Having a newborn is exciting! But there are also many hurdles to navigate as you and your infant enter this new chapter together. One area that can affect babies is inconsolable crying. It's very normal for babies to cry, as that is their primary form of communication when they enter this world. When you have explored all options as to why your baby is persistently crying, such as a wet diaper, hunger cues, wanting to be held, or potentially not feeling well, but it all leads to a dead end, then you'll want to consider colic. This state of infant distress occurs in 20-25% of babies. Attempting to find the root of your infant's colic symptoms may bring some relief for them and some peace of mind for you.
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What is Colic?
It's normal for newborn babies to cry as they are adjusting to their new environment. Your baby may be expressing colicky behavior when their crying becomes prolonged, episodic, and without causation. Colic is the constant and excessive crying that is inconsolable and has an intense high-pitched tone. Criteria for colic entail a "rule of three's"- crying is present more than three hours a day, three days a week, and has been going on for at least three weeks. Colic typically sets in around six weeks old and can self-resolve by three to six months. Often there is no known cause of colic, but the symptoms are similar amongst infants.
Colic Symptoms
There are distinguished features regarding colic. Here are the most common symptoms present:
- Inconsolable and excessive crying
- Crying is cyclical and often in the evening
- Red, flushed face when crying
- Loud and high-pitched with an urgent sound
- Clenched fists
- Bloating
- Tucked in arms and legs towards the abdomen
- Crying with passing gas
- Muscle tightness, especially in the stomach
- Heightened frequency in the evenings
What Causes Colic In Babies?
There is no specific diagnosable cause of colic. There are risk factors that are associated and areas that can be investigated as potential contributors. Discussed below are issues to discuss with your child's doctor if he or she is experiencing colicky behaviors.
Reflux
Gastroesophageal reflux (GER), also known as reflux, can occur in infants. Reflux is when stomach contents, such as breastmilk or formula, move back up the esophagus, and the baby spits it out. This is a common occurrence in newborns. While no research links colic directly to reflux, it is a differential diagnosis when a baby is being evaluated for reflux.
Gas
Infant gassiness could be a contributor to colic. If the baby has intestinal microbial dysbiosis, where bacteria produce gas, that can, in theory, cause irritation and discomfort to the baby. As a baby is feeding, predominantly bottle drinking, they can swallow trapped air in the bottle. Extra air gets into their intestinal tract when they are crying as well. Combine these areas, and that can add up to the perfect storm of discomfort.
Food Allergies
Certain foods can irritate infants, which exacerbates their emotional responses. Both breastfed babies and formula-fed babies can be reactive to foods. One study revealed that a low-allergen, preservative-free, dye-free, and additive-free maternal diet could significantly reduce colic in breastfed infants. This included the mother eliminating peanuts, eggs, tree nuts, wheat, soy, fish, and cow's milk from her diet. While the mothers in the control group continued to consume these foods, the results were very revealing. In the low-allergen diet breastfed babies, there was a 39% reduction in distress, compared to 16% in the control group. In a similar study, implementing a low-allergen diet found a 21% reduction in crying and fussing amongst infants of mothers in this subject group. Overall, there is reasonable evidence that diet affects colic to some capacity.
Milk Intolerances
In terms of specific food intolerances, cow's milk and cow's milk protein are leading culprits for infants. A small study examined 19 breastfed infants whose mothers were on a cow's-milk protein-free diet. Promptly after the mothers discontinued cow's milk products, the colic completely ceased in 13 of the infants. There is some literature on infants who switched to a hydrolyzed cow's milk formula, which is more tolerable for babies sensitive to cow's milk. Results showed a reduction in colic with this formula change.
Environmental Distress
As the newborn is adapting to all the changes of entering the world, their nervous system may not be quite ready. Babies are not innately born with a self-soothing capacity. Crying can be a form of communication, indicating they are sensitive to noises, lights, external stimulation, or a reaction to parental emotional distress.
Functional Medicine Labs to Test for Root Cause of Colic In Babies
The following functional medicine labs can be helpful for understanding the potential causes of your baby's colic:
Food Allergies and Sensitivity Testing
A comprehensive Food Allergy test could be beneficial if the infant is breastfeeding, as well as 96 items IgG Food Sensitivity panel. This could provide information for the mother as to what foods to avoid that may be negatively affecting their nursing baby. Infants can also be reactive to formulas, and in that case, a Dairy Panel could be insightful in ruling out a cow's milk, goat's milk, or specific milk protein allergy.
