Are you dealing with colic in your newborn? Share your questions with midwife Angie

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THIS Q&A IS NOW CLOSED. YOU CAN VIEW MIDWIFE ANGIE'S ANSWERS HERE

Colic is never a fun part of the newborn stage and it can be really distressing for you and baby. We’ve invited MAM midwife Angie to answer any questions you may have about preventing colic, how to recognise it, and soothing your colicky baby.

• Share your questions about dealing with colic below
• Everyone who shares a question on this thread by 10th April 24 will be entered into a prize draw to win a £200 voucher
• Angie will be back online in a few weeks to answer some of your questions

About the expert: Angie is a mum and midwife who has stepped outside her clinical role as a foetal surveillance specialist to undertake a year-long secondment as a Chief Sustainability Officer’s clinical fellowship, delivering sustainability healthcare projects for the NHS. Through this transition, Angie has attracted a large and well-engaged following of parents and clinical professionals, providing authentic and honest advice. Angie now works in partnership with MAM baby UK as their consultant midwife.

Here’s what MAM has to say:
We’re MAM, and we love babies! We’re the world’s leading manufacturer of premium baby products because we believe they deserve only the best quality. That’s why we’ve been developing extra-safe baby products for over 45 years. We’re a family company that combines an appealing, innovative and medically approved design with sustainable resourcing and affordable prices. For peace of mind and a happy baby, MAM is a business you can trust.

Thanks and good luck with the prize draw!

MNHQ

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Disclaimer: Please do not rely on this Q&A as an alternative to medical advice from your midwife, GP or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.

I think we're all just shouting into the abyss right now guys #FreeAngie

Hi everyone - we're really sorry again for the delay! The answers will be posted today. Thank you for your patience.

@HobNobAddict

There are no set foods to avoid with breastfeeding from the outset. The only substance where there is a small amount of research in relation to colic is excessive caffeine intake - however this can depend on the individual person in how quickly they metabolise caffeine and the evidence is mixed - some evidence states there is no impact on colic, some research reported parents reporting their babies as more unsettled and colicky with large amounts of caffeine. The RDA (with minimal evidence to support) of caffeine for breastfeeding mums is 300 mgs a day (for reference outside of pregnancy/breastfeeding the RDA is 400 mgs). It is worth noting however that babies can have food allergies, and the food substances mum eats can cross the breast milk. There are many risk factors for a baby developing allergies these include: family history of atopic illness (eczema, asthma, hay fever), antibiotic use in pregnancy, birth or postnatally, and allergies are becoming more prevalent for a variety of reasons too. If you are not coming colic symptoms in your baby, then a food diary can be really useful to see if there are links between what is being eaten and the symptoms in the baby. Common food allergens are dairy, soya and egg - but there can be others to consider which is why a food diary can be the most useful. If there is colic symptoms in a breastfed baby, I'd recommend face to face support to rule out any latch, attachment issues or potential tongue ties.

@Lighter22

Trying a variety of winding techniques and working out what works best for you baby can be best technique - each baby is different and sometimes the changes in positions works best. One technique which can work for a lot of babies is called 'Wonky winding' which was first discussed by Lyndsey Hookway. This is where you place baby upright over your right shoulder and it can enable the wind to more easily come up, gently patting or rubbing babies back in this position can help. Baby wearing can be useful too for keeping a baby upright too.

@SmartiesParty

All of the reviews of the evidence show little to no difference in using any of these remedies in reducing colic in babies. The evidence we have is often small studies, remembering every baby and parent is individual and the cause for colic in each baby is really unique which makes it really hard in being able to say which ones are 'best'. It's incredibly frustrating that colic is so common, yet the research is limited. This is where having a conversation on an individualised basis can be really useful. In many families the cause for colic is never found, and it is something the baby will 'grow' out of. But for some families this is where looking at the overall picture can help. For example, if there have been antibiotics used this is where probiotics might be of use due to gut changes in the microbiome (studies small, but many parents report less crying). Babies after antibiotics can sometimes develop lactose intolerance (this is not an allergy - lactose allergy is incredibly rare and leads to dehydration and emergency admission - which is why nappy output is so important) too which is why some parents will find improvement with lactase enzyme drops. For all babies looking at the tongue suck and swallow function to see if there are any underlying tongue or lip ties, having a look at latch, attachment or the suction around a bottle, looking at paced bottle feeding to provide the baby to pause and bring up wind more, and the types of bottles used too. If bottle feeding discussing how the feeds are being made up as one of the theories on colic is gut changes and from professional experience, I have known many parents report improvements in colic when they return to making up bottle feeds by the NHS recommendations. It's where if there are any other symptoms where looking at family history, birth history and postnatal history and considering food diaries or if formula feeding looking at the ingredients in the formula to consider switching to an alternative first stage infant milk might help (and if not and allergy suspected then liaising with a doctor for a possible trial of hydrolysed formula.

