Colic Remedies (part one)

  Of course as soon as I posted "living with a colicky baby" hoping that we were past it, Vera had another one of those nights where we questioned if we should take her to the Emergency Room. It has now been a few weeks since we last had that thought. I will start by saying that all of these worked a little, but none of them worked very well and most of the relief was very short lived. Hopefully in my desperation and research I came across some valuable information that can help another crying baby.

swaddling, shushing, and different swinging movements: This is based off of the theory by Dr.Karp the author of The Happiest Baby on The Block.  He claims that human babies are born "early" and immature.  For the first 3 months or so of life, babies crave an environment that mimics the womb. He has written about out the 5 basic calming actions for newborns. "The 5 S’s: Five simple steps that trigger the calming reflex (swaddling, side/stomach position, shushing, swinging and sucking). " For more information you can check out his website.  There are plenty of videos of him online "magically" calming fussing babies, however these techniques did not work for Nic or I. We did find some solace in swinging Vera though the air while simultaneously shaking her butt.... there's no way to explain it other that seeing it in person. Really only Nic had this motion down and it worked for about 20 seconds:)

Different nursing positions and breast rotations:  At one point, pretty early on,  I had an "oversupply" issue; I was making so much milk that it was like she was trying to sip out of a fire hydrant. I would wake up in puddles of milk, shower her (and anything else in a 2 foot radius) with milk during feedings, and leak milk continually.

 I found this awesome article on  La Leche League's website, that cued me into looking at oversupply as a reason for Vera's crying. She met almost all of the common symptoms associated with this: (from LLL)

• Baby cries a lot, and is often very irritable and/or restless
• Baby may sometimes gulp, choke, sputter, or cough during feedings at breast
• Baby may seem to bite or clamp down on the nipple while feeding
• Milk sprays when baby comes off, especially at the beginning of a feeding
• Mother may have sore nipples
• Baby may arch and hold himself very stiffly, sometimes screaming
• Feedings often seem like battles, with baby nursing fitfully on and off
• Feedings may be short, lasting only 5 or 10 minutes total
• Baby may seem to have a "love-hate" relationship with the breast
• Baby may burp or pass gas frequently between feedings, tending to spit up a lot
• Baby may have green, watery or foamy, explosive stools
• Mother's breasts feel very full most of the time
• Mother may have frequent plugged ducts, which can sometimes lead to mastitis (breast infection)

     When a woman has too much milk, the baby drinks proportionately more foremilk which is high in sugar/low in fat. The breakdown  of the sugar produces more gas for the baby and the low fat content of the milk results in green stools. One remedy is to change nursing positions to slow the flow of milk. A few positions I found helpful were, nursing while reclining or having her lay on top of me, essentially forcing her to nurse against gravity. I found these to work somewhat, but it was impractical to lay down every time she wanted to eat. Another option, is to let her latch on until my milk lets down, then let an ounce or two of milk spray out until the flow is much slower. With these techniques she would nurse longer and get more of the high fat hind milk. 

     What made the most of a difference was adjusting breast rotations to actually decrease my supply (I do not recommend this unless you are SURE it's an oversupply issue). One thing that is recommended is to offer only one breast per feeding. Vera was already eating only one breast at a time and she never came close to finishing it. Since I still had an abundance of milk, I only switched breasts after  2-3 feedings. After a few weeks, my milk went down to a much more manageable amount. Making sure she empties the breast completely before switching, ensures that she receives more of the high fat hindmilk . After doing this, I did notice a change in her stools, they had more consistency and were getting back to yellow.

    

Chiropractic care:     

    When I first head of infants being adjusted by a chiropractor, I will be honest, the idea freaked me out. I imagined their little joints cracking and breaking.  But once I saw a baby being adjusted and realized that babies are not adjusted like adults, I became open to the idea. The theory is that during the birth process, the baby's spine/skull can be misaligned and this leads to digestive issues, ear infections, restlessness, and colic. By seeing a chiropractor their spine can be realigned and they are relieved of the issue. 

     The first time I took Vera, she was content being adjusted. The chiropractor held her and gently massaged and realigned her head, stomach, back, and hips. Vera loved it and seemed to have instant relief. She slept for almost the whole day and night after that. However, the next day the crying continued. I took her back to see the chiropractor 3 or 4 times after that and it did not seem to improve the colic, so I quit going.  I have heard of chiropractor care making a world of difference for other babies, but I did not see the same results.

Prone sleeping, positional changes, inclined sleeping (note on mattress): 

    The link below I found extremely helpful. It is AAP's guidelines for the treatment of Gastroesophageal Refulx Disease. It gave me a pretty good idea of what typical western medicine treatments are for reflux, and enabled us to make an informed decision on if we should take Vera in to the doctor. 

American Academy of Pediatrics Guidelines for Evaluation and Treatment of Gastroesophageal Reflux in Infants and Children

Some helpful tips I learned, sifting through this 30 page document:

• The typical treatment is removal of milk products (via formula or the mother's diet) and acid suppression medication.
• The common practice of thickening milk with rice cereal decreases vomiting, but does not improve acid levels in the esophagus.
• Infants have 50-80% less reflux while in a prone (stomach down) position, however this is not recommended for sleeping because of the increased incidence of SIDS associated with prone positioning.  (side note: There is a major campaign in the US for putting infants "back to sleep". However, there is a study that links the prone positioning to SIDS because of off-gassing mattresses. When the infant sleeps face down, they inhale theses low lying gasses, which leads to SIDs. In New Zealand they have almost completely eradicated  SIDS by placing covers on infant mattresses. I hope to write more on this later. Because of this, I feel fine allowing Vera to sleep in the prone position, on my chest or on a non-off-gassing mattress.) In all honestly, the prone positioning after eating and while sleeping is what made the biggest impact decreasing Vera's crying episodes. Lying flat on her back was the worst position, and we completely avoided it for months.
• The semi-supine position (like in a car seat), exacerbates GERD, explaining why Vera hates the car seat.
• Breastfed infants have lower levels of acid in the esophagus compared to formula fed

At 4 months of age, the colic and uncontrollable crying decreased dramatically. Now, Vera is 5 months old, and she had not had one of those crying fits in quite a while. Since it finally seems over, I am finding it difficult to be motivated to write about, however I hope to finish the second half of this post soon.