We all know that as much as we don’t want them to, babies cry, and sometimes a lot. As new parents it’s stressful to discern what our newborns’ cries mean and it’s harder again to know if their crying has escalated into something more like colic? Which raises the question, “Is colic real or is having an irritable baby just a rite of passage those first few weeks or months after birth?” Furthermore “What is reflux, is that the same thing?”
Let’s look at each of these questions and gain a better understanding so that we can stay grounded admits the tears and seek out the best solutions for our babies.
First And Foremost, Colic And Reflux Are Real.
Colic presents as a constantly irritable baby, usually beginning during the first two to three weeks following birth and continuing up to three months of age, sometimes for longer. Unfortunately colic affects up to a third of newborn babies regardless of whether they are breastfed or formula fed. There are several driving factors that result in the symptoms of colic and this is why it is hard sometimes to provide a definitive cause of colic.
Ask yourself the following questions:
- Does your newborn seem to be grimacing in pain?
- Do they seem to be inconsolable for hours at a time?
- Day after day?
- Do they appear uncomfortable when feeding?
- Do they arch their back, clenching their fists?
As you can imagine colic is no fun for anyone and parents often struggle with feeling helpless, not knowing how to soothe their newborn. Take comfort in knowing that there is a reason for your baby’s extreme fussiness and that there are ways to help your baby. So don’t despair!
What Causes Colic?
While there is not one known cause for colic, it is often associated with sensitivity to cow milk proteins. Treatment for colic varies. Mainstream medicine often includes drug therapy or simply waiting for your baby to outgrow this condition. Some doctors may recommend giving them gas drops containing simethicone, an ingredient that helps relieve the pain caused by gas bubbles; this may help if your baby is gassy. Simethicone works by consolidating gas bubbles in your stomach, allowing you to expel them more easily. In a moment we will discuss natural approaches to managing colic.
What Is Reflux?
Reflux appears in a similar way to colic with babies appearing to be in pain and fighting the breast, coming off the nipple, pulling at it or they seem to choke on the milk regularly. They cry and seem uncomfortable after eating, they arch, but they also tend to scream if you lay them on their back. They typically projectile vomit after meals or even spit up a little more than normal (not with silent reflux). They have sour breath and often have gassy and/or foamy bowel movements. Some babies may develop breathing difficulties (respiratory infections) or failure to gain weight. Most doctors will diagnose acid reflux or silent acid reflux in infants by persistent symptoms. However, some doctors may suggest the following tests: blood tests, an ultrasound, a barium swallow or upper GI test, pH probe or upper GI endoscopy. Most of these tests are invasive or involve some negative side effects. I suggest trying all the natural solutions below to see if your baby’s symptoms improve this way before testing and medications are prescribed.
Here’s the thing.
All newborns have some level of reflux. This is because their entire digestive tract is immature. The sphincter muscle that separates the oesophagus from the stomach is often undeveloped and opens regularly, allowing stomach acid to flow back up the throat, causing burning and pain. Over the period of the first few weeks, this tends to ease, as the brain and nervous system develop controlling these mechanisms. Obviously, some newborns however exhibit more frequency and severity in their discomfort and some babies have a combination of colic and reflux. Meaning they are consistently inconsolable, but they may not sick up with each feed. So there does appear to be some overlap. Either way – whether your baby has colic or reflux, your baby is in pain and the goal is to give them relief.
Is There Medication for Infant Reflux?
Of course, medical doctors may recommend prescription medications to decrease or neutralize your baby’s stomach acid, and thereby reduce some of the initial symptoms of baby reflux. Examples include:
- Antacids such as Mylanta and Maalox
- Histamine-2 blockers such as Axid, Pepcid, Tagamet, or Zantac
- Proton-pump inhibitors such as Nexium, Prilosec, or Prevacid
Many infants with baby reflux aren’t producing enough stomach acid, so acid-blocking medications are not recommended in cases of uncomplicated infant reflux. Otherwise, healthy children taking these medications may face an increased risk of certain intestinal and respiratory infections. In addition, emerging evidence suggests that proton-pump inhibitors (PPIs) are not as benign as once thought. Prolonged use of PPIs for infants have also been linked to problems with iron and calcium absorption, respiratory tract infections, gastrointestinal infections, and bone fractures1. Further well‐designed trials and observational studies are needed to shed more light on the efficacy and safety of PPIs in the pediatric population.
How Can I Help To Relieve Colic Naturally For My Baby?