@MidwifeAngie thank you! Actually since posting this we started using probiotics which have had a massive impact and he's much better

@jellybeanpopper

There is if there are allergies. If there is colic in a breastfed baby then face to face support is paramount as the symptoms of colic can be caused by latch and attachment issues or tongue ties and lots of the allergy symptoms such as colic can be caused by excess air intake during feeding. If all of these are excluded, then considering a food diary particularly if there are other symptoms such as: eczema, itchy skin, swelling, poor weight gain, change in the colour of the stools, diarrhea or constipation, excessive wind, reflux, always mucousy. These symptoms need a discussion with a health visitor or GP and this is where a food diary can be useful because it can then guide what to exclude. The most common allergy is cow's milk protein, and 50% of all babies who are allergic to cow's milk are also allergic to soya (which is why when doing a dairy exclusion diet, the advice is not to replace with soya alternatives). If there are suspicions of food allergy then the mum should cut the allergen for a minimum of 3-4 weeks - it takes time not only to come out of the mother's system, but then a week or two for the baby's system to 'settle'. Usually parents will see a difference in this time if it is allergy related. To confirm the allergy (as long as it isn't immediate life threatening symptoms) then the mother can reintroduce the allergen either by choosing something high up on the cows milk protein ladder or by reintroducing lower levels of cows milk protein and see if the symptoms return.

@JacCharlton

Upright will help to limit reflux and aid with air bubbles coming upwards. Similar to adults, babies struggle to lay flat straight after feeds and the recommendation is to keep babies upright for around 20 minutes afterwards (it is where babywearing can be really useful). Led flat and a colic baby massage routine can help some babies with the movement of any trapped air inside, but this is recommended around half an hour or so after feeding.

@DanBenandBud

Anti colic bottles can reduce the amount of air intake a baby is having during the feed (and why I recommend a feeding assessment with colic to look at the suck/swallow, latch, seal and attachment to either breast or bottle). One of the many theories of colic surrounds air intake in babies and trapped wind. There are some research studies which look at parental perception and colic and who report reduced crying times and less colic symptoms when using anti colic bottles. The air intake is highest during the feeding process, and it is where reducing the air intake whilst feeding can be beneficial, and where reducing the air intake during the feeding through the use of an anti colic bottle can lessen the amount of trapped wind therefore lessening the colic symptoms reported.

@LittleDeeAndME

Gripe water isn't recommended to treat colic, and the research has found gripe water might increase the chance of constipation and vomiting in babies too, possibly with an increase in colic symptoms compared to babies who did not receive gripe water. Most gripe water used now has no alcohol (many versions used to contain alcohol). The main treatment for colic is to try and find the underlying cause of the colic where possible - it is latch and attachment to either the breast or bottle? a tongue tie? Is it a food allergy? Could it be gut dysbiosis due to antibiotic use or gut changes, could it be due to ingredients in formula where an alternative could work? trapped wind and where baby massage might help?

(See research PMCID: PMC 4668494, PMID: 26673749)

@itsywitsy

There is one study highlighting the link between colic and IBS/IBD. It is worth noting both conditions have theories regarding the cause - but no confirmed reason/cause currently. There are links between allergies in early life and these continuing, possibly into later life for some children which will give the symptoms when ingested. However the studies are limited. The only research in the early years on conditions like celiac disease and postnatal surrounds the type of feeding with breastfeeding duration lowering (correlational data - not cause and effect) celiac disease. There are theories that any gut microbiome changes in early life (surrounding type of birth, antibiotics, feeding mode) can play a part in things like atopic illness, autoimmune conditions and conditions like IBD but further research is needed.

@Waitingfordoggo

It's a great question. So colic is defined as crying for 3 hours a day, for 3 days a week or more for 3 weeks or more. Crying naturally peaks for babies around 6-8 weeks which can be a prime time for parents to diagnose colic too. Because the cause of colic is still unknown, with multiple theories it can sometimes be hard to differentiate between what is 'normal' crying (particularly as it is the baby's way of communicating) and what could be underlying problems with potential solutions. The evening hours are also the hardest for babies - partly due to stimulation, partly due to brain development, but if there is any digestive discomfort this often builds up throughout the day and often where the knees to chest, squirmy, wind, poos come in. There are also some cultural differences cited too in cultures where babies are held a lot, kept in close contact there are anecdotal reports that colic doesn't really exist or crying is limited - however there is no strong evidence to confirm this, and it is being aware of lots of international differences culturally from diets, to feeding, to family and friend support networks, to working, health and wellbeing, sleep arrangements - so this in itself is multifactorial. In terms of Neurodivergence the evidence is incredibly limited - but considering 1 in 5 babies have or are diagnosed with colic, it might be difficult to show the links between the two, although more research is needed. There is some links with excessive crying later on into infancy and being reported on neurodivergence assessments later (note excessive crying does not cause neurodivergence) but there is also evidence which counters this too. There is this one study you could have a read of: https://pubmed.ncbi.nlm.nih.gov/29573066/

