7 Reasons Why Breastfed Babies Can Get Colic
Table Of Contents
Can Breastfeeding Cause Baby Colic?
What does that mean?
In 2011, two scientists (2) found that if breastfeeding “is not going all too well”, it could increase the risk of a baby to “repeatedly and inconsolably cry without cause” (which is their definition of colic).
Learn more about this study
The purpose of it is to assess, how well (high score) or badly (low score) breastfeeding is going. It involves factors like “how the baby is attached to the breast”, “how the mother holds the baby” etc.
Interestingly, the breastfeeding score was significantly lower in mothers of babies who suffered from colic. In other words, it seems that if breastfeeding is not going too well, it could trigger colic in babies.
Side Note: What is "Breastfeeding Success"?
- “How to hold the baby while breastfeeding”
- “How to put the breast into the baby’s mouth”
- “Transmission of milk from the mother to the baby”
So, let’s have a closer look at what exactly is meant if we say that “breastfeeding is not going well” and how this can promote baby colic:
1 Poor Attachment
If the baby is having problems latching correctly onto the breast, she could be taking in a lot of air which can then cause colic-type symptoms (6).
What Are The Signs Of Poor Attachment?
- Pain and damage to nipples: sore nipples / fissures.
- Breastmilk not removed effectively: engorgement.
- Apparent poor milk supply: baby unsatisfied / wants to feed a lot / refuses to suckle.
- Breasts produce less milk: baby frustrated / refuses to suckle / fails to gain weight
What Can You Do?
As you can see on the picture, suckling on the nipple itself is considered a poor attachment of the baby. It is important for the baby to have a good mouthful of breast.
In order to accomplish that, according to Inch, the bottom lip and the tongue of the baby need to get to the breast first and make contact as far from the base of the nipple as possible (5).
2 Offering Both Breasts During One Feed
And there is a simple reason why mothers do this! They are afraid that they can’t satisfy the baby’s hunger! So, who can really blame them?
However, Jack Newman, chairman of the “Infant Feeding Action Coalition Canada”, says that the result of offering both breasts is the exact opposite!
In an interview with “Pathways to Family Wellness” (8), the Toronto-based pediatrician explains that breastmilk changes during a feed! The amount of fat increases the longer the feed lasts and so does the number of calories.
Because of that, switching from one breast to the other too early can result in the baby getting too few calories, according to Newman. As a result, the baby may feed more often.
Moreover, the baby may also drink considerably more milk per feed to make up for the fewer calories. And this can cause her to spit up.
Finally, the stomach empties quickly because of the low-fat content of the milk according to Newman. Subsequently, a large amount of lactose (milk sugar) arrives in the stomach at one time.
However, the baby’s body is not able to metabolize the high amounts of sugar. This is because there is not enough of the protein available that digests milk sugar: lactase.
Unfortunately, undigested lactose can cause symptoms similar to lactose intolerance, such as gas, flatulence, explosive, water diarrhea and: colic.
That very problem that Newman describes, has also been investigated in a scientific study (9).
The scientists found that babies of women who prolongedly emptied one breast during each feed had a lower incidence of colic over the first 6 months of their lives.
Learn more about this study
The result was that the first group had a lower incidence of colic over the first 6 months of the babies’ lives compared to the group of mothers who offered both breasts during one feed (12% vs. 23.4%).
What Can You Do?
3 The “infant hyperlactation syndrome”
A medical doctor from the Breastfeeding Centre in Vancouver, called Livingstone, was the first one to describe the problem (10). It is yet another scenario in which a too large amount of lactose can enter the baby’s stomach at one time.
In this scenario, babies often come off the breast, just in order to return to the breast shortly thereafter. Yet, because of the strong flow of milk, they let off the breast again.
Some experts (including Newman mentioned above) call this strong milk ejection “overactive let-down” (8). Maybe, you are already familiar with that term.
Such babies drink a large quantity of milk within a short period of time. According to Livingstone, it can be as much as 120 to 140ml (4oz – 4.7oz) within 5-10 minutes.
This can ultimately cause the exact same symptoms of a lactose overload as described above.
What Can You Do?
- Express some milk before you feed your baby!
- Try to lay down flat on your back with your baby on top of your breast! Gravity will often do the job to avoid fast milk ejection.
- Feed your baby in a calm atmosphere! No unnecessary distractions, no TV, no sound, no nothing!
4 Low “Breastfeeding Self-Efficacy”
In simple terms, breastfeeding self-efficacy is “a mother’s perceived ability to carry out breastfeeding” (11).
Side Note: How do scientists assess "breastfeeding self-efficacy"?
Here are 3 example questions so that you understand what their tool is all about:
- I can always hold my baby comfortably during breastfeeding.
- I can always take my baby off the breast without pain to myself
- I can always manage to keep up with my baby’s breastfeeding demands.
