Having a new baby can be one of the most wonderful times in your life, but it can also be one of the most stressful. All babies cry, but how do we know if their crying is normal, or if there is something we can do to help?
Colic is the name given to a condition where there are repeated bouts of excessive crying, in a baby who is well in between times. The accurate definition is; ‘a baby crying for more than three hours a day, for more than three days a week, for more than a week’. This is known as Wessle’s criteria.
It affects up to 1 in 5 infants, and usually resolves on its own after 3-4 months of life.
It causes no harm to the baby but is one of the biggest reasons parents bring their young babies to us. It is distressing to deal with and can be a big contributor to postnatal depression. It can cause mums to stop breastfeeding sooner than planned and is the biggest risk factor for shaken baby syndrome.
One of the biggest concerns parents have is, is there something serious going on? Nine times out of ten, we can safely say no! But a GP can check your baby and explore things like…
Cow’s milk allergy – normally associated with baby not gaining weight well, with vomiting, diarrhoea and possibly eczema or a family history of allergies.
Reflux – associated with vomiting and poor weight gain
Lactose intolerance/overload – this can cause watery, frothy diarrhoea and bad nappy rash. It can be found in breast fed babies who are snacking on the foremilk often, which has a high lactose content, or in babies with an underlying allergy.
We can exclude other reasons for the excessive crying such as a hernia, a twisted testicle, a urinary tract infection, an ear infection or a hair tourniquet (where a hair can get wrapped around a finger or a toe), to name but a few!
Once we are happy there is no medical cause, we can focus on supporting families and trialling different solutions. Unfortunately, there is no guaranteed cure, but there are certainly some things that wok better than others.
Despite over 40 years of research, effective management of colic remains elusive.
Our most tried and tested advice involves establishing a clear pattern for feeding, settling and sleeping. This makes life more predictable for your baby and can make a huge difference. Tips include darkening the room for day time naps, reducing excessive stimulation; noise, light, handling, and excessive quiet, most babies find a low level of background noise soothing. Carrying the baby in a carrier on the front of the chest and doing baby massage can also help. We know these can be very difficult to put into practice, especially with a baby with colic, and sometimes we may consider referral to Family Care Cottage or Tresillian (www.tresillian.org.au).
Exciting recent evidence supports the possible role of probiotics, the results are a little unclear, but they do seem to suggest that Lactobacillus Reuteri DSM17938 can significantly reduce crying in exclusively breast-fed babies. There was not the same level of evidence to support it’s use in formula fed babies.
The next best evidence for colic management is the use of hypoallergenic milk formula or eliminating dairy products from a breastfeeding mother’s diet. This probably only helps babies with an underlying allergy to cow’s milk protein, which is more likely in babies with poor weight gain, vomiting and diarrhoea a possibly with blood in it, as outlined above.
Some women find cutting out eggs, wheat, nuts, caffeine, spices or garlic from their diet helpful. If these changes to you or your baby’s diet don’t help within two weeks, you can revert to your previous diet.
Some studies have shown the benefit of acupuncture in an unsettled baby.
It is important to remember, it’s ok to leave your baby if they continue to cry, and walk away, take 10 minutes to get a cup of tea or phone a helpline (like Karitane 1300 CARING (1300 227 464) OR (02) 9794 2350, manned by caring Child and Family nurses who can answer any question regarding parenting a child 0-5 years old). Soothing an unsoothable baby is exhausting and taking a moment to recharge yourself is important. Allow others to help, maybe try and express enough milk so your partner can do a night shift.
There are many other resources that can be easily accessed –
www.rch.org.au/kidsinfo/fact_sheets/Crying_and_unsettled_babies/
Tresillian helpline – 1300 2 PARENT (1300 2 72736)
Don’t struggle in silence, come and see your GP, or call in to your local Early Childhood Health Clinic, the details of which will be in your blue book. We can check your baby out for serious conditions, and we can help get you through the tough times.
