Colic: What we Know

Colic is a major frustration for many new parents, but it’s not a diagnosis in itself. Instead it is a collection of symptoms- a syndrome. The main symptom is more frequent or longer periods of crying than normal, which are often worse in the evening than the rest of the day.

Symptoms of Colic

The diagnostic criteria of colic has been updated to cover babies who:

• cry for more than three hours a day

• for at least three hours a week

• over a period of at least one week

This criteria does not apply if there is another explanation for the crying.

Beyond the extended periods of crying, symptoms can also include signs of abdominal discomfort, going red in the face, and clenching their fists. Although its impact on the family can be huge, colic only affects babies for a small period of time. By the age of 3 or 4 months, it should self resolve.

Cause for Investigation

As little babies are unable to effectively communicate, we have to consider that their discomfort is something more serious. Colic symptoms lasting beyond 4 months of age should be investigated by your GP.

This is also a situation where you should trust your gut. If you feel that something is not quite right, don’t feel that you would be wasting anyone’s time to have your baby checked out.

Possible Explanations

As colic is not a diagnosis, it does not come with a blanket explanation for why it occurs.

Often there seem to be digestive links, and indeed some of the recognised symptoms of colic are also recognised symptoms of reflux. An arched back, and knees brought up to the chest are good examples of this crossover. Common advice to ensure to wind your baby after feeds could also help to address reflux if that does form part of your baby’s picture of colic.

You can read more about infant reflux here.

In the first four months of life, a baby goes through huge changes. Physically, their bones are growing at an unprecedented rate, and we know in older children that growing pains can be very sore. It is possible that this kind of pain is part of the problem.

Osteopathy and Colic

Evidence for any form of treatment for colic is severely lacking, but steps are being made to research treatment options. Some parents find that gentle osteopathic treatment helps their babies to be more settled. Light-touch work to the joints of the skull, or massage-type techniques for the abdomen may help to settle your baby. A paediatric trained osteopath can also help to stretch out any tight muscles that may be playing a role, and show you how to keep the progress going at home.

As a parent, having a baby with colic can be very stressful. This alone can cause tension in the shoulders, associated with upper back pain or headaches. The advice to hold or rock your baby during an episode might further exacerbate this, but you will likely find yourself at the bottom of your list of priorities. Your osteopath can help your aches and pains as you navigate your baby’s colicky season.

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New Parents' Pains

The long-awaited but sudden transition into parenthood puts all sorts of demands on the body for both parents. Osteopathy can help with the muscle and joint pains, and we can offer some advice for changing your discomfort-inducing habits too.

Carrying Baby

Babies often seem happiest when being held, so it’s not surprising to realise that you’re holding your baby much more than you might have anticipated. If your baby likes to be as close to you as possible, have a look at baby-wearing carriers or wraps. A comfortable one will spread baby’s weight through your upper and lower back, allowing you to soothe them while getting on with your day.

As baby gets heavier and more mobile, their mattress will need moving deeper into the cot. This can make it much more difficult to pick baby up and set them down, so make sure you’re using your legs wherever possible, and listening to your body if you do feel any twinges. Exercises to keep the whole back moving might be a suitable plan of action, and your osteopath can help you with this.

Infant Feeding

If you’re feeding with a bottle, try and keep track of which side you held baby on last. You might find that you favour one side due to the positions that your furniture supports best, but mixing it up is good for you and baby. Management for torticollis and plagiocephaly put a lot of emphasis on giving baby opportunities to strengthen both sides of the neck.

For feeding in bed or on a sofa, try and set yourself up with pillows or cushions before you get started- it’s easier to throw out an extra pillow than squeeze another one in once baby’s latched on. Make sure your arms are supported enough that the shoulders can relax, and the upper back and neck aren’t straining.

Breastfeeding

Finding a comfortable position in which to breastfeed can be a struggle. But you might find you have access to positions that wouldn’t work so easily for bottle feeding too. The same ideas apply as above: keep your arms supported to take the strain off the neck and shoulders. If you’re feeding in bed, you might like to lay back and have baby belly to belly with you, or lay on your side and have baby laying on the mattress with you. Be aware of the safe sleep 7 if you are prone to falling asleep during feeding.

The Upper Back

The upper back is particularly susceptible to overworking when you have a new baby, and often this can be completely asymptomatic. Problems arise when the restriction in the upper back begins to have a knock-on effect for another area, typically the lower back or neck. This might manifest slowly as recurrent headaches or neck tension, or it might be more dramatic and lead to a sudden disc bulge or muscle strain.

Your osteopath will be able to spot these developing patterns, even if you’re not feeling any discomfort.

