Breastfeeding and Colic
One of the most heartbreaking and difficult challenges a new parent can face is the inconsolable crying of their little infant. Colic is described as crying for three hours or more a day at least three times a week. It typically appears within the first two weeks of life, and lasts until the infant is 3 months old or longer. The infant is otherwise healthy.
Traditionally colic was believed to be intestinal distress like gas or cramps, which belief has not been discredited. Also, new studies at the Colic Clinic at Brown University demonstrate that nearly half of babies with colic have mild gastroesophageal reflux. Reflux occurs when the muscle at the entrance to the stomach fails to keep the stomach contents in the stomach. The milk, along with acid from the stomach, backs up into the lower esophagus and irritates the tissues there, which feels like heartburn. (Click
here for symptoms of reflux in infants). Some cases of colic may be the result of lactose intolerance or lactose overload (the latter when accompanied by green stools). Some breastfed babies have problems digesting milk proteins, or have a milk protein sensitivity(milk allergy) due to the mother's diet. The proteins from cow's milk are able to pass through the mother's milk to the baby. Because baby's intestines are still developing this sensitivity causes gas that is extremely painful. It can also cause the excessive spitting up and reflux. The baby c an also have sensitivities to other foods as well.
Sometimes it is difficult to determine the cause of colic, but for the most part, colic seems to be the result of an immature digestive system and/or is related to gut flora and in some cases food allergies. There are several things you can do naturally that have been shown to help with colic.
What mom can do:
- If there is a food allergy, certain foods that a breastfeeding mother eats can trigger an upset stomach in her baby. Some of the most common being; dairy products, peanuts, wheat, soy, eggs, corn, strawberries, and citrus fruits. For a more complete list click
here (scroll down). Deb Donovan, IBCLC advises; "If you believe a food is affecting your baby, keep a food log as you are eliminating foods, one or two at a time, from your diet to see how your baby responds. Avoid the food for two to three weeks for a good test of how it affects your baby. (In some cases you will see positive results in much less time.)
- Take enzymes with each meal to help completely digest proteins and minimize the chance of foreign proteins entering the breastmilk.
- Make sure your baby empties the breast at each feeding. If necessary, only feed from one breast at a time. Jack Newman, MD, FRCPC advises; Human milk changes during a feeding. One of the ways in which it changes is that the amount of fat increases as the baby drains more milk from the breast. If the mother automatically switches the baby from one breast to the other during the feed, before the baby has “finished” the first side, the baby may get a relatively low amount of fat during the feeding. This may result in the baby getting fewer calories, and thus feeding more frequently. If the baby takes in a lot of milk (to make up for the reduced concentration of calories), he may spit up. Because of the relatively low fat content of the milk, the stomach empties quickly, and a large load of milk sugar (lactose) arrives in the intestine all at once. The protein which digests the sugar (lactase) may not be able to handle so much milk sugar at one time and the baby will have the symptoms of lactose intolerance—crying, gas, explosive, watery, green bowel movements.
- Smaller more frequent feedings.
- Candida, or yeast/thrush can also cause gas in the infant's intestines. Probiotics and eliminating sugar/sweets from the mother's diet will help with this.
- Do not stop breastfeeding. Infants with reflux/colic most often do much better on breastmilk as it is easier digested. Breastmilk is an amazing fluid perfectly customized for your baby, and besides nutrition, contains antibodies, enzymes, and as a new study has shown, breastmilk also contains stemcells, which benefits are yet to be discovered.
What you can give to baby:
- Supplement with an infant probiotic (B. longum, B. breve and B. infantis occur naturally in a healthy baby's intestines). See this study on infant colic and probiotics.
- Gripewater can help settle a baby's stomach.
Comfort measures - some ideas:
- Hold your baby and comfort him/her. Colicky babies often like to be held in an upright position.
- Put your baby in an upright sling such as the Sleepy Wrap™ Baby Carrier and sit and bounce on an exercise ball. Perhaps while playing some calming music.
- Put baby in a sling and go for a walk.
- Burp your baby often during feedings.
- Make sure the baby's diaper and clothes are not too tight.
- If your baby has reflux, it may help to put him/her to sleep on a 30 degree incline so that he/she is in a more upright position. Babies with reflux are also more comfortable on their stomach, but talk with your pediatrician about this. Babies without reflux should be put down to sleep on their backs.
Also, talk to your pediatrician about options, and remember to always trust your instincts. You know your baby best.
For more information:
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