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Decoding Colic

May 14, 2013 by lauren.anvari@gmail.com 2 Comments

IMG_0994Asher, thankfully never had colic, but about a quarter of all babies do. (1)  Parents often ask, what they can do to help their colicky babies and honestly I don’t have any concrete answers.  The thing is, no one really knows why colic happens to some babies and not others and what even causes it to begin with.  There are just a bunch of theories.  It’s kind of like morning sickness, in that it’s still so much of a mystery.  The one thing we do know definitively about colic is that: it will go away with time.  Although, I realize that that is of little comfort to the exhausted and raw parents of babies with colic.

There are several things that parents can try to reduce the colic however while they may work for some babies they may not work for others, which is part of what makes colic so frustrating to deal with.  Not only is your little bundle crying incessantly but you also have to hear story after story from other people about how they did x, y and z and it totally cured their baby, yet when you try the same things you get no result at all, which only adds to your feelings of helplessness and hopelessness and makes you feel like you’re doing something wrong.  Well let me set the record straight.  You are not doing anything wrong.  There is no exact science when it comes to colic, just like there isn’t any when it comes to morning sickness.

Definition:

Colic is defined as excessive crying in an otherwise healthy and thriving baby that lasts at least 3 hours a day, for 3 days a week, for at least 3 weeks. (2) The crying typically starts in the first few weeks of life and ends by the time the infant is 3 or 4 months old (3) however it has been known to last longer than this.

Cause:

There are many theorized causes of colic, which include; infants’ difficult temperament, inadequate or inappropriate mother-infant interaction, maternal anxiety, abnormal gastrointestinal function, allergic problems (mainly cow’s milk allergy) abnormal colonic micro flora, increased infant responsiveness, difficult infant temperament, disturbed infant–parent interaction, maternal smoking while pregnant and maternal and paternal depression. (1)  So as you can see, they have pretty much covered all the basis of possible causes, which is just another way of saying that no one really knows why it happens.  In rare cases (5.1%), there may be underlying health problems that are presenting as colic, such as central nervous system problems, GI pathology, infections and trauma. (1)

Treatment:

Treatments for colic fall into 3 main categories: dietary, behavioral and pharmacological. (1)

Diet: When dealing with colic usually the first course of treatment is dietary, mainly because it is the simplest approach and seems to make the biggest difference when it does work.  The best thing to do from a dietary perspective it to go on an anti-colic diet before colic even sets in.  The essentials of an anti colic diet are:

No dairy: especially no milk or cheese
No cruciferous veggies: broccoli, cauliflower, etc
No OJ
No onions or garlic
Low in raw fruits and veggies
Low in soy and wheat

However keep in mind that this may or may not work at treating colic or preventing it from happening, but it is often a good place to start.  After a few weeks you can slowly start adding foods back into your diet to see if they have any adverse effects or not.

Behavioral: There are many different behavioral approaches to treating colic, so I’m just going to touch on two of the most common.

5 S’s – Swaddling, Sushing, Side (as in holding babies on their sides), Swaying and Sucking.  This is the approach made popular by the author of The Happiest Baby on the Block. It basically involves swaddling your baby tightly, making loud shushing noises in their ear (as loud as the baby is crying, think espresso machine), holding the baby in your arms on his or her side, swaying, rocking or gently jiggling the baby and when all else fails offering them the breast to suck.  These 5 steps or some variation there of are really good at calming a crying baby, but they may or may not work at calming a crying colicky baby, still, they are worth a try.

Baby wearing – This involves increasing the time you spend wearing the baby (in a wrap or a carrier) by at least 3 hours.  A lot of people swear by this approach and it is definitely nice to cuddle up to your little one, which also allows you to respond promptly to their needs, however there is no supporting evidence in the literature that increased holding reduces crying time in colicky infants but it may in fact increase stress and anxiety in parents. (1) (3)  Again, though, you may find that baby wearing is what works best for your baby and actually gives you peace of mind, so I recommend trying it.

Pharmocological: This is the treatment method that shows the least results at improving colic symptoms.  Of the drug interventions studied, dicyclomine as shown the most promise, and performed significantly better than the placebo.  The use of anti-reflux medication has shown no improvement in the treatment of colic, even though acid-reflux is one of the theorized causes of colic. (1)  If you’re interested in this route, I encourage you to talk to your child’s pediatrician about whether or not pharmocological treatment is right for your child’s colic.

Final Words:

In general, the best you can do is reassure yourselves that it will get better with time and to develop predictable feeding and sleeping routines, as this will at least help provide some order and structure.  It is tremendously helpful to seek support from other parents who have dealt with colic first hand, because no one really can understand what it’s like unless they have been through it themselves.  It is perfectly normal to doubt everything, to hate your child, to feel like you are at your wits end, to want to pull your hair out and to wish you could send the baby back.  Talking about these things with other parents who have been through it will help reduce the guilt you may be feeling about feeling these ways yourself and give you a shoulder to lean on.  And remember, your baby is just as miserable as you are.  I promise you, one day the colic will be over and you will fall in love all over again with this tiny little miracle that you created.  Hang in there.

