There is no one proven cause of, or treatment for, infant colic, but there are a few 'cures' some swear by, writes MICHELLE McDONAGH
THERE CAN BE few more stressful situations in life than pacing the floor with a screaming baby in your arms for hours on end night after night, week after week and even month after month. Only parents who have had to cope with a colicky baby can truly understand what a living nightmare it can be.
Although an estimated one in five babies has colic, there is no one proven cause and no evidence-based treatment the medical profession can offer for this common condition.
Having said that, there is a wide range of treatments and “cures” out there, some of which have been handed down through generations, some passed along from mother to mother and others available on the pharmacy shelf. So it’s often a case of trial and error to discover the combination that works for your child.
The “cures” range from gripe water, fennel tea and swaddling to craniosacral therapy, massage and even baby fart aerobics. Some parents swear by strapping the baby into a car seat and driving around until they settle. They will try almost anything to stop the crying and get some sleep.
The condition typically begins when a baby is two to three weeks old, reaches its peak at two months, begins to subside by three months and is gone by the time the child is three to four months old.
It is usually diagnosed by doctors using the rule of three: at least three hours of crying, at least three days a week and starting at three weeks of age. The crying spells often begin in the late afternoon and can last for hours.
While parents are assured that colicky babies do not seem to suffer any ill effects from these crying spells and will grow out of the condition, this is of little consolation at the time.
The other symptoms include spasms, contractions, reflux, hiccups, moaning, pushing and grunting, a red face and little hands balled into fists.
Although the cause of colic remains a mystery, there are many theories, from immature digestive systems and lactose or food allergies to emotional stress and overstimulation.
Dr Aileen Malone, a lecturer in paediatrics and child health at University College Cork, stresses the importance of support for the parents of babies with colic.
“Parents of babies with colic need enormous support from their family, public health nurses and GPs because the continuous sleep deprivation is very damaging,” she says.
“It’s very, very stressful to deal with a baby who is crying all the time. It’s common for mothers to think they are doing something wrong, when in fact this is a typical pattern of crying for a baby with colic.”
Dr Malone points out that many mothers who start out breastfeeding change to formula when a baby is crying with colic because they are told the baby is not getting enough milk – only to find that the crying continues.
There is also no evidence that babies can be spoilt by being held too much, she says: in fact, carrying a baby can help to reduce the crying in some cases.
Although colic is a significant problem, there has been very little research done on it. Dr Malone explains that it’s a difficult area to study, due to the temporal pattern of the condition.
“One of things that makes colic challenging to study is that it tends to have a pattern with an onset, a peak and even without any treatment, it tends to go away. If somebody performs an intervention when it is likely to go away anyway, this could appear to be the reason it went away when the crying was due to reduce anyway. Studies of any potential colic treatments would have to be very carefully designed to avoid this problem.”
Through her own research, Malone has discovered that premature babies tend to develop excessive crying around three weeks after their due date rather than their birth date, suggesting that there is a developmental aspect to colic.
With probiotics currently regarded as one of the most promising areas of colic research, Malone and her team are currently looking at the normal gut flora of babies who don’t have colic which they will then compare with that of babies with colic.
The probiotic Lactobacillus reuterihas shown potential in a recent study as a therapeutic approach in treating infant colic while other research has found that infant massage or a crib vibrator may both be helpful in reducing the incidence and severity of the condition.
So where can parents go for help?
First of all, remember you are not alone: colic is a very common problem. All babies cry, especially in the first three months of life.
However, if your otherwise apparently healthy baby is crying incessantly for days on end, then your first port of call should be your family GP to rule out any medical cause for the crying. The GP may suggest switching to a soya-based or lactose-free formula, as some babies benefit from a change to their diet.
There are over-the-counter products available, such as lactase or simethicone drops, which can help some babies. Colief, which contains the enzyme lactase, was developed by Cork mother and businesswoman Mary Buckley after her baby was diagnosed as lactose intolerant.
Breastfeeding mums are advised to look at their diets and to cut out foods such as cabbage, beans and spicy foods that may be giving their babies increased wind.
Generations of Irish and British mums have used gripe water to treat colic and trapped wind in babies. Although this herbal blend of anise, dill and fennel has been removed from the market in Ireland, mums are buying it online or getting it from the North and England where it is still on sale.
Woodward’s Gripe Water, for example, was taken off the market more than 10 years ago because of its alcohol content.
Since then, the alcohol and sugar has been removed, and the product has been authorised by the Irish Medicines Board.
However, the company has not marketed the product here since 2006 for commercial reasons, according to a spokeswoman for the board.
Although there is no scientific basis for its efficacy, rumours of the effectiveness of craniosacral therapy in the treatment of colic are spreading among mothers in the UK and Ireland.
Cork-based craniosacral therapist Judith Monk explains that craniosacral refers to the core of the system therapists work with.
“A tough, fluid-filled membrane extends from the head or cranium down to the base of the spine in the sacrum (pelvis),” she explains.
“This membrane protects and cushions the central nervous system – brain and spinal cord – and any twists or restrictions in the membrane can affect the function of the central nervous system and its peripheral nerves.
“Connective tissue also extends from this membrane right out into all part of the body, enveloping muscles, organs, joints etc. We work in all areas, head to toe, releasing restrictions and improving fluid flow with very gentle touch.”