Make here to make an appointment in Naas for your aches and pains

Tongue Tie (Ankyloglossia)

Under the tongue there is a stringy piece of tissue that connects the tongue to the floor of the mouth. Its medical name is the frenulum, and it is much more prominent in babies than in adults. Sometimes babies are born with a frenulum that is too short, or that extends too far forward. In either of these cases, the tongue will not have the mobility it should.

Symptoms of tongue tie may be evident in the first few days of life. If the baby is breastfed, the mother may find it painful to feed. Baby might struggle to make a proper seal, and be heard to suck in air. They may also seem generally unsettled at the breast, struggle to gain weight, or have unusually long or frequent feeds. Unfortunately, a lot of these symptoms could be attributed to a number of different things, and tongue tie is not always easy to diagnose.

Controversy

Although there are diagnostic criteria for ankyloglossia, they do not appear to be widely adopted. A study published in a Canadian medical journal recognised the need for further research into diagnosis and treatment.

Some cases of posterior tongue tie are missed, as the frenulum limits movement but only towards the back of the tongue. This is unlikely to change the shape of the tongue either, making it harder to spot.

Conversely, there is also the possibility for over-diagnosis, particularly as knowledge of the condition becomes more widespread. Breastfeeding issues can occur for a number of reasons, not just tongue tie.

Lip Tie

There is another frenulum between the gums and the inside of the top lip. This too can be restrictive and affect feeding, although it is less commonly discussed. If your baby’s top lip is always curled in when feeding, this could be a reason why.

Treatment

Insufficient movement of the tongue is associated with feeding and speech issues, but also improper development of the teeth. Tongue tie may not be diagnosed when the baby is young, but become more apparent when starting solid foods or beginning to speak.

NHS guidelines recommend massage as part of a conservative treatment plan for tongue tie. The guidelines also note that some cases will sporadically resolve on their own, or can be managed with the help of a lactation consultant.

Beyond conservative measures, standard medical treatment is a simple incision. However, sometimes the first attempt is insufficient or the frenulum regrows, and the procedure needs to be repeated. Although young babies do not feel sensation in the frenulum, the procedure can still be distressing for the baby and parent.

The frenulum is soft tissue, and osteopaths work on releasing soft tissues on a daily basis. If you suspect that your baby has a tongue tie, and would like to try and avoid surgery, you can book an appointment in Naas here.

Naas Osteopaths - Reflux and your baby

What is Reflux and should you be concerned?

Reflux is a common occurrence in baby’s and normally begins around 8 weeks of age and gradually improves as the baby gets older. Reflux occurs when some of the contents of the baby’s tummy return back up into their mouth. This usually occurs because the baby’s food pipe (oesophagus) is still growing and developing. The ring of muscle at the bottom of the oesophagus develops over time and this will prevent stomach foods from leaking out. It is a common and usually affects up to 40% of babies.

Signs and symptoms

Your baby may show no signs or they may show the following signs

- Regurgitating or spitting up milk during or after feeds.

- Refusing feeds, choking or gagging.

- Continuing hiccups or coughing.

- Excessive crying or crying while feeding.

- Repeated ear infections.

There is no real concern about reflux if your baby is feeding well, happy and gaining weight as normal.

Reflux - Osteopathy and your baby

When should i seek medical advice

Contact your GP, public health nurse or midwife if reflux starts after 6 months of age and continues beyond 1 year, or your baby has any of the following problems:

• Spitting up feeds frequently or refusing feeds.

• Coughing or gagging while feeding.

• Frequent projectile vomiting.

• Excessive irritability or crying.

• Green or yellow vomit

• Vomiting blood.

• Blood in their faeces or persistent diarrhoea.

• Swollen or tender tummy.

• High temperature (fever) of 38C (degrees Celsius) or above.

• Failure to gain much weight, or losing weight.

• Arching of their back during or after a feed, or drawing their legs up to their tummy after feeding.

Osteopathy For Your Baby

Whilst reflux can be a common problem for babies it can also prove to be a distressing time for both mother and child. A careful expert assessment can often find where troubles occur with feeding and offer advice on what can be done about it.

This can often be common sense advice or working in conjuction with other professionals like the lactation consultant and tongue tie specialists. Osteopathy may help the neck and diaphragm of baby relax, so that feeding time is more comfortable and efficient. The digestive system generally responds to soothing and relaxation , so that milk is naturally absorbed and processed.

A combined professional approach can often lead to a breakthrough for feeding comfort and success, allowing parents and baby to relax. To find out more information get in touch with us at Naas Osteopaths by emailing us at info@naasosteopaths.ie