Colic could be an early sign of migraine, study finds
If you’ve ever had a migraine, you probably felt like crying. And that may just be what’s going on with a colicky baby, new research suggests.
Doctors in Europe found that children and teens with serious migraine pain were far more likely to have had colic as infants than other, similar kids who did not suffer from migraines.
The study, published in the Journal of the American Medical Association, may support something many pediatricians have suspected -- that colicky babies are suffering from the throbbing head pain and, possibly, nausea that make migraines so miserable.
“The suggestion is that the colic may be an early form of migraine and that it could very well be head pain or stomach pain or it could be both,” said Dr. Phyllis Zee, a professor of neurology at Northwestern University Feinberg School of Medicine in Chicago, who wrote a commentary on the findings.
Dr. Silvia Romanello of Hospital Robert Debré in Paris and colleagues in France and Italy studied 700 children who visited emergency rooms between April and June of last year. About 200 had severe migraines and the rest didn’t.
They interviewed the parents and then also checked detailed medical records that are kept for all children in France and Italy. About 74 percent of the children and teens being treated for migraine were also colicky as babies, compared to 26 percent of the kids being seen for some other reason.
Children with other types of headaches, mostly stress-related headache, weren’t as likely to have had colic.
The headache patients were more likely to have parents or siblings had a history of headaches, and to have been given formula as babies instead of breastmilk, Romanello’s team found.
“The increased exposure to cow's milk proteins among formula-fed infants could partly explain our finding of a significant association between formula feeding and migraine. The other possibility is that breastfeeding protects children from migraine, but this hypothesis has to be confirmed,” they wrote.
One theory about colic is that the babies are allergic to something in cow’s milk. “The gastrointestinal tract has been suspected because of the infant's apparent abdominal discomfort, and many therapies target it,” the researchers added.
“Although benign and self-limited, colic may cause stress in parents and has been reported to lead to shaken baby syndrome.” It’s also common -- as many as 20 percent of babies may have colic.
“It is usually diagnosed by crying and fussing for more than three hours per day, more than three days per week, and for more than three weeks in an otherwise healthy and well-fed infant,” Romanello’s team wrote.
Migraines are also fairly common, Zee and her colleague Dr. Leon Epstein noted. As many as 3 percent of 3- to 7-year-olds have migraines, with the rates increasing to as many as 23 percent of 11- to 15-year-olds.
“If colic is an early form of migraine, this suggests that migraine disorders may represent a continuum from colic in infancy to cyclic vomiting syndrome in young children to childhood and adult migraine,” they wrote in an editorial.
“Monosodium glutamate, stress, and changes in sleep regimen are common triggers. Disrupted sleep, in particular, may be a critical trigger for migraine at any age,” Zee and Epstein wrote.
That might be why colicky babies often do better when put into a dark, quiet room, Zee says. Parents trying to comfort colicky babies might think of what works with migraines. “Keep them in a dark room. Make sure the environment is quiet. Don’t turn on those lights in the middle of the night just because they are crying. Use a dim light," she advised.
And sleep is very important, Zee adds. Babies are learning to sleep through the night at around two or three months, the same age as when colic starts to go away. A lack of good, solid sleep is associated with migraine, so helping babies learn to sleep well could help with colic as well as being good for their overall health, Zee suggests.
It’s far too soon to think about treating infants with strong migraine drugs, both the European researchers and Zee said. “I would actually try more to prevent them and to decrease the triggers for the colic or migraine because there really aren’t any indicated treatments, especially from the Food and Drug Administration, for children,” Zee said.
Romanello’s team stressed that their study was far from perfect. A better study would follow colicky infants into childhood and adulthood and see if they were more likely to develop migraines or any other type of headache.
“Children included in this study presented with acute headache to the ED and were subsequently seen by a pediatric neurologist,” the researchers cautioned. “Children with milder or less recurrent headaches perhaps do not present to the ED. Children included in the study therefore might not be representative of all children with migraines or tension headaches.”