Tuesday, October 25, 2011

Is it Colic, Acid Reflux, or Cow's Milk Protein Allergy?

Colic: It's the easy diagnosis for every unknown infant ailment.  Depending on where you research, it's said that anywhere from 25% to 70% of babies have colic.  Why such a vast range?  I believe because there's no cause, no cure, and a really long list of symptoms.

  Oh, your baby cries a lot?  Colic.  Has severe gas?  Colic.  Fussy? Could be colic.  The real question we need to ask-is it truly colic?  I can't tell you how many times I've heard babies who were misdiagnosed with colic, then later were found to have some other issue, such as acid reflux, or a formula allergy.  

  My own daughter was diagnosed with colic at three weeks, the "known" age colic is said to start inflicting the young.  After several weeks for constant crying at night, we switched her formula for Nutramigen, a formula for babies with sensitivity to the protein in cow's milk.  After three days, she was a totally new child.  Was it colic, or a formula allergy?  It's funny, because to this day I still refer to her sickness as "colic" when I'm nearly sure she just couldn't handle the protein from the formula she was ingesting.

  What is colic?  The word itself comes from the Greek Kolikos meaning "suffering from the colin".  Doctors believe that pain in the gut leads to a constant hurting and crying infant.  It's interesting because most babies who are believed to have colic start crying around three to four weeks old and usually in the evenings, right around dinner time.  The inconsolable crying can go on for hours and hours.

  Could there be another answer to this puzzling phenomenon?  Acid reflux in babies is the regurgitation or spitting up of the stomach contents into painful acids from an immature muscle connecting the stomach to the esophagus.  Unlike colic, it can being at any time and can be present at birth.  However, due to the fact acid reflux can also cause extended periods of crying and can be hard to diagnose, it can easily be mistaken for colic.  One very distinct thing to look for other than frequent spitting up is if your baby is crying and arching their back right after eating.

  Unfortunately, a baby may not actually spit up when they have the acid reflux.  There's such thing as "silent reflux".  This is found to be more mistaken with colic because there are no obvious symptoms.  Silent reflux can be more painful to your baby as the acid burns on the way up and the way down, causing twice as much discomfort.  Untreated, severe baby acid reflux can lead to long term damage to the esophagus, stomach and throat which lead to other health problems.

  Cow's mil protein allergy is the most common food allergy in young children and most babies outgrow this allergy by the age of two or three.  It causes stomach pain, vomiting, diarrhea and extensive crying.  Sometimes, babies can have both acid reflux and an allergy to the protein in cow's milk, which is even harder to diagnose.

  My friend Lindi, a young mother of her son Kesel, knows all too well about having a child with these issues. Kesel was born with both acid reflux and cow's milk protein allergy.  Unfortunately, it took several trips to the doctor before they could figure out he indeed had acid reflux.  Lindi, being a new mother, had no clue of the difference between spitting up and vomiting with a young infant.  Those with little ones know how true this is; sometimes a child may spit up what seems like an entire bottle and it's actually not vomiting.  Their doctor finally was able to figure out that Kesel had acid reflux when the nurse learned that he arched his back and cried after he ate.  After a few weeks on liquid Zantac, Lindi finally started to notice a change.

  The weird thing was, Kesel was still crying often, not sleeping well, and he wasn't gaining weight.  When Lindi voiced her concerns, her doctor mentioned the possibility of colic.  Already on the verge of a breakdown, Lindi kept pushing.  She continued to take Kesel in to the doc, calling to discuss her worries as well.  At his two month appointment, her nurse pratictioner suggested trying a new formula, Nutramigen AA (amino acid), which is for babies with an allergy to cow's milk protein.

  Lindi, ready to try anything to help her baby, did some research into the formula.  Unlike regular Nutramigen you can buy in stores, the formula they suggested with amino acid had to be subscribed by a doctor, with a cost of $96 per 14.5 oz can.  A baby Kesel's age can goes through two to three of those cans a week, a significant amount of money.  And no, insurance doesn't cover it!  Luckily, the nurse suggested she try looking online on Ebay, as they had clients that purchased the formula at a lower price from people who were overstocked or no longer using it, at a price of $25-$35 per can.

  Within a few weeks of being on the new milk, Kesel was a brand new baby, sleeping and eating better, as well as gaining weight.  With time, the doctors say he will out grow the acid reflux as well as the milk allergy.  As the child gets older, the muscle connecting the esophagus becomes more developed and as they eat more solids, the food tend to stay down better.

  So, the moral to the story is-before you panic that your child has the infamous and well dreaded colic, do your research.  Is your child spitting up more milk at a time and more frequently then you feel is normal?  Are they arching their back and crying every time after they eat?  Do they have constant diarrhea?  Colic may have no cure, but acid reflux and cow's milk protein allergy do.  I got lucky when someone suggested I try Nutramigen (I was just lucky mine was at the store!), otherwise I would've just assumed Callie had colic and she would've continued to suffer when such an easy fix was out there and available.  

  Doctors are so important, and I'd never down-play their role in our world.  Quite frankly, we couldn't live without them.  However, until infants can talk and actually tell use what's bothering them, their symptoms can be hard to read, and therefore, any related illnesses even harder to diagnose.  With so many different diseases and sicknesses out there and even more being discovered, we can't always assume a diagnosis of colic is accurate.  

No comments: