The Colic Conspiracy

If you type “What is colic?” into Google, as many people will, you get this:

colic

ˈkɒlɪk/
noun
 
  1. severe pain in the abdomen caused by wind or obstruction in the intestines and suffered especially by babies.

     

If you look it up in Collins dictionary or online here you get this:

 

colic (ˈkɒlɪk )

noun

  1. a condition characterized by acute spasmodic abdominal pain, esp that caused by inflammation, distention, etc, of the gastrointestinal tract
 

Having looked at this you would assume that if a baby has been diagnosed with colic, that it is to do with trapped wind and abdominal pain.

Wrong!

Are you shocked? I was!

That can’t be possible I thought, so I took to the Internet and found the following from the NHS:

“Colic is the medical term for excessive, frequent crying in a baby who appears to be otherwise healthy and well fed. It is a common yet poorly understood condition, affecting up to one in five babies….. The cause or causes of colic are unknown, but a number of theories have been suggested. These include indigestion, trapped wind or a temporary gut sensitivity to certain proteins and sugars found in breast milk and formula milk. However, there is currently little solid evidence to support these theories. Colic occurs equally in boys and girls, and in babies who are breastfed or bottle-fed”

Further searching shows colic could be related to any of the following:

  • Over stimulation
  • Over tiredness
  • Cows milk protein allergy and/or lactose intolerance
  • Constipation
  • Tongue tie
  • Parental anxiety/stress or PND
  • Birth trauma
  • Food intolerance’s passed through mothers milk
  • Strict enforcement of routines
  • Separation from parents
  • Trapped Wind
  • Plus many more…

There are studies that suggest colic is caused by unresponsive parenting practices and whilst I don’t doubt that parenting practices have a massively important effect on babies, it would be wrong to assume that a baby who has colic, has so because of less responsive or affectionate parent(s).

So how do you diagnose colic or more specifically infantile colic?

The most common criteria used in medical circles is the Wessel Criteria. Dr Morris Wessel came up with his definition in the 1970s, which defined a colicky infant as a child who cried for more than three hours a day, for more than three days a week, for over three weeks. His definition was not considered scientific, but has stuck. It is often referred to as “the rule of threes” and these rules collectively as the Wessel Criteria.

So, colic is a term that is used to define a baby that cries, a lot and no one knows why. There appears to be no singular cause, which means no singular treatment. In fact, it is not actually known if the crying is because they are in pain. Compounding this, many of the signs believed to indicate pain are simply common signs of a distressed baby who has cried a lot (drawing in of arms and legs, a firm/hard stomach). If the cause cannot be isolated, how can you even begin to treat colic?

I see anti-colic bottles, anti-colic teats, anti-colic diets, colic drops and more. But how can you treat something that isn’t, it isn’t a specific disease or disorder. In short, you can’t. This is why I used the term conspiracy, many of the anti-colic aids are targeting a singular, specific cause, mostly trapped wind. But as we now know, trapped wind does not equal colic.

Many remedies contain Simethicone (AKA ‘Activated Dimethicone’) as the active ingredient (a mix of silicone oil and silica gel), with the theory being that it lowers surface tension, causes bubbles to coalesce and makes it easier for gases to dissolve in liquid, thus easing the passage of painful trapped wind. It is found in many of the market leaders “colic drops” such as Dentinox and Infacol (more on Infacol here). Research has shown Simethicone used to treat colic to be no more effective than a placebo! Probiotic remedies have also been shown to be ineffective, but I cannot find the study for the life of me, so will say no more on that subject.

Infantile colic as a definition is wide ranging and non specific, it is bandied about and highly misunderstood. Unfortunately it has become deeply engrained in society, through several generations, to be synonymous with a windy baby and the anti-colic products marketed, merely perpetuate that assumption.

Colic effects as many as 1 in 6 babies and usually peaks at around 6 weeks and subsides rapidly by 12 weeks old. Many appear to suffer the worst in the evenings between 1700 and 2200.

What to do if your child has colic?

Try to narrow down the cause, here are a few suggestions that may help:

  • Visit a lactation consultant/breastfeeding councillor to check for tongue tie, even if bottle feeding.
  • If breastfeeding, assess your diet. Certain foods could cause a reaction in your little one.
  • If your birth was particularly short or long, or if the baby was delivered by c-section, ventouse or forceps; Consider visiting a chiropractor or cranial osteopath.
  • Read up on the Fourth Trimester, you could start here.
  • Wait it out. Get as much support as you can, they will outgrow the colicky stage, remember, however bad it may become, “This Too Shall Pass”.

