Helen Borg is a senior midwife and infant feeding specialist who heads up the drop-in breastfeeding clinic at Mater Dei hospital. As mentioned in the series intro, Helen will cover common issues that can arise when feeding your newborn, giving professional advice and reassurance to help make your journey run smooth.
Q. My baby is irritable and seems uncomfortable with feeds, could it be colic, and how can I prevent it?
There are two conditions out there that could be causing the symptoms, there is colic and reflux. With colic you’ll find that many paediatricians don’t believe it exists, whereas some will attribute it to any irritable behaviour in babies. Ultimately it’s important that your paediatrician is able to observe the baby’s symptomatic behaviour.
Often when you take the baby to the paediatrician, he’s been in the car, he’s all relaxed, and goes in there all calm and quiet, so they can’t really see what you’re talking about. If you have a cranky baby at home, it’s good to film the behaviour on your phone and take that with you to show the doctor. You can see much more from watching a baby having an attack than from just being told, because there are certain movements that I would look for which would give me a clearer picture of what’s causing the discomfort.
With colicky babies, it can be that they’re drinking too much. They’re full, bloated, uncomfortable, just like adults get when we’ve overindulged. You can get this with babies who don’t have good positioning on the breast because they miss out on the fat-heavy milk and end up drinking the less-filling, lactosey milk, which ferments and makes them gassy.
These babies also poop a lot. It is uncomfortable for them, they are in pain, and the way they cry is designed to communicate this pain which can be very stressful for the mum. Often it is blamed on the mother not having enough milk and the baby being hungry, so then you try to feed him more and you start sticking bottles of formula on top, which may aggravate the situation even more.
The other condition is reflux, and the way the baby behaves with reflux is very different to a colicky baby. A reflux baby will tend to arch their back when they are having an episode and calm quickly when put in an upright position. They also cry a lot which is hard for the mums, especially if they have silent reflux where there is no spit-up, because the regurgitated milk stays in the food pipe and it burns. The baby is in pain and very cranky, mum is tired, but there is nothing there visually to give clues as to what’s happening.
Babies with reflux tend to want small feeds very frequently, so giving them big feeds infrequently is going to make everything much worse. In this case, mums have to learn that this is just the way their baby likes to feed and they should continue feeding him little and often as he prefers. I know bottle feeders who will have one ounce every hour because that’s the only way they can feed and remain comfortable, but at least they are growing because you are keeping the hunger at bay.
Positioning for sleeping can also help reflux. If you can elevate them slightly while lying on their back that come sometimes relieve them a bit. Baby slings keep the baby in an upright position, so those can also help. It’s a natural and comfortable position for babies to be in despite some of the misinformation that tells you otherwise. Trial and error, combined with positioning and professional advice should help parents get to the bottom of what’s causing the discomfort.
At the end of the day they are mini humans so the answers sometimes already lie within us. As grown ups we wouldn’t eat a huge meal and lie on our backs, so why would expect our babies to do the same? My advice for colic and reflux would be to film the baby, and keep seeking advice until you find someone who will listen and is prepared to take a few chances to try some treatment. It’s worth exploring.
If you find yourself struggling or feel you need additional advice, don’t hesitate to contact the breastfeeding clinic at Mater Dei hospital.
When it comes to spare equipment for new mums, the breastfeeding clinic relies on donations, so if you have any of the following that you no longer need, you can drop them off at the clinic where they will be gratefully received!
-Milk storage bags or containers