baby reflux

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.

Click here to make an appointment for your baby in Naas

Reflux and Silent Reflux in Babies

New parents expect their baby to regurgitate a fair amount of their milk or formula in the early days. But there is a line between the normal spit-up and reflux.

What is Reflux?

Reflux in both adults and babies, is the return of stomach contents through the sphincter between the stomach and oesophagus (food pipe). Babies are particularly prone to this as their sphincter is less developed than that of an adult. This is why the vast majority of young babies spit up frequently- although this is typically outgrown relatively quickly. Babies with low muscle tone may be more predisposed to developing reflux. Reflux in adults is often associated with diaphragm dysfunction- osteopaths can help with this. Some babies may also have tightness in the diaphragm alongside their reflux.

There is a grey area between spit up and reflux. Generally speaking, if the baby is upset by their regurgitation, we need to start thinking about reflux.

When considering reflux, bear in mind that it is difficult to measure by eye the amount of fluid regurgitated. Try dropping a tablespoon of yogurt on a surface and you’ll see that it looks like a lot. You can gauge better the amount of food baby is taking on board by monitoring weight gain, and production of wet and dirty nappies.

Symptoms

The tissue that makes up the oesophagus is not equipped to deal with stomach acid. The alternative name we give it in adults (heartburn) describes the sensation well. Babies may not be able to communicate their discomfort in a particularly precise way, but there are a few clues.

During a feed, a baby with reflux may continually latch and unlatch. This may coincide with gulping air or burping. Alternatively, baby may cough a lot while feeding. Increased fussiness after feeding, especially if laid down soon after a meal, could also be a sign.

The textbook sign of infant reflux is the arching back (illustrated). Combine this with the other signs mentioned above and it should definitely be considered.

Silent Reflux

Silent reflux is so named because of its more subtle symptoms. Here, the stomach contents re-enters the oesophagus, but is not expelled from the body. It may not even reach the mouth, but that doesn’t mean it is not a problem. The irritation comes from stomach acid returning through the sphincter at the top of the stomach. Regardless of how much further it travels beyond this, the irritation has occurred.

When To Seek Help

Sometimes reflux can be a sign of something more serious. You should seek urgent medical attention if any of the following apply:

  • there is blood in baby’s vomit or faeces

  • baby is inconsolable

  • baby can keep no fluids down at all

  • their abdomen is distended or tender

  • they have a fever alongside reflux symptoms

  • their sick is yellow or green

You should also contact your doctor if baby’s weight gain is not as expected, or if symptoms persist after their first birthday. Symptoms typically resolve spontaneously in the first year of life.

To book an osteopathic appointment in Naas, click here.