Colic Naturopathic Treatment Protocol

Colic Naturopathic Treatment Protocol

This Colic Naturopathic Treatment Protocol is intended as information for Practitioners and should not be substituted for medical advice, diagnosis or treatment.

Definition of Colic

Colic is a state of excessive crying seen in infants typically during the late afternoon or early evening. From 15% to 20% of infants develop colic, and it seems to be more common in firstborns and in boys than in later-born infants and in girls. Colic is seen in otherwise healthy infants and can begin as early as 2 weeks of age. It is self-limited, only rarely lasting until the infant is 6 months old.

Aetiology (Cause) / Risk factors

No cause has been proven for this disorder, but theories include those listed below.

  • Stage in the development of an immature central nervous system or digestive system
  • Response to emotional and family stress—need for comfort
  • Reflection of differences in infant temperament and physiology
  • Intolerance to foods in mother's diet, specifically, dairy products, caffeine, or gas-producing foods
  • Introducing food into infant's diet too early
  • Over-stimulation or under-stimulation of infant
  • Second-hand smoke
  • Antibiotics given at birth or to mother during labour

Signs and Symptoms

  • Inconsolable crying that lasts more than three hours for three or more days a week in a healthy infant 2 weeks to 3 months of age
  • Crying accompanied by vigorous kicking, pulling the legs up tightly to the body, and making tight fists
  • May have swollen or distended stomach, burp, or pass gas often
  • Infant appears to be in pain
  • Arched back and clenched fists
  • Frequent vomiting after feeding

CORE TREATMENT

Support intestinal microbiome

From 0-36 months of age:

Strain Specific Probiotics for Infant Health; or

 

Specialised Probiotic Support during Pregnancy, Breastfeeding and Infancy

 

Maintenance: ½ metric tsp (1.4 g) daily mixed with breast milk, formula or water

To restore gut flora: ½ metric tsp (1.4 g) twice daily mixed with breast milk, formula or water

Infant dose: Empty the contents of 1 capsule and mix with breast milk, formula or water once daily

Children 3+ years and above:

Children’s Dysbiosis Support

 

2/3 tsp daily

If baby is breast fed

Ensure mother is feeding to hind milk on each breast

Breast feeding mother to consume a balanced nutritious diet &/or investigate potential colic inducing foods

 

Modification of intestinal microbiota for the infant and mother specifically:

Specialised Probiotic Support during Pregnancy, Breastfeeding and Infancy

Mother: Take 1 capsule twice daily

Wellness and Healthy Ageing Program

OR

Elimination diet (especially eliminating brassica vegetables for 2-3 weeks at least)

Assess and address parental stress

Use the Mood and Stress Questionnaire (MSQ) to select a formula based on specific patient needs:

Herbal and Nutritional Support for Adrenal Health; or

Rehmannia Complex for Nervous Exhaustion; or

Herbal Support for Hyper HPA and Stress; or

Bupleurum Complex for Nervous Tension; or

Ginseng Complex for Emotional Balance

 

1-3 tablets daily

2 tablets twice daily

1 tablet 3 times daily

3 capsules twice daily

3 capsules twice daily

 

Alphabetical Reference of Nutritional Support

Formula Catch Phrase

Key Benefits

Bupleurum Complex for Nervous Tension and Irritability

Indicated for stress with mood swings, irritability and anger. Symptoms may be exacerbated by hormonal fluctuations, such as PMT and menopause in women. There may be fatigue, worse in the morning, headaches, insomnia, sweating or flushing and shoulder and neck tension.

Children’s Dysbiosis Support

L.acidophilus NCFM and B.lactis Bi-07 are clinical proven to reduce the incidence and duration of upper respiratory infections in children. Combined with LGG this formula reduces systemic inflammation and supports healthy immune function

Ginseng Complex for Emotional Resilience

Indicated for stress with a lack of emotional resilience. Patients may react to stress by crying, a lack of confidence and anxiety. There may be palpitations, restless, dream-disturbed sleep and adrenal fragility.

Herbal Support for Hyper HPA and Stress

An herbal blend designed to manage nervous disorders and restore balance to physiological function during times of nervous tension and anxiety. Helps promote restful sleep and to relieve muscular tension.

Herbal and Nutritional Support for Adrenal Health

Traditional Ayurvedic, Chinese and Western adaptogenic herbs, including rhodiola and withania, with tyrosine, to assist in supporting and restoring adrenal function. This combination may help to reduce physical and mental fatigue caused by stress.

