Colic and choosing the right formula

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Colic and choosing the right formula by BabyYumYumWould you believe that around 40% of infants aged from 2 weeks to 3 months are affected by colic? Even though infants who suffer from colic experience symptoms for only a few months, it still causes high levels of anxiety and stress for parents and the family. Since the condition is non-life threatening, it can be a wrongly undervalued cause for paediatric consultation. This could be because no one really knows what causes colic and is an ill‑defined condition. Various treatment options are available for colic, yet there is no standard care.

So what is colic? The most popular definition is an infant who is otherwise healthy and well-fed, but presents with irritability, fussing and crying that lasts for more than three hours a day for more than three days a week. Additional symptoms may include drawing up the knees, and excessive gas (cramping). Treatment options for colic include pharmacological products (such as lactase enzymes, colic drops etc.), nutritional and behavioural interventions.

Despite its frequent use, pharmacological and behavioural interventions for colic have been reported ineffective or inappropriate for the treatment of colic1. There is some evidence that supports some of the nutritional interventions for infantile colic. Since Baby Yum Yum is an online community and resource for parents and caregivers needing information and advice about formula feeding and nutrition, the focus of this post will be on the dietary options that could possibly help manage colic.

A change of formula would be your first line of treatment as a dietary approach. Here are some options:

  • Partially hydrolysed formulas: the effectiveness of partially hydrolysed whey based formulas (PHF) for the management of colic is debatable as most studies included other dietary changes as well. These formulas may be of some help to colicky babies when allergies are not suspected2. Brands include Similac Total Comfort.
  • Reduced lactose formulas: another option is to try a specifically designed infant formula with reduced lactose concentration. Some babies are lactose sensitive and have a reduced lactose absorption capacity, resulting in less lactose being absorbed in the small intestine and more lactose ending up in the colon where it gets fermented and produces gas. This ultimately leads to some of the symptoms associated with colic, such as cramping, flatulence, excessive crying etc. Using a formula with a reduced lactose concentration could assist sensitive babies and prevent gas development. Brands include Novalac AC.
  • Extensively hydrolysed formulas: If the two formula types above do not assist in the management of colic, one could consider using an extensively hydrolysed, casein protein based formula for infants struggling with severe colic or additional atopic symptoms. Brands include Novalac Allernova Smooth and Similac Alimentum.
  • Soya formulas: often used for colicky babies, but it is important to mention that there is no evidence to show that soya formulas assist with the prevention and management of colic.

Colic and choosing the right formula for your baby by Baby Yum YumFor breast-fed infants with colic, it is suggested that the mother switch to a low allergen diet, avoiding cow’s milk and dairy food with appropriate intake of vitamins and minerals.  You will need to wait at least two weeks though to check the effectiveness of the diet. Any dietary changes should be made under the supervision or with the advice of a health care professional such as a clinic sister, pharmacist, dietician, GP or paediatrician3.

It is fantastic to see how many mommies and caregivers, whose baby has suffered or is currently suffering from colic, are willing to share their thoughts and advice.  This is ultimately the goal of Baby Yum Yum!  We thought it would be ideal to discuss and clarify how some of the options mentioned, mostly homeopathic remedies, could assist in managing colic:

  • Gripe water: these products often help to relieve stomach upsets temporarily by changing healthy pH levels (acidity) in the stomach, but do not treat the underlying problem. This is seen as a “band aid” approach to manage colic and other digestive problems such as reflux and constipation, and often provides little or no relief. Read the label and avoid products containing alcohol, sugar, sodium bicarbonate (baking soda), simethicone, herbal oils or extracts, or artificial flavours. Whilst gripe water is a familiar remedy for infantile colic that has been used since 1851, there are no studies that explore this as a possible treatment.
  • Colic/gas drops: drops often contain the pharmacological product Simethicone which requires constant dosing in order to have an effect. Over use could create a dependency and as mentioned above, this pharmacological intervention has been reported not to be effective or appropriate for the treatment of colic1.
  • Probiotics: limited evidence is available on the efficacy of adding probiotics to ease colic and the evidence that does exist is, on breast-fed and not formula fed infants.

Another issue that came up in our discussion on colic was how to treat constipation.  I think this is because often a constipated baby would present with similar symptoms as a colicky baby. If one pin-points which symptom is most severe, one would be able to use a more specific solution to manage the condition at hand, often addressing the other symptoms then too.  Look out for our next article which will be on constipation and how you can treat and manage it.

Resources: 1 Hall et al., 2011; 2 Vandenplas et al., 2014; 3 Savino et al., 2014

 

Disclaimer: This post is based on personal experience and personal brand preference of the content author and has in no way been paid for or sponsored. BabyYumYum reserves the right to its opinions and fully supports the notion of promotion that breast is best in line with the World Health Organisation (WHO) infant feeding guidelines http://www.who.int/topics/infant_nutrition/en/ Breast milk is the best food for infants. Good maternal nutrition is essential to prepare and maintain breastfeeding. If breastfeeding is not applied, an infant formula may be used according to health professionals’ advice. Preparation and storage of any infant formula should be performed as directed on the tin in order not to pose any health hazards.