@muddlingthrou

There is no evidence to say having had one baby with colic means having another baby with colic, but it can depend on lots of different factors, the temperament of the baby and any possible reasons found for the colic. Each and every baby is different. From personal experience my eldest had colic (along with multiple other symptoms) until we cut out dairy, my youngest in contrast had 0 colic.

@ButterOllocks

The tests are largely inaccurate as a starting point. With the exception of severe allergy (i.e breathing difficulties, sudden rash, sudden swelling of lips, face etc) anaphylaxis occurring within a few hours of ingestion. For most babies, the best way of diagnosing is an exclusion diet of around 3-4 weeks, then reintroduce the allergen into the mum and then observe for the next 3 days. It is important to note 50% of babies who are allergic to cow's milk protein are allergic to soya so important not to replace dairy with soya products in this time. Usually most parents will know in that 3-4 weeks if the symptoms have improved or not.

@Ilostmyhalo

Every baby with an allergy is different. Some present with constipation, some with constant pooping, some have mucus in their stools, some are really greeny (this one can be a sign of oversupply and lactose overload too though), blood in poo is probably the easiest one to spot. Colic is one of the many symptoms a baby can present with when they have an allergy but it tends to present alongside other symptoms too.

@jellycount

Firstly, have you had enough support (I am going to apologise and say sorry if you have not). Things to ask: 1) Has anyone checked latch and attachment, anyone checked for a tongue tie? What type of birth did you have? Anyone checked what the suck/swallow is like of your baby? Have you have a referral to an infant feeding team for more support? Have you been signposted to local breastfeeding support groups, breastfeeding counsellors, the breastfeeding national helpline (now open at night too to call), local lactation consultants? Was there intravenous fluids used during labour which can overinflate a baby's birthweight meaning they wee a lot more but lose more weight? Have you had support in increasing milk? skin to skin, a baby moon, Power pumping, checking the size of a flange with expressing, warm compresses, pumping whilst breastfeeding, breast compressions, frequency of feeding and or pumping 8-12 times minimum? With the bottle feeding are you paced responsive bottle feeding? Bottle feeding is a different mechanism and the feeding method is very different which is why with traditional bottle feeding larger amounts can be drunk more easily (which is part of the reason bottle feeding is linked to increased weight gain). In the early days this is where pausing every 15-20 mls (and then winding) in the first week and then every 30-40mls after this can help with babies regulating their own appetites, when they are full and protecting their tummy sizes. Paced bottle feeding aims to protect breastfeeding with combination feeding. It also enables babies to take a pause like in breastfeeding, but also enable parents to wind their baby in that pause to try and bring up any wind too. With breastfeeding, babies can pause more easily but with bottle fed babies milk still enters their mouth on the pause. Are you using the slowest flow teat rate too?

@youareonlyhereonce

Gripe water isn't recommended to treat colic, and the research has found gripe water might increase the chance of constipation and vomiting in babies too, possibly with an increase in colic symptoms compared to babies who did not receive gripe water. Most gripe water used now has no alcohol (many versions used to contain alcohol). The main treatment for colic is to try and find the underlying cause of the colic where possible - it is latch and attachment to either the breast or bottle? a tongue tie? Is it a food allergy? trapped wind and where baby massage might help?

(see research PMCID: PMC 4668494, PMID: 26673749)

@prawncocktailcrispss

Every baby is different, so it's trying a variety of ways for you and your baby - each baby is different and sometimes the changes in positions works best. One technique which can work for a lot of babies is called 'Wonky winding' which was first discussed by Lyndsey Hookway. This is where you place baby upright over your right shoulder and it can enable the wind to more easily come up, gently patting or rubbing babies back in this position can help. Baby wearing can be useful too for keeping a baby upright too.

@Beabeautiful

Anti colic bottles can reduce the amount of air intake a baby is having during the feed (and why I recommend a feeding assessment with colic to look at the suck/swallow, latch, seal and attachment to either breast or bottle). One of the many theories of colic surrounds air intake in babies and trapped wind. There are some research studies which look at parental perception and colic and who report reduced crying times and less colic symptoms when using anti colic bottles. The air intake is highest during the feeding process, and it is where reducing the air intake whilst feeding can be beneficial, and where reducing the air intake during the feeding through the use of an anti colic bottle can lessen the amount of trapped wind therefore lessening the colic symptoms reported.

