Helping families develop caregiving schedules for the infant’sfussy period is useful. Techniques for calming infants includesoothing vocalizations or singing, swaddling, slow rhythmicrocking, walking, white noise, and gentle vibration (e.g., a ridein a car). Giving caregivers permission to allow the infant to restwhen soothing strategies are not working may alleviate over-stimulation in some infants; this also relieves families of guiltand allows them a wider range of responses to infant crying.Avoidance of dangerous soothing techniques, such as shaking the infant or placing the infant on a vibrating clothes dryer(which has resulted in injury from falls), should be stressed.
Medications, including phenobarbital, diphenhydramine, alcohol, simethicone, dicyclomine, and lactase, are of no benefit in reducing colic and should be avoided. Parents, especially from Mexico and Eastern Europe, often use chamomile, fennel, vervain, licorice, and balm-mint teas. These teas have not been studied scientifically as remedies for colic. Families should be counseled to limit the volume of tea given because it displaces milk from the infant’s diet and may limit caloric intake.
In most circumstances, dietary changes are not effective in reducing colic but should be considered in certain specific circumstances. There is rationale for change to a non-cow’s milk formula if the infant has signs of cow’s milk protein colitis. If the infant is breastfeeding, the mother can eliminate dairy products from her diet.
There is no evidence that infants with colic have adverse longterm outcomes in health or temperament after the neonatal period. Similarly infantile colic does not have untoward longterm effects on maternal mental health. When colic subsides, the maternal distress resolves. Rarely cases of child abuse have been associated with inconsolable infant crying.
Much can be done to prevent colic, beginning with education ofprospective parents about the normal pattern of infant crying.Prospective parents often imagine that their infant will cry onlybriefly for hunger. Increased contact and carrying of the infantin the weeks before the onset of colic may decrease the duration of crying episodes. Similarly other soothing strategies may be more effective if the infant has experienced them before theonset of excessive crying. Infants who have been tightly swaddled for sleep and rest during the first weeks of life often calmto swaddling during a crying episode; this is not true for infantswho have not experienced swaddling before a crying episode.Parents also can be coached to learn to read their infant’s cues of hunger, discomfort, boredom, or overstimulation. It is important to understand that there are times when the infant’s cry isnot interpretable, and caregivers can do only their best.
A temper tantrum, defined as out-of-control behavior, including screaming, stomping, hitting, head banging, falling down,and other violent displays of frustration, can include breath-holding, vomiting, and serious aggression, including biting.Tantrums are seen most often when the young child experiences frustration, anger, or simple inability to cope with a situation. Temper tantrums can be considered normal behavior in1to 3-year-old children, when the temper tantrum period is ofshort duration and the tantrums are not manipulative in nature.
Temper tantrums are believed to be a normal human developmental stage. Child temperament may be a determinant of tantrum behavior.
This behavior is common in children 18 months to 4 years of age. In U.S. studies, 50% to 80% of 2to 3-year-old children have had regular tantrums, and 20% are reported to have daily tantrums. The behavior appears to peak late in the third year of life. Approximately 20% of 4-year-olds are still having regular temper tantrums, and explosive temper occurs in approximately 5% of school-age children. Tantrums occur equally in boys and girls during the preschool period.