Saturday, October 29, 2011

Acid-Reflux and Colic Research BREAKTHROUGH

At least it's a breakthrough for me. :)  As many of you remember, my daughter Eowyn struggled with painful acid reflux (Gastroesophageal Reflux Disease, or GERD) from about week 3 of her life to month 5.  We worked through massive amounts of spit-up (the most epic being at my friend Val's house, one which left us both staring speechless as it soaked down through every layer of clothing on me, pooling in my pants waist band-- gross?  tell me about it), refusal to nurse do to painful association, fussiness... and we made it.  (For more on our drug-free War on Reflux, read here.)

But the same brain that exhausted my grandmother with incessant questions in a ceaseless drive to know wasn't happy here.  My daughter wasn't suffering anymore, but... why had she had this condition in the first place?  Why was there an absolute epidemic of acid reflux in my circle of mommy-friends, with Zantac and Prevacid handed out like candy?  This condition has completely exploded, along with it a huge influx of regular, daily prescription drug use in infants-- which in turn is linked to a whole host of potential long-term (chronic, systemic) problems.  With all my baby sitting, etc., I'd never heard of a baby medicated for acid reflux before my friend's son had it (2 years before Eowyn was born).  True, there have always been "colicky" babies, and I'm sure some of the babies now diagnosed with GERD & medicated would have been labeled "colicky" before. Regardless, I wanted to know WHY.

What's a mom to do?  KEEP LOOKING!

My first bit of light came in reading Dr. Natasha Campbell-McBride's Gut and Psychology Syndrome, which is an exposition of all the ways gut-flora imbalance (too much harmful yeast & bacteria crowding out the good guys we need for good health) affects us.  One big symptom of an imbalanced gut flora is severe morning sickness during pregnancy, especially if there is no family history for it.  (My mom never had it with any of us 3 girls.  I did. Check.)  These same moms with unbalanced gut flora pass on their imbalance to their children through birth and breastfeeding... often leading to acid reflux in babies.  First light-bulb moment for me.

How do we get our gut flora wacked out in the first place?  Antibiotics.  Diets high in sugar & refined grains.  Formula feeding instead of breast-feeding. Environmental toxins. Our moms (and in some part our dads).  About two generations ago, breastfeeding fell into disrepute, at the same time that drugs like antibiotics and vaccines (containing antibiotics) became an integral part of childhood, as the American diet turned ever-more towards pre-made instead of home-grown and canning overtook fermenting.  It would make sense that now we would see a whole host of moms-- perhaps breast-fed by a formula-fed mom-- who grew up on antibiotics and Little Debbies having bad morning sickness, and then having babies with acid-reflux heretofore unseen in such numbers.  Yes, it all fits.

But what to do about it?  KEEP LOOKING!!

In one of my doula-reading books, I found a citation to a 2007 study published in Pediatrics.  This study, in fact.  The boiled-down version:  two sets of babies (all breast-fed) suffering from generic "colic" were treated in low-tech ways.  One group got simethicone drops (gas drops). The other got a probiotic (beneficial bacteria), Lactobaccilus reuteri.  Both sets of moms were avoiding cow's milk in their own diets.
 "Ninety breastfed colicky infants were assigned randomly to receive either the probiotic L reuteri (108 live bacteria per day) or simethicone (60 mg/day) each day for 28 days. The mothers avoided cow's milk in their diet. Parents monitored daily crying times and adverse effects by using a questionnaire.
RESULTS. Eighty-three infants completed the trial: 41 in the probiotic group and 42 in the simethicone group. The infants were similar regarding gestational age, birth weight, gender, and crying time at baseline. Daily median crying times in the probiotic and simethicone groups were 159 minutes/day and 177 minutes/day, respectively, on the seventh day and 51 minutes/day and 145 minutes/day on the 28th day. On day 28, 39 patients (95%) were responders in the probiotic group and 3 patients (7%) were responders in the simethicone group. No adverse effects were reported.
Did you catch that?  Babies were crying about 160 minutes/day (over 2 1/2 hrs) before the intervention, started crying less within one week of getting the probiotics, and went down to under 1 hour of crying (and which baby doesn't cry about 1 hour a day, all told?)!  The babies in the gas drop group was still crying nearly 2 & 1/2 hours every day by the end of the 4 weeks.  The study summarizes "In our cohort, L reuteri improved colicky symptoms in breastfed infants within 1 week of treatment, compared with simethicone, which suggests that probiotics may have a role in the treatment of infantile colic."  I'd say!!!!!

I will keep my eyes peeled for studies that specifically look at probiotic's role in treating acid-reflux (this study excluded infants with that condition to keep variables to a minimum), and ideas about whether other probiotics could be used, even those in yogurt.  (This particular study used probiotics sold by BioGaia AB from Stockholm, Sweden)

In the meantime, may this help any of you trying to shush a sad baby!!

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