Cry me a river
Philippa does not necessarily agree with all the information in this editorial.
Babies cry; it's a fact of life. Crying is a baby's most effective method of communication, as challenging as that can be for her parents! But then there is prolonged crying, the kind that seems immune to comfort. Parents of babies with colic are all too familiar with this heartbreaking and exhausting message from their child.
What is colic?
Unlike reflux, infantile colic is not a medical condition, but a description of symptoms - specifically, excessive crying in infants. As distressing as it seems for both baby and parents, colic is not dangerous to a baby's development and will not delay emotional or physical growth. While often confused with lactose intolerance or gastro-oesophageal reflux, colic is a temporary physical disorder that can be treated with time and nurture, rather than medical interventions.
Colic is sometimes diagnosed by applying the 'rule of threes' - when baby cries for more than three hours a day, for more than three days a week, for more than three weeks. Often the crying episodes occur at around the same time every day, especially in the early evening - a decidedly challenging time for the entire household, with dinner prep in full swing and high demands from any other children. After a day of stimulation, evenings can be particularly challenging for tired babies in general.
Colic is thought to affect one in four babies. Usually it starts when baby is only a few weeks old and improvements are often obvious by the three-month-old mark. Colic can, however, last for as long as six months.
What causes it?
There is no known pathological cause for colic, although plenty of theories abound as to what makes colic worse. Some suggest colic is associated with trapped wind, hence many treatments focus on effective burping techniques.
Paediatrician and author of The Happiest Baby on the Block, Dr Harvey Karp, connects colic with his 'missing fourth trimester' theory. This theory suggests babies are actually born too early, not yet fully developed to withstand the stresses of the world. However, their head circumference, in relation to the diameter of a fully-dilated cervix, makes birth at around 40 weeks optimal for Mum; let's say no more.
Dr Karp states that the intestinal pain and digestion troubles, symptomatic of colic, could be a result of a baby's immature gastro-colic reflex, yet if she was in the womb longer, this would have had more time to mature. The fourth trimester would technically end at three-months-old, the same time may colicky babies find relief.
Dr Karp's advice for soothing a colicky baby focuses on recreating the sounds and motions that a newborn would have experienced in the womb, relating to his theory that this is where she would ideally still be. SO, plenty of swaddling, rocking, swaying and shushing should help. Interestingly, researchers, including Dr Karp, point out that some cultures don't experience colic at all, specifically cultures where parents are constantly holding, rocking, and nursing their babies, actions which all mimic being in the womb.
What can you do about it?
It is all very well to say that colic is harmless and will pass with time, but in reality colic makes the hard work of caring for a baby seem overwhelming.
The 19th century advice to "Just put cotton in your ears and gin in your stomach!" doesn't cut it these days, but what can you actually do to comfort baby and make life easier? This is the golden question. We asked OHbaby newborn expert, Dorothy Waide, and Philippa Murphy, postnatal educator and director of BabyCues, for their advice on soothing a very sad baby.
Advice from Dorothy
Dorothy Waide believes the hardest thing about colic is the parents' feelings of helplessness. Your baby appears to be in pain, but she can't tell you what's going on and you can't stop the crying, no matter what you do. Couple that with a lack of understanding from others, and the resulting perceptions of judgment because your baby seems inconsolable, and parents can lose confidence in their parenting ability.
Dorothy is passionate about encouraging parents in their role, empowering parents in their role, empowering them with the hope that nurturing our babies comes naturally when we slow down and tune in to what they really need.
Dorothy: Focus on being rather than doing. "Hold your babies in an engulf position or a position that baby responds to, and encourage her to fall asleep in your arms if need be. Babies feel secure and comfortable there. A busy household can contribute to a baby's stress levels. The more relaxed the environment, the more relaxed your baby will be.
In saying that, Dorothy is also quick to remind parents to trust their gut instincts and seek help and support when they need it. Alternative therapies such as cranial osteopathy, acupuncture, massage, probiotics, homeopathic treatments, and products designed to assist babies with winding may help. Using a dummy can help too, as babies find sucking a comfort.
OHbaby: Over the years she has spent helping parents care for their newborns, Dorothy has noticed common mistakes new parents make with feeding and winding. Here are some of her tips to avoid them.