-J

 

Sweet Dreams

The first night after our baby’s birth we went to bed and I laid him in the crib in our bedroom, got into bed and stared at him. After a while my husband looked at me and said “It feels so unnatural to have him so far away from us, he has been surrounded by you for 9 months”. In that moment my heart leapt into my throat, thank goodness he had said it, that was my feeling exactly! Everything in me since I had laid him down wanted to pick him back up and be with him. For the next hour or two we sat in bed, me sobbing while holding our baby because I couldn’t bare to be away from him, yet was so frightened of falling asleep with him.

My husband did all he could looking up information and evidence on bed sharing, it’s dangers and how to safely bed share. Eventually we made some quick changes to our sleeping arrangements and had done enough to calm my nerves about sleeping with our son. That night we all got some sleep and the next day we made it so the crib was open and attached to our bed, giving our son his own space and me a little more peace of mind but keeping that all important closeness.

In the weeks and months that have followed our little one has slept by my side every night. This has led me to wonder how many others have found themselves in similar situations?

In the ‘after care’ talk we received at our local hospital we were informed of the safety and dangers of swaddling, baby sleeping on their back/side/tummy and where to position baby in their crib/cot; but nothing was mentioned on the subject of bed sharing. It seems bed sharing in general, isn’t widely spoken about, but why? Is it because it’s not common practice, or is it generally not accepted in society as a safe practice?

Whichever it is, I’m sure there is something else more common and potentially dangerous than bed sharing amongst new parents. Those few seconds you closed your eyes, only to be jolted awake when you felt your body soften a bit too much as you started to fall asleep. As much as we don’t like to admit it, it’s probably inevitable for most, if not all of us. I for one was shocked when I found myself in the wee hours of the morning holding our son and falling asleep standing up!

I’m not ashamed to admit that on more than one occasion I had got out of bed with him and experienced that same feeling. Standing or sitting, it doesn’t matter, when you’re that tired there really is nothing you can do to avoid it, or is there?

If we accept that many parents find themselves in a similar sleep deprived scenario, why do we not do more to educate parents on all safe sleeping arrangements, including bed sharing?

It wouldn’t surprise me if many parents found themselves in situations where they were so exhausted they bought baby into bed on the spur of the moment, just so they could go back to sleep. Unfortunately this is where bed sharing gets a bad reputation, and I feel wrongly so.

If bed sharing is done correctly and the sleeping area has been prepared for bed sharing, then there is a lot less risk to baby then you might think. When you consider that the possible alternatives we find ourselves in; last minute bed sharing or accidentally falling asleep while sitting on the sofa, armchair or worse, standing up; surely a bit of education on the subject of how to safely bed share would be beneficial to a lot of parents?

So if you’re thinking about your sleeping arrangements, don’t be quick to rule out bed sharing. Yes there will be people who will say it’s “too risky” for their liking, but don’t take their or my word for it. Do your own research and come to your own conclusions, you might find the evidence surprises you.

Whatever your decision and whatever your sleeping arrangements, I wish you all a safe and peaceful sleep.

Sweet dreams

-B

The following is a leaflet provided by La Leche League and Pinter & Martin outlining the 7 smart steps to safer bedsharing and is available to download in PDF from here

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The Forth Trimester – Tips To Aid The Transition

Yes you read it right, the fourth trimester! Everyone knows that pregnancy is made up of three trimesters. The first trimester where you may want to hurl when talking about, looking at or attempting to eat food either in the morning, noon or night or if you’re really unlucky, all three. Then there’s that bit in the middle where your bump starts to show, you feel those fluttery movements for the first time and you get to make the decision whether to find out what sex the baby is or to wait for a surprise when the birth happens. Then finally the third trimester where most people including strangers will suddenly want to know the ins and outs of your plans. You know the kind of thing I’m referring to – “Where you’re going to have the baby?”, “Do you plan to breastfeed?”, “Do you know what you’re having?”, “Have you got a name?”, “Is the baby’s room ready?”, ” Have you got everything?”.

The three trimesters we’re all familiar with are related to pregnancy, those 40 weeks that a woman carries her child with her everywhere. Nine months of uninterrupted togetherness; being one and the same, sharing every part of our lives, feeling each other’s movements. For three-quarters of a year we are never alone, we share, bond with and nurture our bodies and our babies to keep them safe, warm and protected, so they and we feel secure.

The fourth trimester refers to the first few months following birth. For first time mums especially, this is usually the period they feel the most insecure, but also the most judged. We are bombarded with conflicting information from professionals, health visitors, midwives, “self-proclaimed baby experts” and other mothers and are asked questions like “Is he a good eater?”, “Is he sleeping well?”, or my personal favourite, “Is he good?”. It’s no wonder we feel under scrutiny.

