PART 4: How do we manage colic?

There is no magic bullet for colic… time is usually the ultimate healer.

 Some basics for all:

  1. Rule out “medical” causes, so watch for “red flags” such as back arching, poor growth, blood in the stools or eczema rashes.
  2. Evaluate the feeding technique and growth: Most babies need between 120-180 mL of milk per kg per 24 hours. Position during breastfeeding or incorrect teat size/shape may lead to excessive air intake.
  3. Consider ruling out a cow’s milk protein allergy: your healthcare practitioner may advise a 2-3 week period of a cow’s milk (and soya) reduced diet in the breast feeding mum, or a specialised formula milk in formula-fed babies. If this helps- then continue (under medical guidance); if it does not work- then revert back to normal.

It is NOT worth have a mom’s diet free of “all allergens” including wheat, egg, nuts and milk etc- this is old fashioned, has not been proven to work and is frankly nutritionally depleting for mother and infant.

If there are no “red flags,” then further management can be explained based on the possible factors contributing to colic:

Altered gut microflora:

  • Try a daily probiotic, especially those containing the strain Lactobacillis Reuteri
  • Breastfeeding mums should continue with a large variation of foods in their diet

Altered gut motility:

  • Sit the baby upright after a feed, and wind by gently tapping the back for excess air to be brought up
  • A warm bath and tummy massage may help
  • In some babies, cranio-sacral therapy or chiropraxis may help if the baby is tense

Hypersensitivity to normal light and sound

  • Hold baby a lot and rock gently
  • Add background “white”noise
  • Give baby a bit of time out to lie in a quiet room in a safe cot on their own, if they seem very overstimulated.

 

What about “Colic medications?”

There is no strong  evidence that any particular dedicated  “colic medication” works, apart from probiotics. Remember- first do no harm- it is NOT worth sedating a baby for colic: some benign or herbal medications may be harmful. If a trial of colic med has not made a difference within 1-2 weeks, then stop it.

 

 

Sources/References:

Gray CL, Van Niekerk E. Food Allergy in a Nutshell (available on www.publisher.co.za)

Kesavelu D. Recent Advances in the Management of Infantile Colic. J Probiotics and Health, 2021

Valla L et al. Association between Colic and Sleep Problems in infancy and subsequent development, emotional and behavioural problems. BMC Paediatrics 2021

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