“The Gripe”

While I was researching herbal treatments for colic for an ABC World News Tonight interview with me scheduled to air Tuesday (May 2, 6:30pm), I came across a fascinating article on the history of “gripe water” and its use for colic.

Colic, no doubt, has been with us for millenia. Yet it wasn’t until 1954 that Wessel gave us the first “official” definition (the rule of “3’s”): sustained infant crying periods that last at least 3 hours a day, for at least 3 days a week, for at least 3 weeks duration. More recently, we’ve started to think about colic as one end of the spectrum of an infant irritability syndrome. After all, babies cry – sometimes for no seemingly good reason. Perhaps they’re just so overwhelmed from multisensory stimulation during what pediatrician Harvey Karp calls the “4th trimester.” In his book, “The Happiest Baby on the Block,” Karp offers a rational explanation for why some babies are fussier than others, and, more importantly, useful tips to help parents cope with their colicky tots. Colic has been associated with short-term significant maternal mental health concerns, most notably, postpartum depression, as noted in a recent British Medical Journal issue. More reassuringly, there seem to be no long term psychological issues for moms of babies with colic, evidenced by the report, “Sequelae of Infant Colic: Evidence of Transient Infant Distress and Absence of Lasting Effects on Maternal Mental Health,” Clifford et al, Arch Pediatr Adolesc Med, 2002.

Speaking of reassurance, conventional advice regarding colic centers on just that – letting caregivers know that all will be well by the 12-16 week mark. Frustrated parents and providers have long searched for more proactive methods to ease the discomfort of colic for newborns. As usual, when conventional medicine offers few safe and effective options for treatment, we turn to complementary and alternative therapies. Holistic pediatricians will seek to involve the whole family in the healing process, understanding that colic has profound emotional and spiritual effects on the family unit. Techniques like infant massage offer parents an opportunity to interact with their infants in a positive, hands-on manner that can reduce irritability (Huhtala V, et al: Infant massage compared with crib vibrator in the treatment of colicky infants. Pediatrics 105: e84-e89, 2000).

A systematic review of colic therapies includes positive news about some specific nutritional and herbal interventions (see reference below). For moms that are breastfeeding, eliminating certain foods from their diets (dairy, eggs, wheat, nuts) may improve excessive irritability, and for those who are formula-feeding, hydrolysated mixtures may prove more digestible and reduce crying time. There are several herbs which have anti-spasmodic GI activity, and have been tested in babies with colic: fennel, ginger, chamomile and dill. Mixtures of some of these, along with some glycerin and bicarbonate, have been included in the recipe for “gripe water,” a remedy that goes back to the 1800’s according to one report.

William Woodward’s formulation, from 1851, was originally designed to treat “fen fever” from malaria (which it didn’t do so well, apparently), but did find lasting success as an “effective soother of fretful babies.” Gripe water over the years has contained varying amounts of alcohol, sugar and different herbs, but the most popular patented brand today is by Baby’s Bliss, which contains a simple, safe mixture containing fennel and ginger. A simple remedy I recommend is just plain old chamomile tea (organic, fair-trade if possible) – a sip here and there (room temperature) does the trick.

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Nutrition References:

Hill DJ, et al: Effect of a low-allergen maternal diet on colic Among breastfed infants: a randomized, controlled trial. Pediatrics 116: e709-e715, 2005.

Jakobsson I, et al: Effectiveness of casein hydrolysate feedings in infants with colic. Acta Paediatr 89: 18-21, 2000.

Lucassen PLBJ, et al: Infantile colic: crying time reduction with a whey hydrolysate: a double-blind, randomized, placebo-controlled trial. Pediatrics 106: 1349-1354, 2000.

Lust KD, et al: Maternal intake of cruciferous vegetables and other foods and colic symptoms in exclusively breast-fed infants. J Am Diet Assoc 96: 46-48, 1996.

Herbal References:

Alexandrovich I, et al: The effect of fennel (foeniculum vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med 9: 58-61, 2003.

Ghayur MN, Gilan AH: Pharmacological basis for the medicinal use of ginger in gastrointestinal disorders. Dig Dis Sci 50: 1889-1897, 2005.

Savino F, et al: A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res 19: 335-340, 2005.

Weizman Z, et al: Efficacy of herbal tea preparation in infantile colic. J Pediatr 122: 650-652, 1993.