Coping With Colic
Could you spot a mum who’s caring for a colicky baby? If the answer is yes, you may be able to provide invaluable advice that will make life a little more bearable, says Nigel Denby…
- by Nigel Denby
Colic may be a condition you have little hands-on experience of – babies tend to enter childcare after their first three months, by which time colic has usually passed. Lucky you! However, it is likely that you will at some point deal with exhausted, emotional and stressed mums (or dads) with new babies who also have toddlers in your care. So, do you stop to ask how it’s all going? The whole family can be affected by colic. Bonding between mum and baby becomes often tricky; older children can become resentful towards the new baby, because of the excess attention he/she is receiving; and mums in particular, can become very low and depressed, as their ability to console and pacify their new baby appears to be non- existent.
For most, the days of having extended family members in close proximity to lean on are long gone. All too often it’s you who’s best placed to offer a listening ear, or some reassurance and advice.
What is colic?
Colic is a broad term used for all kinds of distressed behaviour and prolonged crying during the first year. There’s usually some form of gastrointestinal upset at the root of colic. This includes contractions in the gut, temporary lactose intolerance and trapped gas – all of which can be very painful for the baby. Other theories about the cause of colic continue to be explored, and include problems between parent and child relationships, or that it’s not a problem at all and just normal crying being misinterpreted by over-anxious parents. Little wonder that some parents are reluctant to ask for help! If you’ve seen babies with colic then I’m sure, like me, that you’ll agree it certainly is very real, and can cause huge distress to parents and babies. The dictionary definition of colic is ‘severe, spasmodic abdominal pain’ and the old-fashioned ‘rule of three’ method of identifying it remains pretty relevant – i.e. crying for more than three hours, for three days a week and for more than three weeks consecutively. According NHS Choices, up to 20% of infants may be affected by colic.
What can you do?
Colic almost always gets better on its own after a few months, but this is little comfort to the mum who hasn’t slept for days on end. Ask Mum how she’s coping, and see if she’s tried these simple tips to start with…
Comforting the baby There’s no right or wrong way to comfort a baby; different babies respond to different methods. Holding the baby during crying episodes can help, as can wrapping them snugly in a blanket or a baby sling.
• Trying different positions to hold the baby – on the shoulder; cradled in the arms; or face down, lying along the forearm – can all provide some short-term relief.
• Sitting or holding the baby upright during feeding can help reduce the air the baby swallows. • If Mum is breastfeeding, it can be useful to reduce her caffeine intake; some women also reduce their alcohol and spice intake and find that helps.
• Burping the baby after feeding is helpful.
• Walking the baby outside in a pram or driving in the car can help around the time the crying starts (usually in the afternoon/early evening).
• White noise from washing machines, dishwashers, etc. can have a soothing effect for babies.
• Gentle tummy and back rubbing can help too.
None of these tips are likely to work all of the time, but reassure parents that collectively they have helped many babies.
Formula and treatments
Some babies respond well to a lactose-free formula: The two main varieties are SMA LF and Enafmil Lactofree. These formulae are available on prescription. You should encourage parents to consult a health professional before trying a lactose-free formula, and the formula should only be used for a maximum of eight weeks (long-term use can adversely affect calcium absorption and prevent the gut from recovering its ability to digest lactose). Parents may just need the reassurance from you that the problem does warrant speaking to the doctor or health visitor. Bottle-fed babies may respond well to a fast-flow teat that allows the feed to be dispensed faster and reduces the air that passes into the mouth during feeding. Two popular teats are BFree (contains a valve to reduce the air intake during feeding) and Chicco Physiology Anticolic Feeding Bottle, both are widely available. There’s no evidence supporting drugs for the relief of colic. However, Simethicone (Infacol) is a medication designed for babies to treat excess gas in the intestinal tract, and many parents find it helpful in relieving colic within one week. If crying continues after one week, it’s unlikely to help. Trials have shown that crying time in colicky babies can be reduced significantly when lactase drops (Colief) are added to formula or breast milk prior to feeding. Lactase is the enzyme used to digest Lactose. If the drops are going to help, parents should see some benefit within the first week of use. If there is no improvement by this time, Lactase drop use should be discontinued.
What won’t help?
There will be some babies who don’t respond to any amount of comforting, feeding changes or products, and in these cases parents will need even more reassurance and support. It’s not surprising that these parents may look to less conventional treatments…
• Dicycloverine or Dicyclomine is a medication used to control stomach cramps and was sometimes used in the past to treat colic in babies. This medication is now known to have serious side effects in babies and should never be used to treat colic.
• Star anise tea is a herbal tea often used in the past to treat colic but should not be recommended; the tea contains toxins which are poisonous to babies.
• Hypoallergenic diets – breastfeeding mothers may attempt to follow highly restricted exclusion diets, but these are very unlikely to have any benefit to either the baby or the mother and should not be recommended.
By far the best thing you can do to support the mothers of babies with colic is to reassure them that it will pass, it’s not their fault and they are not alone. Mums may need reminding that their own wellbeing is important too, and that they need to rest when they can. Perhaps you can offer to take over the childcare for an hour or two to give Mum a break? If you know of other mums in a similar situation, perhaps they could meet for a coffee in your setting? A support group called Cry-sis can provide help and advice to parents with babies that cry excessively.
The Facts
Keep these key points about colic in mind…
• One in six parents seeks advice about colic symptoms from a health or childcare professional.
• The most common age for the crying to start is during the second week of the baby’s life; it peaks at around week 6–8 and usually begins to decline by week 12.
• Breastfeeding does not protect against or cure colic.
• Colic can mask the identification of more serious underlying problems, e.g. constipation, infection or reflux, so it’s important that health professionals are consulted
• In extreme cases it can lead to failure to thrive or dehydration.
Nigel Denby is a registered dietician and founder of Grub4Life; for help and advice about your early years food and nutrition provision, email feedback@grub4life.com or follow @grub4life
