Breastfeeding with Infantile Colic

When your baby is experiencing infantile colic, it can be a challenging time for both of you. Colic is defined by episodes of crying for more than three hours a day, for more than three days a week, for three weeks in an otherwise healthy child. This condition can be stressful and puzzling, leaving many families searching for ways to soothe their babies and wondering how it might affect breastfeeding.

Understanding Infantile Colic

Infantile colic is a common condition that affects many newborns. The exact cause of colic is unknown, but it's thought to be related to digestive discomfort. Symptoms usually start between the second and fourth week after birth and typically resolve by the time the baby is four months old. A few things that we watch for as contributors to colic:

• Gut Dysbiosis – a poor balance of healthy, helpful bacteria in baby’s gut can lead to inflammation and uncomfortable digestion in baby’s belly. Mode of delivery, mom’s microbiome, and their environment can all be contributing factors.
• Overfeeding and Lactose Overload – overeating or eating too fast – especially if mom has a milk oversupply – can cause milk to pass too quickly through baby’s digestive system. This can lead to belly discomfort and green, frothy poops. A tongue tie, or ankyloglossia can contribute to this. Lactose overload is not related to mother’s consumption of dairy products.
• Cow’s Milk Protein Intolerance – a rare sensitivity to a protein passed through mom’s milk can cause increased crying, reflux, and diapers with blood or mucous in the stool. Most breastfeeding moms of babies with colic do not need to eliminate dairy from their diet unless they notice these symptoms.
• Other causes for Crying – a pediatrician can do a head-to-toe assessment on your infant to rule out any medical concerns that could be causing baby’s crying, such as a broken clavicle, hair tourniquets, or other medical conditions.

Breastfeeding Challenges Associated with Colic

Breastfeeding a baby with colic can present several challenges:

• Frequent and inconsolable crying can make it hard to know if your baby is hungry, tired, or just uncomfortable.
• Difficulty latching or staying latched due to discomfort, leading to more frustration for both baby and mama.

How to Help a Colicky Baby

Feed in a Quiet, Calm Environment

Try to feed your baby in a place that is soothing and free from overstimulation. This can help your baby focus on feeding and may reduce crying episodes.

Reduce Overfeeding

A lactation consultant can help determine if you have a breastmilk oversupply or forceful letdown that could be contributing to baby’s discomfort. They may recommend block feeding, laidback breastfeeding, or other techniques depending on baby’s symptoms and weight gain.

Ask your pediatrician about probiotics or oral lactase drops

The limited research we have on infantile colic shows promising results with use of oral probiotics for baby or oral lactase drops. Speak with your provider about their recommendations.

Burping Baby

Some believe that infantile colic is caused by trapped gas, but recent studies show that burping baby more frequently or even using gas drops like Simethicone or Mylicon don’t decrease crying time in colicky infants. We recommend still burping baby between breasts and after feedings, but don’t worry about spending hours trying to get a burp out. Some colicky babies will have more gas due to swallowing air while crying, but this is generally not considered the original cause of discomfort.

Offer a Pacifier

Some babies find sucking on a pacifier soothing, which might help reduce crying.

Skin-to-Skin Contact

Holding your baby close can provide comfort and help soothe them. Skin-to-skin contact is also beneficial for breastfeeding success.

Adjust Your Diet

While there is limited data on the topic, some studies indicate that maternal diet elimination for breastfeeding moms could reduce crying time. Taking things like dairy, soy, caffeine, and chocolate out of mom’s diet for 3-5 days could be something to consider. If symptoms don’t improve dramatically within that time period, don’t stress about your diet.

It's important to make any diet changes under the guidance of a healthcare provider to ensure you're still getting the necessary nutrients.

Seek Support from an IBCLC

An International Board Certified Lactation Consultant (IBCLC) can offer personalized advice and support to address breastfeeding challenges related to colic.

What to do During a Crying Episode

If you’ve already tried the basics such as feeding baby, changing their diaper, and rocking, and nothing’s working, here’s a list of things to try to calm a crying baby during a colicky episode. Some of these may not work for you or your baby, but having a list of tools to try can be helpful during these episodes:

• Baby-Wearing – keeping baby close in a wrap can reduce fussiness. Planning on having at least one of baby’s naps in the wrap can lead to a longer sleep stretch for baby and prevent an overtired baby later in the day
• The Colic Hold – for some babies who are having crying episodes due to tummy discomfort, holding and rocking baby on their belly instead of on their back can ease an unsettled belly.

• Get outside: sometimes a change of scenery can help baby calm down. Whether that’s laying out a blanket in the yard and letting baby look up at the sky, or going on a walk, we find that babies who spend more time outside have fewer crying episodes
• Give baby a bath: a warm, soothing bath – or even just warm water over the back of their head (not on their face) can calm a colicky episode temporarily
• Gently bounce on a yoga ball while bolding baby: pacing with a baby can be hard on parent’s back. Bouncing on a yoga ball allows you to get a good rocking motion that is soothing for baby while feeling less strenuous on parent’s bodies.
• Wear noise-cancelling headphones – if nothing seems to be working and you know you’ll be pacing with a screaming baby, noise-cancelling headphones can reduce the stress levels (and decibels) for you.
• Ask for help and take a break – parents of colicky infants are at increased risk of postpartum depression and anxiety. Being more proactive about taking care of your mental health may include getting frequent help from friends and family to take breaks.

When to Seek Medical Advice

It's crucial to consult with a healthcare provider if:

• Your baby's crying is accompanied by other symptoms such as fever, vomiting, or diarrhea.
• You notice a significant change in your baby's feeding pattern or weight gain.
• You're concerned about your baby's health or well-being for any reason.
• You’re feeling overwhelmed or concerned about your mental health.

Related Issues

Colic can sometimes be confused with other conditions that cause excessive crying in babies, such as reflux. If adjusting your diet and soothing strategies don't seem to help, it's important to explore these possibilities with your healthcare provider.

Breastfeeding with infantile colic can be tough, but with patience, adjustments, and support, you can help your baby through this challenging time. Remember, colic is temporary, and it does get better. If you're struggling, don't hesitate to reach out to healthcare professionals and lactation consultants for help and support.

Sources

• National Center on Shaken Baby Syndrome – PURPLE Crying (dontshake.org)
• Colic: Symptoms, Causes & Treatment (clevelandclinic.org)
• Ellwood J, Draper-Rodi J, Carnes D. Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines. BMJ Open. 2020 Feb 25;10(2):e035405. doi: 10.1136/bmjopen-2019-035405. PMID: 32102827; PMCID: PMC7202698.
• Iacovou M, Ralston RA, Muir J, Walker KZ, Truby H. Dietary management of infantile colic: a systematic review. Matern Child Health J. 2012 Aug;16(6):1319-31. doi: 10.1007/s10995-011-0842-5. PMID: 21710185.
• Narang M, Shah D. Oral lactase for infantile colic: a randomized double-blind placebo-controlled trial. BMC Pediatr. 2022 Aug 3;22(1):468. doi: 10.1186/s12887-022-03531-8. PMID: 35922776; PMCID: PMC9347088.
• Shirazinia R, Golabchifar AA, Fazeli MR. Efficacy of probiotics for managing infantile colic due to their anti-inflammatory properties: a meta-analysis and systematic review. Clin Exp Pediatr. 2021 Dec;64(12):642-651. doi: 10.3345/cep.2020.01676. Epub 2021 Apr 12. PMID: 33848417; PMCID: PMC8650819.