IS THIS SOMETHING TO WORRY ABOUT?
The early days are a steep learning curve. Babies do some really weird things in the early days and it’s sometimes hard to work out if it’s something to worry about or not. The hardest thing is to see our babies look uncomfortable or not be able to stop the crying. We want to help them feel better. So what (if anything) can we do?
DOES MY BABY HAVE REFLUX?
Probably! Around half of babies do. Did you know that it’s really common for babies to bring up a bit of milk after a feed? If a baby brings up milk several times a day, but is otherwise ok, there is no need to do anything at all, this is known as physiological (or normal) reflux. This doesn’t require medication. Your baby will probably screw up their face a little (because the milk tastes a bit sour) and may even straighten their body or fuss a little. If you’re concerned, the first line of action (whether you’re breastfeeding or bottlefeeding) should be a feeding assessment. (NICE, 2019) As an IBCLC, I can do a feeding assessment on babies, so if you’re worried, feel free to send me a message.
BUT DOESN’T BACK ARCHING MEAN REFLUX?
I often see people interpreting back arching as a sign that a
baby is in pain and therefore must have reflux that needs to be medicated. Babies arch their backs for a lot of reasons. Often, they’re protesting at lying flat on their back. Back arching is one of the few movements they can do as newborns: back arching will eventually evolve into rolling, so your baby might just be trying to get off his/her back. Remember, their default position where they are always happiest, is curled up on your chest. It can also be a late sign of tiredness, so have a think about the last time he/she slept (Hookway, 2018). Maybe your baby needs a nap! If back arching happens while feeding, the baby is possibly struggling with either a fast or slow flow (a feeding assessment might help identify if this is an issue).
WHY IS MY BABY SO WINDY AND CRAMPY?
Babies burp and fart a lot! Their digestive system adjusts rapidly to having to digest milk, and they quickly colonize their gut with bacteria which will become part of their immune system, but also helps them digest food. All of this results in a lot of wind (from both ends!) which they can struggle to get rid of. I’ve done a video here, which shows some winding techniques which may help. Carrying your baby in a sling during the day may help, as can a bit of gentle tummy massage before bed, or a warm bath where their tummy is completely submerged under the water. Some parents find doing little bicycle movements with their baby’s legs helps, too. Like most newborn behaviour, the amount of wind and the discomfort it causes, improves with time.
WHY IS MY BABY GRUNTING AND WRIGGLING ALL NIGHT?
Babies can make really weird noises at night time. You probably don’t notice them so much during the day, but at night time they can sound really loud. Remember, their digestive systems are developing rapidly so they are probably experiencing all kinds of weird sensations. Babies also have a lot more light sleep than we do (around half the time they are sleeping is spent in light sleep), so you’ll see a lot more movement than you might expect, too. Usually they don’t need to be lifted unless they are crying, but it might be helpful to just wait and watch (or try to sleep). It’s not a sign that they are uncomfortable, they are just being babies. (Pantley, 2020) Some parents find that their babies are more settled and quiet if they co-sleep, so that might be something to consider too, as long as you can do it safely.
MY BABY IS STRAINING AND CRYING BEFORE DOING A POO! IS HE/SHE CONSTIPATED?
Often parents think that their baby is constipated because they strain, go red in the face, cry, for up to 20 minutes… and then baby usually does a soft poo (or they may not poo at all). If this happens, it’s not constipation, it’s a normal event called infant dyschezia (Zeevenhooven et al, 2017). It’s basically your baby learning how to control the muscles that allow them to poo. The good news is, there is nothing you need to do, and it usually stops of it’s own accord once your baby has learned how to control the process a bit better.
WHY DOES MY BABY HICCUP ALL THE TIME?
Parents often report that their babies get the hiccups a lot. It has been suggested that hiccups may help train the breathing muscles while in utero and in the early days (Kahrlias and Shi, 1997, Whitehead et al, 2019). Hiccups usually become less frequent as babies get older, so this makes sense. I have also seen it suggested that it might be linked to an allergic response to something in the baby’s milk (Minchin, 2015). However, unless there are other signs of allergy as well, I wouldn’t use this as the only sign that the baby might be allergic to something. Hiccups are probably also more common if babies have fed quickly, have a very full tummy, or have a bit of wind or reflux, much like what gives adults hiccups! How do you stop hiccups? I would suggest letting the baby feed again, or suck on a clean finger, as the sucking and swallowing seems to stop hiccups.
WHY DOES MY BABY CRY A LOT IN THE EVENING?
This one is TOUGH. You might have heard this called “the witching hour” or colic. When does it stop being normal fussy behaviour, and when does it become colic? It’s hard to say, but if you are concerned and it’s causing you stress, then it’s significant to you. Getting help and support can be really important. If you can, get some extra help in the evening from a grandparent or friend, or switch between you and your partner, to help you get a break. The constant crying can become really difficult to deal with, and you may find that you start to get really stressed out by it, especially if nothing seems to be helping. Know that comforting your baby through it, IS helping them, but sometimes you need to put your baby down in a safe place and walk away, take a few deep breaths, calm down and then go back to cuddling, shushing, rocking…
We don’t really know what causes colic. In fact, there are probably quite a few different causes, and it’s a case of trial and error to identify what is causing colic in YOUR baby. Sometimes the only thing that seems to help is time, and most babies stop crying inconsolably by three months. I’ll share a separate blog on colic next week, because it’s a big topic that needs a bit more a bit more space (and potential solutions).
WHAT MOST BABIES NEED IS TIME
WHAT PARENTS NEED MOST IS SUPPORT
Almost all these behaviours will settle with time, without causing your baby any harm. Navigating those early weeks can be really tough, though. There is nothing more reassuring than talking to another parent, and discovering that they are going through the same thing, or talking to a parent who has gone through it before who can say, “That’s completely normal! It will pass!” If you’re still worried after talking to friends and family, I’m always happy to chat.
Hookway (2018) Holistic Sleep Coaching, Praeclarus Press, Amarillo
Kahrilas and Shi, (1997) Why do we hiccup? Gut, 41, 712-713
Minchin (2015) Milk Matters: Infant Feeding and Immune Disorder, Milk Matters Pty Ltd
NICE (2019) Gastro-oesophageal reflux disease in children and young people: diagnosis and management: https://www.nice.org.uk/guidance/ng1
Pantley (2020) The No-Cry Sleep Solution 2nd Ed, McGraw Hill, New York
Whitehead et al (2019) Event-related potentials following contraction of respiratory muscles in pre-term and full-term infants, Clinical Neurophysiology, 130, 2216-2221
Zeevenhooven et al (2017) The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers, Pediatr Gastroenterol Hepatol Nutr, 20(1) 1-13