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 .
