Infant Colic Tips - Because They Don't Just "Grow Out Of It".

By Amanda Downsborough - Holistic Child Health

BSc, PGDip, GCert, MSc, ACAAM

Colic. This is a topic that is so often ignored, being passed off as something a baby will "grow out of". I can't even begin to tell you how damaging that is to families who are enduring the incessant crying, never mind what the baby is experiencing. And while the concept that they "grow out of it" may be partially true, there are some very useful strategies that can bring much-needed relief, NOW. If you are one of these parents, I know you'll find this more than appealing. I know, because I've been there.

"I know 2am, I know it backwards, inside out. I know the tired tread of tip-toes, that against the silence shouts." – e.h.

Prior to having my own babies, I was a triple certificate Registered Nurse, with Midwifery and Family and Child Health degrees. I worked with mothers and babies everyday, but I didn't have any really helpful information for families dealing with babies who would cry for hours at a time. All three of my babies cried incessantly, the youngest for 18 months, and sometimes more than 20 hours a day. I found out the hard way that I didn't have the tools or knowledge to help them, and every healthcare practitioner we saw had no answers either. Eventually, we found the causes of his pain and, literally overnight, I had a different, happier child. I went on to complete a Master of Science in Human Nutrition and Functional Medicine, which uses principles to investigate underlying causes of illness and bodily dysfunction through biochemistry, genetics, nutrition, and environment. I kept adding more education to this, applied what I knew in clinical practice, and found some much needed relief for a lot of families.

What is colic and what causes it?

Usually starting around 4-6 weeks of age, some babies suffer colic symptoms, marked by excessive crying for hours at a time. This is most common in the evening, but in severe cases it can last all day and all night. The baby may be very fussy and could experience abdominal bloating and pain. Sometimes it resolves within a few weeks or months, and sometimes, it just doesn't. For all the love and science in the world, no one is entirely sure what causes it. Suggestions include an immature digestive system, food sensitivities or intolerances, imbalanced gut bacteria, overfeeding, or infrequent or inadequate burping. The tummy pain these babies experience may be due to spasms in the gut, that could be from a combination of these factors. I will tell you one thing I have found clinically - Food sensitivities are incredibly common. Especially dairy.

Simple strategies to help immediately

These strategies will not prevent or "fix" colic, but can give some immediate relief until other strategies are working.

Massage - Gently massaging the belly in a clockwise direction helps move air that is trapped in the gut.

Positioning - The "Colic Carry" places pressure on the tummy, which may reduce spasms in the gut.

Baths - Warm baths can be very relaxing and help ease tummy pain.

Movement - Moving your baby's legs gently in a bicycle motion also helps move trapped pockets of air.

Burping - Effective burping reduces the volume of air that gets into the gut.

Colic Drops - Both natural and pharmaceutical remedies are available. I strongly suggest using natural or homeopathic remedies wherever possible. Some popular pharmaceutical colic remedies contain aluminium, which is toxic to growing brains. Chamomile and fennel are both very soothing to the gut. Boiling fennel in water, then giving several drops of the cooled, fennel-infused water can help.

Food sensitivities

Different to an allergy that results in anaphylaxis, a food sensitivity is one that is slower to produce symptoms after ingesting the trigger food. It still involves the immune system and can cause symptoms such as nasal congestion, joint or muscle pain, headaches, fatigue, or digestive issues, amongst many others. It can occur as soon as a few hours, or a couple of days after consumption so can be pretty tricky to identify. However, the most common culprit for colic babies, that I have seen clinically, is dairy. Other common sensitivities include gluten, soy, and eggs. Less commonly, nuts, citrus, fish, and shellfish. There may be other problematic foods, and there may be more than one food group causing the symptoms. This is where keeping a food journal might be very helpful for mums who are breastfeeding.

Breastfed babies

What the mother eats impacts on the breast milk, with food proteins crossing through within about 6 hours from consumption. These proteins can remain present in the breast milk for up to 2 to 3 weeks, but in general, they reduce significantly after a day or two. Do not replace breastfeeding with formula in an effort to solve colic as the majority of formula is dairy-based.

