Friday, October 2, 2015

Colic treatment/ standard and alternative



Please see the updated post September 2016 for info on a new product!

I think the most common calls I get are about fussy, gassy babies (although I sure do talk about poop a lot; perhaps it's a tie.) Often these colicky kids have wretched periods during the late afternoon and early evening when it seems to be especially hard to settle them (I refer to this as the witching hours.)

With most of my patients this usually seems to improve at least a little once you hit the 3 month mark (keep your fingers crossed.) If one of those gassy babies is yours and you are breastfeeding, the first thing I will ask about is your diet. I know that not everyone agrees that there is a connection, but in my case I swear to you that if I even looked at cabbage my kids cried for a week. The biggest culprits in my opinion are:

  • coffee
  • caffeine (in tea and chocolate among other things)
  • dairy
  • gassy foods (like cabbage, onions, broccoli)
  • spicy foods

What I suggest you do is see if you can establish a connection between an extra fussy day and something that you recently ate. Yes, I have some moms that know perfectly well that coffee is a problem but drink it anyway because they can't face the day without it. As always, it is a balance. It is worth finding out if there is a connection between your diet and your baby's gassiness, but then make whatever choice works best for you.

The other thing that breastfeeding moms should pay attention to is hind-milk. The milk that the babies get as they empty a breast is helpful with digestion. Sometimes greenish stools (not necessarily something that I worry about) and increased gas issues are because they are switching breasts too soon and never getting to the hind-milk.

If you haven't found any magic cures from a diet elimination, it is perfectly fine to experiment with some different colic remedies. Simethicone is the ingredient found in most of the OTC gas drops that you can get at a drug store. Some of the name brands are Mylicon or Little Tummies. Simethicone drops are very safe and helpful in about 70% of my patients. They are certainly worth a try.

Homeopathic colic remedies come in a few products. I am most familiar with Coccyntal drops (made by the Boiron company) and colic tablets by Hylands. These seem to help about 60% of the time. I consider them fairly harmless if used properly. They too are worth having in your arsenal. Grippe Water is an herbal remedy that can be found in many health food stores or Whole Foods. I find this helps about half of the time. Stools might get a touch green with this (not to worry.)

Soothe probiotics drops: These claim to cut crying time by 50% after a week of use. They should be given daily. 

Brew some chamomile tea, add a few grains of sugar and give a dropperful or two to your baby. This also helps about half of the time. Probiotics may be helpful with digestion in general. This is especially true for babies who were born via c-section.

Colief is a fairly new product specifically for babies who may have a lactose intolerance. Regardless of the directions on the box, it is fine to administer directly to the baby without mixing with breast milk. If you are going to give this a try, you need to make sure you give it with each feeding for a few days to see if it is helping. (You may have a couple of months of colic ahead of you; you will have plenty of time to try all of these.) Dr. Schwanke thinks that the reason any of the above remedies work is because they have sugar in them. I think there is probably more to it than that.

Don't forget about massage! Go on line and check out baby massage techniques on You-tube or take an infant massage class. Make gentle clockwise circles on the baby’s palm with your thumb. Bicycle their little legs. Get up and dance. Hold your baby over your shoulder with their knees tucked up in fetal position. Give firm pats on the back. Sway, bounce and sing. (I teach the "shuffle" at my baby boot camp class.) Warm (not too hot of course) baths are very soothing for some babies.

Ready to think outside the box? Advanced Allergy Solutions ( http://aasclinics.com ) has treated babies and had some good results for colic. This is completely noninvasive and I have had patients who claim improvement.

Craniosacral therapy has been helpful for some of our fussy babies. Two of my favorites are Sandra Roddy Adams 4150566-1900 and Laura Sheehan 415-681-1031

Amy Gelfand, a pediatric neurologist at UCSF, looks at the connection between colic and a family history of migraines. Interestingly, recent evidence suggests there may be a relationship between infant colic and migraines. Mothers with migraine are more likely to have a colicky infant, and colicky infants are more likely to grow up to have migraines as adolescents.

Given this connection between infant colic and migraine, the UCSF Pediatric Headache program is now starting a program for management of infant colic. Their goal is to use what they know about helping children with migraines to also help babies with colic.  
Here is a snippet of info from Dr. Gelfand:

What will happen at my baby’s visit with the UCSF pediatric headache neurologist?
Your baby’s pediatrician has referred you to see a pediatric neurologist who specializes in managing migraine in children.  At the visit, the neurologist will go over your baby’s health history and the details of your baby’s crying pattern.  She or he will also review your family history of migraine. It may help to ask your family members about their headache history in advance of the visit as only about half of adult migraineurs in the U.S. have ever been diagnosed by a physician.  The neurologist will also perform a neurologic examination of your baby.  

If there is a family history of migraine, it is possible that migraine could be playing a role in your baby’s colic.  Given the young age of infants with colic, our approach in the UCSF infant colic program focuses mainly on behavioral interventions to help manage crying. We also want to ensure you have adequate support, as taking care of an inconsolably crying infant can be tiring and stressful. We only recommend medications that are safe for babies, and we work closely with your pediatrician to ensure that medication choices—if they are needed—are safe for your baby.

There are lots of experts who are convinced that the worst of the colic cases slowly build up to the 6 week peak and then slowly subside. As mentioned earlier, by the time three months comes around, most of our families can see the light at the end of the tunnel. One study that I read years ago postulated that kids with lots of colic symptoms ended up with higher IQ's. Hold that thought....

As with everything, this stage will pass. Enjoy the calm moments.

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