Colic

• Conduct thorough history and physical to rule out other etiology
• Conduct feeding assessment to rule out latch, position or other breastfeeding barrier; refer to Lactation Consultant as needed
• Encourage parents to use repetitive, sustained stimuli to reduce crying 
• Increase skin-to-skin contact and close holding of infant
• Recommend initiation of feeding before infant is fully awake
• •Weaning from the breast is not recommended, however if feeding difficulties due to colic become difficult to manage, expressing milk and feeding by cup or bottle can be used to help aid with maternal distress. Reassure mother that colic is not her fault
• Ensure mother has adequate support from family or partner
• Assess for potential GI discomfort, if maternal elimination diet is deemed necessary, consider referral to community-based Registered Dietitian (WIC) for maternal diet management and Lactation Consultant for assessment of breastfeeding concerns
• If GI discomfort is suspected, consider breastfeeding position adjustments that include upright positioning to aid with potential GI discomfort; keep infant upright after feeds. Discourage switch nursing and instead encourage feeding on one breast to ensure higher fat content milk is obtained (hindmilk/ foremilk imbalance)
   

Clinical Guidelines 

• Kellams, A., Harrel, C., Omage, S., Gregory, C., & Rosen-Carole, C. (2017). ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeeding Medicine, 12, 188–198.

References 

1. Brazelton, T. B., & Sparrow, J. D. (2006). Touchpoints: Birth to Three: Your child's emotional and behavioral development (2nd ed.). Merloyd Lawrence. 
2. Campbell, S. H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning. 
3. Lawrence, R. A., & Lawrence, R. M. (2016). Breastfeeding: A guide for the medical profession (8th ed.). Elsevier. 
4. Sadurni, M., Pérez Burriel, M., & Plooij, F. X. (2010). The temporal relation between regression and transition periods in early infancy. The Spanish Journal of Psychology, 13(1), 112–126.