Colic in babies: how delivery, breastfeeding and stress influence pain

For a long time, the cramps of breastfeeding babies were consecrated by the name “rule of 3”.

“It was defined as starting at 3 weeks of age, occurring at least 3 hours a day, on 3 days a week, with a minimum duration of 3 weeks and a maximum of 3 months, all of this in an absolutely healthy child”, explains Tadeu. Fernando Fernandes, pediatrician at the Scientific Outpatient Department of the SBP (Brazilian Society of Pediatrics).

The maxim is still considered valid, although now science has shown that a subtly longer or shorter period also happens.

Why do babies have colic?

Colic happens because of the immaturity of the baby’s digestive system, which in the first few months of life is still unable to fully process food, even if it’s just breast milk, as is recommended up to six months of age.

“Therefore, if the birth is premature, it is common for the occurrence of colic to be even greater”, says Fernandes.

But there are also certain factors that can increase the chances of colic, according to experts. Some of them have to do with the intestinal microbiota, also known as intestinal flora, which plays an important role in digestive processes, nutrient absorption and immune system development.

type of delivery

“When the child is born by vaginal delivery, as it passes through the vagina, it comes into contact with the mother’s vaginal flora. On the other hand, if the delivery is a cesarean section, it is already well scientifically proven that the baby is at greater risk of suffering from colic. environment in which it is born is sterile and, without contact with beneficial bacteria, the intestine is born poor in terms of microbiota”, explains Fernandes.

In a study published in the scientific journal Nature in 2019, scientists analyzed diaper samples from nearly 600 babies during their first month of life, and some fecal samples from babies during their first year of life. The results show that those born by vaginal delivery receive most of the bacteria from the mother.

Read in this article about how the type of delivery affects the bacteria in babies.

Breast-feeding

Breast milk, among all mammalian milks, has the highest content of lactose, a type of sugar that can cause cramping during the fermentation process, especially because the digestive system is still immature.

“Breast milk has three phases: one more watery, then the white, and finally the milk becomes more yellowish, with a higher protein and fat content. the baby, which is why we recommend that all the milk in one breast be emptied before the mother offers the other side, contrary to what was suggested in the past”, says the pediatrician.

Another factor that increases the risk is formula feeding. “While breast milk has prebiotics (substances that stimulate the activity of bacteria in the colon) and probiotics (live microorganisms that help keep the gut microbiota healthy), most formulas only contain prebiotics, which doesn’t help as much with digestion. “.

For mothers who cannot breastfeed, the recommendation is to talk to the pediatrician to seek specific formulas that contain both or discuss the possibility of “supplementing” with probiotics, according to the expert.

Habits in pregnancy

Among other factors that can influence are the habits of the pregnant woman during pregnancy. If she takes a lot of antibiotic drugs for any reason, for example to cure a urinary tract infection, the drugs help to kill the “good bacteria” that populate the intestinal flora. Therefore, it is recommended that pregnant women use these drugs only under medical supervision.

“The same happens if the woman undergoes a lot of stress. As the brain and intestine are interconnected, the harmful effects appear, and the baby does not ‘inherit’ a rich microbiota”, points out the pediatrician.

This is because the intestine is “governed” by the so-called enteric nervous system, which is part of the body’s autonomic nervous system, responsible for directly controlling the digestive system. This nervous system extends through the tissue that lines the stomach and digestive system, and has its own neural circuits. Although it works independently, it communicates with the central nervous system through the sympathetic and parasympathetic systems (divisions of the nervous system). So if either side doesn’t do well – either from stress or other negative emotions or, in the case of the gut, from a lack of bacteria or a nutrient-poor diet, for example – the other side tends to be affected.

family atmosphere

Also because of the brain-gut axis, if the child grows up in a stressful family environment, their levels of cortisol (known as the stress hormone) increase, which can cause colic. “This is also why the affection and warmth of relatives have the power to reduce the incidence of colic in lactating women”, comments Fernandes.

In addition, maternal anguish and anxiety can generate restlessness in the baby, interfering with the time of breastfeeding. “This causes greater intake of air during breastfeeding and consequently more gas, which can also cause pain”, points out pediatrician Caroline Peev, a doctor at Sabará Children’s Hospital.

How to recognize that the baby has colic?

“Infant colic [bebê que está sendo alimentado via amamentação] It has the characteristic of being in the afternoon or at night. In the morning, the ideal is to look for other causes”, explains Fernandes.

Although the most striking feature to recognize colic is the time of crying, doctor Caroline Peev indicates that babies can emit other signs, such as shrinking and stretching their legs, arching their backs and closing their hands and having a swollen belly and releases gases.

Are there remedies to treat colic in babies?

There is no magic remedy to cure colic. It is important, according to experts, that parents and caregivers know that the pain felt by babies is part of a natural and physiological process of the digestive system and does not offer risks, only discomfort.

There are, however, some measures that can help – the cramps will not go away, but they can last for less hours. “In cases of poor gut flora, there are age-specific probiotics that should be recommended by a doctor that help intestinal colonization become more diverse,” says the SBP pediatrician.

According to the specialist, gas medicine like simethicone – if recommended by a specialist – can help, but it treats the consequence, not the cause of colic.

For the safety of the baby, mixtures with herbs and herbal medicines should not be used, according to pediatricians. On the other hand, the use of bags and cloths with hot water poses a risk of burns if they are not administered very carefully.

Pediatrician Carolina Peev also explains that the greatest risk is intoxication generated by medication without guidance or use of homemade medicines, which do not have pre-established dosages. Vomiting, choking, diarrhea and even intoxication can occur.