suddenly as it appeared. Abdominal pain The other most likely cause of discomfort within infants is abdominal pain. The pain originates from hollow organs such as the stomach or intestines if they are stretched. The stretching may be due to constipation, twisting or torsion which disturbs the blood supply to the abdominal organs. Infections such as those of the urinary tract, diarrhoea or dysentery can also cause painful tissue inflammation in the abdomen and intestines. Moreover, one of the intestines can slide into the other and get obstructed, a condition called intussusception. However this has become less common as many children now receive rotavirus immunisation. The abdomen, which contains all the digestive organs, including the stomach, small and large intestines, pancreas, liver, and gallbladder, is richly supplied by nerves which enter the spinal cord from both sides and at multiple levels. This interplay of nerves makes it difficult for adults to accurately localise pain, let alone a child. Generally, pain from the oesophagus and stomach is felt in the upper abdomen, small intestine in the umbilicus, and…