Trial an elimination diet. This where you completely avoid all foods of one or more food groups for a period of time. For example, dairy includes all milk, cheese, yogurt, and butter. You may have heard of some people mention a "gluten and dairy free diet" at some point. This is because dairy molecules, called casein proteins, are similar in size and structure to gluten proteins. It's generally found that the two proteins removed at the same time, can give much better symptom relief. When the gut is inflamed and identifying one protein as problematic, it may target others that seem alike. This is called "molecular mimicry". You won't necessarily be on a different diet long-term, and as your baby grows bigger and the gut matures, these foods may be able to be reintroduced carefully. You might be thinking this is too hard, or you simply don't have the energy to follow through with this, but I promise this could be one of the best things you will do. Once you get used to the different foods, it becomes a whole lot easier.

If you have concerns about your milk supply, consider speaking with a lactation consultant, or phoning the Australian Breastfeeding Association for advice. You should be getting at least 5-6 very wet nappies per day to know your baby is drinking enough milk.

Formula fed babies

"Shaking the bottle is for champagne only!"

Absolute first tip - ensure you are not shaking the formula bottle immediately before feeding your baby. Doing so allows tiny bubbles to be taken in, which then join together and become large bubbles of trapped air in the gut. Try making up the daily formula requirement and storing it in a jug in the fridge, or gently inverting each individual bottle until the powder has dissolved. This strategy alone may be enough to provide huge relief for your baby, and you.

If the above doesn't apply, or hasn't helped, there are two approaches that could next be taken. You will need to use your parental wisdom and judgement as to which path you want to try.

1. Add probiotics to one bottle of the current formula each day. If after 4 to 7 days there is no significant improvement, go to option 2.

2. Change formula. Try either a partially hydrolysed formula such as Aptamil Prosyneo Sensitive, or dairy-free like Novalac Allergy. You can add probiotics to the new formula.

Hot tip when buying a new formula - buy one tin! You may have a lot left over if it is not tolerated and you have to change again.

Chiropractic Adjustment

Especially true for babies born via emergency caesarean, vacuum extraction, or forceps, some babies are born in pain from the position they have spent days, weeks, or months in. Babies who are big (over 4500g), babies who do not have enough fluid around them (oligohydramnios), and babies from multiple births (twins, triplets etc), don't have a great deal of room to move. Consider how you feel when you sleep awkwardly for even a few hours. Nerves can be pinched from surrounding bones and tissues, causing pain and digestive disturbances. Seeking help from a specially trained paediatric chiropractor can be a game-changer.

Probiotics

All colic babies, regardless of how they are fed, may benefit from probiotics. Important to note, probiotics do not colonise the gut. This means that once you stop giving them to your baby, they leave the gut within about 2 weeks. However, during the time they are being taken, they will hold space for other beneficial bacteria to grow, preventing pathogens (nasty bugs) from taking up residence instead.

My top two picks:

Good evidence shows that the probiotic L. reuteri helps colic symptoms, but there is limited evidence as to the exact mechanism of how it works. This is found in some BioGaia products, is very safe in babies over 21 days of age, and available in some pharmacies. Have a chat to a pharmacist about sourcing this.

BioCeuticals BabyBiotic 0+yrs is an excellent probiotic with multiple strains that help with digestion, and supports the developing immune system and brain development. It contains good levels of Bifidobacteria longum infantis, which is the most abundant bacteria in a baby's gut, and very much needed to break down sugars in formula and breast milk. This one I highly recommend for all formula fed babies by adding one scoop to one bottle per day. For breastfed babies, you can make this into a paste and apply directly to the nipple prior to a breastfeed, or wiped into the inside cheek of your baby's mouth.

Probiotics are strain specific. This means that one strain will not do the same job as a different one. Both of these probiotic suggestions will work differently in the gut, so one may bring more relief than the other, or you could use them both together.

Seek further help

Don't hesitate to seek professional help if you need it. Having a colicky baby can be incredibly challenging for parents and other family members, resulting in sleep deprivation and significant stress on overall wellbeing.