Gut Microbiome Evaluation
If colic does not rectify itself within 4 to 6 months, investigating areas of disturbances is valid. As mentioned above, gut diversity can be implicated in gas and colic. If this leads to dysbiotic gut flora, completing a comprehensive stool analysis can provide insight into treatment options. Gut Zoomer 3.0 Complete is a great option. This looks at microbiome diversity and overgrowth of bacteria strains and gives recommendations for probiotics to consider. Lactobacillus reuteri, evaluated in this test, has been researched as a probiotic strain used to treat infantile colic.
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Conventional Treatment for Colic
There are three pharmaceuticals that you may see prescribed for colic. These are Simethicone (prescribed for gas relief), Dicyclomine (prescribed to relieve muscle spasms in the GI tract), and Proton Pump Inhibitors (PPIs) (prescribed to reduce stomach acid). According to the American Academy of Family Physicians, neither Simethicone nor PPIs have proven more efficacious than a placebo. Dicyclomine is contraindicated in infants under six months of age.
Conventional medicine is also of the mindset that colic will come and then go, so their mainstream advice is to confirm the diagnosis, assure parents that this is self-limited, and offer resources for support when necessary.
Functional Medicine for Natural Treatment of Colic In Babies. Colic Diet
The preferred method is to address the infant's diet through the mother's diet or formula changes. The food antigens pass through breast milk, and if a baby is sensitive or allergic to a particular food the mother is consuming, they could react negatively. One way to address this is for the mom to do an elimination diet that is hypoallergenic.
Switching to a partially, extensively, or completely hydrolyzed cow's milk formula may ease the infant's colic if the child is formula-fed. Studies have looked at the implications of bottle types and colic symptoms. Two studies found that specific vent-flowing bottles like BornFree ActiveFlow and Dr. Brown's Natural Flow Baby Bottles significantly reduced infant colic compared to other bottle types used by colicky babies. This information provides context that the type of bottle can play a role in colic.
Supplements and Herbs That Help With Colic
Probiotics That Help With Colic
Lactobacillus reuteri is one of the most common strains studied for use in colic. While there are mixed results based on study parameters, there is potential hope for L. reuteri as a treatment option for colic. One systemic review found that L. reuteri decreased crying time compared to both Simethicone and placebo.
Recent studies have begun looking at other probiotic strains for the treatment of colic. Bifidobacterium breve CECT7263 (B. Breve), a breastmilk-isolated probiotic strain, appears to be an effective treatment for colicky infants. Robust results showed a reduction in crying for consecutive weeks of treatment compared to those taking Simethicone and those taking a probiotic combo of B. Breve and Lactobacillus fermentum CECT5716. Other positive outcomes include better sleep and improvements in the infants' mood.
Herbal Therapy to Reduce Colic
Evidence-based botanical medicines for infantile colic include Fennel, Mentha piperita, Matricariae recutita, and Melissa officinalis. A randomized placebo-control study looked at colic in infants ages 2 to 12 weeks, using Fennel Seed oil emulsion in the treatment group. Outcomes revealed elimination of colic in 65% of the infants taking it and only 23.7% remission in the placebo group.
Per a 2012 study, Mentha piperita, commonly known as Peppermint, had similar efficacy to Simethicone (medication for reducing gas). Both interventions in the study indicated a decrease in daily episodes of colic and a reduction in the total duration of crying per day from 192 minutes to 111 minutes.
Matricariea recutita (German Chamomile) and Melissa officinalis (Lemon balm) are two botanicals that calm organ systems in the body and can improve colic. It’s used in situations of anxiety, indigestion, common cold, and infantile colic. Research conducted a study using a combination product of Matricariea recutita, Melissa officinalis, and Fennel has shown promising results in treating colic. This study used a phytotherapeutic agent of these three in colicky infants. After one week of treatment twice a day, there was an 85.4% reduction in crying in the experimental group compared to 48.9% in the placebo group. These are great results in the hopes of utilizing botanical medicine for infantile colic.
Complementary and Integrative Medicine For Colic
While there have been numerous small-scale studies on using CIM therapies for colic, there is no definitive evidence for using chiropractic, massage, or acupuncture to treat colic. Speaking with your holistic healthcare provider and seeing what their clinical experience and success entails may lead you in a direction that can best support your child.
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Summary
Colic is a challenging diagnosis to navigate. Like most areas of healthcare, it is not a one size fits all condition. Each baby will have unique factors that contribute to the discomfort and colic symptoms. While science has not quite figured out a direct cause of colic, exploring potential causes in this article may lead you down the right path. Working with a supportive healthcare practitioner that can investigate all potential causes would benefit long-term care for your child and their caregivers.
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