Why I am Writing This:
My babies had awful colic/ reflux/ projectile spit up and I tried EVERYTHING in search of relief! I started writing this over four years ago because I wanted to share what I’ve learned.
Note that when doctors say “colic” it isn’t a diagnosis of a disorder; it actually just means “unexplained prolonged crying” but is often due to reflux or digestive issues).
One reason I put this off so long is because it was too emotionally difficult and triggering to think about. As with all the guides I write, I also compiled so much information that it was a lot of work to organize. I talked to many different doctors, experts and read to the ends of the internet about reflux with my first baby, and I still learned new things with the second. One doctor told me I could write a book, but I’ll just keep it to this post so that it can be shared for free.
The biggest message I want to tell people is PLEASE don’t assume that babies just like to fuss, or that extensive screaming is normal. I believe all colic is for some reason. Babies don’t just scream for nothing. We just have to keep trying to figure out the causes (this post will help a lot) for each baby. Try to remember the baby is not doing it on purpose. There is likely something making them uncomfortable, hungry or wanting to be picked up, and crying is their only way to communicate it.
Keep looking for answers. These problems can often go on until over one year of age, so just waiting for them to grow out of it could be a long, painful existence. It’s not known how long reflux will last in any particular baby. People assume it gets better and better over time and fades away. But actually, for many babies, it gets worse and worse until it “peaks,” usually around 4-6 months old.
I know many people don’t think reflux is a big deal. It’s true that all babies spit up sometimes, but some of them have greater issues and serious pain. Sometimes I started to even gaslight myself, wanting to believe that maybe my baby was just a “happy spitter.” But both of my babies truly did have major reflux and silent reflux issues. I now know what the likely biggest cause was, and the best solutions, described below.
The Mental Health Affects No One Talks About:
There are also mental affects and trauma for the parents who have to deal with these issues. My second baby didn’t need to be held constantly, refuse all sleep, or scream as much as the first did, but he did do these things sometimes, and the struggle was REAL, especially because the second time, I had a young child to take care of as well.
I’m not trying to put greater importance on my own well-being compared to my children. Quite the opposite really; I’d say the worst part of my experiences was knowing my babies were in pain and not being able to eliminate it. The next worst thing was the insensitive commentary I got from family and friends along the lines of being told that I just wasn’t a competent mother. Please, have empathy for people going through this and never say such unforgivable things.
Keep in mind I had no childcare, or that “village” it takes to raise a child. I lived in an old, cramped one bedroom apartment and couldn’t do any of my former passions or go out to socialize. My husband worked a lot and slept all night, so I was usually alone, with a baby who wouldn’t stop crying, wouldn’t sleep and couldn’t ever be put down. It was extremely wrenching and isolating.
I have lasting CPTSD trauma from all this. And in the thick of it of it, I was literally barely surviving and barely meeting my basic needs: I got extremely thin, and it was a huge struggle to be able to cook, eat, use the bathroom and shower. So many times, I jumped out of the shower with shampoo still in my hair. I was sleeping almost never, because my baby had to be held for her to sleep. I was losing my mind.
These are thoughts I wrote in the throes of it:
-“This takes the joy out (of parenting, or maybe life in general).”
-“The hours drag on and on like insanity and I wonder what other parents do with all that time they have instead of spending so long trying to get babies to sleep.”
⁃ “I’m bitter that most people don’t have these issues and those that do don’t usually have them this long.” (My babies had reflux and sleep issues for years).
-“Losing the will to live.”
Yes, I seriously felt that way. It’s that bad. I hate using the word “hell” to describe my experience with my baby, but it was. The sound of babies crying is actually used as a torture method, and it’s even worse when it’s your own child you are responsible for taking care of.
I’m not writing about this to complain. I’m sharing information to help others because the thought of babies and their parents suffering like we did seriously breaks my heart and brings me to tears when I think about it. There are some parents who can relate and probably feel alone (I’ve only known two others who went through this to a similar extent), and this post is for you. It’s also to prevent these issues for others.
Here’s something I wrote about my second child’s issues with projectile spit up, and never shared. Cleaning up spit up was a minor inconvenience in comparison to knowing my baby was struggling, but on top of everything it was definitely an added burden.
“So. Much. Spit up!!! I’m not talking about a little dribble here and there. I’m talking about projectile flows that shoot over burp cloths and drip down my arm, or down my chest and pools in the center of my bra, or splatters on the floor or my pillows and sheets. Sometimes the poor guy does it in his bassinet and it gets all over the side of his face.