Here are several suggestions that may offer your newborn effective relief from colic…
1. Have your Baby Assessed by a Chiropractor who is Confident Working with Babies.
Learning to breastfeed can be challenging for both mother and baby and it can be harder again if a newborn has had some form of injury to the spine, jaw or skull from the birth process. Sometimes newborns are unable to suckle properly because they are in pain, and they may gulp and swallow unnecessary air in the process.
Was your birth long or complicated with the use of forceps or colic?
Was your baby born via caesarean?
From a chiropractor’s perspective, many of the resulting symptoms of colic may be due to nerve dysfunction or poor nerve communication between the brain and the digestive organs. Birth trauma is common with both caesarean births and births that require intervention which may result in nerve dysfunction. One simple way chiropractors encourage mothers to assess if their newborn has a vertebral subluxation (creating nerve irritation or poor nerve communication) is to compare how their baby feeds from one breast to the other.
Does your newborn have difficulty breastfeeding, particularly when feeding on one side more than the other?
Often a baby will feed well from one breast, but they will not want to attach properly on to the other side. Alternatively, a newborn baby may come off the breast frequently, and fuss more on one particular side. In both scenarios the baby is likely to have a combination of pressure and irritation to the nerves and vertebra of the neck or to the jaw or skull. The nerve and joint pressure that occurs may not only cause pain and discomfort for the baby but also impact the nerve messages relayed to the stomach and other digestive organs. This is something that occurs frequently with newborns and skilled chiropractors can use gentle paediatric techniques to help the body recreate balance and order in the skull and spine.
Chiropractic adjustments in the early stages of neurological imprinting, safely and effectively address dysfunction and help restore natural, efficient suckling patterns for infants. The healthy functioning of your baby’s spine and nervous system will play an integral role in the overall health of your child. Chiropractic adjustments for the correction of poor nerve communication resulting from vertebral subluxations have been acknowledged as an effective therapeutic tool for infantile colic. While every infant’s case is individual and there are no guarantees, evidence suggests chiropractic typically has a 94% success rate with colic.1 If you intuitively feel that something is not right with your baby, I urge you to have them assessed by a recommended chiropractic doctor. Healthy babies, free of nerve irritation, are happier babies!
2. If you are Breastfeeding, Seek Advice.
If you are breastfeeding, the right advice from a lactation consultant or midwife can make a world of difference. These consultants will observe how your baby feeds and give you wonderful advice on how to make breastfeeding easier for both you and your baby.
It’s important to ensure that your baby is getting enough hindmilk, which is higher in fat, calms the stomach, helps with digestion, and promotes satiety. It’s tempting to feed a little off each breast which results in the baby only gaining foremilk which is higher in sugar. Foremilk is easier for our babies to attain as the milk tends to flow quickly, our babies must suckle harder to gain the thicker hind milk. When our babies only get foremilk, they experience a sugar hit and then a low, and often become hungry again soon.
If your baby’s poop is greenish, frothy or mucuosy, this is usually a sign that he’s getting too much foremilk, which can cause digestive distress. This often happens when a breastfeeding mom doesn’t know to fully empty her breast of hind milk and offers both breasts, she has an overactive letdown or is having oversupply issues, which is very common in the first few months after giving birth.
Gaining advice on fore milk and hind milk is incredibly helpful as is advice on attachment. Learning tips on how to ensure correct attachment helps to prevent your baby unnecessarily swallowing air.
Remember breast feeding is new for both of you so it can be tricky. My fourth son was my hardest to breastfeed. What made things more frustrating was that I had breastfeed our first two sons with relative ease and I couldn’t understand why I was in excruciating pain. If you know our birth stories then you know that our third son was born still at 28 weeks due to a genetic disorder and after my curette I developed an infection. I had to take antibiotics and in my grieving, truth be told, I wasn’t focused on my self-care or my gut health and before I knew it, we were pregnant again. My diet is typically clean, so it wasn’t until the last few weeks on this fourth pregnancy that I developed candida which for us meant that when our baby was born and started feeding, I suffered with nipple thrush.
Nipple thrush is entirely different to mastitis, I found it excruciating, it was exactly as they say – as though someone is pulling glass through your breast tissue. It has also been described as a stabbing or shooting pain, a deep ache or a burning sensation that radiates through the breast. It may be in one or both breasts. Signs of thrush may be present in your baby’s mouth or on your baby’s bottom, or both. Thrush in the mouth appears as a thick white coating on the tongue or white spots on the inside of the cheeks, or both. Thrush on a baby’s bottom appears as a bright red rash with spots around it. There are ways to overcome nipple thrush and thrush in general, please visit our blogs dedicated to this topic.
3. Allow Time to Burp your Baby.
Newborn babies will take a period of time to learn how to correctly feed, burp and digest their food. It is therefore important in the haste of our day that we allow our newborns any additional time they may need to burp. To assist burping: sit your baby on your lap, place your hand across the front and the back of their chest and lift them up slightly. This lightens the pressure on their stomach and encourages them to burp.
How often should you burp a colicky newborn? When bottle feeding, ideally try to burp them after every ounce of milk. If breastfeeding, attempt to burp them whenever they come off the breast as this is often a sign that they have wind.
4. Change up your Formula.
Some studies demonstrated that reflux occurs more frequently with formula fed children than breast fed babies. This is because most formulas contain ingredients that the baby may be sensitive to, which triggers reflux. So, to answer the common question – “Would formula be better for my refluxy baby?”…It would seem that no, formula may not be the better option.
Some cases of acid reflux in babies are triggered by sensitivity to cow milk. If your baby is formula fed, consider that many cow’s find it challenging to break down cow’s milk protein and changing to a less allergenic type of formula typically helps. Choosing a cow milk free formula is a sensible way of eliminating reflux.
That’s why our first recommendation to help you deal with your baby’s acid reflux is a formula based on goat milk, the Holle Organic formula. I believe it is the best on the market. Being a formula based on goat milk, it forms soft curds that are easier for your baby’s tiny tummy to digest. Goat’s milk is the closest type of milk to breast milk. It only has traces of casein, an allergen found in large amounts in cow milk. Even the lactose in goat milk is half of that in cow milk, making it more easy to digest.
This formula is packaged in a cardboard box versus an aluminium can that potentially leaches into the formula. It is organic with a Demeter label, and uses lactose and maltodextrin instead of unhealthy sweeteners like corn syrup, glucose, sucrose, etc. It also has probiotics and prebiotics (US brands mostly only have prebiotics). You know it is a clean, safe formula and the probiotics will promote digestive health.
If these changes do not work, a hypoallergenic formula may be your last card. These formulas are super expensive, but are also highly effective in dealing with all sorts of digestion problems, including cow milk intolerance, reflux, allergies, and mal-absorption issues. Please see our Formula Chapter from Well Adjusted Babies.
Just to be clear, there is a difference between a cow’s milk sensitivity and a cow’s milk allergy for example. An allergy is much more severe. If a baby has allergy for cow milk or Soy, colic would only be one of the symptoms among others such as: frequently spitting up, vomiting, colic-like symptoms such as excessive crying and irritability (especially after feedings) signalling abdominal pain, diarrhea or constipation, blood in stool, hives, a scaly skin rash, coughing or wheezing and other cold like symptoms.
5. Give your Newborn High-Quality Probiotics.
A study by Dr J Fallon3, she discusses one plausible reason for colic and reflux as being a mother’s exposure to drugs during pregnancy. She states, “This incomplete protein breakdown (colic) can be caused by many things, including the use of antibiotics, either by the neonate (baby) at birth, or by the mother during the birth process or during pregnancy. The antibiotics are very caustic to the developing small intestines, and particularly to the proximal small intestines where the protein digestion is most accomplished. In the neonate with this problem, the response most often seen is irritability, and/or reflux.”
Probiotics are extremely important for both breastfed and formula-fed babies. Probiotics are living organisms which strengthen the integrity of the bowel and stimulate the immune system. The anti-inflammatory effects on the bowel are particularly beneficial for colicky babies. Breastfeeding mothers can drop the probiotics into the newborn baby’s mouth just before they attach to the nipple and probiotics can also be added to a bottle of formula just prior to feeding your baby.
Try a probiotic specially formulated for infants. L. reuteri is an especially helpful probiotic strain, as it has been clinically shown to reduce crying time by 50 percent in colicky breastfed infants. The idea is that probiotics can boost baby’s digestion and help alleviate many of the baby acid reflux symptoms naturally. Mix a little into breast milk or formula and spoon feed or give with a syringe. The probiotics that I recommend for clients is Just Thrive.
6. If Breastfeeding, Cut Out all of those ‘Typically Troublesome Foods’ and Cow’s Milk.
If you’re breastfeeding and your newborn is suffering with colic, it is imperative—for a period of time at least—to steer away from foods known to cause irritation. Some of these irritants include drinks such as wine, champagne, fizzy drinks, coffee, tea, and other caffeinated drinks. Foods include chocolate, acidic fruits such as oranges and berries, heavily spiced foods, lentils, split peas (such as pea and ham soup), garlic, cabbage, broccoli, cauliflower, and secondary proteins such as beans. Please see Well Adjusted Babies 2nd Edition for a chart relating to foods to avoid while breastfeeding.