The first few months are called the fourth trimester for a reason. After being dependant on their mother for 9 months, there has to be a period of adjustment. Before birth all a baby is aware of is weightlessness, in warm, soft and dark surroundings, the muffled sound of voices (mostly mums, possibly dads or grandparents), always with the mothers constant heart beat for company. Being born into a bright, loud, cold world with scratchy, itchy materials is a massive change and one that is regularly underestimated.

The mother also has to adjust to her baby being separate from her own body. Looking after your baby when pregnant can be quite simple, avoid certain foods/alcohol and keep a relatively healthy diet; you can’t really go wrong. After birth there’s all sorts of things for mothers to fret about. It’s no wonder we might have a feeling of wanting to carry baby everywhere, it’s what you’re both used to and it’s a very natural way to feel! 

The fourth trimester is about meeting your baby’s needs, aiding their and your adjustment to life on the outside. Think of it as a transition from womb to world. There are a few ways in which to help this:

DO AS LITTLE AS POSSIBLE
This is possibly the only time you can say ‘NO!’ to the hoovering, washing up, food shopping, cooking, clothes washing and get away with it. If you want visitors, why not ask them to bring dinner, make their own tea when they arrive and make you one while they’re at it! After all, you are taking care of a new baby, so you need taking care of in turn. This is the time to call in those friendly favours and your partner to pick up the slack.

BABY WEAR
Carrying baby in a sling, will provide a feeling of comfort and closeness for baby, (a soft wrap sling is great for the early weeks). Being able to hear the heartbeat of the wearer will feel like a home from home for a newborn. With the help of a sling you can carry little one and watch tv, read a book, use the bathroom, eat dinner, it’s a win win.

For mothers, holding your baby releases the love hormone oxytocin into both your systems. This, and skin to skin contact will aid the bonding process for you both.

LISTEN AND WATCH FOR YOUR BABY’S CUES
As we’ve written about HERE, Dunstan’s Baby Language is a must have tool for any parent. You’re baby is trying to communicate with you, albeit with a different vocabulary.

Listen and watch your baby to see if you can pick up on their early signs, this will help lessen fussy and crying periods. Remember, once baby is crying it’s already too late, you’ve missed the cues and their attempt to communicate. The more you study them, the more you’ll learn and hopefully the easier your adjustment will be.

FEED ON DEMAND
Babies, like adults, can get thirsty as well as hungry. Do not worry yourself with unrealistic expectations of your baby feeding a set amount at set intervals. New babies will eat as much or as little as they want at any time of the day or night. I’m sure you do not eat the same amount of food at the same times of day, everyday; so you should not expect your baby to.

Aiming to put baby onto a feeding schedule too early will teach little one to eat when not hungry; promoting bad eating habits, that have the potential to be carried into later in life.

AID BABY WITH SLEEP
Quite a few of us have heard the ‘making a rod for your own back’ speech. This is especially given to mums who let their baby’s fall asleep at the breast and/or hold them to sleep.

Putting a baby down on their own to sleep is an unrealistic expectation, especially in the early months. Babies learn new skills with our help, love and support, this includes sleep and self settling.

SLEEP is an acquired skill and just like walking takes time, help and guidance. You would not expect your child to walk, without first rolling over, sitting unaided, crawling (sometimes backwards first), standing, walking holding furniture, to finally walking alone; albeit with many trips, stumbles and falls. Sleep is a skill that is acquired and will take time and patience to help them master, accompanied by “trips and falls” (the well known 4 month sleep regression is one).

To SELF SETTLE, a baby must first learn this skill. A great way of doing this is to hold and soothe your baby to sleep. Humming, swaying, breast feeding, talking gently or simply sitting still, in a relaxed state will teach your baby that to sleep we must be relaxed and content. The feeling of being close to someone should make for a longer more peaceful sleep for baby.

The ‘rod for your own back’ brigade give mums a false impression that if they hold baby while he/she sleeps they run the risk of baby being clingy and needy. This kind of advice is not helpful nor realistic to the baby’s needs.

Advising mums to settle baby down on their own to sleep, putting baby into eating routines and generally putting space between mother and child is more likely to create a needy baby as they feel their most basic needs are not already met.

FOLLOW YOUR INSTINCTS
For a child to be independent, they must first be dependant on their mother to meet their needs. This allows the baby to later inspect and explore the world from the safety of knowing their mother will meet his needs emotionally and physically, as and when he needs it.

Do not be afraid of following your heart, no matter what others think, YOU know what is best for your child. If it means standing out from the crowd then so be it. A lot of mothers are now are encouraged to not be instinctual; but instead to follow the crowd, trying out sleeping routines, feeding schedules etc, all in the hope of achieving ‘good baby’ status.