A very fast or difficult birth involving the use of forceps or suction delivery can cause some strain or compression to develop, typically in the membranes of the head, the top of the neck and the diaphragm, says Monk.
“What appears to happen is that parts of the nervous system, especially the vagus nerve, then become trapped or compressed.
“Since the vagus nerve is responsible for the automatic functioning of all the major organs, its compression leads to the affected organs becoming irritated, causing among other things more wind, while the tightening of the diaphragm makes winding the baby more difficult.
“The very gentle releases involved in craniosacral therapy free up compressed nerves and the restricted diaphragm, and allow organs to come back to normal function.”
Talking to other parents on parenting support forums such as rollercoaster.ie and mummypages.ie can also be very helpful and reassuring for parents trying to cope with a baby with colic.
'I NEVER IMAGINED HOW MUCH OF A NIGHTMARE COLIC COULD BE': ONE MOTHER'S EXPERIENCE
Jake was about two weeks old when he started crying. We began to dread feeding him because we knew he would be crying in pain afterwards. The evenings were his worst time and his high-pitched, distressed cries could continue into the small hours.
He was in such discomfort that I could not even sit him on my lap to wind him, his back was constantly arched and his little face screwed up in pain.
We tried gripe water, Infacol and fennel tea but they only seemed to make him worse. The stress and lack of sleep began to put an awful strain on the household.
Our 18-month-old toddler, Lucy was very upset by the new addition to the household who was causing such consternation. She was too young to understand that it was not the babys fault. I had heard about colic, of course, but never imagined how much of a nightmare coping with a colicky baby would be.
After a couple of days, I went to our family GP who was as reassuring and helpful as he could be faced with an extremely frazzled, sleep-deprived mother of two babies under two. Once he had checked Jake out thoroughly and ruled out any medical cause for his crying, he advised me to switch him to a different formula.
I changed him to Nutramigen, a special formula for babies with an allergy to cow’s milk. He was slow to take to it, as it tastes very different to other formulas, but it seemed to work for a couple of days. Then the crying started again worse than ever.
The only thing that stopped the crying was literally pacing the floorboards – not too easy when I had a trapped nerve from giving birth to a 10lb baby. My husband and I had to take turns: when one got too tired and stressed, the other took over. The lack of sleep was taking its toll at this stage and the household was in turmoil. Lucy was so upset that she started waking during the night as well looking for bottles.
Through other mums at a baby massage group, I heard about a colic remedy made by Maher’s Pharmacy in Clonmel. The same week, I read an article on rollercoaster.ie about craniosacral therapy.
I rang Maher’s and ordered a bottle of their remedy to be posted out to me the next day. Although they are not allowed to market the product, they are allowed to make and sell it, and every week they post bottles out to mums of colicky babies all over the country.
I also made an appointment for Jake with craniosacral therapist Judith Monk that week. I didn’t have too much faith in the therapy working to be honest, as she barely touched him, but I was ready to try anything at that stage.
The two days after that first cranio session were a nightmare. Jake seemed to scream day and night. But then we woke on the third morning to a different child. He started to bring up huge burps of wind and had a beaming smile.
He had three more sessions after that, two for colic and one for eczema. The pattern was the same, he was very irritable for a couple of days after the treatment, but at the end of his treatment the incessant crying had stopped and he had become a happy, smiling, playful baby . . . with clear skin.
Jake is almost eight months old now and he remains a contented, playful baby boy. His colic never came back, to our relief, and we switched him to a regular baby formula a few months ago with no problems. I think the colic remedy definitely helped him to break his wind but overall, it was the craniosacral therapy that made the most dramatic difference.
My advice to parents trying to cope with a colicky baby is to just take each day at a time. It will go away itself eventually but in the meantime, keep trying everything until you find something that works for your child – and try not to lose heart.
IN THE MOUTHS OF BABES: TIPS TO REDUCE THE DISTRESS OF COLIC
Do not overfeed. A common reaction to a baby crying is to feed it, but try to stick to your babys regular feeding routine.
Try switching bottle-fed babies to low allergy or lactose- free formula – get advice from your GP or public health nurse.
Breastfeeding mothers should try to avoid caffeine, alcohol, spicy foods and gas-producing foods like onions, cabbage, beans and broccoli.
Sit your baby upright during feeds as this may stop them from swallowing excess air.
Wind your baby frequently – always burp them after a feed and try to burp them frequently throughout the day.
Try using anti-colic bottles such as Dr Brown’s or Avent.
Try using mild doses of fennel or dill tea, which can help to reduce gas in babies.
Ask your pharmacist about over-the-counter remedies or probiotic preparations for infant colic.
Cuddle your baby. Being walked around in mum’s or dad’s arms can help calm many crying babies. Some babies like to be swaddled, others hate it.
Try putting your baby in a swing. Colicky babies can be soothed by the gentle rocking motion.
Switch on the washing machine. Some babies seem to be soothed by the white noise created by this or other electric devices such as vacuum cleaners, as it supposedly reminds them of womb sounds. White noise CDs are also available.
Gently massage your baby's stomach or back or place them in a warm bath – stop straight away if the crying gets worse.
Play some music or sing to your baby.
If all else fails, strap your baby into his/her car seat and go for a drive. The vibrating motion of the car can have a calming effect.
If the stress and worry all gets to be too much, take a break. Hand the baby to your spouse, partner or another family member or close friend and get away even just for an hour.
