GER/crying II

Last week I posted thoughts on babies with reflux,  indications and mostly pitfalls of medications there.  Frequently those babies are also colicky; let’s finish this up with a few words about that.

Colic is defined as an otherwise healthy infant who cries for >3 hours/day for > 3 days/week.  It is said to occur in approximately 25% of babies but I think that most babies have at least some periods at some point early on that can be characterized as “colic.” < 5% have some definable cause and most of those are things like constipation, milk allergy, reflux as above, or sensitivity to breastfeeding mother’s diet.  There is no good evidence that it is caused by “gas” but I doubt that we pediatricians will ever convince Grandma of that!

So, generally, these kids are still very healthy.  Mostly, if your baby is eating and eliminating well it is unlikely to be more serious.   I tell parents that after 30 years of practice I have more concern about babies who are listless and seem uninterested in eating for extended periods than for kids who scream unless you feed them and never seem satisfied.  However, if your instincts suggest that something may be wrong its always best to take a look.  We can check many things; a few of note:

  1. Adequate weight gain.  Changing formulas works < 5% of the time.
  2. Fingers, toes, groin–rarely more subtle, serious problems can develop here.
  3. Neurologically normal?  Muscle tone and reflex abnormalities are very difficult to see.
  4. Nursing mother’s diet.  If we eliminate all foods “associated with” colic in nursing moms, I tell them, they would be plants–consuming only water and sunlight.  Nursing mothers should follow Aristotle’s “Golden Mean–moderation in all things.”  A balanced, varied diet without too much of any one thing.  Avoid caffeine, alcohol (one drink/day is allowed) and take only necessaary medications
  5. Even mother’s state of mind–colic may be the baby’s reaction to post partum depression.

Mostly what works best are the low tech, tried and true methods.  Hold your baby, gentle slow movements and speak softly and gently to her.  Avoid loud noise, bright lights, vigorous stimulation.  The warmth of your body, a heating pad, or hot water bottle; even a warm bath.  Pacifiers of course and do not overfeed.  Sometimes it helps even to take the baby for a drive.

A few medicines used commonly: simethicone(“mylicon”) an emulsifier that breaks up gas bubbles; Soothe drops(Gerber)–a probiotic that increases healthy gut bacteria; Gripe water–an herbal product, there are several brands.  I do not endorse any products specifically.  They are mostly safe and some people swear by them.  If you have been following me you know that my advise is usually the less medicine, the better.  Lastly, a Sleep Tight--the white noise and vibrations simulate a car ride.  Again, no endorsement, but long ago it did help a young Luke Geneslaw, recent college grad!

Send along questions and comments, and thanks for following.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s