Lincoln University Take’s On National Colic & Reflux Survey
Lincoln University Take’s On National Colic & Reflux Survey
In 2012, Philippa Murphy, a recognised Postnatal Liaison Educator and specialist in these symptoms, launched a National Survey on Colic and Reflux – the first in New Zealand and internationally for at least a decade. 153 parents shared their experiences in the hope of increased understanding and provoking change. Lincoln University answers their call.
Researchers at Lincoln are currently analysing the data collected in the survey. The results will then be compared with other leading international studies, be passed onto parent and health organisations worldwide with intended publication in medical journals. Murphy says, they will also be used to promote and build guidelines for ‘preventative education programmes’ which will ideally be funded by the government and available to all families.
The survey asked parents their thoughts on the causes of colic and reflux, the methods they used to bring calm, the behaviours witnessed, feeding winding and sleeping practices, and whether they felt supported enough, both within antenatal education and postnatal care. Furthermore they were given the opportunity to tell their story in their own words. ‘Their experiences are enough to bring anyone to tears,’ Murphy says. ‘Some parents spoke of coming very close to hurting their baby, many of ‘yelling at them’ or ‘holding them tighter’ than they should. Other common responses included; isolation, inadequacy, no bond or love formed and a huge amount of guilt, as was the cry for more understanding within society. These feelings can naturally form when we combine this kind of stress with sleep deprivation. With our high rate of child abuse, our knowledge about attachment, and the consequences on development for newborns in these overstretched environments, the passion for change runs high.’
Allan Schore, a renowned scientist, clinical psychologist and neuropsychologist states, “We now know that the evolutionary mechanism of attachment does more than just provide baby with a sense of safety and security. Rather, attachment drives brain development, five-sixths of which happens postnatally.’ Schore goes onto say that brain growth ‘more than doubles in the first 12 months, and 40,000 new synapses are formed every second in the infant’s brain. But, importantly, this brain growth is influenced by “social forces”, and is therefore “experience dependent.” It requires not only nutrients, but the emotional experiences embedded in the relationship it co-creates with the primary caregiver.”
Some believe government funded, mandatory education in the antenatal stages for the prevention of colic and reflux could offer a significant reduction in New Zealand’s high child abuse rate. UNICEF NZ’s National Advocacy Manager, Barbara Lambourn, has been quoted in saying, ‘we must invest more in children. If we fail to invest at the right time we pay for it down the track to put right what we get wrong in the early years.” UNICEF ranked New Zealand 21 of 35 countries for levels of child poverty in March 2013.
An article in the NZ Herald in November 2013, reported that outcomes from an 18-month cross-party inquiry by the parliamentary health committee recommends New Zealand changing its health priorities from the last two years of life to the womb if it is to improve its record on child health and child abuse. ‘Currently, more than half the Government’s $14 billion health budget goes towards caring for people later in life when research shows it would make more economic and social sense to do the exact reverse.’ Committee chairman Paul Hutchison said, "Intervening in the first three years, when children are at their most receptive stage of development, has been shown to have the potential to permanently alter their development trajectory and protect them against risk factors present in their daily environment.” The work of Heckman” a Nobel Prize-winning American economist that the inquiry was asked to investigate, “has built up compelling economic evidence that investment in the very early years, probably from pre-conception, will yield a significantly higher return for every dollar than delayed investment, provided the intervention is of high quality and is evidence based." The committee said that once a New Zealand evidence base was established, the Government should move quickly to reprioritise its focus and investment towards the period between pre-conception and 3 years old.’ Murphy intends to use the evidence based results from the survey along with her evidence based research to resubmit a low cost pilot antenatal education programme to the government.
Alex Simpson, a mother whom took part in the survey, echoed a collective parent reaction to the lack of practical postnatal education, ‘Taking antenatal class’s tricks you into thinking you are well prepared, so it's an even larger shock to the system how hard a newborn can be!’ Many parents commented they weren’t taught what ‘normal’ and ‘abnormal’ behaviours were for a newborn. They didn’t hear about colic or reflux until there baby was experiencing it. Some parents said, until you are going through it, nothing can prepare you. Murphy agrees with this to some extent, ‘the reality is exhaustive on so many levels and currently, very confusing with all the conflicting and misleading information available. However, avoidance of these behaviours is now possible for many cases by teaching basic newborn biology and new proven findings to parents before birth. Prevention through early education is key for newborns, parents, society and government expenditure.’
The survey also features information about the growing, worldwide concern over the safety of extensively prescribed acid suppressants for the symptoms of Gastroesophageal Reflux (GER) in newborns. A March 2013 article in the New Zealand Sunday Star Times reported, ‘prescription rates for acid suppressants have soared in recent years due to a trend toward labelling reflux as a disease, when in fact infants are just grizzly and cry for hours,’ according to a paper published in the NZ Medical Journal. The paper said, ‘research shows acid suppressants have no role in the management of reflux. Yet, despite being unlicensed for use in infancy, the acid suppressant Losec prescription rate for Canterbury infants alone tripled from 4 per cent to 15 per cent between 2005 and 2010.’ In the Sunday Star article, Dr Ben Hudson said the drug Omeprazole, also known as Losec, can be harmful to children, including increasing the risk of gut infections and pneumonia. "They haven't been used so extensively and so long in children so long-term safety is much less understood than in adults. But even in adults there's growing concerns about long term side-effects, like kidney damage."
Murphy agrees, ‘reflux is treated too much like a disease however, inconsolable crying/screaming of a newborn for hours on end or even half an hour, is not normal. Nor is mass refluxing. Thankfully though we now have new information available to prevent and remedy colic and reflux behaviours naturally. Parent’s no longer have to resort to highly controversial acid suppressants which do nothing to treat the cause, only mask the symptoms and cause adverse reactions.’