Interestingly, there is much written about so-called ‘colic’ in babies and everyone seems to have an opinion on it. I have found many babies are diagnosed as having colic, but this can mean very little in reality, as there is no medical definition for the term and it is actually a non-descriptive term for pain.
Colic or reflux? The burning question!!
For example, the Oxford English Dictionary states: colic (n) – a severe spasmodic abdominal pain.
Colic is usually defined as ‘excessive crying in infancy with no known cause’ – but I believe there is always a reason for bouts of inconsolable and excessive crying. After all, an infant’s cry is the only way they have of communication in the first few months – we just need to learn to listen and interpret!
In many babies, the cause of excessive crying can actually be attributed to gastro-esophageal reflux and/or digestive intolerances or allergies. However, getting a diagnosis of this can be incredibly difficult.
If your baby has outward symptoms such as projectile vomiting or is failing to gain weight, then your health provider may suggest reflux could be the cause—but if your baby is not experiencing these symptoms, it can be extremely difficult to get a diagnosis.
Many pediatricians only recognize infant reflux if the above symptoms are present, as they may not understand the more serious condition of ‘silent reflux.’
With a baby that vomits or spits up a lot, it’s relatively easy to understand that the baby may have reflux, whereas a baby that might just have excessive bouts of crying (but is rarely sick and still gains weight) would often be deemed to just have ‘colic’.
I get asked all the time what reflux is. Reflux is quite simply ‘the backward flow of the stomach contents’. Due to the immaturity of the lower esophageal sphincter muscle, the contents of the stomach (known as the refluxate) are able to leak back up into the esophagus, and depending on the force at which it is expelled from the stomach, the vomit may projectile out of the baby’s mouth and nose. It could come up as far as the mouth and trickle out as continuous spit-up—or may just come up part way, hitting the back of the throat and then sinking back down into the stomach. The refluxate consists of, not only what the baby has recently eaten or drunk, but also contains a high concentration of gastric acid.
This acid is naturally present in the stomach and needed for the digestion process, but it should not be present in the esophagus, throat, nasal passages or sinuses as it burns the soft tissues in these parts, causing extreme pain.
The scenario I mention above, whereby the stomach contents continually reflux up and down within the esophagus, is actually known as Silent Reflux……..but, to the untrained eye, because the baby is showing no signs of vomiting or outward signs of having reflux the condition is usually passed off as ‘colic’.
A baby suffering from Silent Reflux will often have bouts of unexplained crying and show obvious signs of discomfort.
They may also suffer from:
- Gagging and choking episodes
- Hold their breath and have episodes of sleep apnea
- Have excess nasal mucous, seeming to often have a cough and cold
- Dribble a lot and often seem to ‘bubble’ at the mouth with excess saliva
- It may be suggested that your baby is an ‘early teether’
- Have a white coated tongue and often be misdiagnosed as having oral thrush
- Go rigid and often arch their back
- Are rarely relaxed and always tense
- They are often muscularly very strong for their age
- Be very difficult to hold and never relax & lie back in your arms as you would expect
- Have bouts of inconsolable screaming and crying
- Have very poor sleep patterns and is very difficult to settle into independent sleep
- Want to feed frequently around the clock and it seems impossible to get them into a feeding routine
- Take ages over each feed and often refuse to take their milk easily
- Become very withdrawn, and quiet and do not interact and focus as they should
- Rarely smile, often frown and look ‘worried’
- Suffer with Bronchiolitis and have repeated ENT infections
- Have excessive blowouts, have explosive stools or seem to be constipated
- Very hard to burp and difficult to feed
As you can see, the list is endless and no two babies will ever display exactly the same symptoms. Hence, it can be extremely hard for health professionals to make a diagnosis especially if they have never before dealt with a reflux baby.
If you instinctively feel that something is not quite as it should be with your baby or your baby is displaying some of the above symptoms, then I urge you to seek professional help.
You will also need a medical diagnosis, ideally from a Pediatric Gastroenterologist who should offer a forward treatment and management plan to ultimately bring the symptoms under control…and then you will need to teach your baby to sleep as proper, restful, regenerative sleep is the best cure-all around from my experience.