Reflux, Colic and a Witching Hour – Oh My!

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I  was recently called to help a third time mom who really wanted some help sorting through a few things. Her little one was about 3 weeks when she contacted me. He was eating nearly every hour and she was spending another roughly 6+ hours per day trying to get her baby to sleep for naps and at night. At the recommendation of a friend and hopeful to get some much needed sleep before her maternity leave was over, she called me.

colic newborn baby won't sleep
colic newborn

I consulted with her several weeks while I was traveling. Her baby was making improvements, especially during the day. No more snack feeds and an appropriate schedule meant he was napping longer and getting much needed awake time during the day. Nights were still a struggle. Getting him to bed was taking 3-4 hours each night.

After working with and observing this mom and baby, I suggested she take him to the pediatrician. As a Newborn Care Specialist, Baby Nurse, Postpartum Doula and Infant Sleep Consultant, my role is non-medical. I had my suspicions as to part of the problem, but I am not trained to diagnose, only recognize when there is potentially something underlying that needs to be addressed.

My suspicions were right and the pediatrician said “he has some reflux, but not to rule out colic”. Some medication was prescribed and the baby did improve, but he still had somewhat of a difficult time going to bed until we made some additional tweaks to his schedule.

There were multiple things compounding with this baby causing him to have trouble. As a Newborn Care Specialist, Postpartum Doula, Baby Nurse and Infant Sleep Consultant I do see these things on a consistent basis and thought it may be helpful to other parents to provide my two cents on the topics.


Katie Bishop - The Early Weeks

Meet Katie of The Early Weeks. With 22 years experiece, she has helped 250+ families & littles sleep better.

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REFLUX

Gastroesophageal reflux disease, other wise known as GERD. GERD occurs when food and contents from the stomach come back up (refluxes), typically causing the baby to spit up (1). There are variations of standard reflux which include Silent Reflux and Nocturnal Reflux.

Silent reflux can be harder to detect because the contents of the stomach don’t usually come out of the mouth (instead they are swallowed) and the baby may not show any signs of discomfort until they are around 3 months old (2).

Nocturnal reflux is reflux that is worse at night. Reflux can be worse at night for 3 reasons (3):

  1. Acid concentration in the stomach is higher at night.
  2. The baby is likely lying down, so there is no assistance from gravity to help keep the contents of the stomach down.
  3. While sleeping we don’t swallow. Saliva contains bicarbonate which neutralizes stomach acid. Meaning when we swallow our saliva neutralizes the acid that can be irritating to the esophagus.

Symptoms of reflux I have seen:

  • Irritable during or after feeding
  • Gulping, arching, and pulling away from breast or bottle
  • Baby has lots of burps
  • Inconsolable crying
  • Vomiting or projectile vomiting with most feeds
  • Blood in the baby’s stool
  • Frequent nursing. Sucking and swallowing is soothing to babies that have reflux. They tend to want to continually eat to soothe, but it overloads their digestive system and perpetuates the cycle.
  • Wanting to eat, but fussy while eating
  • Failure to gain weight or gaining weight too quickly
  • Family member that has or did have reflux (genetic factor)

Things that can be helpful in relieving reflux:

  • Making a reflux nest (discuss with healthcare provider)
  • Making some modifications to the breastfeeding mother’s diet, particularly removing dairy
  • Changing formula
  • Probiotics for mom, if breastfeeding and baby (infant probiotics and non-dairy)
  • Not allowing baby to snack feed, which continually puts stress on the baby’s digestive system
  • Keeping the baby elevated for 20 minutes after each feed
  • Changing the bottle used and pace feeding

COLIC

Traditionally colic is defined by the rule of 3’s and by a baby that cries uncontrollably for:

  • 3 hours per day
  • 3 days per week
  • For 3 weeks in a row

I do believe that the baby I was working with and most babies in general go through a few weeks that can be pretty difficult. Suzy Giordano, author of Twelve Hours’ Sleep By Twelve Weeks Old talks about this. (Great book by the way). She calls it the Two-Week Storm.  “Typically starting around 3-4 weeks for a singleton and 6-8 weeks for twins. “Easy”, “angel” or “perfect” babies may cry uncontrollably, have bad gas, struggle with intestinal cramps or be restless between feedings. The length and severity varies with each baby and may be related to immune or digestive system changes” (4).

It is my personal opinion that Colic is a blanket term. It is too widely used and is somewhat of a cop-out used by professionals. Yes, colic is a thing. There are babies that cry as describe above. But, I wholeheartedly believe there are valid underlying factors such as critical brain development at a certain age, scheduling adjustments, the mother’s diet and reflux that contribute. You won’t ever hear me say “oh it’s colic. Just put him/her in their crib and let them cry. They will outgrow it around 4 months” (I have heard this). There are always adjustments that can be made to help the baby and family be much happier. 