You may not always feel like you’re getting it right, but if you follow your instincts and remain objective about your choices then you’re mostly there.

 

Keep in mind that this period of adjustment is far more upsetting for baby then it is for you. You have the ability to ask for human contact if you’re feeling scared, able to express your upset and to ask for comfort if needed, make yourself something to eat or drink or take something for trapped wind. You know this world, the sights, sounds and smells. You have control of your body and know the sensations you feel. Your baby does not, and has limited ways of communicating.

So while mums, dads and babies go through this period of adjustment, encourage them to embrace the fourth trimester, not go against it. Hold baby if they want to, whether the baby is sleeping or not. Instead of showing your disapproval of bed sharing, help them find the necessary information to ensure they do it safely.

Encouraging parents to go against their instincts makes more nervous, anxious, less confident parents. Instead, encourage her mothering instincts and provide her with the same love and support she is trying to nurture her baby with. We all deserve the opportunity to become the best parents we can be to our children; with the right support along the way, we all stand a fighting chance.

 

-B

Your Baby Can Talk!

Okay, not talk, communicate, just not in the conventional sense. The early noises that generally pre-curse a cry can be differentiated and do mean different things. Then there’s the body language, some obvious and some individual to the child.

Let’s start with the cries:

Priscilla Dunstan teaches that babies make sound reflexes. Much like sneezing and hiccuping that have recognisable patterns (when sound is added to the reflex), so too do babies cries.  She outlines 5 of these sounds in ‘Dunstan’s Baby Language‘. We found this to be extremely helpful, but not fool-proof, as all babies vary in their annunciating. The five sounds she outlines are: 

NEH – Hungry
EH – Upper Wind
HEH – Discomfort
OWH – Tired
EAIRH – Lower Wind

Not all babies will use all these sounds, according to Priscilla, some you may hear a lot, others occasionally and some never. We have heard all 5, lucky us, but some have been very rarely used or heard.

The sound for hungry is NEH, the neh coming from the suckling reflex. We did not hear this properly until our little one had his tongue tie snipped at 4 weeks, until then it was more an EH (which DBL teaches is upper wind). Once the tongue had been freed we heard it multiple times a day and used it to our full advantage. 

We have had some difficulty differentiating between our little ones EH and EAIRH sounds, most likely our bad ears (We certainly don’t have Priscilla’s photographic memory for sound). We would try to help ease lower wind pain and promptly get a large release of upper gas! We have heard these fairly regularly and only time will tell if our ears become trained to know the difference between these two. 

The discomfort sound HEH didn’t really appear to us until around 4 or 5 weeks. Maybe we missed it, maybe we kept him so comfy he had no use of it (I doubt it, but enjoy a bit of wishful thinking). We found if we weren’t paying attention it could be missed entirely or mistaken for playful sounds. They were not loud or abrupt, but more akin to rapid or heavy breathing. This developed into the typical sounding HEH as he grew and became more aware. We would hear this sound several times a week.

The tired sound of OWH (yawning reflex) first appeared at approximately 6-7 weeks. By approximately 9 weeks old we had heard this no more than a couple of times. It was very distinct and we understood it immediately and heard it more as his night-time sleeping increased and his daytime sleeping reduced.

 

Body language:

Body Language can be ambiguous and not always as straight forward as DBL’s pre-cries. Some are common and easily understood whilst others completely individual to your child. Here is a list of some examples we have found or had mentioned to us. Your baby may do some if these or none of these. Even if they do, it does not necessarily mean the same thing.

Ear Pulling or Hiccupping; May mean your baby is getting tired.

Gaze aversion; May mean your baby is tired or over-stimulated.

Pulling up legs; Can simply be a reflex action to indicate upset, not always an indication of abdominal pain.

Going red; Can mean the little one has been crying for too long or is overheated, not necessarily in pain or constipated.

Blue outline to lips; Could mean your baby has trapped wind.

Sticking tongue out, putting fist in mouth or fidgeting; Could mean your baby is hungry.

Rooting (A head-turning and sucking reflex towards a stimulus, apparent in young babies); Generally indicates hunger.

Clenched fists tightly; Can indicate hunger. Their fists become loose when sated (it’s more noticeable once grasp reflex gone somewhere around 2-6 months).

Head butting, head shaking (like saying no) and drooling; Can indicate hunger.

Wiggling down when on shoulder or throwing in direction of breast; Can also indicate hunger.

I hope these make communication with your little one easier and less frustrating.  Bare in mind your little one is as individual as you are, as are their queues and body language.

 

Good Luck!

-J