Four causes of colic
Article Published in The Natural Parent Magazine
Traditionally colic is thought to be something that newborns just have to live through, if you can call it living, and that there really is nothing parents can do but try to sooth the symptoms. It is largely said that the causes of colic are not really known and hey, it’s okay because your screaming, non-sleeping baby that feeds constantly, and won’t let you stand still for a minute will grow out of it by three months of age. So just dig deep and get on with it. It’s normal! Well guess what, it isn’t normal, there is something you can do about it and thankfully, we do now know the causes. What a relief!
The overall cause of colic is Digestive Overload - yes, it’s actually quite a logical explanation with no mysticism surrounding it at all. Digestive Overload, the causal label I prefer to use for colic, reflux, lactose and dairy ‘intolerance’, has four main physiological causes and because we are all born with the same fundamental human biology, the formula for healing these is largely similar for each newborn. However, while this is true, each case of Digestive Overload is slightly different as we all have our own DNA, which of course forms unique digestive sensitivities. This must remain an aspect to consider when we begin to heal these ‘colic’ behaviours:
- Intermittent irritability, grizzling, inconsolable crying, screaming.
- Bloating, cramps, excessive gas.
- Heightened communication around times of bowel motions from excessive wind or ‘sesame seed’ like deposits passing through the intestines.
- Frequent frothy and/or explosive bowel motions, constipation.
- Weight gains that are consistently at the upper regions or beyond recommended levels, or, as colic has been described by Morris Wessel, your baby will ‘look to otherwise be thriving.’
- Wakefulness from discomfort with episodes of longer periods of sleep, but the latter is often from exhaustion through crying and lack of sleep rather than because the newborn feels comfortable.
- Frequent searching for something to suck – exhibiting the ‘rooting reflex’ which can often be misunderstood as a hunger sign.
- Arching backwards or sideways, writhing, wriggling.
- Pedalling legs.
- Gulping their milk, seeming very hungry while being restless – sometimes refusing to feed, bopping or pulling of the nipple, or when bottle fed, having flailing arms and legs with much turning of the head caused by digestive discomfort.
- Hiccups – a newborn’s natural reflex for releasing ingested air. The more overloaded they are with wind, the more hiccups they experience.
- Blueness or darkness around the mouth, which will come and go. This can be visible above the top lip, under the bottom lip, or both simultaneously and can sometimes spread as far as the bridge of the nose between the eyes. This sign of wind is present for all newborns because all experience natural levels of ingested air with or without Digestive Overload, but this sign becomes more prominent as wind accumulates to overload levels.
The traditional definition for ‘colic’ that came about over 61 years ago now, and is often described as the ‘modern’ definition for colic, was from a man named Morris Wessel. He said a baby that had colic was, "an otherwise healthy baby who has outbursts of crying, irritability and fussiness lasting for more than three hours per day, more than three days per week for a period of three months". Some paediatricians still use this definition but after my years of research on the subject I propose a new, ‘modern’ version: ‘Colic is better described as Digestive Overload. Digestive Overload can happen at any time of the day and night but it is known to be more prevalent in the evening because of the daily cycle many parents fall into providing (known as ‘the common cycle of digestive overload.’) When the majority of behaviours listed happen every day, or every second or third day, the newborn is generally exhibiting Digestive Overload. This may be apparent from Day One but is more often seen when a newborn begins to ‘wake up’ to the world at around two to three weeks following the birth (unless born prematurely). However, Digestive Overload can occur for the first year and sometimes beyond. This depends on how overloaded the digestive system has been earlier in life, and how much overload and imbalance continues. The four main individual influences that contribute to Digestive Overload behaviour are as follows.
Unbalanced feeding practices
This cause encompasses quite a few factors, we will only look at two aspects here.