Rehmannia Complex for Nervous Exhaustion

Where there is anxiety with nervous exhaustion rehmannia and American ginseng calm and nourish the nervous system and adrenals. Lavender and hops are included to support reduce anxiety and exhaustion. American ginseng is shown to prevent decreases in dopamine, noradrenaline and serotonin in times of stress and promote the anxiolytic effects of GABA.

Specialised Probiotic Support during Pregnancy, Breastfeeding and Infancy

Some probiotics have evidence specifically for pregnant and breastfeeding women and their infants strains such as Lactobacillus rhamnosus (LGG®), Bifidobacterium breve (M-16v), Bifidobacterium breve (M-16v) and Bifidobacterium animalis ssp lactis (BB-12®) support the  Modification of intestinal microbiota to improve health outcomes in infants.

Strain Specific Probiotics for Infant Health

Research has shown that probiotic strains Lactobacillus rhamnosus (LGG®), Bifidobacterium animalis ssp lactis (BB-12®), Bifidobacterium longum (BB536) and Bifidobacterium breve (M-16v) populate the infant gut, enhance microbiome development, support immune function and promote gut health. These strains have also been shown to reduce the incidence of infantile and childhood eczema, upper respiratory infections, gastrointestinal infections, ear infections, antibiotics prescriptions and antibiotic-related side effects.

 

Supportive Lifestyle Programs

Elimination diet The Elimination diet, with food challenges, is the most effective way to identify food allergy, sensitivities and/or intolerances. When following this program over at least six weeks, patients learn to identify the impact that food may have on their health and wellbeing. 
Wellness and Healthy Ageing Program This program recommends a low glycaemic load diet with lifestyle recommendations for exercise, relaxation, intellectual stimulation and effective stress management – all factors associated with healthy ageing and chronic disease prevention.

 

Diet and Lifestyle

Because there is no identified cause, treatment involves finding what is effective from among the items listed below, and supporting the parents.

  • For a breast-fed infant, decrease the time between nursing sessions (nurse on demand) and have the mother eliminate dairy products, caffeine, high fructose juices / drinks and all foods that give the mother gas (sensitive foods may include citrus, spicy foods, broccoli, onions, brussels sprouts, cauliflower, cabbage and soy).
  • For a bottle-fed infant, change to a formula that is not based on cow's milk. May need hypoallergenic formula.
  • Do not offer solid foods to the infant before 6 months of age.
  • Remind parents that this condition should last only a few months. Encourage them to take breaks if the crying becomes unbearable, join a support group, or call the practitioner if they fear they will harm the baby.
  • Review with parents different methods of burping.
  • A tea made from fennel seed (Foeniculum vulgare) or anise seed (Pimpinella anisum) may be administered directly to the infant (1 tsp before and after feedings) or drunk by the breast-feeding mother (1 cup three to six times/day). Both fennel and anise act as gastrointestinal relaxants and help to expel gas. Ensure it is cooled before administration.
  • Other herbs that have relaxing effects and help reduce colic are lemon balm (Melissa officinalis), catnip (Nepeta cataria), peppermint (Mentha piperita), spearmint (Mentha spicata), and linden flower (Tilia cordata). These may be added to the above tea as needed.
  • Chiropractic and Homoeopathic treatment may be helpful.

 

Pathology Tests

TEST

INTERPRETATION GUIDELINES

None may be required In the absence of poor feeding, diarrhoea, weight loss, fever; black, green, or bloody stools in an infant less than 2 months old, or the persistence of crying beyond 6 months of age, no laboratory tests are needed.

 

Pharmaceutical Treatments

  • Drug treatment generally has no place in the management of colic, unless the history and investigations reveal gastroesophageal reflux.
  • In suspected allergy to cow's-milk protein, a protein hydrolysate formula, such as Pregestimil or Nutramigen (Mead Johnson) or Alimentum (Ross Pharmaceuticals) is indicated.
  • Simethicone is a nonabsorbable medication that changes the surface tension of gas bubbles, allowing them to coalesce and disperse and releasing the gas for easier expulsion. Experimental evidence does not support its use.
  • Sedatives, such as phenobarbital, chloral hydrate, and alcohol (gripe water) should never be used, however tempting.
  • Drug treatment generally has no place in the management of colic, unless the history and investigations reveal gastroesophageal reflux.
  • In suspected allergy to cow's-milk protein, a protein hydrolysate formula, such as Pregestimil or Nutramigen (Mead Johnson) or Alimentum (Ross Pharmaceuticals) is indicated.
  • Simethicone is a nonabsorbable medication that changes the surface tension of gas bubbles, allowing them to coalesce and disperse and releasing the gas for easier expulsion. Experimental evidence does not support its use.
  • Sedatives, such as phenobarbital, chloral hydrate, and alcohol (gripe water) should never be used, however tempting.