Colic in the Breastfed Baby

8. A nipple shield may help, but use this only if nothing else has helped and only if you have had access to good help without any change. This is the second-last resort. Please note that a nipple shield is only very rarely the answer to any breastfeeding problem and in most situations it makes the situation worse, not better.

9. As a last resort, rather than switching to formula, give the baby your expressed milk by cup or by bottle if baby won't take a cup. Adding lactase to the expressed milk may help as well.

Foreign Proteins in the Mother's Milk

Sometimes, proteins present in the mother's diet may appear in her milk and may affect the baby. The most common of these is cow's milk protein. Other proteins have also been shown to be excreted into some mothers' milk. The fact that these proteins and other substances appear in the mother's milk is not usually a bad thing. Indeed, it is usually good, helping to desensitize your baby to these proteins. Ask about this if you have any questions.

Thus, in the treatment of the colicky breastfed baby, one step would be for the mother to stop taking dairy products or other foods, but only one type of food at a time. Dairy products include milk, cheese, yogurt, ice cream and anything else that may contain milk, such as salad dressings with whey protein or casein. Check labels on prepared foods to see if they include milk or milk solids. When the milk protein has been changed (denatured), as in cooking for example, there should be no problem. Ask if you have any questions.

If eliminating certain foods from the mother's diet does not work, the mother can take pancreatic enzymes (Cotazyme, Pancrease 4, for example), starting with 1 capsule at each meal, to break down proteins in her intestines so that they are less likely to be absorbed into her body as whole protein and appear in the milk.

Of course, your chances of not being able to produce enough of your own enzymes from your pancreas are very low (unless you have cystic fibrosis, for example), but it has been shown that whole protein does get absorbed into the breastfeeding mother's body and into her milk and adding the enzymes may decrease the amounts of whole protein entering your body and getting into the milk.

Please note: Intolerance to milk protein has nothing to do with lactose intolerance, a completely different issue. Also, a mother who is lactose intolerant herself should still breastfeed her baby.

Suggested method:

  • Eliminate all milk products for 7-10 days.
  • If there has been no change for the better in the baby, the mother can reintroduce milk products.
  • If there has been a change for the better, you can then slowly reintroduce milk products into her diet, if these are normally part of your diet. (There is no need to drink milk in order to make milk, for example, so if you don't drink milk normally, don't while you are breastfeeding). Some babies will tolerate absolutely no milk products in the mother's diet. Most tolerate some. You will learn what amount of dairy products you can take without the baby reacting.
  • If you are concerned about your calcium intake, calcium can be obtained without taking dairy products. Speak with your doctor or a dietician. But, 7-10 days off milk products will not cause you any nutritional problems. Actually, evidence suggests that breastfeeding may protect the woman against the development of osteoporosis even if she does not take extra calcium. The baby will get all he needs.
  • Be careful about eliminating too many things from your diet all at once. Everyone will know someone whose baby got better when the mother stopped broccoli, beef, bananas, bread, etc. You may find that you are eating white rice only. Our diets are too complex to be sure exactly what, if anything, is affecting the baby.

One more piece of information. Some babies are hungry even if they are gaining weight really well. This may occur for several reasons, some mentioned earlier in this information sheet. One more way a baby can be hungry and nevertheless gain weight well is that you are limiting the feedings; for example, you feed the baby 10 or 20 minutes a side. If you have a lot of milk, the baby may gain weight well and still be hungry. So don't limit feedings.