How can you tell if your baby has colic?

Possible Signs of Colic and/or Reflux: Arch back to escape pain, inconsolable crying, frequent spitting up, sleep disturbance, poor weight gain, more crying at night compared to day-time.

Normal Weight Gain: 6-8 ounces/week or 2 lbs/month for the 1st 3 months

What is colic?

Colic has been defined as excessive, inconsolable crying of the infant, and research has shown that 10-20% of all infants under the age of 4 months suffer from infantile colic. Episodes of colic can happen anytime day or night, but will usually begin to follow a pattern.

What is colic caused by?

The general consensus between pediatricians is that colic is caused by excessive gas in the gastrointestinal tract and so their response is, of course, to utilize colic medicine. The most commonly prescribed medication for the treatment of colic is dimethicone. The side effects of this drug include: fatigue, sedation, blurred vision, loss of appetite, constipation, nausea and headache. While this list is certainly reason for pause, the most alarming fact is that the makers of this drug note on their literature that this chemical should not be given to infants under 6 months of age. Always ask for and read the drug inserts to be informed about this vital information.

Infant reflux

While most infants will spit up a little after eating, infant reflux or gastroesophageal reflux (GER) is a whole different matter entirely. It typically happens due to a relaxation of muscles at the bottom of the esophagus, and is considered a result of a lack of coordination between the organs of the upper digestive system.

What are the signs and symptoms of reflux in babies?

Sometime reflux symptoms in babies start a few weeks after birth. This is because allergies or sensitivities to foods take time to develop. The infant has a leaky gut until about 6 months old. Proteins from foods and beverages are able to leak through the digestive tissue causing an immune response, therefore causing food sensitivities.

Sometimes the matter being regurgitated is breast milk or formula, but a lot of times it will include stomach acids causing the infant to be extremely distressed due to the discomfort caused to the esophagus.

The highest concern when an infant is suffering from infant reflux is the fear of “failure to thrive.” Since sometimes a large amount of the child’s nutrition is being regurgitated, many parents worry that they aren’t getting enough nutrition. With this concern in mind many pediatricians will immediately prescribe a drug treatment regimen.

Chemical treatment of reflux.

Drugs can be given to infants with reflux, but usually the problem persists. The problem with using a drug that blocks acid production is that the body needs the acid to break down food. The acid in the stomach also helps to prevent harmful bacteria from colonizing. Drugs may also cause other digestive issues and increased risk of pneumonia and gut infections later in life.

The drugs most commonly used to treat infantile reflux are H2 blockers such as ranitidine, famotidine and nizatidine (also known as Tagamet, Zantac and Pepcid). With all of these chemicals the side effects can include sleepiness, dizziness, rapid or changed heartbeat, diarrhea, nausea, vomiting and trouble breathing. It should also be noted that since this is a prescription that has to be given on a regular basis at specified times, missing doses can also cause irritating and uncomfortable side effects.

The second round of treatment when H2 blockers fail is usually proton pump inhibitors (PPIs). These include esomeprazole, omeprazole and lansoprazole (also known as Nexium, Prilosec and Prevacid). With these chemicals the side effects can include headache, diarrhea, abnormal heartbeat, rash, dizziness, muscle pain as well as nausea and vomiting. Has it not occurred to them that they’re actually causing what they want to stop?

How do you help a baby with reflux?

Solve Feeding Issues

You are not alone. We can figure this out together. Even if you are bottle feeding your baby breastmilk, we can help. Call us to schedule your lactation consultation today.

• A strong let down causes the baby to gasp and swallow a lot of air.
• A poor breastfeeding latch can also cause baby to swallow air. 5 Steps to the Optimal Latch
• Change feeding positions, take brief breaks, and burp frequently
  • If bottle feeding- feed in an upright position on your lap (“pace bottle feeding”)—this allows the baby’s stomach to catch up and tell the brain when they are full, which prevents over feeding. Check out YouTube for instructional videos on Pace Bottle Feeding.
• Different Styles of burping include: against your chest, sit upright on your lap and support the neck under the chin, and lay baby across your lap with the head higher than the chest.
• Keep the baby in an upright position for 15-20 minutes after nursing or feeding.
• If the baby cries and wakes up during sleep- burp them.

***If formula feeding

• • Feed the infant in an upright position on your lap and support the head (“pace bottle feeding”), which prevents over feeding.
  • Switch formulas (try to avoid corn and soy in the ingredients)
  • Make your own formula

Stay Close and Comfort the Baby

• Push gently pressure on the belly of the infant while they are laying across your lap on their stomach to help relieve tension.
• Fold their knees up to their chest
• Swaddle the baby
• Wear the baby in a carrier or wrap, stomach to stomach with baby always facing you.
• Give a warm bath
• Gentle music
• Lay the baby on the left side, which helps keep the contents in the stomach. You can use rolled receiving blankets behind the back to prevent rolling. Swaddling the baby also prevents rolling to the stomach because of the fetal positioning.

Eliminate Food Sensitivities

• Chemicals and proteins in the food that mom eats find their way to the breast milk and cause irritation. The large proteins found in milk and other dairy products, including yogurt, are one of the most irritable foods for a nursing baby.
• Other Common Irritants: Caffeine, alcohol, food additives, chocolate, eggs, spices, beans, cabbage, broccoli, cauliflower, peanuts, wheat, soy, onions, and tomatoes
• How to determine which foods are causing the sensitivity: Avoid all of the above mentioned foods for 2 weeks. Then add one of the listed foods or a suspected food back into the diet every 3 days. The reason to wait 3 days in between each food is because sometimes the baby reacts immediately, but other times the baby may react a few days later. If you notice that the child’s reflux improves during the 2 week period, but has episodes during a certain added food, avoid that food as often as possible while breastfeeding. Then be aware when adding that food into your child’s diet when adding solids.

Treatment Options

• Chiropractic
• Acupuncture
• Digestive Enzymes- DGST-P (pediatric) by Loomis Enzyme
• Probiotic- reputable brands- Metagenics, Nature’s Way, Klaire, Allergy Research Group
• Herbal Remedy- Grow and Thrive or Tummy Tamer by Chinese Medicine Works
• ORGANIC Gripe Water
• Acupressure massage- Tui na & Sho Ni Shin
• Fennel/Barley Water or Tea- The mother can drink this and give the baby some in a bottle
• Homeopathic Remedies- found at a health food store- give a single dose of 12C or 30C tablet and wait. If symptoms return repeat the dose. The symptoms should decrease with each dose and eventually disappear.
  • Chamomilla- calming and soothing for babies that are screaming and failing
  • Colocynth- indicated if pressure relieves the discomfort
  • Dioscorea- indicated for an infant that arches back
  • Jalapa- indicated when the infant cries all night, but is fine during the day
  • Lycopodium- indicated when the symptoms are worse between the hours of 4-8pm, tendency towards constipation, pressure aggravates
  • Nux Vomica- irritable and worse after eating, has trouble in the morning, sensitive to a food or spice in the mother’s diet

Have more questions about colic and infant reflux? Call First Step Family Wellness today at 314-805-7837, or fill out our contact form!