22 COMMENTS

  1. My little nunu has developed rash i tried not to use baby soap nd bath him with baby aqueos as the Dr said but now his skin becomes dry

      • Hi I am.having baby no 2, with my first born I had him on Nan formula milk and he started getting reflux and also had colic. I then put him on Isomil which he thrived on. Just wanting to know what formula I can try with the second one. I can’t breastfeed so will be giving formula from day 1. Which formula milk do you recommend? Do you think it’s wise to try Nan again?

        • Dear Eleanor
          Formula selection is a rather confusing yet personal choice. based on clinic studies done and personal preference we like to recommend Novalac 1 as a great formula. Should you then determine that your baby has colic you can swop to Novalac AC which is just for Colic symptoms. They have a great range.Let us know how it goes please .

  2. Thank you for a great article. Please note that chiropractic care has shown to be extremely effective in the treatment of colic and colicky symptoms.

    • Hi Thanks for your response. we would love to feature an article on Colic and Chiro for kids. Do you have any articles to share with us ?

  3. Hi

    My baby is colic, tried using isomil but that makes her constipated, i dont really have much breast milk, i wanted to know if the Novalac Colic would be suitabkle for her? she is 6 weeks old now.

    I dont want to get something that will worsen the colic

  4. My baby is 11 days old on Nan Sensitive because similac gave cramps in the hospital. He is now battling with severe cramps and seems gassy. Could it be the formula again?? Keeping in mind mommy and his older brother are both lactose intolerant.

    • If there is family history of lactose intolerance then one should probably consider a lactose free formula, yet Similac Total Comfort is lactose free so it does not make sense then that baby got cramps. . . However, one should also keep in mind that baby is so small still and cramps could simply also just be part of normal baby’s gut immaturity, but the changing of formulas and adjustment could be bringing on the cramp. So try and stick with a formula for at least 7 days. If your baby is lactose intolerant then NAN Sensitive would not be the ideal product, because it contains lactose. If baby is not settling on Nan Sensitive then an Extensively Hydrolysed formula that is also lactose free should be considered like Novalac Allernova Smooth, since studies have shown that these formulas help with “colic”/ crampy and crying babies. However, with any sensitivity/ allergies/ intolerance it is necessary to consult a healthcare professional!

  5. My little boy has been on Novalac Premium 1 for two months, he is just a little over 14 weeks now. He thrived on it and we never had any issue, lately though it seems as if he doesn’t like it anymore. He also seems more gassy and spits up more – would you recommend I try Novalac AC for this?

    • This one keeps coming up – It depends on what the major issue is…if it is gas, then yes you can try Novalac AC, but if the spitting up is possibly reflux, then baby may need to be on a thickened formula like Novalac AR. If you would say it is both then try Novalac HA (it has the thickener of AR, but low lactose like AC…) – best of both worlds… Might be a good idea to visit a healthcare professional for some advice!

  6. My boy is 2weeks now cause I give his brother nan paragon I thought I should give him as well but he doesn’t feel comfortable in his sleep,he struggle 2 poop he has gas and he cries each and every minutes in his sleep what formula should I give him cause my milk just went dry

    • Hi Tsakane, I would suggest Novalac HA, which will assist with the gassiness, cramps, constipation, as it is partially hydrolysed, reduced lactose and a bit of thickener added.

  7. My baby is on Novalac AC for 3weeks now. My pediatrician advised me to put my baby on it as he is colic but he has been constipated since and it is not getting any better. Please advise if I should wait longer too see if the constipation gets better or should I change his formula?

    • Hi Karla, I think try and wait a month, so another week, before you switch formula, as it sometimes takes baby a while to get used to a new formula. If this continues, perhaps speak to your pead about changing him to another formula, or if the pead thinks he may possibly be allergic to milk? Have a look at our article here as well: http://babyyumyum.co.za/from-constipation-to-diarrhoea-what-to-do/ which has suggestions on how to deal with constipation. Let us know how it goes!

  8. Hi. My name is Tintswalo having a 14 weeks baby. I am currently breastfeeding and giving her Isomil to supplement as i don’t have enough breast milk of which i think is constipating her and she is has more gas in her stomach. She also cries a lot , more than 3 hrs a day. Which formula will be suitable for my girl?

    • Hi Tintswalo, usually that is quite common for babies at that age to have gastrointestinal problems like gas. Novalac has a good formula for babies that cry a lot and that have gas. It is the Novalac AC. It has lower lactose that sometimes is the reason for the gas. The baby might not be able to digest all the lactose and the excess lactose ferments that causes gassiness.

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