Yes, it is now official. Baby crying in the UK leads the world in the wailing stakes! Professor Dieter Wolke from Warwick University recently released his meta study formulating the world’s first universal charts for the “normal” amount of crying in newborns.
This week, I was interviewed by Hattie Garlick on the Daily Telegraph about all this, and she has written an excellent article bringing together many angles of the crying problem for British babies. And I thought I would take the opportunity here to expand on some of the points she quoted me on.
This new study highlights the prevalence of colic among babies worldwide in the first 12 weeks of life and draws on data from 8,700 babies from 28 previous studies. And guess what? British babies are among the best in the world at crying. That is one heck of a lot of overtired babies and parents living on one small island.
On average, it was found that babies from around the world all cry for around two hours per day in the first two weeks. Crying commonly peaks to around two hours fifteen minutes per day at the six-week stage and then reduces gradually to a typical 1 hour 10 minutes by the twelve-week mark.
Colic is defined in this Warwick study as those babies who cry for more than three hours per day for at least 3 days a week. The highest levels of colic were found in babies from the UK (28% of infants at 1-2 weeks). So why is it that we Brits breed colicky babies, or is there something different we are doing? Should we be learning from other countries?
I remember well the witching hours from 5pm to 9pm every night with my first one. He screamed and screamed every evening for hours and we were at our wits end! We read the baby books and tried their suggestions, but not much helped and resigned ourselves to the fact he would grow out of it, which luckily, he did. However, I swore that we would have a different outcome for our other babies. When I was less sleep deprived I did some of my own research into the reasons behind why colic is triggered, and found evidence that probiotics and vitamin D might help. These small interventions made a huge difference to my other babies and the evenings were certainly more peaceful. We also see many crying new born babies in our clinics, with sleep deprived and frazzled parents and often probiotics and a top up of vitamin D make quite a difference.
The microbiome connection
A baby’s gut is populated with billions of microbes known as the microbiome. This microbiome shapes the immune system, mood and gut health of the baby. Even a slight imbalance of gut flora can send a new born baby’s tummy out of sync. The usual reason why gut flora might be disrupted is a course of antibiotics. Antibiotics have transformed healthcare for mums and new born babies but the price that is often paid is a more colicky baby.
If the sore tummy and crying started shortly after mum or baby were administered antibiotics then this is big clue that the antibiotic has thrown out the balance of microbes in the baby’s gut. Without the right balance of bacteria in the gut, fermentation in the gut is more likely which in turn produces more wind and gas.
Probiotics are important microbes that help to replace the beneficial bacteria in our intestines that are thought to control gut health, mood and immunity. Live yoghurt or kefir can be helpful here, however research has shown that a good quality probiotic given for a few weeks may be better at sorting out the situation. A 2015 study found that colicky babies in Canada cried and fussed less after being given the specific probiotic Lactobacillus reuteri DSM 17938.
There is also a link between caesarean section births and colic in young babies. C-sections can be life-saving, however the numbers are on the increase. Thirty years ago, 10% of births in the UK were by caesarean section however since then, the proportion has risen to over 25%. Could this been one of reasons why in Britain we have so many colicky babies?
Again, I suspect this may also be linked to the microbiome. In natural births, the process of travelling through the birth canal results in the baby ingesting a lot of good bacteria from the mother. C-section babies don’t get that experience. Last year, a study found that babies born by c-section, and those given antibiotics early in life, do indeed have a different balance of gut microbes. This is why probiotics again can be helpful here.
The use of c-sections and antibiotics and at birth has really stepped up in the UK, so I always suggest that mothers and babies who’ve had c-sections or antibiotics should take probiotics – they’re one of the few interventions that are suitable for new born babies.
Not enough vitamin D?
We don’t get much sun in the UK, and there has been much research into the link between vitamin D levels and bone health, immunity and inflammation. In February 2017, a study from University College Cork found that almost half of newborns were deficient in vitamin D and that figure rose to over 60% in wintertime. The NHS now recommends that breastfed babies are given Vitamin D drops from birth, however the message has not got through to all new mums yet.
Even if we do get any sunshine in the UK, it isn’t advisable to put babies out in the sun, from where most vitamin D is obtained. Severe vitamin D deficiency does cause problems which would usually increase crying in babies, and supplementing babies’ vitamin D is a good idea anyway. I also recommend women top up their vitamin D throughout pregnancy and while breastfeeding.
As with all supplements, get age-appropriate dosages, take care and always read the label.
I wonder if making probiotics and vitamin D a normal part of the pregnancy and the fourth trimester could change things for the better for our British babies? It would be great to see one day that we have the most content and healthy babies in the world and I suspect these small changes could make quite a difference.
- Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938.
- Probiotics to prevent or treat excessive infant crying: systematic review and meta-analysis
- Early-life nutritional exposures and lifelong health: immediate and long-lasting impacts of probiotics, vitamin D, and breastfeeding.
- Intervention strategies for cesarean section-induced alterations in the microbiota-gut-brain axis