Can Breastfeeding Cause Colic?

Wait--what? Everything I've heard or been told is that breastfeeding is the best thing I can do for my baby. And I've heard people say that "when their baby had colic it was the worst time of their life." So now you are saying that nursing is a possible cause of colic?

Well, it's not the most common cause of colic but it is a possibility.

First, just to be clear, let's define what colic is. The medical definition is:

A healthy, well-fed infant who cries for more than three hours per day, for more than three days per week, for more than three weeks.

When an infant cries inconsolably, one night can seem like a lifetime. Two nights and most new parents have made an appointment with their doctor.

Given that the misery of colic can persist for a month or more, it is advisable to explore all possible causes--and, believe it or not, that list can include breastfeeding. Studies have shown (National Health and Medical Research Council 1996 Infant feeding guidelines for health workers. Australian Government Publishing Service, Commonwealth Australia) that breastfeeding can occasionally cause colic. But why? How can this be?

There's no question that breastfeeding is nearly always the best thing for your baby. However, for an unfortunate few, it can contribute to colic. There are a number of potential reasons for this--but don't lose hope, and don't give up yet on nursing: changes in behavior or diet can often cure your baby's colic.

The first thing to look at is how you are feeding your baby. Is there good suction? This is also known as a good latch. Occasionally, the size or shape of the breast makes it difficult for a baby to latch on properly. Sometimes the way the nipples are formed can make it difficult for a baby to get the nipple all the way into his or her mouth. A large breast can make it hard for a baby to latch on correctly.

One of the ways you can tell if your baby's latch is not as good as it could be is to watch to see how much work your baby is doing to get at the milk. Does he tend to struggle and wiggle around as he feeds, or does she tend to spill a lot of milk? These signs can mean that your baby may be getting too much air with the milk. This can result in excess gas and can lead to the symptoms of colic. If you've tried repositioning and nothing seems to work or is comfortable, considered getting advice from a lactation specialist. Check with your pediatrician or organizations like La Leche League.

Another potential cause of colic is the active letdown reflex--that is, your baby gets too much milk too fast. When feedings are too infrequent, your breast becomes engorged. It is like a balloon that is filled with too much air. When your baby then first starts to feed, the milk comes out forcefully and will often spit from the breast. This pushes air down into your baby's stomach and can result in cramps that lead to colic symptoms. There's a simple solution for this: feed more frequently.

Timed feedings are also a possible cause of colic. One doctor noted that, in countries where watches or clocks are common, colic seemed to be more prevalent than in parts of the world where they are rarer. Sometimes, taking a baby from the breast too early, before a feeding has truly concluded, can result in some subtle side effects that may contribute to colic. Early in a feeding, much of the content of breast milk is sugar or lactase. This is known as the fore milk. Most of the calories, fats, and complex carbohydrates are in the hind milk. Your baby gets to this milk when the breast is almost empty. When a feeding is artificially concluded too soon, your baby gets mostly the milk sugar. Their bodies are not capable of breaking this down, which often leads to gas and bloating. It can even lead to very soft stools or diarrhea.

In addition, because the caloric content of fore milk is not high, your baby will be hungrier. This, in turn, makes him or her more likely to attack the breast, which can result in a poor latch, leading to air and gas that cause symptoms of colic. What do you do? The simple solution is to feed often and avoid switching breasts. Don't time your feedings; allow your baby to finish one breast thoroughly in a feeding. Let your baby tell you when to stop the feeding. When they are done, then the feeding is over.

If none of these strategies seem to work, try to start a Misery Journal: record when your baby cries; how long; his or her affect (e.g., bent legs, clenching fists). This will help your health care provider come to a quicker diagnosis.

It may come down to your diet. It is possible your baby is allergic to something you're eating. (If you're lucky, it's something you really hate.) Keeping a record of your diet will probably pay off, as this is most likely the first thing your health care practitioner will ask for. Hopefully, she will tell you that the issue lies in the low chocolate content in your diet.

Make sure you are always checking your baby for other symptoms of fever, excessive drooling, vomiting, or diarrhea. If your baby is showing any of these symptoms, call your doctor right away as these are indications of a more serious illness.