A Wholistic Hack to Defeat Colic

I remember when our daughter was just two days old. For three to four hours every day, she would scream her head off. It seemed like the nightmare of colic was becoming real for us. Despite having cared for thousands of newborn infants, I felt helpless and overwhelmed. I could only imagine how much worse this nightmare would have been for me and my wife, had I not had over a decade of pediatric experience. On day three of life, she got one osteopathic treatment and within six hours her “colic” was gone. Now, I only wish that treating colic was this simple for all. It is not! If you are the parent of a colicky baby, I am sure you have tried everything on the market and already know that there is no such thing as THE “magic cure.” There is no magic cure because colic is not a single entity with a single cause! Through these series of blogs, I want to teach you how to hack colic and learn why YOUR baby suffers and what to do about it.

To understand colic, we need to first understand why the hell we have such a hard time understanding it. When I was in training, I (and every other pediatrician) was taught that colic is a “normal” condition that does not have a “real physical cause,” and it eventually “passes.” Now please help me understand something, because this is where I get really confused. You have a human being (small or not) who cries as if in they are in pain for 3+ hours a day, and we call it “normal.” We say there is “nothing wrong” because we cannot “find” any physical explanation for it. If an adult screamed in pain for 3-4 hours every day, would we call that “normal”? Probably not!

Perhaps we can’t find the answers we need because we don’t know where to look. We have cool medical tools (blood tests, stool tests, MRIs, xrays, etc.), but they simply lack the ability and sensitivity to detect the problems that cause colic. Unfortunately, these same problems apply to our medical operating system. Our current approach to colic is like running Dos 2.0 on your computer (if you even remember what that was). J What the heck do I mean by this? Often, we approach diseases (even at a holistic level) from a single-view perspective. Functional medicine doctors focus on the diet and gut. Acupuncturists work on meridians and organs. Osteopaths and chiropractors work on the structures within the body. These single-view models are the reason why we cannot find an effective solution to colic! To create the operating system that lets us understand colic, we must throw away the barriers of each medical system and merge them all together. By viewing colic from this multi-dimensional lens, we can begin our Wholistic Hack on colic. Our hack will be divided into different sections, which are broken down as follows:

1. The Body
2. Got Milk?
3. The little guys
4. Let’s play chemistry!
5. Crazy Transformation
6. Piecing it all together

Let’s get started!

THE BODY – ACT ONE

ACT ONE, PART ONE – Somewhere along the way, we have come to think that young infants are babies and not actual human beings! I know this sounds crazy, but I would like you to consider this: if you were in a horrible car accident and had aches and pains in all parts of your body, you would likely be complaining day and night about how much pain you are in. If you went to go see a doctor, he or she may order an MRI, CT scan or x-ray, and would likely tell you “there is nothing wrong”. But you are still in a hell of a lot of pain, and because you can talk and advocate for yourself, you would ask for a pain reliever, seek out acupuncture, massage, chiropractic treatment, etc. If you are like me and have a low pain threshold, you would complain a lot.

Now, help me understand how you would feel if you were squeezed through a tube 1/3 the size of your body (AKA the vagina), especially if hardcore medications (Pitocin) are used to create back-to-back huge forces to push you through this tube? Any woman who has ever experienced Pitocin without an epidural says it hurts like hell. Now drag this delightful experience out for 12–24+ hours, AND add to it a huge vacuum stuck  to your head with someone 20x times your size and weight pulling on your head and neck with all their freaking might. How the hell would you feel? Would you have a headache or backache? Your cry would probably make the infant’s colic cry pale in comparison! Why on G-d’s good earth do we not think infants cannot suffer from this? Now, this is not to blame the OB! The job of these heroes is to get the baby out SAFELY and make sure these babies don’t suffer any permanent damage (brain damage, etc.). IF your baby had a prolonged birth (>24 hours of active labor), was positioned face up (face down is ideal), needed Pitocin or other assisted delivery – it would be very helpful to find someone who can help relieve the tension from birth. Generally speaking, osteopathic physicians, chiropractors and craniosacral therapists who specialize in infants are best suited to help relieve any tension or discomfort from birth. For our daughter, we had a prolonged birth with more than 12 hours of Pitocin at high levels. Thanks to our incredible OB, she came out perfectly safe and healthy, but she was fussy as hell and spent the first three days of her life crying pretty much all the time. I called my dear friend who is a gifted osteopathic doctor, Dr. Eric Dolgin DO, and after one treatment, she went from crying all the time to being completely comfortable and sleeping 4-6 hour stretches.

