

Feeding Problems in the Early Years of Life
When you’re a new mom or dad, it can be a huge challenge to parent a baby who’s always cranky. Friends may say your baby is “colicky” or suffer from “reflux” What’s going on and how can you make it through this? COLIC Colic is common, poorly understood & frustrating feeding problem and cause considerable stress for parents & health professionals. Colic is the word derived from the Greek word meaning ‘colon’ and it implies that the baby cries because of stomach pain. Colic affects 10-40% of all babies. It is present equally in boys and girls and equally in both breastfed as well as formula fed babies. Crying seem inconsolably for hours at a time for no apparent reason and tends to occur in the late afternoon and early evening. Symptoms appear typically around 2 weeks of age, lasts until 4 months of age Symptoms usually peaks at 6 weeks of age Spontaneous resolution by 3-6 months of age (3 months: 60% of babies, 4 months in 90% of babies) Starts in premature babies 2 weeks after the due date Higher incidence in C-section babies Characteristics Inconsolable crying – for hours at a time, fussing & irritability in otherwise healthy baby Cry longer and louder for at least 3 days of the week and last about a minimum of 3 hours a day Present with excessive & persistent crying Difficult to comfort Screaming Drawing up of the legs/knees after feeds Tension of the body Fist clenching Arching of the back Flushing of the face Cause: Nobody really knows and the cause of colic remains a very controversial subject. What we do know is that it is related to an immature digestive system. Researchers have been trying to find out why babies cry for no apparent reason and some of the explanations include: Pain caused by build up of wind in the baby’s stomach. This may happen if they Overfeeding – swallow air when they cry, feed or suck. An intolerance to lactose A cows’ milk protein allergy/intolerance Imbalance in intestinal microflora (good and bad bacteria) Maternal smoking Whatever the reason, the most important thing to remember is that the crying is not anybody’s fault. You could be the most attentive, sensitive parent in the world and still have a colicky baby. You can be assured that colic usually resolve by itself within 4 months. Is there anything I can do to help my baby? There are many different things you can try to soothe your baby’s crying and discomfort. Every baby is different and respond differently to treatment, so if it doesn’t work today it may work tomorrow. 1. Keep a diary of your baby’s behaviour. Record your baby’s activities, sleeping, eating, crying, fussing for at least 4-7 days in a row. This will give you a good impression of your baby’s behaviour and possible triggers. 2. Positioning Hold your baby to your chest in the upright position or gently rock him in your arms. The closeness and body warmth will be comforting and soothing. 3. Getting rid of the wind When babies cry they gulp air which can make them windy. Try burping him by supporting his tummy against your shoulder and help dislodge any trapped wind. Massaging the tummy in a circular motion or a warm bath also help to relieve discomfort. 4. Making-up feeds Be careful when making feeds up, don’t shake the bottle to vigorously as this trap air bubbles. Ensure that the bottle is not in a horizontal position during feeding because it could cause your baby to swallow air. 5. Teat size An anti-colic teat or slow flow teat/bottle is a useful option to try. 6. Type of milk Breastfeeding: If a baby is breastfed, correct latching to the breast is important to prevent swallowing air bubbles. Make sure that a breast is emptied before moving onto the next breast, since the hind milk contains much less lactose than the fore-milk and by swopping breasts to quickly your baby will end up filling themselves with fore-milk which could worsen the colic. Eating rich or spicy foods, dairy products or gas forming foods have all been associated with possible reactions in babies. If you think your baby’s crying is linked to something you’re eating a dietitian would be able to assist you with an elimination diet in order to identify the possible culprit foods as well as on a suitable vitamin/ mineral supplement to avoid any nutritional deficiencies. Formula feeding: If your baby is unable to digest lactose (milk sugar) in a formula or is intolerant to cows’ milk protein then it may be beneficial to change their milk formula either to an lactose-free formula or an extensively hydrolysed infant formula. Your dietitian would be able to advise you on the most suitable formula. 7. Frequency of feeds It could benefit your baby by reducing the volume of feeds and increasing the frequency of feeding to help ease digestion.E.g. instead of having 6 feeds of 150ml at a time change it to 8 feeds of 115ml at a time. 8. Probiotics There is a possibility that the colic symptoms could be due to an imbalance between the friendly bacteria and the unfriendly bacteria in your babies’ digestive system. Thus by supplementing the so-called friendly bacteria it may help to restore the imbalance and resolve their symptoms. 9. Digestive enzymes Enzymes can be given before feeds to help with digestion. If your baby is unable to digest lactose their body most probably lack the enzyme lactase that usually digest lactose. A failure to break down lactose by enzymes causes the milk sugar (lactose) to end up in the large intestine where it starts to ferment and produces gas, eventually leads to discomfort and some cases diarrhoea. REFLUX AND REGURGITATION It is estimated that 15-30% of normal babies experience problems with mild to moderate regurgitation (spitting-up) and gastro-oesophageal reflux. It is not common immediately after birth, but normally appears within or during the first week