Many mothers experience fussiness in their babies once in a while, and this is usually accepted as part of the trials of motherhood. However, some babies have “colic,” which is described as a healthy baby, who is gaining weight steadily, crying inconsolably for over 3 hours, for an incidence that happens more than 3 days a week, for over 3 weeks. The crying usually starts at around the same time every time and is usually in the evenings.
It doesn't matter whether you bottle feed or breast feed your baby--roughly one in every five babies experience colic. Colic starts at around 2 weeks and ends at around 4 months old. Some identifiers of colic are:
baby pulls up his legs while crying
baby's hands may be in a fist
baby is very gassy and his stomach is harder than normal.
The worst part about colic is that there is no proven treatment.
I was one of the "lucky" moms with both of my babies having colic, and at first I blamed myself. I thought I did something wrong and that my children were suffering because of what I did. I just did not understand how my children could be experiencing colic since I took care of myself during both pregnancies and during breastfeeding: I exercised, limited my caffeine intake, rarely consumed any dairy products (I have never liked cow’s milk), ate plenty of fruits, legumes and vegetables and ate organic as much as possible. Yet both of my babies experienced colic during their first four to five months of life, and even though my second daughter is having bouts less frequently, she still has periods of extreme fussiness. The change is that I now know how to treat and even sometimes prevent them.
Although no one really knows what causes "colic", everyone has their own theory. It really annoyed me when people would tell me I needed to stop eating my kale, cabbage, onions and spicy foods (being from Southern California, spicy Mexican foods have become a part of my heritage!) and that the colic would go away on its own. While studies show that some babies might indeed have an allergic reaction to certain food proteins that resist digestion in the small intestine and find its way into breast milk (usually typical allergens such as dairy, nuts or soy), I didn’t stop eating my kale and onions without looking into other possible problems and how to fix them. Here are some things to consider based on my studies and research:
Incorrect Latch Issues
A good latch is the key to easy breastfeeding! A lot of parents don’t realize that proper latch on the breast is absolutely necessary for a successful feed. This problem happens usually to newborns in the first few days after their mother’s milk has come in. If your baby is not latched on correctly, he could be swallowing a lot of air, thus making him gassy. Moms are also likely to have very painful nipples and even mastitis due to the improper latch. Latch is the easiest problem to solve if it is what causes your baby to have colic.
A proper latch is when the baby’s chin is pressed against mom’s breast and their nose is well away from the breast. I like to call the shape baby’s lips make a “fish’s tail”. Baby should also not be making loud sucking noises when he feeds. Contact a lactation consultant, your midwife or doctor if you have any concerns or issues with your baby latching on.
Overactive or Forceful Letdown (Milk Ejection Reflex)
With both of my daughters, I have had an overactive letdown; sometimes so much that I could feel the letdown coming quite painfully. With an overactive or forceful letdown, your milk comes down very forcefully, making it hard for your baby to swallow while breastfeeding. Baby may even gag and swallow a lot of air along with the milk. An overactive letdown can cause baby to be fussy at the breast. Baby may also become unhappy once the flow of milk starts to slow down.
When baby fills up on the watery foremilk, he may get a stomach ache from the combination of filling his stomach too fast, swallowing air to keep up with the let-down, and the laxative effect of a large quantity of lactose (milk sugar). The enzyme lactase, which digests the sugar, may not be able to handle so much milk sugar at one time and the baby will show symptoms of lactose intolerance—crying, gassiness, and explosive, watery, green poop. While people might that that having “too much” milk is a good thing, it can be very frustrating for both baby and mom.
Keep baby on one breast per feed. If your other breast is too uncomfortably full, pump just enough between feeds to relieve the fullness, but not so much that you overproduce milk (Remember that milk production is a supply-and-demand issue). Make sure that your baby drains that breast completely to get all of the fatty hind milk, even if you have more than one let down. With a forceful letdown, it is usually the first let down that is the most painful.
Find a position that keeps baby’s head above your breast, such as propping baby up in a “sitting” position with your arm supporting him, to prevent choking during the letdown. You can also try feeding your baby while lying down in a side-lying position.
