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Friday 25 September 2015

Dealing with colic and reflux in babies


The two don't always happen together, but for many, the symptoms are incredibly similar (usually including inconsolable crying) and equally as distressing  - for the baby AND for the parents. This post includes some advice, links and helpful information on how to deal with colic and reflux in babies...


Dealing with colic and reflux in babies

Like many parents, we suffered the effects of both colic and reflux, and tried almost everything we could to remedy the situation. 

Included in this blog post are some suggestions and some information which you may find helpful if you are an expectant or new parent going through a similar situation. 

(Addition: Since writing this post, I have had another child who also suffered with Reflux, but not colic, and have another blog post here with 6 products which help with Infant Reflux the second time around)

NB: I am not a medical professional, and any information or advice given in this post should not be deemed to be of a professional standard, or used as a substitute for seeking medical advise from your GP or HV. The information given is simply our own personal experience of different solutions.

Here is our story...

Dealing with colic and reflux in babies - remedies


dealing with colic and reflux

Arthur was born 2 weeks late after a pretty quick labour for a first baby - just over 4 hours (sounds great you may think - but a fast labour comes with its own perils, such as no time for pain relief, an increased risk of severe tearing, less chance of the mucus inside your baby being 'squashed out' when travelling down the birth canal, lack of 'moulding' of the baby's head and of course, the risk that you may almost have your baby somewhere you hadn't intended - such as a hospital corridor).

The first week of parenthood was tiring - Arthur fed every 1.5 - 2 hours, 24 hours a day. I hadn't realised how frequently breastfed, newborn babies may need to nurse, but this is perfectly normal, please don't let anyone advise you otherwise. Click here  to navigate to the Kellymom website for more info.

On day 10 things suddenly changed. At 3pm in the afternoon he suddenly started crying inconsolably - for a long time. He got worse if we laid him down. At 10pm it happened again and lasted until 3am. Nothing seemed to help. Not cuddles. Not rocking. Not singing. The crying continued and we were exhausted....and we had no idea what to do.

This same pattern continued at similar times every day, for hours at a time with more symptoms steadily becoming apparent:


  1. Inconsolable crying for long periods of time
  2. Crying if laid down
  3. Crying if held in a 'cradle hold'
  4. Crying after a feed
  5. Drawing knees up to chest after a feed
  6. Being sick/spitting up after every feed
  7. Taking over 40 minutes to bring up wind after a feed

Professional advice mainly consisted of reassurance that this was an incredibly common issue and was usually short lived...this  wasn't at all comforting when we hadn't slept for more than an hour at a time in weeks. Advice was hard to come by - so...

What can I do to ease my baby’s colic? 



There are a number of different ‘holds’ for a baby, such as ‘tiger in the tree’ which lots of parents swear by. Cycling their legs to help get rid of wind can often help, as well as wearing your baby upright in a sling as much as possible...

 Here is a list of the things we tried to help with colic and reflux - it may be helpful to you too...


Remedies for Colic:



Infacol


This is usually the first thing that you will be advised to try for 'colic'. The drops are given to your baby before every feed and will take a couple of weeks to start to work. The ingredients in Infacol are supposed to help the small air bubbles in your baby's tummy join together to form large bubbles which are easier to expel or 'burp'. This seems to work for a lot of parents, but sadly it did not for us.


Colief for reflux or colic


4 drops of Colief are added to your baby's milk before being administered. This required me to express milk in advance and then add the drops and give this to baby before initiating a breastfeed. I put this into a small cup (the tommee tippee formula pots) and gave it to Arthur this way - it was much easier than trying to administer on a spoon!


This seemed to be like a miracle cure (but a short lived one - it worked for a couple of weeks or so, but at that time a few weeks was better than nothing!).



The problem with Colief is that it is really expensive usually over £10 for a 15ml bottle, which with Arthur's frequent feeds (little and often!) meant a bottle lasted us 2-3 days max!

