Reflux 101 – What is Colic?

Welcome Robynne Elkin MOT, OTR/L, CKT, Pediatric Occupational Therapist and Co-inventor of the RES-Q Infant Wedge, as this week’s guest blogger

The instructor of your “Baby Basics” class probably left out the information about caring for infants with reflux and focused more on diaper changing, how to trim your baby’s nails, and what kinds of bottles to buy. She also likely forgot to mention that your newborn might not let you sleep, could be difficult to feed, and could spew formula across the room like Linda Blair’s pea soup in The Exorcist.

What Is Colic?

Crying infantWhen our moms refer back to our infancy, and if we were irritable babies, we had “colic.” The term colic derives from the Greek word kolikos or kolon, suggesting a disturbance in the gastrointestinal (GI) tract. Colic is a poorly understood phenomenon; researchers have postulated nervous system, behavioral, and psychologic etiologies. We do know, however, that it is most likely to occur during the evening hours without any identifiable cause. We also know that during episodes of colic, otherwise healthy neonates aged two weeks to four months are very difficult to console. They often stiffen, draw up their legs, and pass gas. Colic is equally likely to occur in both breast fed and formula fed infants. The frustrating fact remains that although one in four babies has colic and much research has been done on the topic, there is not one proven cause. The crying or fussing most frequently begins suddenly, often after a feeding. It can last for 1 to 4 hours. Recent research indicates that use of Probiotics may help to soothe inflammation of the GI tract. GI inflammation may be a factor in colicky babies, which makes a compassionate healthcare provider so important for guidance and direction.

Here are some helpful suggestions to deter colicky symptoms:

  1. Over feeding is futile as a means of lessening crying.
  2. Feeding certain foods, especially those with high sugar content, for example, undiluted juices may increase the amount of gas in the intestine and worsen the situation;
  3. The presence of excessive anger, anxiety, fear, or excitement in the household.

Here are some suggestions to help colicky symptoms:

  1. Do not overfeed! Stick to your baby’s regular feeding schedule of timing and amount of milk taken, as measured in ounces in the bottle-fed baby or in minutes on the breast in the breastfed baby.
  2. Breastfeeding mothers should avoid milk products (“you don’t have to drink milk to make milk”), caffeine, onions, cabbage, beans, broccoli, and other gas-producing, irritating foods.
  3. Avoid juices (young infants should not be drinking juice anyway).
  4. In the formula-fed baby, try changing to a formula containing whey hydrolysate (such as Good Start) or try a low-allergy formula (such as Nutramigen, Alimentum, or Pregestimil). Some research suggests that making these changes can result in a decrease in the number of episodes and duration of symptoms in some infants. It is worth the expense of a week’s trial to see if the formula is at all contributing to the colic.
  5. Take a break! When the anxiety, fear, and tension get to be too much (or perhaps an hour before!), try to have someone else watch the baby, even for an hour, and leave the house. Try to keep a positive attitude.
  6. Try walking the baby in a front-pouch-style carrier with his legs drawn up and pressure off of his belly.
  7. Though there is no clear evidence that physical stimulation helps, many parents swear by it. Some babies seem to be soothed by rhythmic, steady movements, like rocking gently (recommended for term babies) or by sounds, like running the vacuum, or having the clothes dryer within earshot. (Never leave a baby unattended near the dryer, as there is a serious risk of injury.) White noise can be a God send.
  8. Wrap the baby firmly in a comfortable blanket (“swaddling”).
  9. Medications, such as simethicone (Phazyme, Flatulex, Mylicon, Gas-X, Mylanta Gas), and other homeopathic treatments have not conclusively proven to be more effective than placebo (sugar pill) and should be avoided unless prescribed by your infant’s medical provider. Hyoscyamine (Levsin), an antispasmodic medication used to treat adults with various intestinal ailments, has been associated with serious side effects in young infants.
  10. Recently, there have been some interesting results using certain Probiotics (dietary supplements containing live bacteria or yeast and used to aid digestion). It is important to discuss these options with your provider prior to using them.

Robynne Elkin, MOT, OTR/L, CKT
Pediatric Occupational Therapist/Co-inventor RES-Q Infant Wedge. The RES-Q Infant Wedge is the first reversible orthopedic FDA class 1 device for babies with reflux (colic) which promotes musculoskeletal alignment in both tummy and back-lying positions. The device is designed for infants from birth to 12 months of age. It was developmentally designed by a pediatric occupational therapist, physician, and dietitian to meet the needs of premature and term infants. 

Next week read the second part of Robynne’s guest post GER: A Hidden Cause of Colic and if your baby has been diagnosed with reflux, see how you can enter to win a RES-Q Wedge.

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