New study offers possible prevention of colic in infants

Robin Wulffson MD's picture
infant colic, crying, distress, bacteria, treatment
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A colicky infant is a force to be reckoned with, causing extreme frustration as how to soothe an infant expressing extreme discomfort. Researchers in The Netherlands and Finland have unearthed a possible reason for the condition. They published their findings online on January 14 in the journal Pediatrics.

The researchers considered that microbes present in an infant’s intestinal tract might be responsible for colic. Therefore, they conducted a comprehensive analysis of the fecal microbiota (microscopic organisms) present in infants with colic, as compared with control infants, during their first 100 days of life. The investigators analyzed microbial DNA of more than 200 samples from 12 infants with colic and 12 age-matched control infants.

The investigators found that microbiota diversity gradually increased after birth only in the control group; furthermore, in the first weeks of life, the diversity of the colic group was significantly lower than that of the control group. The stability of the successive samples also appeared to be significantly lower in the infants with colic for the first weeks. Further analyses revealed which bacterial groups were responsible for colic-related differences in microbiota at age 1 or 2 weeks, the earliest ages with significant differences. They found that proteobacteria were significantly increased in infants with colic compared with control infants, with a relative abundance that was more than twofold. In contrast, bifidobacteria and lactobacilli were significantly reduced in infants with colic. Moreover, the colic phenotype correlated positively with specific groups of proteobacteria, including bacteria related to Escherichia, Klebsiella, Serratia, Vibrio, Yersinia, and Pseudomonas, but negatively with bacteria belonging to the Bacteroidetes and Firmicutes phyla, the latter of which includes some lactobacilli and canonical groups known to produce butyrate and lactate.

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The researchers concluded that their results indicate the presence of microbial signatures in the first weeks of life in infants who later develop colic. These microbial signatures may be used to understand the excessive crying. They note that their results offer opportunities for early diagnostics as well as for developing specific therapies to treat colic in infants.

Almost all babies go through a fussy period. When crying lasts for longer than about three hours a day and is not caused by a medical problem (such as a hernia or infection), it is called colic. This phenomenon occurs in almost all babies. The only thing that differs is the degree. Colic usually strikes toward the end of a long day, when your baby is just about at the age when your sleep deprivation has really begun to set in. Your baby stops being the quiet, peaceful, miracle baby and begins screaming every evening. It is no wonder that parents can become frustrated, discouraged, and depressed.

The child with colic tends to be unusually sensitive to stimulation. Some babies experience greater discomfort from intestinal gas. Some cry from hunger, others from overfeeding. Some breastfed babies are intolerant of foods in their mothers’ diets. Some bottle-fed babies are intolerant of the proteins in formula. Fear, frustration, or even excitement can lead to abdominal discomfort and colic. When other people around them are worried, anxious, or depressed, babies may cry more, which in turn makes those around them even more worried, anxious, or depressed.

Possible triggers:

  • Foods: If you are breast-feeding, avoid stimulants such as caffeine and chocolate. Try eliminating dairy products and nuts for a few weeks, as these may be causing allergic reactions in the baby. Other foods may also irritate the baby.
  • Formula: Switching formulas is NOT helpful for most babies, but is very important for some.
  • Medicine: Some medicines mom may be taking can also lead to crying.
  • Feeding: If a bottle feeding takes less than 20 minutes, the hole in the nipple may be too large. Avoid overfeeding the infant or feeding too quickly.

People often hear that breastfeeding moms should avoid broccoli, cabbage, beans, and other gas-producing foods. However, there is not much evidence that these foods are a factor.