So what the heck is osteopathy or craniosacral, and how can it help a screaming baby? To understand aches and pains, we need to learn about the body’s elastic tissue (fascia). Fascia connects and literally holds together everything from our heads down to our toes. Without fascia, we would be one wobbly blob. Like a rubber band, this elastic tissue happens to be excellent at storing energy and force. We think forces go right through us, but instead they are often stored within the fascia. Years ago, my brother and I were in an accident that left the car totaled. Every part of my body hurt, and I knew I did not have a bone fracture or nerve injury. The wonderful pain I experienced after the car accident was the stored energy in my fascia tweaking my bones and muscles, setting up strains throughout my body. My daughter, like other babies, likely felt something similar. Practitioners like Dr. Dolgin are able to use the gentlest techniques (usually we don’t see any movement or force at all) to release the stored tension and bring release. They can literally unwind the rubber band(s) and release the distorted/stored energy to bring incredible relief.  In the right hands, these treatments are completely safe and gentle. If you have someone who wants to pop any bones on a young infant – RUN AWAY! These treatments should be gentler than what you would experience in a soft massage. Capable osteopathic doctors can be found at https://cranialacademy.org/find-a-physician/. If you wish to work with an osteopathic physician, preferably work with someone who does osteopathic work more than 90% of the time (percentage listed on website). There are also many gifted chiropractors and craniosacral therapists who can also provide profound relief. http://www.acsta.org/ also has a list of many craniosacral therapists. Craniosacral therapists vary in their degree of training and experience. As with any practitioner with whom you choose to work, please first do your research and then have the practitioner’s office tell you how much experience they have with newborns. Generally speaking, within one to two treatments, you should start seeing benefit and relief in your infant’s colic symptoms. If there is no improvement, you may want to start looking for answers elsewhere.

Now, there will be those skeptics who will immediately say, “well, what about the babies who were born c-section?” Or, “If difficult births CAUSE colic, then why don’t all babies develop colic with these challenging births?”  Mmmmm – remember my very long rambling about how colic is rarely due to one thing? Yeah!!  Hold your horses and keep reading!!! This is just one piece to the puzzle.

ACT ONE, PART TWO – I wish colic was as simple as a baby just having some pain in the head, neck or back. But oohhh no! Things are never that simple. About two years ago, my mind was blown when I truly realized the complexity of the tongue, mouth, suckling, feeding, etc. To put it lightly, any problem with the tongue, mouth or feeding can cause a royal mess for a baby. Who cares and why does this matter? I dare say that 20-30% of “colic” symptoms are actually feeding problems related to a tongue or lip problem. Consider what parts of the mouth are needed to form an effective seal around the breast/nipple and to feed? If the lips cannot flare out to form a nice, effective seal, you end up getting a weird clicking noise. That weird clicking noise is the seal that is constantly being broken allowing TONS of air to be swallowed with the milk. Babies do not like having a stomach filled with air. But then who really does?

How about the tongue? That is a whole other, even more complicated, can of worms. Tongue ties are when the base of the tongue is abnormally attached to the floor of the mouth, and the tie restricts the movement of the tongue. In the obvious cases, you see elastic tissue (a band) connecting the bottom of the tongue to the mouth. These babies cannot stick their tongue out past their lower lip, have a heart-shaped tongue and their latch hurts like hell. While it is easy to identify these obvious anterior tongue ties, there are other tongue ties that are far more difficult to identify. Not only do tongue ties make feedings a whole more difficult, they can actually cause weird restrictions and imbalances throughout the entire body.

Now if this was not enough, for reasons we don’t entirely yet understand, we are now having an epidemic of tongue and lip ties. When I was in training, tongue ties were uncommon. In the last 3-5 years, something has shifted, and at least in our community 30-40% of newborns have some type of tongue or lip tie. Now you may think, “Well Dr. K, what if it is just your paranoia that is detecting more of these ties, and they have always been there?” I wish. Every expert I have spoken to acknowledges an increase in tongue and lip ties. At this time, we don’t know what factor(s) is/are contributing to this, and unfortunately the MTHFR mutation is NOT a likely a major contributor.

We have had children with “colic”, “constipation,” “reflux,” etc. suddenly have full resolution of their symptoms once the tongue or lip was released. Whaaaat?? Remember that entire discourse about fascia and how these elastic bands store energy and run all through the body and connect everything? We often forget, but the tongue is a rather powerful muscle. When this powerful muscle is tied down, every time a baby comes to feed, this muscle ends up tugging on all other parts of the body. EVERYTHING IN THE BODY IS CONNECTED. A restriction in the mouth can create a pull on the esophagus or stomach and cause “reflux” or disrupt bowel motility (how the intestines move) and cause “constipation.” Tongue ties can even cause tension in just about any part of the body!

SO… how the heck do you know if a lip or tongue tie is a problem for your little person? If you are seeing colic or reflux symptoms, feedings are either painful or take forever (feedings should typically take 10-20 minutes per side), you hear clicking, see the elastic attachment at base of the tongue OR thick attachment connecting the middle of the upper or lower lip to the gums, you see a heart shaped tongue, don’t see the tongue ever come out past the lower lip, baby chomps on the breast rather than effectively suckles, etc.…., then you MAY have a tongue and/or lip tie. Breast feeding basics is a great website that explores how to effectively identify lip and tongue ties.

