305 – Colic and Reflux

Season Three Introduction 0:00

Hi, welcome to season three of the baby manual podcast, the holistic mama's handbook. This season will go through alternative and supportive care to help you take care of your little one when they're sick, but too young to take most medicines. I'm your host, a pediatrician and mom, and the author of The Baby Manual and The Holistic Mama's Handbook, Dr. Carol Keim. Hello, welcome to this week's episode of the Baby Manual Podcast. I am super excited for this one. It's all about colic and reflux. And the reason I'm so excited is that we get asked these questions a lot in the office.

A lot of babies suffer from coli and reflex. Unfortunately, there's not a whole lot we can do from a Western standpoint, and we usually don't have time to go through all of these supportive and alternative things you can to help. This is going to be really great. I'll just jump right in. So, colic. Colic is defined by the rule of threes, which means that a baby who has true colics is one who cries for three hours per day,

Understanding Colic 0:55

three days per week, for 3 weeks. But a lot of babies will have symptoms of colick without being diagnosed with full-on coli, and all of these things should help. Colic peaks around four to six weeks of age, so if your baby's around a month old, you're probably struggling with something like this right now, and it can be really frustrating for parents. So from a Western standpoint, first of all, what we recommend is burping your baby often. Sometimes colic we think is related to gas in the intestines.

Nobody really knows what causes coli, but we thing it has to do with a little bit of that and a bit discomfort because of gas. So if you burp your babies about every five minutes while they're breastfeeding or after each ounce of bottle feeding, that can help to get some of the extra air out so it doesn't go into their intestines We can also try tummy time. When babies are on their tummies, that little bit of pressure can help to aid with digestion. Remember with tummy-time, what you're gonna do is have your baby either on your chest while you are leaning back, or you can put them on a blanket on the floor.

And you gonna be watching them very closely during tummy times. It should last about 15 minutes, once or twice per day. Bicycle legs can also help. You can just lay your baby on their back, either on your lap or on the floor, and pedal their legs like they're riding a bicycle. Or you can do up and downs with the legs, where you tuck their knees up to their chest and then pull their leg down straight again. And do a couple of those in a row. Belly massage can help to move some gas around. you want to go in clockwise direction because that's the same direction as their digestion goes naturally.

Or if they're on their tummy during tummy time, you can rub their back. You can either rub straight down their bag or rub in a counterclockwise direction to go, again, with the direction of digestion.

Western Remedies for Colic 2:50

There are two medicines that might help with colic. The first one is probiotics. And actually, I don't know that that's not really a medicine. It's more of a supplement. But probiotic are good bacteria that help us digest foods, and they're the only thing that have been shown in Western studies to actually help Pretty much all probiotics are good. The only ones that are FDA regulated recommended in this age group is one called culturel, which is lactobacillus acidophilus. You can add that, it's a powder, you can it into your baby's breast milk or formula if they're having it in a bottle, or just sprinkle it onto their mouth.

It's not flavored. and that can help them, but also you can get probiotic drops. And I actually really like to do some probiotics that have multiple strains of bacteria in them. So if you could find one that has a few different types of bacterial in it, especially ones that are refrigerated, those tend to be really good ones for babies. The other medicine that we sometimes recommend is simethicone. Now, simethicone is just a medicine which breaks up gas bubbles in the intestines. It's not absorbed at all.

And it takes a very long time to work. So, if you think of medicines like acetaminophen or ibuprofen, they work by being absorbed into the bloodstream and they take about 20 minutes to kick in. With simethicone, because it's just acting physically on the gas bubbles that are in the intestines, it takes a couple of hours to start working. And it is super safe because its not absorbed, the babies can't really overdose on it, so it can be given up to 12 times per day. So what I recommend with simethicone if you're going to use it for colic and also for gas it helps too, you should give it at least four times in a row right before your baby eats.

The semethicone, it's marketed in the US as baby gas drops. And it comes with a little dropper with the measuring thing on the droper itself. and the bottle will tell you how much to give based on their age. You just put that little drop or into their mouth right, before they eat for four meals in row to decide if it is working. If it still isn't helping at that point, then it probably not going to help. But if you just give it once or twice a day, it's definitely not going to help. It won't really do anything.

So from an acupuncture standpoint, both acupuncture and Chinese herbs can help with symptoms of colic. So if you check with your pediatric acipuncturist, they should be able to help out and give you some recommendations. Remember, acu-puncure in babies is called shone shin, and it doesn't involve needles. It just involves pressing or tapping on points with special tools. And it's not painful for babies.

