Why does my baby cry after feeding?

Three-month colic

Three-month colic (Regulatory disorders): Continuous crying of a baby - usually after feeding - for no discernible cause.

A "crying baby" is an infant who screams for more than 3 hours a day for at least 3 days a week for more than 3 weeks for inexplicable reasons and can hardly be calmed down. These so-called Three-month colic usually start around the 2nd week of life and increase until around the 6th week of life. As a rule, the "colic period" goes back completely by the end of the 3rd month - hence the name "three-month colic".

  • Suddenly the baby's high-pitched screams, the forehead is furrowed, the face red, the fists are clenched, the legs are drawn up
  • Repetitive seizures that usually end after 5–20 minutes
  • Attempts to calm down, such as the usually effective picking up or feeding, only help temporarily
  • Increased occurrence of symptoms in the afternoon and early evening hours
  • Otherwise completely normal growth and development of the infant.

Today if

  • Your baby is not thriving because it is not drinking well (see Failure to thrive).
  • it is apathetic, listless or pale (or pale gray).
  • it keeps vomiting.
  • it screams in pain or high pitch for more than 1 hour; this can indicate a pinched inguinal hernia or an invagination of the bowel.
  • Your baby cries beyond the normal limit of around 3 hours a day and in the process eludes any outside influence (such as lifting or trying to calm down).
  • it has difficulty adjusting to sleep and wake phases, it usually only sleeps briefly during the day (often less than half an hour) and it also has problems falling asleep.
  • You feel overwhelmed and / or are afraid of losing control (e.g. shaking too hard, yelling at, hitting the baby).

Disease emergence

Many infants have a short “vaccination time” right after drinking. The baby may have a bloated stomach, spit a little or cry - with the "pelvic" the crying stops. It is different with the so-called three-month colic, from which almost every fourth baby suffers. The babies cry continuously and repeatedly, preferably in the early evening hours, but often also into the night, and it remains unclear what is behind this. The "colic" often begin after the first few days of life. Fortunately, however, there is light at the end of the tunnel: 85% of babies have their "colic period" behind them after 3 months.

causes

The causes of the Screaming attacks are not known. Only in rare cases are there tangible causes that cause pain for the little ones, such as otitis media, reflux disease or an anal fissure.

However, there are many indications that it is abdominal cramps, as the term "colic" suggests. The stomach is often tense. The infants tighten their legs and then suddenly straighten them again, as if they wanted to "kick away" the pain. These cramps are reduced by "winds" or by leaking a chair. However, x-rays show that crawling babies don't have more intestinal gas than "healthy" babies.

Sensitivity. Today it is also assumed that the stomach cramps only as episode the screaming and the associated excitement arise, so that at the very beginning there is another trigger and then "hits the stomach". It is therefore assumed that baby cribs are "more sensitive" than their peers and therefore react more sensitively to the air swallowed each time they scream. Another suggestion is that some babies have more tummy responses to stimuli than others. This assumption fits that the colic mainly occurs in the evening, when the baby is tired and possibly overexcited anyway. Since these babies have not yet learned to calm themselves like their peers, experts count this behavior among the so-called "regulatory disorders", which also include sleep and feeding disorders.

Melatonin theory. Under the local lighting conditions, the hormone, which is partly responsible for the biorhythm, is only formed in sufficient quantities from 3 months after birth. Until then, its relaxing effect on the intestinal muscles is missing - babies are therefore more prone to intestinal cramps during this time.

Overcrowding theory. In warm climates, babies drink mainly "thirst-controlled" and thus far more often than in this country, where babies drink "hunger-controlled". It is believed that the large amounts of milk that are typical for local meals are not digestible for some babies. This theory is supported by two arguments: On the one hand, spitting, which is often observed in our latitudes, occurs less often in warm countries. Second, experiments show that frequent feeding actually works as a preventive strategy against colic for some babies.

Early childhood dysregulation. In most babies, the crying disappears. With some, however, it remains; Doctors refer to this as "persistent" screaming. The children also often have other personality traits - parents describe them as demanding, dissatisfied and easily irritable. Sometimes there is also a great deal of physical restlessness, so it is no wonder that these children sleep poorly. Pediatricians also refer to this phenomenon as early childhood dysregulation. Many of the children affected have phases of anger in early childhood and have difficulty adapting in kindergarten and school. Some are later diagnosed with AD [H] D.

Risk factors

Swedish researchers have been able to detect too much of certain hormones that affect bowel movements in children with colic (e.g. Motilin). A study by the University of Houston indicates a disturbed intestinal flora; it came to the conclusion that colic babies have an unusually small variety of bacteria in their intestines. The researchers hope to find a therapy for persistent screaming based on a probiotic diet soon.