Tips for comforting the infant:

  • Different children are comforted by different measures. Some prefer to be swaddled in a warm blanket; others prefer to be free. Try many different things, and pay attention to what seems to help, even just a little bit.
  • Holding your child is one of the most effective measures. The more hours held, even early in the day when they are not fussy, the less time they will be fussy in the evening. This will not spoil your child. Body carriers can be a great way to do this. As babies cry, they swallow more air, creating more gas and perhaps more abdominal pain, which causes more crying. This vicious cycle can be difficult to break. Gentle rocking can be very calming. This is directly comforting and seems to help them pass gas. When you get tired, an infant swing is a good alternative for babies at least 3 weeks old with good head control.
  • Singing lullabies to your baby can be powerfully soothing. It is no accident that lullabies have developed in almost every culture.
  • Holding your child in an upright position may help. This aids gas movement and reduces heartburn. A warm towel or warm water bottle on the abdomen can help. Some babies prefer to lie on their tummies, while awake, while someone gives them a back rub. The gentle pressure on the abdomen may help. (To avoid SIDS, DO NOT put babies on their tummies to sleep.)
  • Some babies are only happy when they are sucking on something. A pacifier can seem like a miracle in these cases.
  • The concentration of breast milk changes during a feeding. The “foremilk” at the beginning is plentiful but low in calories and fat. The “hindmilk” at the end of emptying each breast is far richer. Sometimes you can reduce colic by allowing the baby to finish the first breast before offering the second. If the baby still seems uncomfortable or eating too much, then offering only one breast (as often as desired) over a 2-3 hour period might give the baby more hindmilk, which is richer and sometimes more soothing.
  • Some children seem to do best when they are riding in a car. If your child is one of these, you might try a device developed by a pediatrician to imitate car motion and sound. Alternatively, some kids do better with cheaper forms of white noise, such as a vacuum cleaner motor or the sound of a washing machine or dishwasher.
  • Simethicone drops, a defoaming agent that reduces intestinal gas, may help. It is not absorbed into the body and is therefore quite safe. Sometimes doctors will prescribe stronger medicines for severe colic (but this should only be done after a physical exam).

Take breaks. Each of you can take charge and relieve the other. Time for oneself is an important part of the new family dynamic. You will be able to pay more loving attention to your baby when you’ve had a chance to get refreshed.

Reference:
Pediatrics

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Comments

Good to see dairy products mentioned! One of the strangest sights is a woman breastfeeding her baby while she (the mother) is still wet nursed by a surrogate mother, the cow. As the constituents of the milks of cows and humans vary considerably, it is a good idea to avoid milk products in all its forms, not only while lactating, but for good! The chart below shows that there is three times as much protein in cows milk than in human milk. but less lactose to digest it with. This leaves undigested protein in the gut of the baby, which not only causes colic but is also implicated in permeable bowel syndrome, or leaky gut syndrome. As the gut wall is a two way street, it causes undigested proteins entering the blood, and blood to leak into the gut. The first scenario causes toxicity causing a weakening of the immunity, leading to an infant with health problems, restlessness and lots of crying and the last one causes anemia as the blood leak could be faster than the production of fresh blood. Human milk has the right balance of lactose to digest the right amount of protein for human babies, and cows milk has the right balance suitable for calves. Breast is best by far! Constituent; Protein Lactose fat Human; 1.2 7 3.8 Cow; 3.3 4.8 3.9 Goat 3.4 4.7 4.1 "Cow's milk can cause blood loss from the intestinal tract, which over time, reduces the body's iron stores. Blood loss may be a reaction to cow's milk proteins." Journal of Pediatrics, 1990, 116 "...infants who consume cows' milk during infancy are at increased risk of developing anaemia. Breast milk is the ideal..." Public Health Nutr, 1998 Jun, 1:2 "Cow's milk can cause blood loss from the intestinal tract, which over time, reduces the body's iron stores. Blood loss may be a reaction to cow's milk proteins." Journal of Pediatrics, 1990, 116 "Cow's milk-induced intestinal bleeding is a well-recognized cause of rectal bleeding in infancy. In all cases, bleeding resolved completely after instituting a cow's milk-free diet. J Pediatr Surg, 1999 Oct, 34:10 "Cow's milk allergy (CMA) is one of the most common food allergies in young infants...The clinical presentation of these infants may be very traumatic to their parents, as significant rectal bleeding is the most common symptom in this disease." W V Med J 1999 Sep-Oct;95(5)