1. Nurko, S. Colic in Infants. Boston: Children’s Hospital.

2. Lucassen PLBJ, Assendelft WJJ, Gubbels JW, et al. Effectiveness of treatments for infantile colic: systematic review. BMJ1998;316:1563–1569

3. Lucassen, P. (2010). Colic in infants. Clinical Evidence , 0309.

Filed Under: Health Tagged With: baby, colic, colicky baby, crying, excessive crying, fussy, infants, treatment

Surviving Growth Spurts

May 8, 2013 by lauren.anvari@gmail.com 2 Comments

When you’re a new parent it can be tough to tell when your child is going through a growth spurt and figuring out how best to get through them can feel like walking a gauntlet.  Growth spurts can be incredibly confusing and frustrating, just when you thought you had your little one’s schedule all figured out a growth spurt will hit that can send their whole routine spiraling out of control.  Asher generally sleeps very well at night, but during a growth spurt, he may wake up as often as every hour or two requesting, nay demanding to be fed.  Needless to say this is no fun for either of us.

Growth spurts are an important part of infant development and are usually accompanied by an increased appetite either followed or preceded by longer periods of sleep. Babies need sleep in order to grow. There is a strong relationship between sleep amount and growth spurts, which indicates that it is very important for infants to get high quality sleep (1).

Frequency:

Most babies will experience 5-7 major growth spurts in their first year, these occur at around 2 weeks, 4 weeks, 6 weeks, 3 months, 6 months and 9 months. However every baby is different so this time frame should just be used as a rough guideline.

Duration:

Most growth spurts last 2-4 days, but some can last up to a week or more.

How To Spot a Growth Spurt:

There are several signals that can tip you off that your little one is in fact experiencing a growth spurt.

Hunger: Your tiny tot will generally have a seemingly insatiable appetite and may want to eat seemingly around the clock, sometimes every hour.  If you are exclusively breastfeeding resist the urge to supplement with formula or expressed milk during this time.  The best way to increase your milk supply and support the higher caloric demands of your child is to put your baby to the breast as frequently as possible.  Short but frequent feedings are better than long and infrequent feedings at signalling to your breasts to produce more milk.  If you really want to try to speed things along, then you can consider pumping for 10 minutes after each feeding, just make sure to freeze the milk you pump for a rainy day rather than give it to your baby during the growth spurt.

Mood: Your little one may also be quite cranky or fussier than normal, which can sometimes be mistaken for colic.  They may even complain while at the breast, pulling of and re-latching over and over.  This mood swing is due in part from lack of sleep (eating all the time really interrupts catching some good quality shut eye) and in part due to the higher caloric demands (they want more milk NOW).

Disrupted Sleep: Your baby will likely wake up more often at night in order satisfy their increased appetite.  Some parents find this one the hardest to identify.  It can sometimes be hard to tell if your baby is going through a growth spurt or experiencing sleep regression.  The best way to tell is if your baby is waking up at the same times every night, then it is probably sleep regression or habitual waking.  However if the waking times are sporadic and hold no pattern then you are likely dealing with a growth spurt, in which case it’s best to feed your baby promptly.  I have definitely been guilty of mistaking a growth spurt for sleep regression and let me tell you, doing so just prolongs the whole process and makes it that much more painful for you both.  

Increased Sleep: As I mentioned earlier, either preceding or following a period of increased feeding your baby will exhibit periods of extended sleep.  Don’t wake up the baby to feed during this time because sleep is essential for their growth.  In fact babies generally do most of their growing while they are asleep (2) and can gain 1-3 ounces and grow up to 1 cm in length over the course of a day (3). I suggest reveling in this respite and catching up on some sleep yourself.  

When to Be Concerned:

If your little one is still experiencing the signs of a growth spurt for longer than two weeks or doesn’t seem to be gaining weight you should talk to your child’s pediatrician to rule out any other problems.  In fact if you’re worried about whether or not your baby is getting enough food in general then I suggest going to a lactation consultant and weighing your baby on their high tech scale before and after a feeding.  That way they will be able to tell how many ounces your baby is consuming, which is pretty neat!

How Best to Survive a Growth Spurt:

The best thing you can do during a growth spurt is to hunker down and ride it out.  Feed on demand.  You may feel like you’re nursing non-stop, and that’s probably because you are.  Just remember there is an end in sight and the less you resist the process, the easier it will be.  In the meantime take extra care of yourself.  Drink lots and lots of water and make sure you eat sufficiently to help support your increasing milk supply.  All the late night feedings may leave you feeling extra exhausted and strung out so make sure to cut yourself some slack and enlist help to tackle all the non-growth spurt related tasks.  When Asher is going through a growth spurt, I like to curl up with him and nurse whenever he wants it, which is constantly.  Don’t expect to get much else done.

(1). Lampl, M., & Johnson, M. L. (2011). Infant Growth in Length Follows Prolonged Sleep and Increased Naps. Sleep , 34 (5), 641–650.

(2). Tikotzky, L., DE Marcas, G., Har-Toov, J., Dollberg, S., Bar-Haim, Y., & Sadeh, A. (2010). Sleep and physical growth in infants during the first 6 months. Journal of Sleep Research , 19, 103-110.

(3). Kirton, B. (2012, Novemeber 6). Everything you need to know about infant growth spurts. Retrieved May 7, 2013, from Life Stages Feeding: http://www.lifestagesfeeding.com/blog/everything-you-need-to-know-about-infant-growth-spurts/

 

Filed Under: Health, My life Tagged With: appetite, babies, baby, development, feeding, growing, growth spurts, infants, nursing, nursing on demand, sleep

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