Colic- What exactly is it?

Colic is defined as intense, frequent and inconsolable periods of crying. It is important to note that crying is a natural instinct to a baby and the following Dr Sears guidelines will help us establish whether your baby is a colicky baby or not, Dr Sears rule of 3’ are 

1. Crying starts within the first few weeks of life?
2. Lasts at least three hours per day?
3. Happens at least three times per week?
4. Carries on for at least three weeks?
 
Although there is no medical evidence for over the counter medications I believe ‘Colief’ works well. Theoretically it should work as it contains the enzyme lactase which is the enzyme that breaks down lactose which it thought to cause the pain of colic. Always seek advice from your GP before administering any product to your baby. Lactose is a disaccharide which means it’s a combo of two sugars joined together. Disaccharides are too large for our bodies to absorb so firstly they need to be broken down into glucose and galactose which are monosaccharides (single chain sugars). This is done by lactase (our digestive enzyme), so with a lactose intolerance life can become very tricky for a baby, especially a baby where it goes undiagnosed. Lactose that cannot be broken down and digested draws unnecessary fluid to the bowel by osmosis which results in many watery stooled nappies with a green hue. Additionally, bacteria in the bowel ferment the undigested lactose and produce gas excessively. All of this extra work the body of an infant is doing to simply digest milk deprives them of energy and metal wellbeing for other pursuits and they can become tired, withdrawn and lose weight as the body uses its own fat as fuel as they cannot absorb adequate calories from feeds and have disproportionate calories leaving the body in the way of soiled nappies. Infacol is another over the counter remedy that works quite well with colicky babies, essentially gathering up all the tiny little wind bubbles and creating one big bubble so baby can burp easily. It is also worth researching whether your baby may have something other than colic. Advice from your GP is always advised before administering any product to your baby, even if it is an over the counter med. There could be a number of issues that cause colic these include: 

1. Secondary Lactose Intolerance. This is a damaged gut lining, it is temporary and can heal. Probiotics can be useful as this usually follows a bout of gastrointestinal upset such as gastroenteritis/ tummy upset. Once the inflammation of the small intestine has gone the calls that produce lactase return to normal and thus baby is able to digest lactose again. 

2. Lactose Overload or Functional Lactase Insufficiency. Usually an unsettled baby with large amounts of weight gain. Frequent wet nappies and explosive green soiled nappies. Usually characteristic of Mothers with an oversupply or hungry bottle fed babies. Mothers feed frequently as they have an upset baby and don’t realise that the lactose overload is the cause so feeding frequently makes the situation worse (as breastmilk contains lactose). Babies have a natural instinct to suck until around 3-4 months and cannot self-regulate so the standard advice to feed on demand can sometimes be detrimental in these cases. Feeding management should be looked at and can usually be resolved in 24hrs following the help of a lactation consultant. 

3. Sensory Overload- Exactly what it says on the tin. An environment so stimulating baby can’t settle. Look at bringing audio and visual stimulation down and bring things back to basics 

4. Anterior/ Posterior Tongue-Tie- Affects the suck/ swallow breathing flow mechanism of feeding babies and they end up taking in too much air causing wind. Tongue tie can usually be dealt with by your Midwife or Doctor with a simple snip. Babies who have tongue tie experience latching difficulties and are frequently upset whilst feeding so as well as having colic pain due to the excess wind the source needs to be found – e.g.- The tongue tie 

5. Reflux – Possibly a cow’s milk protein allergy. Mother can eliminate dairy from her diet or if formula feeding introduce a hydrolysed protein formula such as Neocate or Nutramigen. Very useful to keep a food diary and note down when baby is upset in relation to what Mother has previously eaten and drank.