WITCHING HOUR

Doing some research you may come across the term “witching hour”. For an infant, it is usually known as a period of time in the late afternoon or evening where the baby doesn’t seem to know what they want. It is a consistent time everyday where your baby will fuss and cry on and off for hours.

I do believe witching hours and colic are similar and go hand in hand. For a baby, early evening is a time where they are starting to process things that have happened during their busy day. It is also the end of the day, so they are tired.  I just don’t like to place blame and leave it at that. Too many new parents and their precious babies are struggling. It doesn’t have to be ‘normal’ and 3-4 hour struggles each night shouldn’t be normal. They are down right exhausting.


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In conclusion

Reflux, colic and witching hour(s) can be tricky to understand and remedy. Most often there are things that can and need to be addressed -> the baby’s schedule, the mother’s breastfeeding diet, formula, external stimulation, tongue/lip tie identification and learning appropriate baby cues. These things often significantly improve, if not resolve completely, the reflux, colic and witching hour(s) you and your baby are experiencing. You don’t have to just deal with this endless cycle. There are so many things that can be supportive to you and your baby.

Katie Bishop Pediatric Sleep Consultant

Katie Bishop
The Early Weeks

Certified Pediatric Sleep Consultant | Newborn Care Specialist | Board Certified Holistic Healthcare Practitioner 💤

Katie has over 25 year experience working with children of all ages. As an Advanced Newborn Care Specialist & Infant/Pediatric Sleep Consultant she has supported families and babies worldwide over the last 10 years. Her mission is to help the entire family unit get better sleep, utilizing a holistic approach that supports the baby or child’s natural biologic drive to sleep. She has personally served 200+ families and holds 16,000+ hours exclusively caring for infants & babies.

Resources:

  1. https://www.mayoclinic.org/diseases-conditions/infant-acid-reflux/symptoms-causes/syc-20351408
  2. https://www.livestrong.com/article/526686-silent-reflux-in-newborns/
  3. https://www.medicinenet.com/script/main/art.asp?articlekey=13834
  4. https://www.amazon.com/Twelve-Hours-Sleep-Weeks-Step/dp/0525949593/ref=sr_1_1?ie=UTF8&qid=1508179392&sr=8-1&keywords=twelve+hours+sleep+by+twelve+weeks+old

Disclaimer:

The content contained in this blog is for informational and educational purposes only. It is not intended as medical advice or to replace the advice of any medical professional. It is based on our opinions and experience working with newborns and their families. Other’s opinions may vary. It does not represent the views of any affiliated organizations. The reader understands that term “Babynurse” is often a word used to describe a newborn caregiver. However, unless otherwise disclosed, we are not licensed nurses in any state. By reading and/or utilizing any information or suggestions contained in this blog, the reader acknowledges that we are not medical professionals and agrees to and waives any claim, known or unknown, past, present or future.

© 2024 Bishop Enterprises, LLC All Rights Reserved


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9 thoughts on “Reflux, Colic and a Witching Hour – Oh My!”

  1. This is an awesome read- thank you! We are new parents to an almost 5 week newborn. We believe she has reflux as we some of the above symptoms, however none of the severe symptoms such as blood in stool etc. we were prescribed omeprazol for her (1.25ml) and she had some horrible side effects- including 20 dirty nappies in around 6 hours, so we took her off it straight away. She tends to cry in the evenings between 7-9pm, which we were told is ‘colic’. I’ve just started her on some gripe water and infacol- hoping for some improvements but I don’t really know whether I’m coming or going!!

    Reply
    • Aaaaw sorry to hear you’re going through a tough time. Know you’re not alone – first time mom of a beautiful 6-week-old baby girl who too is suffering from reflux. I’m trying the “no dairy” route for us, and we’re keeping her upright for 45 min after each meal…so tough at night 🥱 Good luck and hopefully we all get some good sleep soon 🤞

      Reply
  2. the baby at the beginning literally could of been written about my nearly 4 week old 🥺 my heart breaks for him and we are getting no where with doctors

    Reply
  3. How is one supposed to prevent snack feeding or comfort nursing when to do so makes the baby inconsolable. Talking about early days.

    Reply
    • Hi Kathryn,
      Does your baby have reflux? If so, the ‘snack’ feeding can actually make the discomfort worse. Generally there is an irritation that is occuring with reflux, when a baby eats all the time, there is constant irritation, spitting up and discomfort. Focus on getting a good solid full feed. Upright after the feed for a period of time, then feed again in another 2.5-3 hours.
      I would be happy to hop on a call to discuss this more in depth. There are a lot of factors to consider. The good news is that there are many things that can be done to address reflux and help make your baby more comfortable.
      https://www.theearlyweeks.com/contact/

      Reply

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