If you aren’t familiar, spit up looks and smells like curdled milk. I change clothes (his and mine) multiple times a day and do lots of laundry. I’m still trying to find ways to reduce the reflux. One thing I tried was stopping periodically during nursing to burp him more often, and he started getting so angry! Crying also leads to swallowing air so I feel that defeats the purpose.
My second child spits up even worse than my first, and more projectile. Depending how I’m holding him, it will go flying over my shoulder and drip down my arm and back. Or in my hair. Not to mention, all over the bed and pillows where I nurse him. Or if we are around the house, it often splatters all over the floor.
The worst incidences involved the spit up dripping down and getting stuck in various crevices around the house, such as: Next to both sides of the stove, connectors of the playpen, joists of bed frame, and seams of toys.”
I hope this post helps you and your baby avoid being covered in baby vomit multiple times a day.
Symptoms of “Colic” or Baby Reflux:
-Sudden screaming during sleep and waking up frequently, crying.
-Arching back.
-Turning red/deep red while arching.
-Startles easily.
-Very little sleep or only short naps.
-Stiffening of body and legs.
-Frequent hiccups.
-Moaning, groaning, and straining during and after feedings, as if trying to pass gas or a bowel movement.
-Other noises associated with ruminating.
-Hoarseness of voice.
-“Sour look.”
-Acidic (clear) spit up, spit up with pain, or projectile spit up.
-Pulls away from bottle or breast while feeding and is obviously still hungry OR is constantly hungry and still feeds even after being overfed.
-Very tense during feeding with fists clenched tightly and legs drawn up.
-Often congested.
-Loose stools.
-Bubbling at mouth.
-Crying or screaming after feeding, and at random times every day.
-Can’t lay flat on back.
-Crying or screaming for long periods of time.
Is it Colic, Reflux, or Something Else?
As mentioned in the intro, “colic” isn’t a disorder or actual diagnosis; rather it actually just means “unexplained prolonged crying.”
What is reflux and/ or gerd? Infant acid reflux (GERD) is Gastroesophageal reflux disease, which is similar to heartburn (acid reflux) in adults.
Silent reflux or laryngopharyngeal is a condition in which stomach acid flows back into the esophagus and irritates the throat, but doesn’t necessarily come all the way out as spit up.
If your child truly does have an acid issue, learning about cyclical “acid dumps” may be useful to know.
What I’ve learned after such a long journey is that I believe for most babies with the above symptoms, the problem isn’t acid at all! Gas, tongue tie, and food intolerances to something in the breastmilk or formula (especially dairy insensitivity) are just a few likely factors that will be further explained below.
Many people think babies are lactose intolerant, and while it is possible, most of the time it turns out that the proteins in milk are to blame (this means even lactose-free products will still be bothersome).
Crying from the pain of reflux (or any other issues mentioned) leads to swallowing air, leading to even more gas which exacerbates all the issues, creating a bad cycle.
Gagging, coughing or a wet sound to your baby’s breathing sometimes indicates that milk has found its way into the airways. Either your baby completely aspirates milk or fluid into her airways or it penetrates them and then is expelled when she coughs or gags. This is rare but unfortunately, if aspiration is left untreated, it can lead to serious complications such as pneumonia, bronchiectasis and failure to thrive.
Problems With Prescription Anti-Acid Drugs:
I’m not sure how often this happens presently, but in the past babies were frequently prescribed Zantac/Ranitidine H2 receptor antagonists, or H2RAs, which reduce the amount of acid the stomach produces by lowering histamine production. Also frequently prescribed were PPI (proton pump inhibitors) like Omeprazole, Prevacid, and Nexium.
In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market because of unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products.
The worst part about the fact that thousands of babies were prescribed these drugs is that doctors openly admitted that they didn’t even usually help babies with reflux. Yet, that was often considered the standard first response for a prescription to try.
The next step is PPI drugs, and they can actually have a reverse effect on reflux and in some situations can actually give you more reflux symptoms (and more screaming) than not taking them. The reason for this is because they lower stomach acidity, making it somewhat more difficult for the stomach to break down the food. Because of this lower acidic level in the stomach this means the stomach takes longer to digest food and this can mean more exposure to reflux symptoms from the longer digestion process. Also, when first starting these drugs, the stomach produces even more acid to try to compensate for the sudden lack of digestive acid.