There is a lot of literature which discusses the high incidence of cow’s milk allergies that we have today. In fact statistics indicate that many of us may unknowingly suffer with these low-grade sensitivities. This is a concern for both breastfed and formula-fed babies. If you are unsure if you have a cow’s milk allergy and you are breastfeeding, then you may wish to trial cutting out cow’s milk and all dairy products from your diet for at least three weeks and see if your baby’s symptoms improve. If your baby is more settled, then it is likely that you have an allergy to the protein or the sugar in cow’s milk. Seek further allergy and dietary advice and try to source alternative calcium-rich foods.
7. Carrying Position and Stomach Massage for your Baby.
By carrying your baby across your forearm with their stomach facing down, you can elongate their abdominal area, offering your infant some relief whilst you massage their stomach. To hold your baby like this, extend your forearm across your body and then place your baby face down on top of this forearm with their head close to your elbow and your hand underneath their nappy/groin area. Your baby’s legs will fall either side of your hand. In this position you should be able to hold the baby entirely with this arm. Now with your free hand gently place your fingers on the middle of your newborn’s upper tummy area—just under your baby’s lowest rib. Very gently start to rub your fingers in a downwards motion towards your baby’s belly button. The intention of this massage is to help relax the stomach. It may help to imagine that with your gentle finger movements you are trying to elongate a small tight ball of play dough into a flat pancake shape.
8. Other Body Work.
It can be very useful to try and massage your baby with aromatherapy oils. Moving your hands gently along their digestive tract in a clockwise motion. You can also do some basic movement/massage exercises with your baby such as bicycle legs targeting gas and bloating.
9. Tissue Salts, Homeopathics, Special Tonics or Herbal Supplements.
Across the world there are a great number of natural herbal based colic remedies sold online and in health foods stores or pharmacies. You will need to use buyer’s discretion to ascertain the quality of these. Personally, I think that the tissue salt Nat Phos (also available as a homeopathic) is a great option. Nat Phos is a natural cell salt that we normally produce to aid in digestion, but it can be insufficient in newborns. You may wish to discuss this tissue salt or homeopathic with your paediatrician but it is likely they have little experience with them and will simply negate their effectiveness.
You may wish to try dissolving 1/2 a tablet in breast milk and feed to baby with a syringe after each feeding. Children under three months can typically have up to six tablets per day. I’m comfortable with the cell salt, because it is supplementing something our body already creates (versus adding in new herbs or formulations). A baby’s microbiome is so pure—you want to be careful what you add to it.
10. For Reflux Elevate Baby while Sleeping and Eating and Hold your Baby upright for at least 30 minutes after feeding.
For a refluxy baby you may like to elevate them while sleeping and while feeding. There are now cribs that have functions enabling them to being elevated or you can elevate the head end of the cot with a piece of wood underneath the cot mattress itself. It’s also advantageous to hold your baby upright for at least 30 minutes after feeding in a baby carrier. This ensures that the milk goes down into the stomach versus staying up in the oesophagus, which causes the discomfort.
In closing here is some fascinating research on colic relief that has stood the test of time…
Two major studies on chiropractic and infantile colic have shown how spinal adjustments may have a positive effect on colic.2
One study carried out in 1989 was published in the Journal of Manipulative Physiological Therapeutics. In this study, 73 chiropractors adjusted the spines of 316 infants with moderate to severe cases of colic. These babies were averaging 5.2 hours of crying per day. The infants’ mothers were given a diary to record the baby’s symptoms, intensity and length of colicky crying and the level of comfort or discomfort of the infant. Over a period of two weeks (usually three visits), 94% of the infants treated with spinal adjustments showed a successful rating when compared with the other group of babies. One fourth of these showed improvement after the first adjustment. The other group of babies, who were medicated using Dimethicone drops, only improved by 38%. Again in 1999, researchers compared their new results with this previous trial and the results of the two studies were virtually identical. . . . . .
As you can see there are several strategies you can take when your baby is experiencing colic or reflux. Be sure to try these before rushing into taking a prescriptive medication. For further information take a look at Well Adjusted Babies — Relieving colic (Chapter 18), as well as many other useful chapters, such as “Breastfeeding” (Chapter 16) and “Formulas” (Chapter 17)… please take a look at Well Adjusted Babies . . . . .
Yours in health,
Jennifer Barham-Floreani,
Bach. Chiropractic, Bach. App Clinical Science
Registered internationally, no longer practicing as a chiropractor in Australia.
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