When Your Child is Sick: Coping With Colic

Surprisingly, though we have been studying colic for years, it is still a bit of an enigma. No one has yet shown a single cause (or a single cure) for it. About a third of colicky babies will improve on treatment. But it may not be the same treatment and the crying may ease but not stop altogether. Which points the finger at more than one cause. Most studies have now narrowed them down to any (or a mix) of three:

• The windy
• The demanding
• The feeding

A ‘windy gut’ is often blamed, though it still hasn’t been proved, and very few colicky babies cry because of wind. But tests go on. It’s thought that the tiny digestive system is still working out how to release wind. Babies do create more gas in the colon during their first three months because they are not too good at absorbing lactose. But any evidence that this extra gas causes colic is really very weak. Of course, raucous crying and gulping will really fill her with air and then you have a vicious circle. There is some evidence that how you feed your baby can help. The idea of the ‘demanding baby’ is gathering support. Your colicky baby’s only thought for the first weeks is sheer survival (after leaving the cosy womb). Then she tries to make sense of her new world and she may be more sensitive (or downright demanding) than others. Other factors include sensitivity to noise, fatigue, too little or too much attention. When something distresses your child, her instinct is to keep shouting. It’s her ‘white noise’ to shut it all out and it may take a lot to calm her because she is really very new to the whole business. Of course, if your baby is stressed it will stress you and one feeds off the other. The ‘feeding theory’ (what she is eating) has some basis too. Maybe you are putting a bottle in her mouth every time she cries? Babies are generally self-regulating and spew out surplus milk, but if she is bothered and sucky she may overfeed. Am I a Good Parent? It is really important to say this: your baby does not have colic because you are a bad parent. It is not because of your inexperience, your childcare methods, your personality or because you are depressed. The most experienced mother can have a colicky child after four sunny, sleepy children. It will be quite natural for your own moods to swing wildly while the colic lasts. You may barely survive from day to day and it may seem as if your baby is controlling you. Worse still, you may question your own feelings. ‘I’m giving her all the attention and loving I can – what more do I have to do?’ Remind yourself that you are doing the best you can. And luckily colic is short lived. Home Treatment: Colic First rule out other possible reasons for the crying – hunger, exhaustion or boredom. Then rule out a more serious cause. If your doctor says it is colic, you can help your baby to get through it.

• Keep a crying diary where you track your baby’s crying and show your doctor when it starts, stops and if anything you do reduces it.
• Find a routine (however imperfect) for handling colic bouts and stick to it. It will help to relax you and baby. If the colic strikes at roughly the same time every day, try to free yourself to handle it. No matter what it takes, you must get breaks every day while this lasts.
• Good support from a health visitor, counsellor or relation will make a difference in how you cope.
• Stick to the recommended feeding routines. If she has colic, don’t be tempted to feed her as soon as she cries. Some babies can be persuaded, between feeds, to suck on a dummy for comfort and others may accept small sips of boiled and cooled water from a bottle. (Some parents put sugar in the water, but this is not good for small babies.) Try feeding your child upright and burp regularly. If you are breastfeeding, try emptying each breast completely before changing sides. Try also to get an afternoon rest – she may cry every evening because your milk is low – and give a full evening feed (have expressed milk on standby just in case). Stop eating spicy foods, caffeine and allergy-causing foods such as nuts, eggs and seafood in case they’re affecting her.
• Don’t cut down on baby’s formula milk – she needs it. Changing her formula milk will not usually help. If you suspect a milk allergy, talk to your doctor. A two- week trial of hypoallergenic formula can sometimes form part of tests – but only under medical supervision.
• Don’t be tempted to give a baby under four months solid food in an effort to calm her.
• If you are breastfeeding and taking medication, this could be causing the colic-like symptoms, so talk to your doctor.
• Small sips of boiled, cooled water between feeds may comfort or distract a child with colic
• Forget all the anti-colic remedies on the market. Invest in an hour’s babysitting instead!
• Ease your stress where you can. Some parents find exercise or yoga helps.
• Some parents try chiropractic or osteopathy for colic, but the jury is out on the effects.
• There have only been two randomised trials of these and neither was conclusive.
• Carrying baby 80 per cent of the time, Pleistocene fashion, reduces crying in normal babies, but its effect on colicky babies is less clear. It’s the preferred way in Africa, where colic is extremely rare, and it may be worth trying, but it is demanding.
• Every baby is different and some of these may ease things:
• Small sips of herbal tea (especially chamomile, fennel and lemon balm) can have a calming effect. But some are not safe for babies, so always check with your doctor. And please don’t reduce or replace your baby’s milk!
• Probiotic drops seem to help some babies, but never use them without seeking medical advice.
• Use an anti-colic bottle and teat.
• Swaddle baby in a light blanket and hold her close.
• Soothe her with a body massage or a bath.
• Take her for an evening walk.
• Try anything that makes ‘white noise’ like a hairdryer or a heartbeat tape.
• Using a swaddling blanket can ease symptoms of colic
• Let her suck on a dummy (if nothing else it can distract her).
• Use the traditional ‘colic carry’. Lie her, face down, over your lap on your forearm, to increase pressure on her stomach.
• Over-stimulation can make it all worse, so less is probably best. I know colic parents who take to bed every evening with a book and a swaddled baby!
• Don’t expect a miracle cure and be wary of anyone who offers one. Find your own routine and a lot of patience. It will get better.

Red Alert If it is all getting on top of you, you need to visit your doctor. Doctors take the problem of colic very seriously. CALL A DOCTOR AT ONCE IF YOUR CHILD IS:

• Under three months old and also has a temperature.
• Over three months and also has a temperature with other symptoms
• Very pale, screaming and has blood in her stools (it could be a bowel problem called intussusception).

Please get help now if you worry that your child may get hurt because of you – or your partner’s distress. This is an extract from When Your Child is Sick by Professor Alf Nicholson, Professor of Paediatrics at Temple Street Children's University Hospital and Grainne Malley.