Colic, Breastfeeding and Infant Nutrition - Fat is Where Its At

Colic- what a word!  This little five letter words strikes fear in the hearts of most new parents and brings to mind visions of sleepless nights, and endless frustration in trying to parent the new bundle of joy.  Any parent who has ever had a colicky baby would not wish the same fate on anyone.  Some people think that colic only happens to formula fed babies but this is not so. Breastfeeding is not a guarantee that your baby will be free of infant colic.

What is infant colic?

Colic is simply a word that means stomach pain.  In the absence of any real scientific evidence the widely held belief is that infant colic results from intestinal cramping.   Estimates are that colic occurs in about 20-30% of all babies at some time or another, most commonly in the first three months of life.

How will I know if my baby has colic?

Infant colic is easily identified by the baby's behaviour especially after feeding. The baby acts like she is in pain.  Crying is often accompanied by vigorous leg movements and the child may spasmodically extend her legs during a bout of crying.  Sometimes she will expel gas and have green stools.  The baby's crying escalates as the discomfort increases and parents and babies alike become fretful.  Nothing is more distressing that a baby who cannot be consoled.

Can a breastfed baby develop infant colic?

There can be no argument that the best source of infant nutrition is your own breastmilk, but even if you are breasfeeding, colic can still occur. There is absolutely no reason why breastfeeding should be discontinued if your baby is showing signs of infant colic.  There are, however, things that you can do to change your  breastfeeding technique and reduce the possibility and severity of the colic.

Breastfed colicky babies  are very often good eaters, and have a good healthy pattern of weight gain.  Parents often say that the baby seems hungry all the time but the more she is fed the crankier she gets.  Some parents misinterpret this to mean the baby is not getting enough breastmilk and in desperation may switch to formula thinking that mom does not have enough milk.  This is absolutely not the case.

In fact the breastfed baby who is experiencing infant colic is probably getting too much breastmilk, and too much of the wrong kind of breastmilk.

Here's why:

When you put your baby to the breast the baby starts to suck and a hormone is released that makes the milk ducts contract and breastmilk is literally "squirted" into the baby's mouth.  This is called the let down reflex and you might notice it as a slight aching that occurs within the first few minutes of the baby on the breast.

During breastfeeding the fat in the breastmilk clings to the sides of the milk ducts and is not released until the end of the feeding.  Babies who have short feedings are often getting lots of the skim breastmilk (called "foremilk") and not the fat rich milk at the end of the feeding (called "hindmilk").  Because of the lack of fat hunger returns quickly.

Your colicky  baby is actually getting lots of milk but the breastmilk does not have enough fat so she is not satisfied for very long.

The foremilk  your baby is receiving has a high concentration of lactose and can cause intestinal cramping.  Lactose is such a powerful stimulator of intestinal contractions that it is used in high concentrations for the treatment of adult constipation!  Is it any wonder that the breastfed baby who gets lots of lactose in her feedings has intestinal cramping and diarrhea stools?

As a breastfeeding mom what can I do to help my colicky baby?

Your main objective will be to make sure that your baby gets more of the fat rich hindmilk.  This reduces the concentration of the lactose and gives the baby the fat needed to create satiety.  In other words the baby will be satisfied for longer if she gets more fat at each meal.

• express milk before the feeding.  This starts the flow of milk and reduces the amount of foremilk that the baby receives.
• nurse only from one breast at each feeding. This makes sure that  the baby completely empties the one breast and gets all of the fat rich hindmilk that lingers in the milk ducts until the end of the feeding.
• sit your baby up.  This may require changing your usual position and using the "football hold" . In the football hold the baby is held by your side facing the breast that the baby will feed from.  If you are nursing on the right side, place the baby beside you, on your right side facing the right breast.  Your right arm should go around the baby , along her back and hold her at the back of the head.  You will need a soft pillow to create a little "seat" for the baby so that she is more upright than lying down.

If these measures do not alleviate infant colic then you could try eliminating cow's milk from your own diet.  There is lots of good anecdotal evidence to suggest that some infants show signs of improvement when mother eliminates dairy products.  However, try the other measures first as they are more likely to bring about the best benefits for you and your baby.

You can and should continue breastfeeding your colicky baby.  There is no reason to withhold the best possible source of infant nutrition from your baby if she has infant colic.  Now that you know what causes infant colic, a few simple changes in your breastfeeding technique can make all the difference.