Family environment. Whatever the trigger, it seems to have little to do with what parents do or don't do. Studies show that mothers of colic children are no different from those whose children do not have colic. They are neither “more insecure” nor less “capable of bonding”, nor is their upbringing style different. Often in the same family, one sibling is affected and the other is not.

Nutrition. "Allergies" or "milk intolerance" as triggers of three-month colic has not been confirmed in the vast majority of cases - such diseases are not only shown by screaming, but also by other signs such as diarrhea, blood in the stool or poor growth. The fact that "colic" occurs roughly equally in breastfed and non-breastfed children shows that food does not play a role in the vast majority of children. The intolerance to milk sugar (lactose intolerance), which is also sometimes suspected, is so rare that it is hardly valid as a general explanation.

Household smokers. Studies have shown that there are more baby cribs in smoking households than in non-smoking households. The explanation for this seems to be that nicotine encourages the intestine to cramp.

Overstrained parents. In Germany around 400 children suffer a shaking trauma every year, a quarter of them die from it. If parents shake the crying baby in their desperation, there is a risk that it will suffer serious damage within a very short time: Since the neck muscles are still weak and the head in babies makes up a large part of the body weight, the shaking will move the head forward and thrown behind. The brain mass moves back and forth, which in the worst case scenario ruptures blood vessels and nerve tracts and leads to cerebral haemorrhage and brain injuries. Bleeding from the eye retina is also possible, possible consequences are visual disturbances or even blindness.

Complications

In the Intestinal invagination (Invagination) a section of the intestine is telescoped into itself without a previously known cause; this cuts off the blood flow. Around 80% of all intestinal invasions occur in babies between the ages of 6 and 12. Month on. Sudden screaming that doesn't stop is typical. The child often pulls its legs up, and sometimes it vomits. Even if the baby calms down in between, the pain attacks will come back and the child may become pale, restless, or even apathetic. Bloody slimy stools may appear after a few hours.

In order to rule out a physical illness (e.g. an otitis media or constipation), a careful medical history and the descriptions or records of the parents about the distribution of the crying and the food intake help.

Ultrasound scans, x-rays, blood or stool tests. These tests are rarely necessary, but they help rule out physical illness.

85% of the babies got over their "colic period" even without medical treatment after 3 months at the latest.

Intestinal invagination. If there is a suspicion of an inversion of the intestine, the pediatrician tries to palpate the affected part of the intestine, or the diagnosis is made by an ultrasound examination or an X-ray of the large intestine with contrast agent instilled through the buttocks. In most cases, the cause is eliminated at the same time: the pressure of the liquid contrast medium pushes the turned-in piece of intestine back into the correct position. If this does not succeed, an operation must be carried out.

Video analysis. In serious cases, consider analyzing the behavior of parents and baby as part of a relationship analysis with video feedback. Studies have shown that parents were better able to recognize their child's needs and respond accordingly.

Despite the high level of suffering in the infant and the parents: three-month colic is harmless. Even if the colic and the accompanying crying are a great strain for the baby and parents - after 3 months the symptoms subside on their own and do not lead to long-term health problems.

What you can do as a parent

The first thing to do is check to see if your baby is sick and is therefore crying. If there is blood in the diaper, apathy, paleness or vomiting, contact the pediatrician immediately.

In the case of three-month colic, the strategies that are effective for "normal screaming" - such as breastfeeding, feeding or giving the pacifier - do not work. Often times, mooring or feeding makes things worse. The following strategies can be tried:

  • Carrying and body contact. For many babies, carrying around, rocking, and close physical contact help. Some babies prefer vigorous movements, others like it gentle. Gently caressing the stomach brings relief to some infants.
  • Massage. A gentle massage of the abdomen is calming and often helpful, as the screaming is sometimes also caused by gastrointestinal complaints. Or lay the baby on its stomach and gently stroke its back with your fingers.
  • Wrapping. Many parents have also had good experiences with wrapping the baby tightly in a large towel and then cradling them gently in their arms. A warm bath can also "solve" colic.
  • Sling or carrying frame. Carrying the baby in a sling on its back has also proven effective; there the child can be rocked without much effort.
  • Rhythms. Some colicky children can be soothed by rhythms or monotonous tones, for example when you turn on the vacuum cleaner, the baby hears the rhythm of the washing machine (child only stand next to, not on the washing machine) or take the baby on a drive in the car or with you take him for a walk in the fresh air. Singing has also proven its worth.
  • Rub in. Some infants like it when the belly is rubbed with fennel oil, slowly in a clockwise direction, always around the tummy (the large intestine also works in this direction).
  • Pads. A tea made from aniseed and fennel or from caraway and fennel is prepared for the warm, moist topping. 1 tablespoon of the seeds are scalded with 0.5 l of boiling water and then steep for about 10 minutes. Soak a cotton cloth with the brew and place it on your stomach. But test the temperature on the inside of your wrist beforehand. Place another cotton cloth and a small woolen cloth over the overlay. Let the towels sit until they have cooled down.
  • Relaxation bath. A warm bath may also "solve" colic. Mix 1 tablespoon of heavy cream with 2 drops of essential oil (for example anise and caraway or fennel and caraway) and stir this mixture into the bath water.
  • Cherry stone pillow. Place a warm cherry stone pillow on the baby bump. But test the temperature on the inside of your wrist beforehand. In no case do not make the pillow too hot!
  • Fennel tea. The European Medicines Agency (EMA) advises against giving children under 4 years of age the otherwise effective fennel tea, as it may contain carcinogenic substances.

