infant colic

[jonheatley]

As a GP and father of three boys all healthy (thank goodness) I would like to pass on my thoughts about colic. It is so common as to be regarded as normal behaviour and if your infant misses it count your blessings.
The new baby is used to perfect comfort in the womb so the first year or two can be quite a challenge for them to adapt. Thus they will scream if tired or hungry or uncomfortable in any way. The bowels need to adapt to the business of digesting food whether breast or bottle milk and this will cause mild abdominal discomfort - ie colic. Nothing can really remove this mild discomfort and after a while the baby gets used to it and the colic/screaming stops. Therefore although it sounds harsh they have to learn to deal with it. This means that being anxious about it and trying desperately to reduce the distress is probably going to make it persist longer and cause the poor parents a lot of angst. No baby has come to harm from it and they are much tougher on the whole than their parents. I remember admitting a screaming 5 month old one christmas afternoon as his parents had blended up a normal christmas dinner and fed him that from a bottle! He created for hours until he had digested it then was back to his usual happy self..

Yes, wonder how many are left with true colic. I've had two, one diagnosed with colic which was actually tongue and upper lip tie and one that I can't ever remember crying. My friend's baby had "colic" and while they were doing tests for another condition found that she had CMPI. They cut out all dairy and funnily enough the colic disappeared too.

I have done an internet and medical journal search on colic and what may be causing it and the great majority of cases have no obvious or discovered cause. We do try to look for tongue tie and encourage mothers to try different formula feeds and they will themselves avoid foods like grapes that seem to bring it on. However there seem to be a lot of parents out there who suffer greatly during this distressing period of colic and feel there has to be something that will cure it. In the old days merbentyl stopped it almost instantly and we know it worked by stopping the normal movement of the small bowel musculature. I am intrigued by the lack of explanation of why it just spontaneously resolves itself. As far as I can tell no one has come up with an explanation which is why I am left wondering if it stops when the baby finally gets used to it? This may sound harsh and I don't mean it to be, but could it be the explanation? Does anyone out there have any ideas why it stops spontaneously?? Would be interested to hear your views.

Grapes are very unlikely to give your baby colic, have a read of this on kellymom.

If you do try to look for tt, are you familiar with all kinds of tt and upper lip tie? Do you suggest that the parents get a second opinion from a BFC, lactation consultant or an online diagnosis service like milk matters.

Its a sad fact, but there is a whole thread on Mn of MNers who have been told that there Lo didn't have tt by HCP only to find out that they had. My HCP didn't even bother to check

Grapes that bring it on, ffs get yourself some bf training. Maternal diet is irrelevant unless the infant has a cmpi or similar.

Bf or ff on demand and carry baby in a sling, exclude cmpi, reflux and tt and actually not many babies have colic. The parents of the ones who do need support, understanding normal baby behaviour mat be part of this.

Yes, are you able to spot a posterior or submucousal tie? How do you diagnose??

Because if it's just by looking for ties you can see then you will miss LOADS of them.

DS1 didn't have "colic" as a baby, but went on to develop severe reflux when he was 5yo which disappeared when his tongue tie was revised. ALL the docs poo pooed me when I said it would.

It needs to be taken more seriously.

Do you ever consider CMPA as a possible cause? It's not a rare condition (see below, from the BMJ report), though it seems to be inadequately picked up by HCPs, leading to avoidable illness with ongoing and distressing symptoms such as weight loss, eczema, colic, reflux etc.

"Between 5% and 15% of infants show symptoms suggesting adverse reactions to cow?s milk protein (CMP),1 while estimates of the prevalence of cow?s milk protein allergy (CMPA) vary from 2% to 7.5%.2 Differences in diagnostic criteria and study design contribute to the wide range of prevalence estimates and underline the importance of an accurate diagnosis, which will reduce the number of infants on inappropriate elimination diets. CMPA is easily missed in primary care settings and needs to be considered as a cause of infant distress and diverse clinical symptoms.3 Accurate diagnosis and management will reassure parents. CMPA can develop in exclusively and partially breast-fed infants, and when CMP is introduced into the feeding regimen. Early diagnosis and adequate treatment decrease the risk of impaired growth.4"

I was actually advised by my HV to feed milky puddings on weaning in order to try and reverse the weight loss caused by the CMPA...

If you try looking up colic on google scholar it is frustrating as most of the scientific articles are not available to us public. however this is one that is, and worth a read

archpedi.jamanetwork.com/article.aspx?articleid=204192

It concludes with the following:-

This study represents an important contribution to furthering society's understanding of infant colic. Parents can be reassured that, for most infants, colic is confined to the first 3 months of life, with little lasting effect on levels of maternal distress. These observations should not justify the abandonment of research. Rather, the absence of definitive conclusions regarding colic's etiology, along with its relatively frequent occurrence, the feelings of despair it can evoke, and, in a few cases, its persistence, underlines the importance of continued research that examines the many subgroups of excessive infant crying. In the meantime, we should provide parents with education and support that enable them to cope during this potentially difficult time.