Colic, Reflux, and High Needs Baby

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TIPS

Music/Sound: Traditional lullabies, classical music composed for infants, and heartbeat/womb sounds are very popular external remedies that relax many babies suffering from colic/reflux. Slumber Sounds, www.slumbersounds.com, has terrific options. Some parents have had great success by placing baby in a car seat on top of running dishwasher, washing machine, or dryer, or near running vacuum cleaner. A gentle shushing sound in baby’s ear can work magic, as can soft whispers and humming and singing.

Diet: Bottle-fed babies with colic may show improvement if switched to a different formula, such as soy. Mothers of breastfed babies may have to pay close attention to their own diet to make sure that baby is not having negative reactions to certain foods.

Gripe Water & Probiotics: Be sure to check the ingredients before buying a gripe water. Many claim to be natural but include artificial ingredients and preservatives. A colicky infant’s digestive systems does not need these potential irritants. There is a very effective and safe gripe water on the market called Colic Calm Gripe Water, which you can purchase online at www.coliccalm.com. It has the highest success rate on the market. Also, try using a probiotic. There is good research which shows that the right probiotic can reduce gassiness. A probiotic that practitioners recommend for babies is HLC Neonate Powder by Pharmax (purchase from Amazon).

Warm Aromatherapy Bath/Massage: Add a few drops of lavender to a warm bath and follow with the soothing touch of massage. Focus massage on the tummy area to relieve painful trapped gas. Research baby massage techniques online or read a book on the subject. A good one to try is The Practical Art of Baby Massage by Peter Walker (www.amazon.com). You can buy lavender, chamomile and fennel massage oils specifically designed for baby massage.

Swaddling: Babies are often soothed when swaddled or held close to a parent’s chest and heartbeat, or when swaddled and put to sleep in an upright position. Swaddling at the heart/midline is the preferred soothing position for babies.

Motion: Walking, rocking, and movement are very comforting to most babies. The good old rocking chair may be all it takes, or you can use an exercise ball for bouncing. Some parents have been known to push a stroller or drive around in car until baby falls asleep. Try putting baby in an infant chest carrier or sling so that your hands can be free. For colic, walk with baby facing down, across arm, with hand under the abdomen, while applying gentle pressure. This position is often referred to as the “colic hold”. For reflux, walk with baby in upright position, up over shoulder, or facing out with babies back against your chest, or in a Baby Bjorn carrier. Many babies like to be outdoors. Almost all babies love swings. Try a combination of the above to see what helps soothe baby the best.

Position: For keeping baby upright after feeding, use a Bjorn, bouncy chair, or your arms. Most importantly, when feeding at breast try to feed baby upright, by “The Monkey Hold Position”, or elevated with pillows, rather than feeding baby flat on back on a breast-feeding pillow or Boppy. When using a bottle, hold baby more upright, leaning up against a pillow, to help keep food down.

Medication: If you baby needs medication for reflux, you will want to know why the medications are being prescribed and their possible side effects.

Histamine H2-receptor antagonists (H2-Blockers)

  • Generic (Brand) Names: Cimetidine (Tagamet), Ranitidine (Zantac).

  • What they do: Reduce the amount of acid the stomach produces.

  • How they work: The chemical histamine causes certain cells of the stomach to produce acid by attaching to places on the cells called H2 receptor sites. H2-receptor antagonists attach to the H2 receptors and block the histamine from attaching to the receptors. This inhibits the productions of acid.

  • Side Effects: Headache, dizziness, malaise.

Proton Pump Inhibitors (PPIs)

  • Generic (Brand) Names: Omeprazole (Prilosec), Lansoprazole (Prevacid).

  • What the do: Reduce the amount of acid the stomach produces.

  • How they work: The cells of the stomach contain pumps that produce acid to aid in digestion. PPIs inhibit the production of acid from these pumps, reducing the amount of acid in the stomach.

  • Side Effects: Reported to be uncommon but can include allergic reaction, headache, stomach pain, and diarrhea.

Prokinetic Agents

  • Generic (Brand) Names: Metoclopramide (Reglan).

  • What they do: Keep the contents of the stomach from reaching the esophagus, reduce the amount of acid in the stomach.

  • How they work: Prokinetic agents make the valve between the stomach and the esophagus shut tighter. They also make the contents of the stomach empty quicker.

  • Side Effects: Reported in over 30% of patients. Include: nausea, diarrhea, nervous system side effects, drowsiness, restlessness, dystonic reaction. Can have interactions with other medications.

Parent support: Most babies are through the worst of their reflux by 4 months of age. Peak fussiness is between 6 and 12 weeks, so be patient, and remember that baby will get better. It might be helpful to hire a mother’s helper, nanny or doula to come over a few days a week to help with baby and give you a break! Or ask friends and family if they would be willing to help comfort baby, even for a few hours a week, so you can get a break. There are parent support groups as well as moms’ groups. Do your best to get out of the house every day, even for a short walk. Remember, you may have to make some allowances like holding baby more and putting baby to sleep in a swing in order to facilitate baby feeling and sleeping better, and you getting more sleep as well!

Dark and quiet sleep environment: Research is now showing us that some of these babies have a less mature regulatory system and need more of our help to settle, soothe and go to sleep. Darken up the room where baby is sleeping (very dark), use a sound machine, and be sure to swaddle baby for all sleep.

Introducing Solids

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  • Try to have a predictable routine associated with the beginning and ending of meal times.

  • Introduce changes in food texture slowly. Offer sippy cup of water often to aid in chewing and swallowing.

  • Children are much better at starting new foods or new textures when eating finger foods as opposed to being fed.

  • Avoid foods that have a safety risk, such as nuts, raw carrots, popcorn, and slices of hotdogs.

  • Introduce easily crunchable foods that do not require a lot of chewing, such as Cheerios and cheese curls.

  • Remember, the face is the most sensitive area of the body, so touching in or around the mouth can be over-stimulating to the child.

  • Minimize cleaning around the mouth during feeding if your child reacts strongly to it. When you must wipe, pat instead.

  • Give the child time to close the mouth on the spoon and remove food rather than scraping food off on the upper lip or teeth.

  • Limit meal times to 20–30 minutes. If your child shows signs of being finished, usually by pushing the spoon away or throwing food, offer food 1–2 more times, then end the meal.

  • Avoid power struggles with your child during meals.

  • Offer one food at a time, placing in front of your child and giving your child time to become interested in the food.

  • Serve yourself and enjoy a meal with your child! This helps your child to experience food/meal time as a social time.

  • Only offer two choices if you are asking your child what they would like to eat for a meal.

Self-Soothing Signs

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Is your baby showing at least four of these signs? If so, they may be ready to sleep train.

  1. Putting their fingers and hands to their mouth

  2. Bringing hands to their midline like they were inside the womb

  3. Rubbing their face into you; your stomach, the crook of your armpit, your shoulder, trying to “get to” a dark place

  4. Rolling to their side or tummy

  5. Grunting and fussing

  6. Rubbing a lovey around their face or head or pulling on their hair or ears

  7. Yawning, eyes and the area around the eyes turning red.