Provide relief. But the most important thing is your own relief - because everyone runs the risk of losing their nerve with an insatiable crying infant. Whenever possible, your partner, childminder, friend or relative should help out in the evenings during the difficult weeks. It is also helpful if one parent stays with the crying baby while the other leaves the room for a few minutes to relieve himself. After 5–15 minutes it can be exchanged.

Quiet. Babies need enough rest to process the many new impressions. Treat your child to a regular daily routine and make sure they have enough time to sleep.

Scream clinic. You can also get help from professionals: in every major city there are crying clinics, most of which are located in children's hospitals. It often helps to describe the problems and then seek advice from experts. Ask the pediatrician or your midwife for local addresses.

Appropriate medication

Defoaming drugs with the active ingredient simeticon (e.g. in sab simplex® and Lefax®) bring relief to simple flatulence; they have no effect on colic.

Carminativum Babynos® is also marketed and recommended as a therapeutic agent specifically against flatulence in infancy and childhood. The drops contain a herbal combination of chamomile flowers, peppermint leaves, fennel and caraway fruits as well as bitter orange peel, but also have a high sugar and alcohol content, which is why they are controversial. Even so (or because of it?) They seem to work in some infants.

A study from 2013 shows that probiotics (lactic acid bacteria) also reduce the duration of daily colic. However, earlier studies came to a rather cautious result with regard to effectiveness, even if certain effects were sometimes noticeable. Still, it's definitely worth a try.

Complementary medicine

Homeopathy. Many parents try homeopathic remedies such as: B. light probiotic drops like BiGaia®. If your child's head is crimson with screaming attacks and sweat forms on their foreheads, Belladonna is said to help.

Acupuncture. A new study has shown that mini acupuncture (acupuncture point L14) reduces screaming.

Prevention

To prevent colic, patent solutions are unfortunately often offered, but they only seem to work for the neighboring child. Most parents of colic children find that the measures taken can at best only win one stage.

  • Change the diet of the nursing mother. This is also worth a try, but nothing more. Skip the bloated onions and the beans and maybe the cabbage, but avoid eventually ending up on a radical diet that drains your own strength. The evidence that such dietary changes are beneficial is very poor.
  • This also applies to a change in ready-to-use milk. Of course, it doesn't hurt to switch from Hipp to Beba or vice versa, and even in the first few days you often think that the screaming would be less - but the effect usually doesn't last. This basically also applies to the often recommended hypoallergenic foods (HA foods): There are indeed positive studies, but if you read them carefully, it is not clear whether the positive result is due to the (more expensive) foods themselves or just in the expectation of the parents. The same goes for "alternative" milk such as soy milk.
  • If you don't breastfeed your child, try whey-free milk substitutes instead. Feeding soy milk is not recommended for infant colic as the proteins may cause allergies; In addition, the content of plant estrogens in these preparations is questionable.
  • And breastfeed differently? That also usually turns out to be useless.Advice like "pump the first 30 g so the milk doesn't shoot into your baby's mouth" or "limit breastfeeding to 20 minutes" are well meant, but most of the time it just adds extra work, tension and annoyance. It may be easier (and, according to individual studies, also successful) to put the baby on more often overall - this could relieve the stomach with the individual meals.
  • Easier to implement is the tip to breastfeed in a semi-upright position so that the swallowing of air will prevent your child from belching more often (but who doesn't?), Or, for bottle-fed children, not to use a teat hole that is too large (ideal is supposed to be when one drop per second comes out of the bottle).

Note: Under no circumstances should you stop breastfeeding. It's not breast milk that is causing your child to cry.

Authors

Dr. med. Herbert Renz-Polster in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections "Description", "Symptoms and complaints", "When to see the pediatrician", "The disease", "Confirmation of diagnosis", "Treatment" and "Your pharmacy recommends": Dagmar Fernholz | last changed on at 10:10