We went to the Dr to ask for this to be prescribed and unfortunately the initial response from the Dr was that colic is not a medically recognised condition, this particular Dr hadn't heard of Colief - but upon looking it up in his book found out that it was linked to a possible intolerance to lactose based on the lack of an enzyme in the body called lactase - this usually corrects itself by 3 months. He said he wouldn't prescribe the Colief as he couldn't determine whether Arthur actually had a lactose intolerance unless he performed a number of (invasive) tests which would not have been appropriate. He also mentioned an advisory note of not prescribing. I was advised that if I formula fed my baby there would be special types of milk I could try which would help.



This was really upsetting, and clearly didn't support my want or need to continue breastfeeding -  but it made us even more determined to find out more information and a way around the decision.



It turns out that in many areas, Colief is on a list of non prescribeable products and there has been a significant push not to prescribe it. It is, however, perfectly acceptable and safe to buy this product yourself and give it to your baby without a prescription!



We did some digging and found the following document: (Click here) which we took back to a different Dr in the surgery who agreed to prescribe Colief on a temporary basis because of the information in this document. For info - the document linked is from Cumbria NHS which states within: 



"Breast fed babies can sometimes get temporary lactose intolerance in the early days of breast feeding. Breast fed babies with lactose intolerance can be prescribed Colief at a dose of four drops per feed for 4-6 weeks or until symptoms have resolved. This should be added to 1 tsp/5ml of expressed breast milk in a sterile container and given on a sterile plastic spoon before breast feeding as normal. Prescriptions should be endorsed ‘ACBS’. Exclusion of lactose from the maternal diet is unnecessary as lactose is present in breast milk, independent of diet."  This document was reviewed in November 2014 - which is after Colief was added to many non-prescribe lists.

NB: Looking back, I do believe that Arthur had a cows milk protein allergy (as his younger sibling does) and this is why the colief offered some respite. I didn't know much about CMPA at that time and it was never mentioned to me by a health professional, in spite of it being SO common. Cutting out ALL milk/dairy from my own diet whilst breastfeeding would have helped with this.



Infant Gaviscon for newborns 


This is a powder that is mixed with water or milk and usually given after feeds. It can have a side effect of making your baby constipated. I tried this when Arthur was 5 months old after his reflux suddenly got really bad and he was bringing almost every milk feed back up with quite some force! After night 3 of projectile vomiting in his cot after a feed (despite having been kept upright for an hour!) i decided to give this a go. Many friends had used this successfully with their baby. Unfortunately, rather than keeping the vomit/milk down - it made it really thick like jelly which he gagged and choked on trying to 'spit up' which happened so forcefully he ended up having blood in his sick. I didn't try it again! Instead I started to wean him 2 weeks early ( I figured he was 2 weeks late so this was ok) and the introduction of some solids (baby rice) did help.


Cranial Osteopathy for colic 


Sometimes the force of labour can put pressure on your baby's skull and neck which leads to pain and headaches. When Arthur was 20 days old we took him for his first session with a cranial osteopath where it transpired that he had some tension in the base of his skull and one side of his neck within the muscles which not only caused him pain when lying on his back, but also put pressure on a nerve running through to the abdomen which could cause tummy ache. The day after each of his sessions he was calm, would lay down and sleep - it was like having a different child! It didn't last long in between visits and was very very expensive, but definitely worth having the treatment for the long term benefits of balancing out his neck muscles and making sure the plates of his skull were in the correct position.


Baby sling/carrier to help with milk spit up 


As well as helping with reflux and wind by keeping your baby in an upright position (particularly after feeds), wearing your baby in a sling can increase your bond by encouraging skin to skin contact. This helps baby to regulate their body temperature, breathing and heart rate. Please read my blog post here on slings for information and recommendations. We really could not have lived without one - quite often on an evening I used to to wear Arthur in a sling whilst bouncing on a birth ball to help wind and settle him.


Feeding in an upright position for reflux 


 I wished that i could feed lying down to get more sleep - but honestly, this made things worse. Even holding Arthur in a cradle hold didn't help. Feeding him in an upright position (and then keeping him upright) seemed to help with the reflux. As he got bigger he would straddle one of my legs, using it as a seat whilst feeding from the same side.




