The experience of an inconsolably crying baby can be deeply unsettling, often leading parents to question their routine, particularly feeding. Colic is defined by the “Rule of Threes”: crying for more than three hours a day, for more than three days a week, and persisting for at least three weeks in an otherwise healthy infant. This diagnosis is given when no other medical cause for the distress is found. Parents often wonder if breastfeeding is contributing to the problem.
Is the Act of Breastfeeding a Cause of Colic?
While breastfeeding itself is not a direct cause of colic, mechanical aspects of the feeding process can introduce or exacerbate similar symptoms. A common issue is the swallowing of excessive air, often due to a less-than-optimal latch. This ingested air travels through the digestive system, leading to gas and abdominal discomfort that manifests as crying and fussiness.
An overabundant milk supply or an overactive letdown reflex can also cause issues when milk flows too quickly for the baby to manage. The infant may gulp, cough, or choke at the breast, taking in large amounts of air with the milk. This rapid ingestion and subsequent air swallowing result in significant gas and discomfort, which may resemble colic.
A temporary foremilk/hindmilk imbalance is another potential mechanical factor, often related to high milk volume. Foremilk, received at the start of a feeding, is higher in lactose (milk sugar) and lower in fat than hindmilk. If a baby consistently fills up on high-lactose foremilk without reaching the higher-fat hindmilk, the undigested lactose ferments in the gut. This fermentation creates gas, leading to abdominal bloating, discomfort, and sometimes foamy, green stools, mimicking colic symptoms.
How Maternal Diet Impacts Breast Milk
The composition of breast milk is largely stable, but certain food proteins consumed by the mother can pass into the milk and cause distress in a sensitive infant. The most common protein implicated is cow’s milk protein, which can trigger a reaction similar to an intolerance or allergy in a small percentage of breastfed babies. Other common allergens like soy, eggs, wheat, peanuts, and tree nuts may also occasionally cause a reaction.
Studies show that when breastfeeding mothers of colicky infants eliminated common food allergens, the infants experienced a significant reduction in crying and fussing. This suggests that for some babies, the irritant is transferred through the milk, causing a digestive response in the infant’s gut. However, this dietary link is not the cause for all colicky infants, and breast milk remains the optimal form of nutrition.
If a dietary sensitivity is suspected, a temporary elimination diet can be attempted under the guidance of a healthcare provider or lactation specialist. The usual first step is removing a single food, such as cow’s milk products, for about two weeks to see if symptoms improve. A highly restrictive diet should not be maintained long-term without professional supervision to ensure the mother’s nutritional needs are met.
Differentiating Colic from Other Infant Distress
Not all crying or fussiness is colic, and not all digestive issues relate to feeding mechanics or maternal diet. Colic is a diagnosis of exclusion, meaning other medical causes of distress must be ruled out first. For instance, gastroesophageal reflux (GER) occurs when stomach contents flow back up into the esophagus due to an immature lower esophageal sphincter.
A baby with GER may show signs like frequent spitting up, arching their back, or crying during or immediately after feeding, which differs from the scheduled crying bouts typical of colic. While colic does not affect weight gain, poor growth can signal that reflux is severe enough to be classified as gastroesophageal reflux disease (GERD) and requires medical intervention.
General fussiness observed in newborns is often due to an immature digestive and nervous system that is easily overwhelmed. The infant gut is still developing its helpful bacteria and coordinated muscle movements, leading to periods of gas and discomfort, especially in the late afternoon or evening. The developing nervous system can also lead to overstimulation, where excessive sensory input results in an inability to self-soothe and subsequent prolonged crying.
Managing Colic in a Breastfed Baby
When addressing colic in a breastfed baby, the initial focus is on non-dietary and mechanical adjustments. For infants who gulp air or struggle with a fast flow, adopting paced feeding techniques helps manage milk flow and reduce air intake. This involves feeding the baby in a more upright position to allow gravity to assist with milk regulation, or burping the baby more frequently during the feed.
Soothing techniques that provide rhythmic motion and consistent sensory input are highly effective for a colicky baby. Gentle rocking, using a baby carrier, or applying low, steady white noise can help calm an overwhelmed nervous system. Techniques that apply mild pressure to the abdomen, such as tummy time, gentle clockwise massage, or “bicycle legs,” help move trapped gas through the digestive tract and relieve pain.
It is important to seek medical advice if crying is accompanied by other concerning symptoms that may signal a condition beyond typical colic.
When to Seek Medical Advice
Signs that warrant an immediate consultation with a healthcare provider include:
- Poor weight gain.
- Fever.
- Persistent vomiting.
- Blood or mucus in the stool.
Colic is a temporary condition that resolves as the baby matures, but addressing mechanical or dietary factors can provide relief for the infant and parents.