10. Colic

It can be very distressing if your baby has colic, and you are probably willing to give anything a go. However, before you cut anything out of your diet, it is important to know the facts. Sometimes improvements in your baby’s feeding position can make a real difference. Although feeding may not be enjoyable or relaxing, it should be reassuring to know that babies with colic generally take just as much milk as others and gain weight normally. There has been some suggestion that babies of vegetarians are more likely to have colic, but this hasn’t been tested specifically. It is speculation based on Dutch research which found that low vitamin B12 levels in early pregnancy were associated with more crying and colicky symptoms in babies. The media interpreted this to mean that eating steak in pregnancy leads to more contented babies.

What is colic?

Colic is thought to affect about one in five babies. It is characterised by periods of frantic crying at roughly the same time every day, typically early evening. A baby with colic may draw their knees up to their chest, pass wind and become red in the face. Colic generally appears in the first few weeks and disappears by the time a baby is three or four months old. If you are unsure whether your baby has colic, talk to your doctor to rule out other possible causes of distress.

Colic and cows’ milk

In some babies, colic may be the result of lactose intolerance or an allergy to cows’ milk. These may sound very similar, but they have quite different causes and should be treated differently.

Lactose intolerance

This is a sensitivity to the sugar (lactose) found in milk, including formula and breast milk. If a baby doesn’t produce enough of the enzyme lactase, he or she is unable to break down the lactose sugar in the small intestine. The lactose therefore passes into the large intestine, where it ferments, producing hydrogen and methane gases and discomfort. If your baby is receiving formula, your health visitor may suggest switching to a lactose-free formula. Breast milk contains lactose no matter what you eat, so cutting out milk and dairy foods from your diet won’t help: your body will still produce lactose for your milk. What you can do, however, is to give your baby lactase, for example Colief. This shouldn’t be given to your baby directly but added to a small amount of expressed milk. Your baby can then be given this mixture from a spoon or cup, before being put to the breast as normal for a feed. The problem is often called ‘transient lactose intolerance’ because babies usually grow out of it. Once your baby is three to four months old, he or she should be producing sufficient lactase, so you won’t need to supply it.

Cows’ milk allergy

This is an immunological response to the proteins that cows’ milk contains. These are found in most formula milks, as these are based on cows’ milk, and in breast milk if the mother consumes milk or any milk products. If your baby is receiving any formula, then switch to a hypoallergenic variety. The only way to ensure your baby does not receive any cows’ milk proteins from your breast milk is to remove all cows’ milk and milk products from your diet. Your doctor or health visitor should be able to advise you on how to do this and how and when to try reintroduction. Allergies to cows’ milk are rare and occur in only 0.5% of exclusively breastfed babies. Removing cows’ milk for a week should be sufficient to see if this is the real cause.

Other causes and cures

Both lactose intolerance and cows’ milk allergy are rare, and in most cases of colic the cause is unknown. Some research suggests that the baby’s immature digestive tract could have difficulty coping with milk; as a result, the baby suffers from cramps. Colic may also be due to babies swallowing air bubbles when they feed or cry. To help minimise this, try to sit your baby as upright as possible during feeding, rather than laying him or her on their back, and burp your baby well. The drug simeticone may also help; this is an anti-flatulent, which changes small bubbles of gas into larger bubbles that are easier to burp up. Simeticone has been used for years and is readily available from pharmacists, for example as Infacol. It may also help if you feed at one breast until your baby has definitely had enough. Switching before your baby has had sufficient of the high-fat hind milk may mean that he or she feeds more to compensate, resulting in a larger volume of milk to cope with and more lactose than he or she can handle comfortably.

If you think something in your diet is triggering colic, it may be worth cutting out a particular food for a week to see if it makes any difference. The foods most commonly suspected of causing or aggravating colic include:

  • tea and coffee;
  • alcohol;
  • cruciferous vegetables such as broccoli, cauliflower and cabbage: these may encourage the production of wind;
  • wheat and corn;
  • fish;
  • eggs;
  • onions;
  • chocolate;
  • citrus fruit. 

Knowledge about colic is continually developing, so it is best to talk to your GP, health visitor or a registered dietitian. Be careful about using alternative treatments, as some, such as dicyloverine and star anise, have been found to be potentially dangerous. Sometimes women find breastfeeding a colicky baby so stressful they wonder if they would be better off with a bottle. However, formula-fed babies are much more likely to get colic than those who are exclusively breastfed.

11. Looking after yourself

New mums sometimes forget how important their own well-being is, but it’s important to think about yourself as well as your baby. Eating well while you’re breastfeeding is just as important for your own health as for your baby’s. If your diet is less than ideal, you could suffer, even if your baby is fine. Research has shown that mothers can have signs of malnutrition, including bone demineralisation, B vitamin deficiencies and multiple infections, even when their baby appears to be healthy and has a normal or low-normal weight. So, by all means congratulate yourself if your baby is thriving, but remember this isn’t everything. On the plus side breastfeeding also gives you certain benefits. It reduces your risks of breast cancer, ovarian cancer and osteoporosis.

Eating well while you’re breastfeeding will boost your energy levels and could even help with postnatal depression. Although there is not much research into diet and postnatal depression, having a good intake of iron, zinc and vitamin B6 are thought to be important. In addition, intakes of DHA and EPA are thought to affect mental health. Several studies have looked at whether intakes of these long-chain omega 3s can prevent or treat postnatal depression, but the results are inconclusive, with only some studies finding a benefit. However, given the other potential benefits of omega 3s, it’s worth ensuring you have a good intake. Some herbal remedies that are believed to help improve mood, such as St John’s Wort, are not recommended, as they may not be safe for babies. If you’re not feeling yourself, then don’t suffer in silence, as there is plenty of help available .

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