@DinkyDaffodil

Very few healthcare professionals discuss it (it was something I added into my antenatal courses post my eldest for this very reason), and very few mums know about it in my experience as a midwife, but it is something often discussed by health visitors most likely because it's most common later on in the postnatal period starting around weeks 4-6 for many babies. In my health visiting experience, colic and things to try to relieve it were talked about a lot especially in well baby clinics - however I am aware that access to health visitors and well baby clinics has changed across the country for many mums which is really challenging and I am sorry you did not have any tips or things to try

Hello @Raveceleste

Firstly you are not alone, and whilst it might not be what you want to hear, only 14% of babies have slept 'through the night' by 6 months old occasionally. 86% of babies at 6 months old never have. Developmentally and realistically most babies begin sleeping through more consistently and regularly by 2 years old. The first two years babies go through so many changes from teething, developmental progressions (this upsets sleep a lot every time they learn a new skill, start moving, talking etc). I highly recommend reading or downloading the gentle sleep book by Sarah Ockwell SMith to understand you aren't alone, your baby is developmentally normal and whilst it is so incredibly hard (been there where you are and at 23 months my daughter who never slept for more than an hour 4-12 months, is now sleeping through at 23 months old - it's progressive improved with age). Comfort milk can be harder for some babies to digest and cause digestive problems for some babies. There are many things to explore here, and where the gentle sleep book could help. Colic is unusual at this stage however 6-12 months is a prime time where babies will wake up more because their guts are adapting to food. This is a huge deal for the gut to process on top of development. The things to consider include: exploring safer co-sleeping - this is safer than dropping baby, or falling asleep on a sofa. Both the lullaby trust and NHS website have got information to explore this. Taking it in turns at night and 'layering' when feeding. There is a small amount of research showing that when partners are involved in nighttimes sleep can improve for both parents, making a plan such as 'you take time to XX time' and I'll take over from there can help. This will mean you can maximise sleep and then you can maximise your other half's sleep too. Breastfeeding to sleep is biologically normal, and is often the quickest way to settle a baby. It promotes oxytocin in you both which aids sleep too. But this is where layering (such as patting, shhhing, music, white noise, teddy, comforter - whatever works for you and your family) alongside breastfeeding can help start to develop sleep associations other than the breast. It is not going to be a magic solution overnight, but it will in time help enable your little one to transition to something other than the breast. Finally this is nothing you have or haven't done, nothing you can really control (with the exception of sleep training which has pros and cons, and is not guaranteed to work, and has been shown with a lot of babies need repeating every time the baby's sleep patterns change again due to illness, teething, development progression), and nothing to do with 'an imperfect' bedtime routine. Sleep is multifactorial - development, genetics (babies whose parents were poor sleepers are more likely to have low sleep needs babies), as well as the environmental aspects (temperature, food, quiet, dark etc). This is one of the hardest aspects of parenting the sleep deprivation. Good accounts to follow on social media include sarah ockwell smith, Lyndsey Hookway and Little Nest sleep. You are not alone and sometimes just having a conversation with other parents who are also in the thick of the sleep deprivation can really help. And if anyone hasn't told you recently: You are doing a great job parenting. Remind yourself of that each day even in the thick of the lack of sleep.

@changer2010

This depends on your baby, how you are feeding and how old they are. If bottle feeding trying to wind every 15-20 mls in the first week, and then as they grow, winding can occur after slightly larger amounts. If breastfeeding, can wind when they naturally come off before offering the other breast.

@jacqui5366

With colic, it is worth exploring the possible reasons behind the colic symptoms before considering the remedies, and it is where a conversation with your health visitor can be useful. There is little to no evidence any of the anti colic agents work from the cochrane review www.cochrane.org/CD009999/BEHAV_pain-relieving-agents-infantile-colic#:~:text=Pain%2Drelieving%20agents%2C%20such%20as,amount%20of%20time%20spent%20crying. There is however a small amount of evidence for probiotic usage and for lactase enzyme drops for babies in reducing crying and colic symptoms reported by parents in the research, and in terms of dosage following the guidance on the information.

@DanBenandBud

It is unlikely too with feeding too soon - however they are unlikely to take much if they aren't hungry. Sometimes with a baby who has been requesting a feed for a while if they are excessively crying it might lead to increased air intake in that specific feed, particularly if they have worked themselves up. If possible, trying to feed when baby makes feeding cues before they begin crying (I am aware this is sometimes easier said than done as all babies do different things on different days and can be unpredictable, in addition many babies give minimal warning they are hungry whereas others give a good time length) can help to avoid this

Thanks to everyone for taking part in this Q&A!

The winner of the prize draw is @LauDeLau - congratulations!