Eventually, the scores of all answers are added up. Higher scores indicate higher levels of breastfeeding self-efficacy and lower scores mean the opposite.
How Is Low Self-Efficacy Related To Baby Colic?
For example, a mother with low self-efficacy might not know how to properly attach a baby to her breast. This in turn might cause colic, or at least colic-like symptoms, as the baby could take in lots of air with each feed.
Of course, a low self-efficacy does by no means mean that this mother is less capable of breastfeeding her baby!
It just means that she has not received proper training, for whatever reason. And let’s be honest here! Even if you would have received the best training ever: hearing the theory and then actually holding your baby in your arms are just two completely different things.
What Can You Do?
Now that you have your baby, it will be much easier for them to show you how to correctly breastfeed. They are now able to observe you while you breastfeed your baby! And because of that, they can give you immediate feedback on what you might be doing wrong.
So far, we have been looking at colic-causing factors, which are related to the act of breastfeeding. However, what if your breastfeeding skills are perfect and your baby still develops colic?
Could it be that there are substances in your milk which can promote baby colic? So let’s have a look at reasons, why breastfed babies can get colic, which are not related to the act of breastfeeding itself:
5 The Breastfeeding Mother’s Diet
A particular focus here are allergenic foods, like cow’s milk, eggs, peanuts, tree nuts, wheat, soy and fish, as well as cruciferous vegetables and foods which contain high levels of FODMAP (these are short-chain carbohydrates like fructose, lactose). Some studies have shown that eliminating such foods reduces colic in breastfed babies (12, 13, 14, 15, 16).
However, other scientists have criticized that the quality of those studies is low (17). Some of them even put the reliability of their results into question (17).
On top of that, it is worth noting that there are also scientists who come to different conclusions. In other words, they do not find that eliminating foods from a mother’s diet has any effect on colic symptoms in babies (18, 19).
Therefore, as of today, scientists are still unsure if restricting a mother’s diet can help prevent colic in babies. That is why it is up to each mother herself, to make a decision to restrict her diet or not.
If that’s something you are interested in, read my blog post: “Anti-colic diets for breastfeeding mothers: do they work?“
In this blog post, I will tell you everything about what we currently know about the effect of a mother’s diet on baby colic. Moreover, I will show you, which foods you should eliminate from your diet according to scientists.
6 Exposure To Nicotine While Breastfeeding
It has been suggested by numerous scientific studies to date, that smoking during pregnancy can cause multiple problems in a baby. One of those negative effects could be developing baby colic according to many scientists (20, 21)! In fact, the risk of developing baby colic seems to be twice as high when the mother is smoking during pregnancy.
But what about smoking after pregnancy when a mother is breastfeeding? Is it likely for a breastfed baby to develop colic when her mother is smoking?
Indeed, maternal smoking has been identified as potential risk factor for colic after the baby is born too. For example, a study from 2000 found that colic is more frequent in infants of smoking mothers (22).
The finding that smoking could promote baby colic was also confirmed by another study one year later (23). Interestingly, that study did not even focus on maternal smoking, but on environmental tobacco smoke in general.
What does that mean?
Imagine that a baby is exposed to nicotine from a smoking nanny and not from her breastfeeding smoking mother. Is the baby likely to develop colic in such a scenario too?
According to the study, the answer is “yes” (23). The scientists have found a positive link between a baby being exposed to environmental tobacco smoke and her colic symptoms (23).
Therefore, keep in mind that being exposed to tobacco smoke is always bad for the baby!
What Can You Do?
However, there is a reason why they call it “addiction”.
“How to quit smoking” is a question that I hear very often as a practitioner. Since I am a TCM practitioner, I naturally offer acupuncture treatments, as they tend to work really well in such cases.
However, treating addictions effectively can require many acupuncture sessions which can be too costly for many people. Therefore, I usually recommend my patients the book of Allen Carr: “Easy way to stop smoking”.
So far, all except one of my patients have been able to quit smoking after reading his book. Therefore, I can wholeheartedly recommend it to everyone who wants to quit smoking!
7 Administration Of Antidepressants During Breastfeeding
The scientists found that the antidepressant was transmitted through the breastmilk to the baby. The result was that the baby developed symptoms like increased crying, decreased sleep, increased vomiting and watery stools. These symptoms improved once the infant was formula fed.
Please note however, that this is the only study to date that I could find about the effect of antidepressant on colic symptoms in babies.
What Can You Do?
If there are no other options, not even pausing the antidepressant during breastfeeding, talk to your pediatrician about switching to formula milk.
It is important though, that you do not just make a decision by yourself! Never stop taking antidepressants by yourself, without talking to an expert first! Likewise, do not just stop breastfeeding, without talking to your pediatrician first! Keep in mind that human milk is the best possible form of nutrition for your baby!