Alternative Colic Support 5:30

This is something that you can try out. Chiropractic is also something that can help with colic. I actually took my baby to a pediatric chiropractor for this and I saw a really good improvement with that. They just very gently adjust their back, like on their low back for this and middle back. And remember when they're adjusting, they are not doing twisting, there's not any popping in little babies. It's really just using very light pressure or light stroking along the spine to do the adjustment.

A lot of times they can adjust the baby on your chest while you're holding them or while your laying on the table with the Baby on top of you. from a nutrition supplement standpoint. So again, probiotics are great. Also prebiotics. Prebiotic are things that feed the probiotic bacteria. If you're breastfeeding, breast milk has prebiotics in it, but if you increase your fruit and veggie intake, that can also help to put more pre-biotics into your breastmilk. Formula also has a pre biotics in as well, so you don't necessarily need to add anything into the formula.

You can just give the formulas and then give a probiotc with it. Gripe water is something that a lot of parents try and I would use it with caution. Gripes water not FDA regulated and some preparations of it will have alcohol in it. So just double check, look on the back of and check with your doctor. You also don't want to give too much of the gripewater because babies can fill up on that and then they're not eating as much breast milk in formula. Some kinds of tea can help with tummy upset. So if mom is breastfeeding, she can drink chamomile tea or licorice tea, or ginger or mint tea.

Some of that will get into the breast milk and can helps to settle your baby's tummy. But if you want to give it directly to your baby, you can make it either half to quarter strength and then just give them a spoonful of that once or twice per day. You don't need to add anything into it like sugar. Definitely don�t add any honey. Babies less than a year are not able to have honey, but if we just gave that tiny little bit of tea, sometimes that can help to settle the tummy as well. Homeopathy standpoint.

Remember, homeopathy is not fully supported by Western medicine, but the ones that are recommended for colic are chamomile vulgaris, colosynthis and lycopodium clavatum. When you're giving homeopathic remedies to babies, in this age group, what you would do is put one of the pellets into a teaspoon of water and then just give them a few drops of that water by mouth. From an aromatherapy standpoint, you can actually use some topical oils on your baby's belly. When you're using aromatherapy oils, topically you want to mix them with a carrier oil so that they're very dilute because essential oils can burn your baby's skin because they are very concentrated.

So you mix it with the carrier oils such as coconut oil, avocado oil and almond oil. Just one drop of the essential oil into about a teaspoon up to an ounce of carrier And the oils that are recommended are fennel,

Understanding Reflux 8:40

star anise, marjoram, ginger, roman chamomile, rosemary, or bergamot. And you don't need to use all of these. I would just pick one, if you have one on hand already you can try that. If it's not super helpful you could try a different one. But these can help topically, just put it on baby's belly, rub in a clockwise direction on the abdomen. Also, if mom is breastfeeding, she can consume the essential oils and you can have two to five drops of either peppermint, ginger or chamomile oil. and you put that in a cup of water and drink it.

But remember, don't give this orally to babies because it's too concentrated for them and can be poisonous. Now reflux is when the stomach contents come up into the esophagus. And reflox is something that happens normally in young babies, because there's a sphincter that goes between the oesophagus and the the lower esophogeal sphrinctor. It develops around 6 to 12 months of age, becomes fully functional. So for the first 6-12 months, baby stomachs are sort of like a to-go cup with a straw in it.

There's not really anything pinching off that connection between it and you know if you have a cup of liquid with the straw and then you tip it sideways, the stuff will just come right out that straw. Reflex is actually a normal functional thing in babies. But when it gets to a point where it's causing symptoms, it can actually be called GERD or gastroesophageal reflux disease. And some of the problems with that are that babies might not gain enough weight or they might even have weight loss and could potentially choke.

It's not super common that baby's choke though. A lot of babies will reflox and even if their stomach contents come out all the way up through their nose, It's still not typically dangerous. If it does come out their nose, just use a bulb sucker to clear their noses out. So symptoms of reflux, spitting up, arching the back. Sometimes babies will cry and arch. And sometimes they're reflexing in between eating and it's just the acid from their stomach that's coming up and that can be a little uncomfortable or painful.

And sometimes they can cause things like coughing or choking type of symptoms in between meals. It's a lot more common after they've eaten because then their stomach is full and when it starts to digest, everything sloshes around and kind of squeezes up their belly. So from a Western standpoint, we start with the non-medical approaches. First is to, again, burp often while you're feeding your baby. Every five minutes while breastfeeding or after every ounce while bottle feeding. and then keep them upright for 20 to 30 minutes after they eat.

