3. Feeding problems
There are a wide range of feeding problems that can occur in breastfed and bottle fed babies
Colic is one of the most common feeding problems in babies, but normally resolves by four months of age or six months at the latest. There are several things to remember when considering colic – an infant must display all of the following symptoms from birth to four months of age:
- Bouts of irritability, fussing or crying that starts and stops without obvious cause
- Episodes lasting three or more hours a day and occurring at least three days per week for at least one week
- No failure to thrive.
The exact reason for colic is not known, but the symptoms and possibilities are discussed in Coping with colic.
Frequently winding a baby during feeding can sometimes help. Special formula milks or anti-colic teats may also be beneficial. Over-the-counter medicines such as dimeticone (e.g. Dentinox Infant Colic Drops – GSL*), simeticone (e.g. Infacol – GSL*) or lactase drops (e.g. Colief), as well as homeopathic remedies such as colic granules and gripe water, are also available.
Cows’ milk protein allergy
Cows’ milk protein allergy is the most common food allergy in babies, often causing an immediate reaction and symptoms such as irritation and swelling of the eyes, skin, mouth and tongue; sneezing and blocked nose; abdominal pain; diarrhoea; and vomiting. Delayed reactions can also occur. These are often with gastrointestinal or skin-related symptoms (e.g. eczema).
The symptoms and different treatment options for cows' milk allergy are discussed in more detail in Cows’ milk allergy.
Lactose intolerance can occur in babies when there is a lack of lactase, an enzyme needed for the digestion of lactose. A lactose-free infant formula milk could be used, or alternatively, lactase drops (e.g. Colief) may be used to break up some of the lactose.
The definition, symptoms and treatment options of lactose intolerance are discussed in more detail in Lactose intolerance.
Reflux and regurgitation
Reflux is when the contents of the stomach come back up into the oesophagus, and mild cases are quite normal in healthy babies. Winding the baby during a feed and holding them upright after feeding can help to prevent reflux. Giving smaller feeds more often may also help. Thickened feeds may also be recommended. Regurgitation (or posseting) is when the stomach contents come back up to the baby’s mouth.
The definition, symptoms and treatment options of reflux and regurgitation are discussed in more detail in Reflux.
Babies, like everyone else, differ when it comes to frequency of bowel motions, but when constipated they will pass infrequent, dry, hard stools that may be accompanied by straining and pain. It is important to check that bottles are being made up correctly, as too much powder will make the feed more concentrated, which may lead to constipation.
The definition, symptoms and treatment options of constipation are discussed in more detail in Constipation.
If parents mention any symptoms or behaviour in a baby that seem unusual or start alarm bells ringing, refer them to the pharmacist.
A healthcare professional, such as the pharmacist, may suggest a special infant formula milk for babies experiencing feeding problems. See the Specialist milks section for details.
*Prescribing information can be found in the electronic Medicines Compendium.
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