Dorothy: When breastfeeding, try lowering baby's bottom so that her head is slightly elevated while feeding. When bottle-feeding, take care not to position baby so her tummy is squashed and she will therefore only drink small amounts. Instead, stretch baby's body out so her head and shoulders are slightly elevated. Crying babies are often offered another feed as comfort, but this means they never have the chance for good gastric-emptying. Avoid overfeeding as it just exasperates any wind issues. Make sure, in efforts to wind baby, you are not extending their wake times. Instead, settle baby in your arms and allow her to fall asleep there, if she has been upset. You can then transfer her to the cot, or have a nap yourself with baby upright against your body.
Advice from Philippa
Postnatal educator, Philippa Murphy, has just published a book, BabyCues: Nurture with Nature, which is available at babycues.info. We asked Philippa about her background and to explain her approach to treating colic.
Philippa: I never set out to find the remedy for colic or reflux when I started maternity nursing at the age of twenty-four in the United Kingdom and Europe. For six years I lived-in with families, teaching them how to foster the best care for their baby, twins, or triplets. During these thousands of hands-on hours I initially cared for babies who inconsolably cried from obvious digestive pain. Unable to believe nature could get this so wrong and desperate to find the cause, not just manage symptoms, I turned to the babies for answers. Slowly they revealed a new way to nurture which involved understanding the relationship between their digestive mechanisms and their cues - this relationship is innate to all humans in our first year of life. I then studied our early biology for a year and now marry my research with this to teach a new form of care – Bio-logical Care (Life-logical Care), care that nurtures within our biological digestive function.
OHBaby: What are some of the common mistakes new parents make with feeding and winding?
Philippa: Overfeeding. Many babies these days are being feed beyond their digestive capabilities whether it is too much food, they are fed in quick succession or being fed too quickly at each feed. These feeding methods and more, leave their digestive organs to process milk or solids abnormally. Unbalanced feeding practices are a huge contributor to colic and reflux.
Not releasing enough wind after each feed through burping. Parents are widely taught that a couple of burps after a feed is enough, or babies don’t need to burp – quite simply, this is not the case. Parents are also taught to settle a baby to sleep straight after a feed once two or three burps have been released. However, the copious amount of retained air in the stomach is then left to move onward through the intestines and bowel causing discomfort, heightened communication, pedalling legs and arching backwards, which contributes to the diagnosis of colic and reflux. In the situation of reflux, the retained air throughout the milk pushes the feed up the oesophagus. This is a natural process and to a degree reflux is normal however, mass refluxing is not normal and is caused when an overabundant amount of wind is retained and/or overfeeding is occurring. By releasing the optimum amount of wind and feeding in accordance with biology we can avoid mass reflux.
OHbaby: What would be your top three tips for new parents struggling with crying babies who are obviously struggling with colic?
Philippa: Try and find others that has been through it with their baby, it could be very beneficial for your mental health. Until you have lived with these behaviours it is difficult to understand how hard they are on everyone involved.
Seek holistic help. Balanced feeding practices and appropriate release of wind create healthy, developmental sleep patterns. Therefore, a health professional that considers all of the aspects together is best for your baby.
Try a good cranial osteopath. While I haven’t witnessed colic and reflux being remedied from this since it is largely caused by ‘input and output’ practices, I have witnessed babies being calmer after a session for generally a couple of days.
OHbaby: What products do you recommend to help babies with winding issues?
Philippa: I believe it is healthier to allow a newborn’s digestion to work as close to nature’s wish as possible therefore, I don’t actually recommend any remedies that make a newborn burp - after trying many of them myself and finding they made me more windy, I decided on a different approach. Instead, I use an alcohol free homeopathic remedy that stimulates calm for about five minutes. This lessons the tension in the baby’s body which then allows the digestive movement that they are fighting against to happen, whether it is in the stomach, intestine or bowel. By teaching parents how to feel, read and naturally respond to these movements less products are needed. The only other product I use from time to time, dependent on the newborn’s situation, is Slippery Elm. When taken internally it stimulates nerve endings in the GI tract, leading to mucus secretion which can help to sooth the stomach - this does need to be given in the correct dosage for weight.