PPI’s come with a host of issues including vitamin/mineral absorption problems. More information and studies about why anti-acids don’t work.
I encourage you to try the solutions below before trying any of these acid-blocking drugs.
Cures/ Solutions/ Remedies:
1. By far, my biggest recommendation is a book/ ebook called BabyCues: Prevent and Remedy Colic, Reflux, Lactose and Dairy Overload. This changed my life. After trying EVERYTHING else and spending hundreds of dollars and hours of heartache and sleeplessness, this was the only thing that really helped!!!
I have recommended this hundreds of times already and I get absolutely no benefit of sharing or writing this. I don’t know the author personally and she doesn’t know I have been sharing this book. This is NOT an affiliate link: https://www.babycues.com/books/colic-reflux-prevent-remedy/
The biggest thing the book explains is that many problems are caused by trapped wind (needing to burp and/ or pass gas) and feeding too much/ too often. A lot of conventional wisdom is turned on its head, like the advice to feed constantly and keep babies upright. Laying down actually helps the burping process.
Here are a few main points (some of which I’ve also read elsewhere, and some including my thoughts and experiences):
-Only feed the amount the baby’s body is designed to take (which is less than you’d probably think; Babies stomachs are super tiny). There are special directions for how to feed with bottles.
-Pulling away from the milk during a feed may mean the baby needs to burp. Don’t try to push more milk if baby wants to stop.
-Burp the baby a lot! The author of the BabyCues Book, Philippa Murphy has found that all newborns have these cues (link) that mean they are ready to burp. Knowing these, and the positioning and calming advice was invaluable to my baby. This will take longer and more burps than you may be used to; the book explains more details and techniques. Try to keep baby calm because tension prevents burps from being able to come up, and don’t pat or jiggle because that can break the air bubbles and make them harder to expel.
-Space the feeds out as explained by this article. I know there are varied opinions about not feeding so often. Especially with newborns I struggle with it. But feeding too much too often can overload their system. My firstborn acted hungry constantly even though she was extremely overweight. I know breastfeeding advocates recommend feeding on demand, but one doctor told me that my exclusively breastfed baby was overfed. I was livid at the time but now I know it was true. The closer together her feedings were, the worse the spitting up was.
I found that what we think are hunger cues are sometimes tired cues. Or, what we think are hungry or tired cues are often digestive pain. Babies can seem hungry even when they are full, but they are actually just seeking to relieve their gastric discomfort. It’s a bad cycle of the air trying to get out and pushing out milk with it, plus the stomach acids coming up and irritating the throat. Then they want to drink more to wash it down but are too full and throw it back up. This BabyCues article explains it as digestive overload and why the “witching hour” isn’t normal.
There’s more on the BabyCues site but I extremely recommend buying the ebook or book because it contains so much information that can’t be found anywhere else. Even if you don’t do the spaced feedings, I think the rest of the book would still be beneficial.
The book is about making babies feel better, function as they should, and escaping bad cycles of feeding too often, not being able to sleep, etc. I highly recommend reading the whole thing. At least skim through or look at the steps of burping and the pictures of the positions, it will help you a ton if you try them!
There is also another BabyCues book I purchased for when babies are ready to start solid foods. It takes into account when babies stomachs are capable of digesting different types of foods. There are several other books offered and I’m unsure if they were available when I had my babies, but they look great as well.
My advice based on current research, standard medical and expert advice is to make sure to wait until at least 6 months before giving any foods, including thickening bottles with rice cereal or oatmeal.
2. Check the breastfeeding latch with a lactation consultant. Make sure baby gets a deep latch, which will help get the hindmilk to keep baby satisfied and also swallow less air. I was like many women who worried I wasn’t producing enough milk, because of how hungry my baby seemed (see #1) and because when I tried to pump, almost no milk would come out. But pumping often doesn’t yield the same volume as breastfeeding directly, because babies can nurse more effectively and get more directly from the breast. Doing a weighted feeding (weighing baby before and after breastfeeding) can help alleviate your concerns about this.
3. Tongue and/or lip ties can cause improper latching and swallowing leading to excess gas, and a host of other issues. Find a tongue/lip tie specialist for an exam and revision if needed. Regular pediatricians and nurses do not usually know what to really look for, and will often say things look fine when they are not. Adequate specialists used to be referred to as “tongue tie preferred providers” but now I believe this is the resource list they go by: https://tonguetieprofessionals.org/directory/
4. Visit a reputable chiropractor who is trained and experienced with babies and uses gentle techniques, meaning they don’t do the exaggerated neck turning or loud cracking.