Now, before you jump the gun and convince yourself that the tongue/lip tie is the cause of all your baby’s woes, please explore the following sections of this blog to get a complete picture of your baby. Not all tongue or lip ties cause a problem. There are plenty of babies who have mild ties and do just fine and grow up to be healthy adults! Let’s say the ties are of concern. What do you do? There are many great pediatricians and dentists who do tongue tie releases, a procedure called frenectomy. Just like with everything else, I have been humbled to realize how complicated tongue ties can be. I have seen frenectomies go wrong where either it was not done correctly or the family was not taught the right exercises to do afterward to prevent the tongue from reattaching (yes, just because the tie is cut doesn’t mean everything is automatically fixed forever). To add to this mess, I have seen many pediatricians, dentists and ENTs miss tongue ties because the tie was not obvious.

Here is a sad story to put this all into perspective. Little Johnny is a 2 year-old boy who came to see me because he was not gaining wait and failing to thrive. While he was born normal weight, by 3 months of age, he fell to the 1% (lowest percentile) of weight. He was hospitalized and was tested for everything imaginable and found to be “normal.” Feedings were always a problem and by the age of 18 months, he could not tolerate the texture of most foods. He basically drank formula and ate a handful of pureed foods only. No one knew what do with him and his weight never could go above the 5%. Even though his mother kept asking, none of the countless doctors and specialists who saw him considered that he was tongue tied. When I examined him for the first time, he did not have the classic heart-shaped tongue with an obvious tie in the front. His tongue did not move very much in his mouth, and he certainly could not stick it out very far. I immediately referred him to a dentist that specializes in tongue ties, and sure enough he had a severe posterior tie. After surgery and several months of feeding therapy, this little guy is now eating almost all solid foods and his weight has gone up to the 30%. Johnny’s case is so sad to consider, but also imparts an important lesson; just like with so many other causes of colic, tongue ties can be easily missed if you don’t know how to look for them.

For the more superficial ties, pediatricians and dentists who are trained in frenectomy can be a great place to start. If you have any doubt, check to see how many frenectomies the doctor does per week and how much post-operative care they provide. Ideally, you want someone that does this procedure often (even a few week) and will monitor the outcome afterwards to make sure everything is fully released. If the procedure is not done correctly, AND if you are not taught the right exercises afterwards, the tongue can easily re-attach and create a bigger mess than before. In fact, I am currently working with a family whose infant had a tongue release in the hospital by the nice pediatrician but, unfortunately, it was not done properly. We now have a baby whose tongue is re-attached with extensive scar tissue that is creating a mess. While ENTs are surgically more than capable of addressing these ties, not all of them know how to recognize the deeper or posterior ties. The same will apply to dentists or other healthcare professionals who are not highly trained or focused on releasing tongue/lip ties in young infants. To identify the tongue and lip ties, you can seek out a very well-trained/qualified lactation consultant or an occupational or speech therapist that focuses on feeding problems in the young infants. For the more complicated tongue ties, you may want to find a very experienced dentist or ENT who specializes in identifying and releasing tongue ties in young infants. You may end up paying more upfront for the procedure but, trust me, this is money very well spent.

Ok. Now that we got that discussion out of the way, let’s go a little bit deeper. Remember the entire discussion of the fascia and how they hold energy? Ok, so let’s say the competent doc comes and perfectly releases the tongue or lip tie (an elastic rubber band) but then nothing else happens or, worse yet, your baby gets even more upset. What the hell? Remember how fascia store energy AND how it is all interconnected? When we cut the tight rubber band that was tugging on everything else, sometimes the other bands of fascia snap back into place, and that creates a new tension the baby does not like. Other times, the fascia still have stored energy that has not been released and just stays there. If you have chosen to have your baby’s tongue/lip released AND they continue to have feeding problems OR are still fussy, a good osteopathic or craniosacral treatment to release the tension can make a world of difference. We have had several cases where the clicking and feedings improved after the tongue/lip release, but the baby was still fussy. One treatment to release any residual tension AFTER a tongue or lip release, and presto! Suddenly you have a comfortable little human being.

You might be thinking, “Oh my G-d, what am I to do?” “I suspect my baby has a tongue tie, but I am really worried about doing this surgery…” Make the equation simple for yourself. Is your baby feeding well and gaining weight? How fussy or uncomfortable is he or she? If feedings are going well, and the fussiness is mild, then no – it is probably not worth it to do the surgery and discomfort that can come from it. While these surgeries and treatments can be miraculous for some, I have also seen a few infants actually have MORE fussiness after the surgery because the surgery and associated pain really threw them off. All of this is to say that you should take a moment to weigh the pros and cons. But I also want you to know that you are not alone! You are welcome to join our Facebook group https://www.facebook.com/WholisticKidsAndFamilies/ to have a more detailed discussion about everything we have discussed, including benefits and risks of frenectomy.

In the future, I will be inviting some of my favorite experts to join us in this discussion.

Time for a breather.