Colic and Reflux in Babies – How to Treat and Diagnose

Summary:

Colic and Infant Acid Reflux are common conditions that affect babies from 1/2 month to 6 months old. The symptoms of each can look similar, but the causes and treatment options of each differ.

It is gut wrenching to see your baby spit up or hear your baby shriek. And worse when you don’t know how to help him. Our goal is to provide you with all the information you need to self-diagnose and sooth your distressed baby. 

Table of Contents: 

  • Basic definitions of reflux and colic
  • Why do each conditions occur?
  • How to diagnose each and tell them apart?
  • How to treat both ailments?

What are the differences between colic and reflux?

Infant Acid Reflux and Colic are both common ailments, each affecting at least 20% of all babies. 

Colic can be defined as, “a severe spasmodic abdominal pain”, “waves of pain associated with dissension of the bowel due to digestive gas”, and “excessive crying in infancy with no known cause”. Affecting one of every five babies, 2 weeks to 6 months of age. With the highest proportion of cases affecting babies 2 months of age.

Reflux is easier to define and visualize than colic. Reflux is defined as, “movement of fluid, food, and acid from the stomach into the esophagus”, or “the backwards flow of stomach contents – food and gastric acid – into the esophagus and throat”.

*gastric acid is always present in the stomach, but should never be found in the esophagus, throat, or nasal passage where it can burn soft tissue, causing pain.

Reflux is more common that colic. More than 1/2 of all babies experience various degrees of reflux symptoms. Reflux can begin within one week of life. And most babies stop showing reflux symptoms by 6 months of age.


Why does colic and reflux occur? (It’s not the same reason)

The cause behind colic is only theorized. Medical experts suggest the condition is caused by internal bacteria in the gut. Scholars claim the cause is due to sensitivity of a non-mature stomach, or physical strain of muscular tissue. 

Certain foods may trigger colic. Food allergies can induce colic-like symptoms.

If baby is fed mother’s breastmilk, mom’s diet can have an impact on how baby feels. The baby could be consuming more lactose – sugars in milk – than he can tolerate, which causes gas and pain.

“Gassy” foods, such as beans, brussels sprouts, onions, garlic, and broccoli – “belly bloat” foods – can have a negative impact on your baby’s digestive process. Mothers can test whether a certain food is affecting their baby by cutting that food out of her diet temporarily. 

There is no link between how a baby is fed – bottle fed formula or breastfed milk – and whether he suffers from colic or not.

Identifying the causes of reflux are just as easy as defining what reflux is. All degrees of reflux are due to an overabundance of gas and feeding imbalances.

Consuming relatively large volumes of milk or formula with little to no burping during or after feedings is a sure way to stimulate episodes of acid reflux. Feedings babies in a horizontal position – laying down, cradled in arms – prevents gas from slowly and continuously migrating out of the stomach. Instead large bubbles accumulate, often carrying liquid, that forcefully leave the throat.

Babies are also often born with underdeveloped muscular systems. 

Infant Acid Reflux
Acid Reflux

Newborn’s lower esophageal sphincter, the “last barrier” to reflux – the ring of muscle meant to isolate the stomach from esophagus – is rarely fully developed. The lower esophageal sphincter is meant to only open while swallowing, but will allow acidic stomach contents to leave the stomach when it misbehaves. To make things worse, babies can be born with a short esophagus, reducing the distance stomach bile has to travel before reaching the baby’s throat. 

*Another example of under-development is a heart murmur – “whooshing” sound heard by a stethoscope due to holes in the heart that have not been sealed by birth (sounds much worse that it is – heart murmurs are very common and usually heart murmurs go away after a week)

Another condition worth mentioning before moving on to the next section, silent reflux. Silent reflux is very similar to infant acid reflux, the difference being that the stomach contents never enter the throat. To an untrained eye, this can be mistaken as colic since no spitting up takes place.

If other symptoms also exist, such as diarrhea or skin rash, and the baby is on breastmilk, the baby could have a dairy allergy. When mom consumes dairy it trickles down to her breastmilk. Mom can test this by not eating dairy for a few days to see if baby’s reflux symptoms improve. If a negative condition exists and the baby is on formula, consider a prescription formula. Several brands are available that are easier to digest than others. 


Symptoms – How to diagnose why your baby is upset

When our little ones are crying and upset, it hurts us when we don’t know how to help them. It is a helpless feeling not knowing how to help. Our goal is to give you the information you need to ask your doctor the right questions.

Fortunately spotting the symptoms of colic is easier than identifying its causes! Colic often displays as frequent bouts of inconsolable crying. Sounds terrible, but don’t fret. There are ways to prevent colic before symptoms appear.

