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What Doctors Don't Tell You

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May 2019 (Vol. 4 Issue 3)

Colicky babies

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Q) My daughter's new baby is very colicky

Q) My daughter's new baby is very colicky.She insists on using Infacol, but there must be many more natural remedies to choose from. What would you recommend?-P.M., Dundee, Scotland

A) Colic is the number-one problem for both babies and parents. It's probably the worst pain a baby ever experiences, and it's both distressing and sleep-depriving for mothers, too. Doctors tend not to take it that seriously, how-ever, as it's neither life-threatening nor permanent-it rarely persists beyond the age of six months. It's believed to be caused by excess gas in the stomach.

Infacol is one of the most popular medicines for colic, and many mothers swear by it. Its active ingredient is simethicone, an 'anti-foaming agent' that is supposed to reduce trapped wind in the gut. However, the product appears to have been marketed without any kind of supporting medical evidence, given that three clinical trials showed "no benefit" with simethicone (BMJ, 1998; 316: 1563-9).

Infacol's other deficits are its so-called 'inactive' ingredients, which include not only saccharin, but the infamous preservative parabens. Extraordinarily, although the damning report in the British Medical Journal was written almost 10 years ago, Infacol is still actively marketed.

What are the healthy answers to colic? Well, the almost folkloric 'gripe water' certainly isn't one of them. Originally developed in the 1850s, its ingred-ients include ginger, dill, fennel and chamomile-but also alcohol and sodium bicarbonate. According to one estimate, the amount of alcohol in a typical daily infant dose is equivalent to five tots of whisky in an adult (J R Soc Med, 2000; 93: 172-4). And baking soda-an antacid-can alter the infant's delicate acid-alkaline balance, possibly exacerbating the problem as well as depleting folic acid and iron. So, much better to put the bicarb into cakes than into babies.

One of the latest, most promising treatments is probiotics. It's been found that babies with colic tend to have fewer beneficial bacteria in their gastro-intestinal tracts, making it sensible to try giving them a probiotic supplement. In a 28-day study, Italian paediatricians from the University of Turin tested 90 colicky babies, giving half of them a few drops of a liquid containing 100 million live Lactobacillus reuteri bacteria, and simethicone to the remainder.

The results were dramatic: only 7 per cent of the simethicone group got better, compared with 95 per cent of the probiotic group, who cried for only 50 minutes a day compared with more than two and a half hours with simethicone (Pediatrics, 2007; 119: e124-30). The product used in the trial is from the Swedish company BioGaia AB, but it's unlikely to be the only probiotic that works for colic. The research is ongoing.

A similar product which uses prebiotics, rather than probiotics, is Nutrilon Omneo. This contains oligosac-charides, which stimulate the growth of beneficial bacteria, together with whey proteins and vegetable oil. When the same Turin group tested Nutrilon against simethicone in a 14-day trial, once again, the natural product won out, resulting in roughly half the number of "crying episodes" after two weeks (Eur J Clin Nutr, 2006; 60: 1304-10).

Herbal preparations have also been tested in clinical trials. A mixture of chamomile, fennel and lemon balm has been shown to more than halve colic, as measured by daily crying time. Perhaps surprisingly, the benefit from the herbs persisted for as long as two weeks after the end of the treatment (Phytother Res, 2005; 19: 335-40).

Another rigorous clinical study of more than 120 infants tested a 0.1-per-cent fennel-seed oil emulsion against a placebo. The fennel emulsion reduced colic by 65 per cent, vs only 24 per cent with the placebo. The fennel dose was 1-4 tsp up to four times per day (Altern Ther, 2003; 9: 58-61). Neither of these herbal trials reported any side-effects.

Homeopathy works especially well in children, and it offers a number of remedies for colic, with Colycinthis and Chamomilla being the most popular. Although there is little supporting clinical evidence, a recent survey of Scottish GPs revealed that nearly a quarter of them regularly prescribe homeopathy particularly in infants, and particularly for colic (Br J Clin Pharmacol, 2005; 59: 743-9).

In addition to natural therapies, you should also encourage your daughter to do a simple check of how she's feeding her baby. If she's breastfeeding, she could try changing her diet by cutting out dairy, wheat, eggs, nuts and fish. When this sort of low-allergen regime was tested on mothers, their babies' colic reduced almost threefold and within only eight days of starting the diet (Pediatrics, 2005; 116: e709-15).

Similarly, if your daughter's using milk formula, she could choose a low-allergen type or a non-cow's milk formula such as goat's milk. Low-allergen formulas have been shown to reduce colic by up to 60 per cent (Pediatrics, 2000; 106: 184-90).

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