Dummy/Pacifier for colic 


I was completely against dummies - adamant that I would not use one, not just for the dental issues they can cause but I had also seen first hand in my Teaching role the speech and language difficulties that can arise from the use of a dummy. It wasn't until Arthur was 2 months old that we decided to give one to him at night time and nap times to help settle him (and as a sleep signal). We chose an orthodontic newborn dummy ( they also come in age 6month+) by Dr Brown's which helps to reduce some of the dental problems that could arise from using a dummy.


Raising the head of the cot to combat reflux


or the moses basket. This can help with reflux by keeping the stomach acids and milk down (due to gravity) rather than coming back up through the immature stomach muscle at the top of the tummy. This by your bed sleeper crib for a new baby can be raised on an incline to help with reflux.



Keep a food diary - cmpa can cause colic and reflux


 If you are breastfeeding, sometimes the foods you eat can affect your baby's digestive system. Some Mothers find that cutting out dairy products can help. A food diary helped me to establish that orange juice and other citrus fruits made Arthur's reflux worse. If you use formula milk, there are different options to try, such as comfort milk which may help with colic and reflux. If your baby doe suffer from CMPA (cow milk protein allergy) then cutting out all dairy from your diet will eventually clear your breastmilk and things should start to improve. If you formula feed then a GP can prescribe dairy free milk for your baby. 

NB: My second child, Charlotte, was diagnosed with CMPA and also a Soya allergy, we have been dairy free since the start of 2018. 


Of course, cutting out dairy (or any specific food group) from your diet can come with its own risks if you don't replace those nutrients in other ways. If you are UK based, it is important to speak to your GP and gain a referral to a dietitian to help advise and manage your nutritional intake to make sure your body it getting what it needs.  

If you are based in the USA, you may prefer to use more easily accessible nutritional tests to test common deficiencies in a broader diet, in order to inform and improve a healthy lifestyle. Health labs are offering 15% off for any of my readers who would like to undergo nutritional testing here. (This is NOT an affiliate link).


If you have recently tried cutting out dairy from your diet and would like some treat recommendations, have a watch of our video here:



You can find more helpful colic and reflux products and advice that worked for me the second time around in my blog post - 6 products to help with Infant Reflux here


You may be wondering whether colic remedies safe for your baby?


Never follow old wives tales and remedies for colic for your baby. Colic remedies direct from the pharmacy or your GP, such as infacol or colief are safe for your baby providing they are used as directed. 


What causes colic in babies?



The cause of colic can be a symptom of a number of different issues and so this does depend a lot on your baby -  Digestive issues are usually to blame for colic symptoms, which is why babies will often be upset after a feed or later on in the day. Sometimes this is because of infant reflux. Infant reflux in breastfed babies can sometimes be caused by over supply and hyperlactation which leads to a forceful letdown (meaning baby takes in a lot of air or chokes on the milk)  or too much foremilk which can have an impact on digestion and also lead to loose stools.

Another common reason for colic is food allergies such as cmpa (cows milk protein allergy) or other childhood allergies such as soya, egg or any of the other 14 main allergens. Allergies in babies and young children can cause stomach pain, discomfort, excess wind, loose stools and/or constipation alongside many other possible symptoms.

Following on from labour, some babies may suffer from tightness in the neck or abdominal muscles which can lead to tension in the tummy and can also put pressure on the nerve running into their tummy - which is something my 1st child struggled with. A cranial osteopath may be able to help with this. 


Will my baby grow out of colic? 

Usually, babies grow out of their colic by 6 months. Symptoms which last for longer than this may be due to an underlying cause and should always be investigated further. 


Can anti colic bottles help bottle fed babies? 


  If your baby has colic due to allergies, then the only thing which will help is changing their milk to one without the allergens. For breastfeeding mothers this means cutting the allergens out of their own diet.  If your baby has a poor latch whilst breastfeeding, or the breastfeeding mother has a fast let down which causes the baby to take in air, then an anti colic bottle may help here.


Have you tried anything else that worked well? Have you been through something similar? I'd love to read your comments and experiences below.


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