Colic - for lots of babies it’s short lived and manageable. But for others, it’s intense and not so easy to figure out how to help your baby feel better and can be really really tough when you’re in the thick of it. Part of the problem is that the term ‘colic’ refers to a description of symptoms, not a diagnosis and sometime working through the symptoms to figure out what’s making your baby so unhappy can take time and a lot of detective work.
I recently met up with Vikki Wareham who’s a trained paediatric nurse and who’s launched a new service for parents looking for support with issues like colic, reflux and allergies as well as lots of other health and development related things.
She’s very helpfully written this fab blog all about colic, reflux and allergies, what to look out for and how to get help….
‘I can’t look at my WhatsApp again; why am I the only one with a baby that cries? They can’t seriously all sleep 4 hourly already. One of them must be lying, well I wish one of them would lie just for me. I know, they are a great bunch of women and I don’t know how I would have survived the first month without them, but I feel left behind now. They are so sympathetic, but they don’t just understandhow hard it is.’
‘I’ve changed him. I’ve fed him yes, yes I burped him – for about 10 minutes! Why are you questioning me? No, I know you’re trying to help, but I’ve done it all, I just can’t settle him, I don’t know what I’m doing wrong?’
How many of us have asked that question?The answer is almost certainly you’re doing nothing wrong!
Let’s get some perspective here; you aren’t alone - early infant sleeping and crying problems are the most common reason parents seek health professional help in the first three months of life, costing an estimated £65 million pounds per year in the UK. This was in 2001….imagine what it is now!
The colicky baby
All you want is a reason, and in turn a solution, an end to the baby’s tears, and end to yours. The diagnosis of colic doesn’t necessarily bring that relief, as most parents will attest; there is no rhyme or reason to colic, often no obvious cause and consequently no quick fix. One of the most commonly used definitions (although not the only one) is crying for at least 3 hours a day, at least 3 days a week, for at least 3 weeks. ‘At least’ that means for a lot of infants, they are crying significantly more than that. The prevalence of colic is thought to be 5–19% of infants, that’s nearly 1 in 5. That’s significant.
There are several different theories around colic, one being migraine - Often parents find a daily elimination plan might help, so by cutting out/reducing noise/heat/light etc. For example some children find over-stimulus too much, so while a noisy rattle might distract and entertain one baby, it might be too much for another.
Holding the baby, use a sling, touch, skin on skin and comforting goes without saying – but remember to look after yourself as well. You can take a pee without a baby strapped to you! There is now research to suggest that probiotics can sometimes help. The incidence of colic often drops around the 3-month mark, which is when their sleep patterns change as well, so stay strong team – it won’t last forever!
The reflux baby
You might have been to and from the GP several times already; without a doubt your baby behaved beautiful while you were there, may be even smiled at the doctor? It’s typical right? When you’ve been up all night dealing with a squirming and inconsolable baby. You know they are in pain, you know something isn’t right, but diagnosis and treatment can be tricky to get sorted quickly.
Let’s get that perspective again – Regurgitation can affect up to 80% of infants in the first month of life. That’s a lot! Luckily, though, that number drops to 10% at a year old. It’s important to identify there are those children who are seemingly unaffected by it and continue a normal life, others display all the signs of discomfort and clearly need intervention.
Some common symptoms:
Posseting and vomiting
Refusal to eat and difficulty swallowing
Irritability during feeding
Wet burps or hiccups
Failure to gain weight
Abnormal back arching
Frequent coughing or recurrent pneumonia
Gagging or choking.
There is a comprehensive guideline that now works with a helpful tick box criteria. Health care professionals should be using it and if your child hits enough of the markers, they may need medicinal help. Otherwise the evidence-based research behind non-medical intervention is often not significant, i.e. no one thing works, otherwise we’d all be doing it right? In some infants, these tricks help; smaller and more frequent feeding and raising the head of the cot (While still adhering to safe sleeping practice).
The allergic baby
Similar to a colic or reflux baby, these poor little ones often present as pain and discomfort. The prevalence of food allergy in breast-fed infants is just over 7%. It’s not as significant a number as colic and reflux, but it is still enough and in fact the consequences of allergic reactions means that these babies need diagnosis quickly.
Some common symptoms:
Belly pain.Coughing
Diarrhoea
Hives or rash
Nausea or vomiting
Red rash around the mouth
Runny or stuffy nose
If you are concerned about an allergy and you are breastfeeding, you will need an elimination diet. If you are bottle-feeding formula you’ll need to see your GP for a prescription for an alternative formula that’s either lactose free or completely dairy free (there is intolerance and allergy and within allergy there are different types as well, so it’s important your baby gets properly assessed.) It can take several weeks for remnants of the allergen to leave the body, so don’t necessarily expect an instant change.
The problem with these three presentations are that the signs and symptoms of all of them overlap. What I’ve listed above are the more common ones, but certainly don’t cover it all, (plus some children won’t have these symptoms….just to add to the minefield!) There are always going to be infants that have a differential diagnosis as well, meaning there is something else going on and needs further medical investigation and treatment.
If you have any concerns about your little one, or recognise some of the signs and symptoms above then please get them checked out. Your GP or health visitor will be able to assess for you. Alternatively I’m very happy to do this. Babies this age are puzzles and there is a lot of information to be gathered a few different ways. You have to build up the picture, starting from the edges and make sure no pieces are missed.
Building the puzzle takes time, which is why I offer an hour and a half one-to-one session. It includes taking a full history of your child, including pregnancy, their illness and importantly your family medical history. Then I do a physical assessment, which is another crucial aspect, how a baby handles as well as assessing their appearance. Please do make contact if you’d like to chat through anything or make a booking.
The important message to convey to all you parents out there is that this is NOT YOUR FAULT. Do not blame yourselves for this. You cannot prevent these conditions, all you can do is help recognise them or get help from a professional in recognising them.
You are doing so well, parenting isn’t always easy. The first few weeks and months are even harder as not only are you learning your baby but also how they are trying to communicate with you and what they are saying. Deep breaths, be kind to yourself.
Vikki x
#itsoktoaskforhelp
Vikki Wareham is a paediatric nurse and Founder of Fairy Godnurse. She is a trained sleep adviser, a breastfeeding consultant as well as a reflux, colic and allergy specialist. Vikki provides a unique, one-to-one holistic consultancy encompassing all areas of infancy, up to 6 months old. Through 20 years of physical assessments of children Vikki has developed an intuitive knowledge, to identify potential problems and symptoms.
A senior staff nurse, a trainee Advanced Nurse Practitioner in Critical Care in PICU, as well as a member of the South Thames Retrieval Team (STRS) stabilising critically ill children across the south-east of England. She has spent the last 15 years working in Paediatric Intensive Care at Evelina London Children’s Hospitallooking after ventilated children needing multi-organ support.
Vikki is a mother to 2 small children, aged 3 and 1. She is based in Forest Hill in South East London.