Symptoms of Colic include:

  • Rule of Three – high pitched screaming and crying that lasts for 3 hours per day for 3 days per week. 
  • These screaming fits are normally predictable, occurring around the same time each day.
  • Baby will draw knees towards chest (it is theorized this is to relieve abdominal cramping)
  • Abdominal pain
  • Excessive gas
  • Infrequent pooping
  • Distention (like having a bloated tummy; increased internal pressure, which causes discomfort)

If your baby shows non-colic symptoms such as fever, rash, diarrhea, lingering cough, vomiting, or blood and/or mucus in the poop, something besides colic is probably affecting him and you should consult your pediatrician. He could be dealing with a lactose intolerance or GERD.

Symptoms of Reflux include:

  • Spitting up milk/formula during and after feeding
  • Coughing during feeding
  • Turning away from the breast/bottle during feeding
  • Irritability during feeding
  • Slow weight gain (GERD)

Symptoms of Silent Reflux include:

  • Gagging
  • Sleep Apnea – trouble breathing while sleeping
  • Excess mucus
  • White coated tongue
  • Apprehension towards feeding
  • “Early Teether” label

Remedies – How to treat Colic and Reflux

Your goal should be to provide long periods of deep sleep to your baby, which is critical for early-stage development. Health professionals agree, a baby’s digestive system is immature and can struggle with the digestive process. Combined with a lack of burping, baby can experience pain and discomfort. Fortunately there are ways to help reduce the symptoms or prevent reflux and colic.

Colic Remedies:

A combination of regular winding (burping), conservative feeding practices, and head elevation are the best preventative treatments for colic. 

Reflux Colic Gas

Winding babies regularly keeps belly pressure low which helps to alleviate pain and discomfort. In other words, burping babies helps to reduce symptoms of colic. Periodic winding – every three hours – throughout the day and immediately after feedings will help prevent the buildup of excess digestive gas and belly pressure. 

Try the following approach when implementing a conservative feeding approach.

  • Don’t let your baby overeat.
  • Limit the amount of ounces you feed your baby per feeding and try your best to feed your baby every three hours.

Use your judgement on how much you should give your baby each feeding. If you need help, start with the total amount he eats per day then divide by 8 feedings per day (or one feeding every 3 hours). Overfeeding colicky infants in effort to comfort them can increase instances of reflux.


Tip: when warming up bottles of milk or formula, always stir or swirl, never shake. Shaking milk or formula can introduce air bubbles that your baby consumes. This helps to prevent the accumulation of air bubbles and digestive gas in your baby’s belly.


Elevation of the head and chest can help reduce symptoms of colic.

Gas bubbles are buoyant and want to migrate upwards, out from the baby’s stomach and into the throat and mouth. When a baby is lying in a horizontal position, digestive gas bubbles migrate to the top of the stomach and gets trapped. When the baby’s head and chest is on an incline, higher than the stomach, gas bubbles take the natural path upwards and are gently and continuously dispelled by burping.

After understanding this, parents tend to incorporate a subtle sleep incline even if used only as a precaution.

A common product used to help provide this inclination is a baby wedge pillow. Cher Bébé specializes in the design and production of wedge pillows. Offering two main types: crib wedges and bassinet wedges. It is important to use the correct type to ensure a proper fit with your baby’s sleep surface. 

bassinet wedge
Bassinet Wedge

Reflux Remedies:

Feeding your baby in an upright position and maintaining this position for as long as possible after feeding is the best way to prevent reflux. 

If you need to lay your baby down soon after feeding, place them on an inclined sleep surface if possible.

Baby Crib Wedge
Crib Wedge

Our youngest boy, 4 months, has been sleeping with a bassinet wedge under his mattress pad since one week of age. Our oldest boy, 21 months, had a crib wedge under his crib mattress until recently – as he has become more daring, the three extra inches of crib wedge gave him enough of a boost to almost climb out of his crib! 

If bottle feeding, focus on the bottle’s nipple – the nipple should never point down with the baby’s mouth facing the ceiling. Aim to keep the nipple horizontal or tilted slightly upwards if there is enough milk in the bottle to do so.

Feed your baby slowly, giving them one to two ounces prior to a burp-break. Give your baby’s tiny digestive system time to handle the milk. Even if your baby wants to eat faster, slow them down. Remember smaller, but more frequent feedings is the way to go.

If your baby suffers from severe reflux symptoms and is struggling to gain weight you should schedule an appointment with your baby’s pediatrician. Your baby could be suffering from GERD, or gastro-esophageal reflux disease. An anti-acid, like losec omeprazole may be prescribed. This medicine lowers acidity production in the stomach.

Conclusion:

Cher Bébé is here to help. We hope that this blog post has helped you to understand what colic and reflux are, why they occur, how to diagnose each, and the remedies for both conditions. Remember, both are temporary. You and your baby will get past this difficult stage of development.

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