And this allows gravity to keep that food in their stomach while it's digesting. It makes it a little less likely that it will reflux up. To hold a baby upright, for younger babies you want to kind of keep it on your chest, on the shoulder, use a burp cloth over your shoulder in case they

Western Reflux Management 11:30

do spit up, For older babies, once they're around four to six months old, they can sit with a little bit of support. So make sure their neck is always supported. But you can have them kind of sitting on your lap while you're holding them or even sitting facing away from you or sideways on you lap. Either of those would be fine. You can also put babies over six month old into baby chairs like a high chair or some kind a supported baby seat. I wouldn't do a swing because swings can actually make them throw up a little bit more, but something where they're seated in a more upright position around nine months of age is when babies are able to sit all on their own.

And a lot of times by then the symptoms of reflux have gone way down. Make sure you're not swinging or rocking your baby in your arms or laying them flat or rubbing their belly for those 20 to 30 minutes after they've eaten, because that can also make the spit up. If these things are not quite enough, you can consider thickening the feeds, but always check with your doctor first before doing this. The way we recommend doing that is putting a teaspoon of rice cereal into two ounces of milk. It makes it come out a bit thicker from the bottle.

They have to work harder for it. they burn more calories while they're eating it, and it can sometimes be frustrating for babies to be sucking this thicker formula out. So just double-check with you doctor whether that's a good idea or not. Thickening feeds have sort of come in and out of fashion, and it's something that nowadays is not recommended as much as it used to be, but I have seen some success with this. There are also anti-reflux formulas that you can get if your baby is formula fad. The only medicine we do for reflux is renitidine.

And what renididines does is it decreases the acidity of the stomach contents, but it doesn't actually stop the reflox from happening. So babies will still spit up. They'll still have some symptoms of reflux. But if they're having a lot of pain because of their refux, then reninidin is one that can help. So definitely still use supportive measures even if your baby is given this medicine for reflux. And the downside with renitidine is that over time it can cause decreased bone density and they're more likely to get broken bones as children.

So if you're child is on renididines, make sure you are checking with your doctor at each well child check appointment to see if they still need it or if can cut down on the dose or stop it. From an acupuncture standpoint, both pediatric acupuncture and Chinese herbs can help with symptoms of reflux. So you can talk to your pediatric accupuncturist about that. And from chiropractic, chriopractic does also help reflux, so you speak to a pediatric chiropractor about it.

Alternative Reflux Support and Wrap-Up 14:20

When you're looking for a pediatric chiropractor, I recommend the website icpa4kids.com and I'll put a note in the show notes about this. That's where you can search for one that is pediatric certified in your area. And I do recommend ones that are certified as pediatric Chiropractors because they have a lot more experience with babies and adjusting babies is very different than adjusting adults. From a nutrition and supplement standpoint, besides thickening the feeds, and again, controversial nowadays with that, breastfeeding moms can decrease some of the things in their diet that are acidic, so less acidic foods, things like tomatoes and citrus fruits, then avoid chocolate, caffeine, alcohol, spicy foods while breast feeding, or at least cut back on those, because they can all make reflux a little bit worse.

Mom can drink ginger tea and chamomile tea, and if you wanted to give a spoonful of this dilute tea to your babies, those are teas that can also help settle the stomach. And remember that babies less than a year should not have any honey in their tea. But you can use sugar to sweeten it if they need it, or if your baby is over a From a homeopathic standpoint, the remedies that are recommended for reflux are antimonium crudium, chelidonium magis, and Nux vatmica. Reflux can happen kind of throughout a baby's life, and I wouldn't really go and treat it until they're about six months old.

If they are less than six month old, we usually just consider them happy spitters, unless they aren't gaining enough weight. But I would try these remedies in older babies, six-months and older, if you are going to try them. And once they eat foods, it is okay to give them one of the pellets by mouth, or you can mix it with water and give that water to drink. From an aromatherapy standpoint you can use ginger or chamomile oil topically. So again, you dilute that in a carrier oil and rub it on their belly.

With reflux symptoms you want to do it before they eat so that they're not throwing up after you do that from rubbing their bell. And for children who are over a year old, so you put a drop of this ginger and chamamile into that carrier and let them take it by mouth. and they would take about a few drops of that diluted oil by mouth. So it's very, very little of the actual aromatherapy oil that they are getting, because remember those are super concentrated and I shouldn't be having those directly by my mouth, so it can be poisonous.

I cover reflux, colic, gas, all of these things in the baby manual as well and in an earlier podcast, but I'm really excited that you guys got to hear about some of the other supportive and alternative measures that we can take to help decrease these. Make sure you hit that subscribe button if you haven't already. Next week, we're going to be talking all about vomiting and diarrhea. I look forward to talking to you then. Have a great day. Thank you for listening to the Baby Manual Podcast. Please hit that subscribe button below so you don't miss the new episodes as they come out.

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