Can Breastfeeding Protect Against Colic If Done Correctly?
We have seen how, why they might have come to different conclusions. Breastfeeding has many facets. So it is not sufficient to look at breastfeeding as a whole. We need to look at the many things which can go wrong during breastfeeding.
If, however, a mother is able to eliminate the very factors related to breastfeeding, which might cause baby colic (for example, by holding her baby correctly or by attaching her baby correctly to the breast or by avoiding smoking), then breastfeeding could indeed become a protection against colic.
For example, a study by Engler and his colleagues found that exclusively breast-fed babies have a significantly lower incidence of colic attacks (25).
They also found that breastmilk contains melatonin during the night. They assume that melatonin in the breastmilk plays an important role in reducing colic, as well as in improving sleep.
Should I Stop Breastfeeding To Avoid Colic?
The simple answer is: no, absolutely not!
First, please note that colic in babies can have many reasons apart from factors related to breastfeeding! Because of that, you can never be sure if breastfeeding itself is the very reason which causes colic! In other words, even if you stop breastfeeding, your baby could still develop colic symptoms.
Next, keep in mind that the benefits of breastfeeding outweigh any possible negative effects by far!
Breastmilk is the best possible form of nutrition for your baby. It provides your baby with all the macro- and micronutrients that she so urgently needs for her development.
On top of that, it offers your baby tons of other health-related benefits.
Furthermore, keep in mind that switching to formula can actually make things worse for your baby! That is, because you do not know how your baby is going to react to cow’s milk, goat’s milk or soy milk.
If you believe that factors related to breastfeeding could be the cause for your baby to get colic, please talk to a doctor! Alternatively, ask a member of staff at the hospital where you gave birth to your baby! They will be more than happy to help you!
Many moms have asked me for reasons why breastfed babies can get colic.
The truth is, even breastfed babies can get colic and there are many reasons for this:
First, breastfeeding itself can be the problem: A baby may not be properly attached to the breast or she may take in lots of air during the feed.
Moreover, if the mother offers both breasts during one feed, or, if the baby drinks too much milk too quickly, the abundance of lactose in her intestines could cause colic symptoms.
Furthermore, a mother’s low perceived ability to breastfeed (i.e. low “breastfeeding self-efficacy”) could increase the likelihood of colic in babies.
It does not mean that a mother with low self-efficacy is less capable of breastfeeding her baby. She just has not received proper training.
Next, some scientists found that a mother’s diet could cause colic symptoms in their breastfed babies. But the issue is controversial!
Moreover, breastfed babies might develop colic when their mother is smoking. This might not only be the case if the mother herself smokes! It seems to be sufficient to expose the baby to environmental tobacco smoke (for example, smoke from a smoking partner).
Finally, it is important to be careful with the administration of antidepressants while breastfeeding! They could be another potential cause of colic symptoms in babies.
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(2) Yalçın, SS., Kuşkonmaz, BB. (2011): Relationship of lower breastfeeding score and problems in infancy. In: Breastfeed Medicine. 2011 Aug; 6(4): 205-8.
(3) Aktas, S., Küçük A.D. (2018): Correlation between Infantile Colic and Maternal Breastfeeding Self-Efficacy, Breastfeeding Success and Breast Milk Amount. In: Journal of Tropical Pediatrics. 2018, Aug; 21.
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(6) La Leche League GB: I think my baby’s got colic. Accessed on 05/15/2019: https://www.laleche.org.uk/i-think-my-babys-got-colic/
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Medical Disclaimer: The information on this page is not intended to diagnose, prevent, mitigate, treate or cure any disease! It is not personal medical advice. We recommend that you ask a doctor whenver you are looking for medical advice!
ABOUT THE AUTHOR
Nathalie has 15+ years of experience in Traditional Chinese Medicine (TCM), acupuncture, reflexology, Shonishin baby massage techniques, Western and Eastern massage techniques (including TUINA), as well as herbal medicine and nutrition.
She has a degree in TCM (including nutrition) and a postgraduate diploma in Herbal Medicine. Moreover, Nathalie used to work for the highly respected Asante Academy in North London and was in charge of the Maternity Acupuncture Clinic at the Whittington hospital in London. She is also a member of the British Acupuncture Council, the official regulatory body for TCM in the UK.
Today, Nathalie runs her own company and has a broad customer base in London, where she specializes in the treatment of babies and children as well as gynecologic and fertility-related issues in women.
RELATED BABY MASSAGE COURSES
This blog post explains the 12 things that pregnant women can try to prevent colic in their baby.
This blog post summarizes what we currently know about the effect of a breastfeeding mother’s on baby colic. Moreover, it educates about what foods not to eat while breastfeeding a colic baby (according to scientists) and what mothers need to consider before making a decision if they should restrict their diet or not.
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