Mums often come to see me saying that they have been to other health professionals who have said “It’s just colic; they’ll grow out of it”. Poor mum is then left to manage a very sad, tired and hurting baby whilst trying to manage her own sleep deprivation. There are many things you can do about colic. It is real; there is a cause, so let’s find the solution.
Colic is defined as:
• Uncontrollable, extended crying in a baby who is otherwise well. They scream for at least 3 hours per day, at least 3 times per week, for at least 3 weeks.
• It’s often described as a ‘mystery’ and many doctors are unable to find the cause.
Your poor baby appears to be in pain, have a tight tummy, pull their knees up, pass a lot of wind, often have green, frothy poos and scream, writhe and grunt.
SO WHAT DO WE DO?
I follow a simple checklist before I jump to anything more serious. This simple checklist has made a significant difference to so many mums and babies. See our blog on Reflux for further help beyond this list, or come in for a chat.
Colic is almost certainly a feeding issue…that causes a sleeping issue…that affects the feeding issue (in cases of reflux, it could be a food intolerance or may be a more serious illness).
• Knowing your baby’s cues and responding appropriately is KEY.
• If your baby is tired then he needs help getting to sleep. What he doesn’t need is more food, as this will compound the problem.
• If your baby is hungry, he needs to have an effective feed.
• This is where demand feeding may be problematic.
We want to ensure that your baby is getting a full feed from one breast before you move them onto the other breast. If they are just getting a short feed from each breast or you have an oversupply of milk, their little belly may have an issue with lactose overload.
LACTOSE OVERLOAD
Lactose overload does NOT mean your baby is lactose intolerant (that’s a cow’s milk issue); it just means an excess of foremilk in their little tummy.
If your baby has lactose overload, they:
• Will be unsettled
• May often scream
• May pull knees up
• “Appear” hungry
• Want to suck
• Have good to large weight gain
• Have heavy, wet nappies
• Will often have explosive, green, frothy poo
The excess lactose from your oversupply, or excessive feeding from just the front milk (or ‘foremilk’ – the sugary milk), does not get digested and so it ferments in the bowel whilst drawing in water. This fermenting causes gas and fluid in the bowel, showing as tummy pain, screaming, pulling legs up and wanting to suck for comfort not food.
Remember – not all sucking means hunger; it can be a way of your baby saying “I need comfort”.
OUR CHECKLIST
1. Try changing from “on demand” feeding to 1 breast per feed or block feeding. Allow the other breast to drip whilst feeding. Try and allow 2 ½ – 3 hours between feeds to allow the gut to settle. If this is not effective, there may be another issue requiring extra help.
Pay attention to your baby’s nappies. Green, frothy poos can indicate that your baby is receiving too much foremilk and it can cause quite nasty tummy upsets. A good solution here is to express off some of the foremilk prior to a feed. Foremilk is not bad, but too much of it can cause issues. You may need help from your local lactation consultant to navigate this skill.
Having looked at lactose overload and changing to full feeds from one breast 3 hourly, try these other tips:
2. Have your baby in a more upright position to feed. This allows burps to come up more easily.
3. If you have an oversupply, you can try expressing off the first 30mL before the feed begins. It is wise to chat this through with your lactation consultant first.
4. When you feel a “letdown” or you notice your baby suddenly gulping, take them off the breast (much to their distress) and allow that milk to spray into a cloth nappy or bottle. This will help your little one to avoid swallowing too much air, which is a huge issue with colic and reflux.
5. Diet can also play a part. Many will tell you “Your food makes no difference!”. From years and years of experience, it can! If it gives YOU wind, it may well give your little one wind. It’s different for everyone and you will need to experiment. It may be broccoli, cauliflower, cabbage, onions, sultanas, grapes, fizzy drink, etc.
6. If these tips have not helped over a period of several days, it may be time to consider mum going off dairy. This includes all cheese, yoghurt, milk, chocolate, ice cream, etc. This can make a huge difference to babies and has prevented many babies from being unnecessarily put on reflux medication. If dairy is not an issue and you would like to try other food groups, wheat and soy may also play a role. It is not wise to cut out whole food groups for long periods of time unnecessarily, so it is worth chatting these things through with your Lactation consultant.
7. A tongue tie is also a significant consideration. When a baby cannot latch properly due to a tongue tie, they take in a significant amount of air. Unfortunately, very few health professionals are trained to correctly diagnose a tongue tie.
8. Is your baby actually hungry or are they overtired and just need help getting to sleep?I am just a consult away from you starting your journey of good sleep. It is very sad to hear that babies are on reflux medication when they are simply overtired and need help to get some sleep.
I have some beautiful, gentle, sleep “training” techniques that will help you all to have a good night’s sleep, whilst never leaving your baby to cry for more than 2 minutes without comfort. You can always book in at Alara Women’s Health to chat this through.
Jen Milligan is a midwife, Sleep consultant, Lactation specialist and Hypnobirth educator.