colic or hunger?
16 January 2010
Most of the mothers who consult me because their babies won't settle after feeds tell me that breastfeeding is going well but say they need my help because their baby is suffering from colic. It never occurs to them that their baby might still be hungry after a feed because they have been taught in their antenatal classes that every mother has enough milk. Moreover, many of them have been told that it's no good offering a baby a top-up bottle after a breast feed to check to see whether the baby is hungry because breastfed babies will always drink extra milk from a bottle - even if they're not hungry.
I find it amazing that anyone (especially health professionals) can think that a breastfed baby will always drink more milk whenever he is offered it, Because his stomach is exactly the same as a bottle fed baby's stomach. When a bottle fed baby is full he won't drink any more milk even if you keep offering him more, so common sense says that a breastfed baby will also refuse to drink extra milk if he's full!
A good example of this muddled thinking is a mother I saw this week. Her five week old baby had been crying after every feed but had become much more settled after her health visitor had diagnosed colic and recommended that she started using Colief. Watching the mother feed her baby I was convinced that the problem was low milk supply rather than colic, but the mother assured me that her baby had improved dramatically as soon as she started using the Colief. On further questioning it turned out that the baby was being given the Colief in 60 mls of formula milk immediately after each feed. When I pointed out that maybe it was the extra milk that was settling their baby rather than the Colief, the father thought this made complete sense - especially as he'd noticed that their baby settled even better when they gave the Colief in 120 mls of formula!
So, my tip for all mothers with unsettled babies is to rule out hunger before you start assuming your baby has colic. If you offer your baby extra milk (preferably using expressed breast milk rather than formula) immediately after a feed and he drinks it and goes to sleep, he does not have colic. But if he refuses it or drinks only a tiny bit and is still unsettled, he is more likely to be suffering from colic or reflux than hunger.