5. Offer a pacifier after feeding. The sucking helps keep the acid down and soothe baby. A very respected lactation consultant said the traditional shape (that look like the Avent Soothie) is best for proper sucking: https://amzn.to/3PVsKdc. But, others recommend the orthodontic shape, such as the Nuk brand: https://amzn.to/3U7dlZx or https://amzn.to/3xrSIyr. I got both types but am inclined to go with the lactation consultant; if they learn to suck correctly than reflux may be less of an issue. IMO if they can’t suck the soothie shape, there are likely issues such as tongue tie or other latching issues. But getting both may be a safe plan. If your baby does have reflux issues, perhaps see if the orthodontic shape helps.
6. Sleeping positions: If your baby truly does have acid reflux issues, sleeping can be a heart wrenching struggle. They don’t want to lie on their backs because it hurts. Doing “cry it out” methods are particularly cruel to these babies.
The BabyCues techniques should help to alleviate this, but as you transition, you can try the conventional advice to look into safe ways to have baby sleep at an incline. This was the most useful site on the topic of keeping babies with GERD upright, and the tips for not letting babies slouch is good for all babies.
The research on babies sleeping on their bellies has changed and my doctor gave permission to let my baby sleep that way, once he could turn his head.
7. Also… do whatever else it takes to help baby sleep enough. Check out of sleep tips for how to have a more conducive sleep environment, including having it be dark and quiet. Look up sleeping charts and “baby awake time length” to see how often baby should sleep.
My babies had to be rocked or bounced on an exercise ball every nap and then held, for all their naps. Movement often soothes babies with “colic” because it’s usually just gas bothering them. When a baby is not moving, the gas can form a large gas bubble that painfully puts pressure in the abdomen. When the baby is gently bounced or rocked, the gas is dispersed, relieving the pain. If the pain were really caused by an overabundance of acid, then rocking or bouncing would make it worse.
Baby wearing is also often recommended and helps partly because it soothes the baby to be close to someone, and also because it involves motion by the person wearing the carrier.
8. Ask for help from others, such as cooking, cleaning, holding the baby so you can eat and shower, etc. I relate if you feel you have no one to ask, but you might be surprised. You can even try local online mom groups; another mom may be willing to help you out! You can also start a “meal train” to ask others to bring food. I also know it’s hard to admit you need help, and feel embarrassed to ask. But the saying about “it takes a village” is really true, especially if you have the added struggle of colic issues.
If you have time, therapy is always a good thing for everyone, but likely extra beneficial at a time of high hormones and stress. Also, please get yourself outside into the sunshine each morning. I believe one aspect of Post Partum Depression is from suddenly being inside all the time, along with a lack of vitamin D and loss of circadian rhythm.
9. I know the temptation to buy a bunch of remedies, but honestly please try the Baby Cues strategies first. It could be the only thing you need to buy. If you haven’t begun yet or your baby still has gas, you can do gentle abdominal massage and exercises such as bicycle legs.
I tried all kinds of natural remedies with my first baby and nothing helped, and the second time I learned more about how the gut isn’t ready for anything except milk until at least 6 months old. Even at older ages, many medicines such as gripe water and mylicon type drops have toxic ingredients, and those can bother babies too.
Products like Baltic amber necklaces have not been proven to be effective and are often fake. You’ll also see products such as heading pads for baby, but those can easily be too hot and cause burns.
Natural products that may help but I recommend looking into yourself are listed here. Be sure to double check that anything you give (especially the homeopathic remedies) do not contain lactose/ dairy. Also be sure to look at all the ingredients of any other products you look at, including inactive ingredients; many times toxic components are added in! All links are Amazon Associates, and I don’t have any special affiliation to any of these brands:
-George’s Aloe Juice: https://amzn.to/3VPSvzg
-Kid E Col organic drops: https://amzn.to/3vITl6g
-Boiron Cocyntal Colic: https://amzn.to/3TRjLuu
–Hyland’s #10 Cell Salt: https://amzn.to/3TGD3Tq and #9 https://amzn.to/3vwMJbe
-Boiron Lycopodium Clavatum for Bloating and Gas: https://amzn.to/49rqMIb
-Bach RESCUE Remedy Kids: https://amzn.to/3PUHc53
-Earthley Wellness, Teeth Tamer: https://amzn.to/3vIAbxg
-Boiron Camilia Teething Drops: https://amzn.to/3VN4760
-If you try probiotics, make sure there’s no lactose /dairy and start with very small amounts. Studies show that the probiotic strain of Reuteri helps colic but isn’t like a typical probiotic blend. However, when I looked recently I couldn’t find it available as a single-ingredient powder; let me know if you see one. I didn’t like the inactive ingredients in any of the liquid versions I saw.
