Infantile Colic + Effective Relief
It is normal for babies to cry. It is their way of communicating their needs be it hunger, tiredness, a dirty nappy, a thermic change or digestive discomfort. Colic is quite different from the normal crying seen in healthy babies.
What is Colic?
Infant colic is defined as “recurrent and presents with prolonged periods of crying, fussing or irritability in otherwise healthy infants under the age of 5 months”. It usually presents in the first weeks of life. Colic is the diagnosis that is given after you’ve seen a doctor and other conditions have been ruled out such as gastrointestinal reflux disease (GERD), food allergies, food protein-induced enterocolitis, eosinophilic esophagitis (EO) plus other medical conditions. Having a baby with colic can be very distressing, tiresome and frustrating, as the cause is unknown and treatments are limited.
What is the cause?
Although the cause of colic is unknown, there are some theories. Indigestion, trapped wind and gut sensitivity to some food proteins are among the proposed potentiating factors.
What is the treatment?
Treatment options for colic are limited. Often symptoms will subside with time. Some “colicky” babies are given a trial of a proton pump inhibitor (PPI’s), a medication that reduces stomach acid in the hope of alleviating symptoms and reducing crying episodes. This type of medication is more effective cases of true GERD and EO presentations rather than in colic, but it can sometimes be used as a diagnostic tool.
Full discloser; I’m no expert on drugs and I’m not a doctor, but what I will give you is my perspective on the effects of PPI’s in infants, dietary information and some promising study results on specific probiotics so that you can make an informed decision on how to best go about dealing with colic in your baby.
About Protein Pump Inhibitors
PPI’s reduce the acid in the stomach, which can be helpful in cases of GERD, to allow healing of the oesophageal lining when damage has occurred because of excessive stomach acid.
Stomach acid is your first line of defence against ingested bacteria. When stomach acidity is decreased, bacteria can enter the digestive system potentially causing infective enterocolitis. Another common occurrence in infants on PPI’s is small intestinal bacterial overgrowth (SIBO). The small intestine is not supposed to be colonised with bacteria. SIBO can cause constipation, bloating, diarrhea and potentiate food intolerances.
Potential maternal dietary triggers and allergies
I believe there is a lot of awareness around the mother’s diet and how it affects the baby. In colicky babies, one of the most common potentiating food triggers is dairy products. Most of the time, mum eliminating all dairy can resolve the unsettledness in the infant. Occasionally soy also needs to be excluded as well as dairy.
Always trust your gut when it comes to identifying potential food triggers and allergens. A lot of mums are able to pinpoint exactly what foods trigger colic in their baby. I always emphasise, when eliminating foods from your diet to (a) do one food or food group at a time so you can easily identify what is working and (b) make sure you are making up for nutritional losses with either alternative foods or need be supplements especially in the case of calcium and protein for breastfeeding mums.
Probiotics + Colic
It’s important to note that not all probiotics are created equally, and different species have specific therapeutic indications. Most infant probiotics supply Bifidobacterium species as this is the most common strain found in breastfed infants.
Lactobacillus reuteri is a probiotic strain that has the most research behind it and has been shown to be effective in different 5 randomized controlled double-blind trials in the management of colicky infants. Lactobacillus reuteri is most effective in breast-fed infants with reflux or colic, either used concurrently with proton pump inhibitors or without. When used concurrently with PPI’s, Lactobacillus reuteri helps to reduce small intestinal bacterial overgrowth. Further studies are needed to confirm the effectiveness in formula-fed infants. A daily dose of 10 billion CFU’s (colony forming units) for 21 days was used in the studies and produced a beneficial effect on reducing crying time and/or fussing time in breastfed infants.
You’ll need to speak to your pharmacist or health care practitioner to find these probiotics. They are quite different to the regular infant probiotics.
A. Pärtty, S. Rautava and M. Kalliomäki, Nutrients, 2018, 10, 1836.
V. Sung, F. D’Amico, M. D. Cabana, K. Chau, G. Koren, F. Savino, H. Szajewska, G. Deshpande, C. Dupont, F. Indrio, S. Mentula, A. Partty and D. Tancredi, Pediatrics, 2018, 141, e20171811.
O. Belei, L. Olariu, A. Dobrescu, T. Marcovici and O. Marginean, J. Neurogastroenterol. Motil., 2018, 24, 51–57.
The information contained in this article is for informational and educational purposes only.
We cannot guarantee that any information found in this article, will work as advertised, nor that they will give you the desired results. Individual results may vary.
None of the information contained in this article is intended to diagnose, treat, alleviate or relieve any medical or health conditions nor serve as a substitute for the advice provided by your physician or other healthcare professional.
You should always speak with your physician or other healthcare professional before adopting any treatment for a health problem or undertaking any new dietary regime. If you have or suspect that you have a medical problem, or you should contact your health care provider.
Written By Brittany Darling
NUTRITIONIST (BHSC), WESTERN HERBAL MEDICINE (ADV DIP),
CERT. PAEDIATRIC NUTRITION