My last suggestion is to take your baby off the breast when you feel a strong letdown coming. Catch the overflow of milk in a clean cloth, then place baby back on your breast once the letdown slows. This may or may not upset your baby more, so make sure you follow baby's signs cues.
Sensitivity to cow’s milk proteins
This is NOT lactose intolerance. Lactose intolerance is the inability to digest the sugar lactose found in milk, while Cow’s Milk Protein Intolerance (CMPI) is an immunological reaction. Babies who are sensitive to dairy in mom’s diet are sensitive to specific cow’s milk antibodies in the form of proteins (not lactose) which pass into the mother’s milk. Cow’s milk (either in the mother’s diet or added into formula) is a common source of food sensitivity in babies. If your baby is sensitive to dairy in your diet, it will not help to switch to lactose-free dairy products. The problem is the cow’s milk proteins, not the lactose.
CMPI can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea, bloody filaments found in stool, constipation, hives, and/or a stuffy, itchy nose1.
If your baby is only a little sensitive to dairy proteins, you may be able to relieve baby’s symptoms by eliminating only the obvious sources of dairy: milk, cream, yogurt, butter, cheese, sour cream, ice cream, cottage cheese. You may even be able to eat small amounts of dairy without it affecting baby.
If your baby is highly allergic, it will be necessary to eliminate all sources of dairy proteins, which requires a careful reading of food labels. Also, a large amount of babies allergic to cow’s milk proteins are also allergic to soy1,2 and some may even react to goat’s milk, sheep’s milk, and even beef.
Sources of Cow’s Milk Protein:
Beef, butter, butter fat, buttermilk, casein, cheese, cottage cheese, cream, ghee, half & half, kefir, lactoglobulin, lactose, all forms of milk (condensed, sweetened, whole fat, non fat, evaporated, skim, malted), nougat, pudding, sour cream, whey, whey proteins, yogurt.
**Also make sure to avoid deli meats since many of them do contain dairy products or may have been contaminated with dairy during the process.
Sources of Soy:
Edamame, soybeans, soy proteins, soy milk, soy bean oil, tofu, tempeh, soy sauce, tamari, soy flour, miso, soy lecithin, and soy isoflavones.
It can take up to 2-3 weeks for the proteins to completely exit the mother’s system1, but sometimes baby can show improvement within as little as a week2.
Once the trigger foods have been eliminated from your diet for some time, you can try slowly reintroducing dairy products. If baby still reacts, it is best to wait until baby is around 6 months old and his digestive system is stronger before reintroducing dairy into your diet3.
The main concern with a CMRI elimination diet is the fact that dairy is a major source of calcium for many breastfeeding mothers, and without dairy it may be difficult for them to maintain the 100 mg daily recommended dose.
However, it is possible to consume enough calcium without dairy. Here are some sources of non-dairy calcium:
Collards- 1 cup boiled and drained – 357 mg calcium
Rhubarb – 1 cup cooked– 348 mg calcium
Sardines – 3 oz / 85 grams – 325 mg calcium
Spinach – 1 cup boiled and drained – 291 mg calcium
Turnip Greens – 1 cup boiled and drained – 249 mg calcium
Blackeye peas – 1 cup cooked – 211 mg calcium
Kale – 1 cup boiled and drained – 179 mg calcium
Bok choy – 1 cup boiled and drained – 158 mg calcium
Beans, baked– 1 cup – 142 mg calcium
Okra – 1 cup boiled and drained – 136 mg calcium
Shrimp – 3 oz / 85 grams canned – 123 mg calcium
Crab – 1 cup canned – 123 mg calcium
If you are not sure that you are getting enough calcium through diet alone, consider a calcium supplement. If you do this, make sure that the supplement you choose is combined with magnesium in a 2:1 ratio so that your body will readily absorb it.
**Before starting any elimination diet, please consult a nutritionist or your doctor to ensure you will be getting enough nutrients and to make sure you will not be deficient.
"Dairy and Other Food Sensitivities in Breastfed Babies." Kelly Mom. 26 July, 2011. Web. Mar 2014.
"Cow's milk protein allergy through human milk." National Center for Biotechnology Information. March 19, 2012. Web. Mar 2014.
"Eating Like a Cow: Breastfeeding & Cow's Milk Protein Intolerance." Childhood 101. n.p. Web. Mar 2014.