Feeding a baby beyond their physiological digestive capabilities
Currently it is widely taught that you cannot over fed a baby, but newborn biology and current research tells us otherwise. A recent article written by Joy Anderson, a counsellor for the Australian Breastfeeding Association, an International Board Certified Lactation Consultant and Nutritionist, reads, ‘Gas and fluid build-up cause tummy pain and the baby 'acts hungry' (wants to suck, is unsettled, draws up his legs, screams). Sucking is the best comfort he knows and also helps move the gas along the bowel. This tends to ease the pain temporarily and may result in wind and stool being passed. Since the baby indicates that he wants to suck at the breast, his mother, logically, feeds him again. Sometimes it is the only way to comfort him. Unfortunately another large feed on top of the earlier one hurries the system further and results in more gas and fluid accumulation. The milk seems almost literally to 'go in one end and out the other'." Names for this kind of feeding include cluster feeding, demand feeding, cue lead feeding and bunch feeding, with all of these being one of the biggest causes of symptoms labelled as colic.
Another set of findings from a study on the ‘Development of bowel habit in preterm infants’ also suggests that the more feeds a newborn has, the more stools they have, this is also obvious throughout my years of working with newborns. The study says that, “frequent milk feeds override the intrinsic, fasting, motor activity of the colon, and induce regular defecation at a frequency determined directly by the volume of the products of digestion that reach the rectum.” In other words, when a newborn is fed too often the sheer volume pushes the food through to the duodenum and onto the large bowel, all before the stomach enzymes and acid have processed the milk fully. This places unnecessary pressure on many physiological components and has the baby’s body struggling with unnatural processes. It is this pressure that contributes to communicated discomfort and the possible diagnosis of ‘colic’ as the duodenum, colon and large bowel try to cope.
Feeding newborns beyond their stomach capacity
It often surprises people when they learn how big a baby’s stomach is at different ages. According to La Leche League International, at days one and two a baby born at around 40 weeks has the stomach size of a marble. By day three the stomach expands to the size of a ping-pong ball and around day ten it has grown to the size of a large chicken egg. This is where it remains for the next few months, slowly growing to infant size, which is where the surprise happens. Did you know that at one year of age an infant’s stomach is the size of their two fists combined, so around 150mls or 5oz? Unfortunately too many newborns consume this amount, close to it, or well beyond it well before this age thus creating the behaviours of Digestive Overload. If you look on the formula tins, manufacturers say a newborn should be having 250mls by six months! Add to this the amount of solids most parents are taught to offer and we have newborns that are obese for their age, unsettled, perhaps living in a sleep deprived state thus feeling mentally and physically imbalanced. Incidentally, an adult’s stomach is the size of a softball – around 250mls.
Retained air (wind)
Wind is part of our biological make-up and it naturally forms in a baby's stomach through the processes of feeding and swallowing. Achieving optimum burping that is conducive to a newborn’s age, and well above one or two burps per feed, helps to maintain digestive balance. When enough air isn’t released from the stomach via the mouth, the accumulation is left to pass through the intestine and bowel, causing some of the listed behaviours of Digestive Overload like pedalling legs, arching backwards and frothy bowel motions to name a few. Learning how to burp a baby properly can have a vast positive effect to their mental and physical health.
Tongue and lip tie
This occurs when the muscle around the tongue, called the frenulum, is attached in such a way to inhibit fluid movement for sucking. This can cause serious feeding and digestive problems with newborns like potentially stimulating less milk than required and swallowing larger amounts of air when they feed from the breast or bottle. Generally, tongue tie can be remedied by having the frenulum snipped or by laser treatment. If you would like help diagnosing this for your child then I can am qualified to do this via a consultation.
Newborns not swallowing their natural requirement of saliva enzymes
Saliva is one of the first digestive instruments for all human beings and research shows that many of the lingual enzymes are a newborn’s natural digestive medicine. They play a significant role in lessening Digestive Overload, and it is now thought that this may be the reason newborns spend a lot of time sucking their thumb in the womb. When born it is up to us to continue this biological requirement for them, which is often replaced with the uncomfortable frequent feeding cycle earlier expressed by Joy Anderson, instead of offering healthy, frequent sucking away from food. Learning how to use a pacifier as a tool, rather than a plug in for peace, can be so helpful for reducing discomfort.
Last Updated: 11 May 2016