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10.25.2010

The Truth about Colic


I have had a whirlwind few weeks and have hardly touched my computer. My brain is still full of topics pertaining to kids and the like, though. I have a few posts in the works (a two part series on breastfeeding, for one...) and loads of ideas. Here's a quick one.

One that came up in conversation over the past few weeks was MSPI. Don't worry, even I didn't know what that was at first. It stands for milk soy protein intolerance. I have known so many mothers whose newborns either had colic, reflux, digestive, or skin issues in the first few months (including both of my kids) and in all the cases where the breastfeeding mother eliminated dairy and soy from their diet the issues cleared up almost immediately. I knew about this, I just didn't know it had a name (MSPI). Then I was talking about colic with my nurse-in-training sister (about how it's often mistakenly thought to be caused by gas) and she mentioned that most colicy babies turn out to have MSPI. It's one of those things I wish I had known more about before I had kids.

Colic is defined as excessive crying (3 hours or more per day for 3 or more days per week for at least three weeks... a little too specific for me, but that's how some doctor dude in the 50's decided it should be defined) when the baby is otherwise well fed, comfortable, and healthy. Often the crying happens at the same time each day, usually between 4pm and 10pm. Don't worry about meeting the criteria exactly. You know if your baby is colicy.

First of all, let me say again that colic is not caused by gas. All babies have gas, and unless there is some underlying OTHER problem the gas doesn't cause them discomfort. No one is 100% sure exactly what causes it, though. Two of the most likely theories are MSPI and "the fourth trimester."

MSPI is just the inability of the baby to tolerate soy or milk proteins. If your baby is on formula, you may have a hard time because there are no formula options that don't have either milk or soy protein. Lactose free formula isn't likely to help because only the milk sugar is removed, not the protein. However, if you're breastfeeding all you have to do is avoid all soy and dairy. This is easy if you follow a whole food diet, but if you eat anything processed be sure to check labels vigilantly- soy especially is in just about everything.

ETA: I didn't realize that there are hypoallergenic formulas available as well. Also, here's a little more info on MSPI. It's not technically a food allergy, and the more I read about it the more I realize that my kids likely had MSPI and not a true food allergy, although Oliver may have had MSPI AND a wheat allergy.

The "fourth trimester" is a theory developed by the esteemed Dr. Harvey Karp, pediatrician and author of the best baby book ever, The Happiest Baby on the Block. He theorizes that, because of our larger brains, human gestation had to be shortened through evolution else we risk baby's head becoming too big for healthy birth. But because of this change the baby isn't quite ready to be out in the world and suffers from over-stimulation easily for the first three months after birth (the fourth trimester). Sounds a little nutty, I know, but when you're in the throes of colic with a six week old and you try some of his recommendations and they WORK IMMEDIATELY you loose all skepticism. Read the book- it's invaluable, but as a preview, he recommends the following: create a womb-like atmosphere with the 5 S's- Swing, Swaddle, Shhhhh, Side, and Suck. Swing involves any side to side or up and down motion, like bouncing. It's supposed to be enough to activate the balance mechanism in the inner ear (so not gentle rocking). Swaddling is invaluable and the nurses in the hospital should have shown you how. If not, I believe there is a video on YouTube demonstrating how (and there is an illustration in the book). Swaddling should be tight and secure. If you haven't been swaddling from day one your baby will probably cry when you first try it. But it will pay off- baby will sooth easier and sleep better and longer. I swaddled Izzy until she was four months old and Oliver until after he was six months. It's helpful to wean them off of it (allowing one arm out at first) between four and six months. Shhh at it's most basic is making the "shhhh" sound near the baby's ear. But it can mean any white noise. I used to hold Izzy near the exhaust fan above my stove. Blow dryers and vacuum cleaners also work well. Side means hold baby on his side or tummy (while holding, don't lay him down to sleep like that!). While flat on their backs babies often will trigger their startle reflex, which will make them upset. When on their tummy or side, though this reflex isn't triggered. And we all know how much sucking helps babies. Sucking actually releases dopamine in a baby's brain, like eating chocolate does for us adults. The need for this varies, but all babies have the need to suck, often beyond the sucking they need to do to eat. Hello pacifier:) Often moms, especially the rock star moms who are breastfeeding, will just allow baby to eat and eat and eat. Yes, for the first six weeks while BFing you want to let baby eat on demand as long as he/she wants. But if you're in the midst of colic overeating can cause discomfort and excessive spitting up (which just adds to the misery). My midwife taught me a neat trick to help with this (because a baby can't just say "hey, I'm full, but I still need to suck- wanna help me out?"). She said that when a baby is hungry he will clench his fist, but once he's full his hand will relax. Oliver used to projectile vomit massive amounts after feeding. After I started watching his hand and stopping his feedings just after he relaxed his hand he was still satisfied and his spitting up decreased dramatically.

How in the heck do I get so off topic? Anyway, that's the skinny on colic. They should seriously hand this info out at the hospital because colic is at the top of the list of most trying, demanding, frustrating parts of babydom, and the remedies are such simple things.

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