Colic is completely draining. Defined as constant crying for 3 hours a day or more, for three days or more, for three weeks or more, it is stressful for any parent. Colic affects 1 in 5 babies and can increase the chances of postnatal depression, bonding and attachment concerns for parents.
Why does colic happen?
There isn’t a conclusive answer here, but many theories are due to the links behind it. The jury is still out on whether colic is a symptom of something underlying, or whether it is a medical condition of its own.
The first is increased air intake, as colic is more common with babies who are fed formula than breastmilk. In babies who are breastfed, if they have a tongue tie or latch or attachment issues, this increases the chances of colic. Colic is also more common after instrumental births, possibly due to the ways in which the skull plates have been manipulated.
The Second theory is an imbalance of good friendly bacteria within the gut. Maternal antibiotics during pregnancy or birth wipe out a baby’s gut for 8 weeks (Shamir et al, 2015). Antibiotics given directly to babies after birth reduce the gut microbiome for four weeks in contrast, however, this can vary depending on whether the baby is given breastmilk (which have prebiotics and probiotics in amongst millions of good bacteria to replenish the gut), or whether the baby has formula milk. In addition, the type of birth mode and skin to skin also plays a part on this theory.
Allergies are the final potential reason behind colic, as babies who have allergies have digestive pain which causes the crying. Common culprits are dairy, soya and and eggs but there can be other culprits such as wheat, nuts, fruit or vegetables. I highly recommend reading Grow Healthy babies by Michelle Henning if you are pregnant, have a child with allergies already, have eczema, asthma or allergies yourself.
What can you do to help your baby if they seem to have colic?
1. Firstly support is key. Whether that is with your family or healthcare providers, support for you is a must have.
2. Baby massage can aid moving trapped wind around in times of colic. There is a video on my instagram page which can help with this.
3. Baby probiotics have been shown to lessen the crying time for colic and improve symptoms. If there is any antibiotic use in labour or birth, then start the probiotics as soon as possible after birth to replenish the gut – both for you and for your baby.
4. In addition, if you are having a caesarean birth, ask for the antibiotics given to you to prevent infection to be given after your baby is born and not routinely before the birth of your baby. Probiotics taken both during pregnancy and postpartum can reduce the chances of allergies, eczema and atopic illnesses in babies.
5. Consider breastfeeding to reduce the chances of colic, and seek support if you are having feeding issues. Breastmilk has long lasting benefits for babies and for the long term microbiome (gut bacteria) for babies. This reduces allergies significantly and is more easily digested compared to formula milk.
6. If you are breastfeeding and your baby has colic, then keep a food diary to see if there are any allergenic links. If there are, then exclusion diets will confirm this. With allergies, there are often other symptoms besides just colic, and allergies are on the rise every year for many different reasons (as seen in the Grow Healthy Babies book).
7. Tongue ties can increase the chances of a baby (breast or formula fed) experiencing wind and colic issues. Sometimes there can be posterior tongue ties which are not as easy to see as anterior ones by healthcare professionals, but again due to the seal around the breast or bottle can increase the chances of colic for babies.
Many NHS trusts offer tongue tie divisions – however most have strict guidance on what will and won’t be cut. Start by asking for a referral from your midwife or health visitor if you suspect a tongue tie, or consider seeking help from a lactation or infant feeding specialist privately.
8. If you are formula feeding your baby, then consider anti colic bottles to reduce air intake and paced bottle feed which will enable the wind to be regularly released rather than waiting until the end to finish winding. In addition, wonky winding allows pockets of air to come up easier than winding upright due to how the stomach sits within the abdomen.
9. Making up feeds one at a time using fresh water from the kettle is also really important. Prep machines provide a hot shot of water and do not kill off all the bacteria from powdered formula. As seen above, an imbalance of good bacteria can increase the likelihood of colic.
I have seen, as a health visitor, an improvement in colic symptoms reported by parents when they returned to using the kettle to make up feeds rather than the prep machine. If you continue to use the prep machine, ensure filters and cleaning cycles are undertaken every 4-6 weeks and bottles continue to be sterilised, along with good hand hygiene when touching bottles or making up feeds.
10. There is no evidence or research that changing formula brands or types work and the official guidance is that all babies should have first stage infant formula for the first year of life as it is nutritionally designed for babies with the best nutritional composition in mind. That said, there are slight variations between formula brands.
For example SMA has slightly more iron in increasing the chance of constipation. Kendamil is made without palm oil which, for some babies, the formula is tolerated differently, and there are organic formulas on the market which will be made from cows who have not been given antibiotics or other chemicals, which again might slightly change the tolerability of milk (there is limited evidence other than anecdotal from parents who found switching brands improved symptoms).
However, if you do switch, then stick to it for at least a month as there may be time your baby’s digestive system needs to transition with it, and you need a good 4 weeks to notice any differences.
11. Colief lactase drops are another option, particularly for babies who have been given antibiotics. Antibiotic use can increase the chances of temporary lactose intolerance and what the Colief drops do is work as a lactase enzyme to break down the lactose in milk. There is some evidence Colief can reduce crying and colic times for parents – particularly for babies fed formula.
12. Tummy time is another great way of helping move any trapped wind around, as well as aiding with development of babies. As adults, we use our core muscles to aid the movement of wind, and babies have immature muscle strength. Tummy time helps to build on this.
13. Baby wearing and keeping baby upright rather than laying baby straight down after feeds will also aid the movement of any trapped wind in both directions. Baby wearing also provides comfort to babies in times of pain and discomfort too, and can lower both maternal and baby cortisol (stress) hormones, also aiding with attachment and bonding.
14. As another final option, particularly if there has been any instrumental or more challenging birth, cranial osteopathy can help move the skull plates back into shape. In addition, if there are any flat patches on your baby’s head, this will be putting pressure on the cranial nerves which supply the nervous system and blood flow to the digestive system. Whilst there is limited research to show this works for colic, there are many parents who have found cranial osteopathy worked incredibly well at reducing colic. Just ensure you choose someone reputable with extensive credentials.
Food standards agency prep machines https://elht.nhs.uk/application/files/4915/5533/6985/Statement_on_formula_preparation_machines_Nov_2016.pdf