10. Something that helps many is to completely eliminate dairy indefinitely. This is listed last but is one of my top recommendations. This means removing even trace amounts, so check all labels and your probiotics and supplements too. If you are breastfeeding, cut out ALL dairy (milk, butter, etc.). If you use formula, you can get a dairy free version. It can take 4 to 6 weeks or more to fully clear out of the body, so don’t give up too soon to see benefits.
If you are breastfeeding, other things to experiment avoid consuming: Acidic foods (citrus/lemon, tomato), spicy foods, foods known to cause gas, probiotics (these can be beneficial but in some cases can cause issues especially if they contain traces of dairy). Also It can’t hurt to look up the lists of foods most likely to cause reflux, like onions, chocolate and the top 8 allergens, and do experiments with eliminating them: Wheat, peanuts, tree nuts, fish, crustacean shellfish, soy, eggs, milk.
When eliminating foods, it is important to be vigilant. If you’re eliminating something, don’t eat even one bite. It can take 2-6 weeks to clear the top 8 allergens from your body.
BabyCues has a Breastfeeding Diet Guide with guidance about what to eat when breastfeeding. It’s one of the the guides I haven’t read but I’m sure it contains helpful information.
I also highly recommend avoiding foods that are known to contain high levels of heavy metals or mold. I also highly recommend you have your living space tested for hidden mold, because mold can impact your gut, sleep, pain levels, temperament, and overall health. Here are my guides for heavy metals and mold.
More About Diet Changes During Breastfeeding:
I read a hypothesis that baby reflux issues are all because the mom’s gut is troubled and not digesting properly… so I worried about that. I do think diet matters, but I never found any safe foods and I think there’s other factors at play, mentioned above.
As mentioned, I do feel it is worthwhile to completely eliminate dairy. Additionally, there may be something else you’re eating that is bothering the baby through breastmilk, or an ingredient in the formula.
This link explains how long it takes for food to affect your breastmilk.
Some people benefit from probiotics, but you have to use tiny amounts only and make sure no dairy is in the product. Some say probiotics can make it worse.
There are many Facebook and other support groups for diet changes such as dairy and soy free support groups. Soy usually also needs to be eliminated with dairy. Keep in mind that these groups usually don’t consider other toxic aspects of foods, so many of the “substitute” foods they recommend are processed and not organic, etc.
Some thoughts I wrote during one of my past experiences with elimination diets:
“I’ve eliminated everything on the common lists, as well as the obscure lists. I’m eating only about 10 foods right now. It’s WAY harder than you think. It’s also extremely tricky to even know which foods are affecting the baby.
Foods can affect breastmilk anywhere from 1-24 hours after consumption, and dairy products can have effects for up to 6 weeks! There’s also no definitive list of what causes reflux. There’s various lists that claim to identify most common triggers, but the reality is that ANY food can cause it, it just depends on the person.
I think I’m finally starting to identify safer foods and a few triggers (but I think there are many more that I haven’t figured out yet). I fear nuts are a trigger, and if you know how big nuts are in my life, you’d know that was slightly devastating.
In addition to lists of common reflux triggers, I also avoid the foods thought to be likely to cause gas. To get even more difficult, things that add flavor to food, such as salt, spices, and all fats (🤯) are often triggers, so I am avoiding them too. [Note that I don’t recommend eliminating healthy fats, but someone recommended that to me and I tried it briefly.]
I have no idea what to eat anymore. Really spiraling down the rabbit hole now looking into FODMAPS, FPIES. If you overlap those with reflux and gassy food, I think almost everything is eliminated. I think I might have a gut health/ digestion issue myself. Since both my kids have these issues.
I have eliminated all the recommended foods for reflux, gas and allergies. I think there is less spit up from some things, but I’ve never found a baseline or know for sure that ANYTHING is safe.”
That shows the overwhelming frustration that can happen with elimination diets, so other than dairy and then the main culprits thought to affect reflux and gas issues, I don’t recommend doing crazy elimination diets unless everything else on my recommendation list fails.
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