Link between baby obesity and colic and reflux in NZ
Research into the colic and reflux situation in New Zealand suggests link with baby obesity
With the World Health Organisation (WHO) adopting resolutions for maternal, infant and child nutrition and reporting that being obese in childhood increases the likelihood of being obese as an adult, this new research may provide some answers.
In 2013, Lincoln University analysed the results of a 2012 New Zealand Survey on Colic and Reflux held by Postnatal Educator, Philippa Murphy, an author and specialist in this field. A small but noteworthy number of 154 parents took part in the first New Zealand parent survey on this since the 1980’s. They were asked questions about feeding practices, behaviours witnessed, the methods used to bring calm, the parents beliefs and thoughts on the causes and antenatal education.
Recently published in the International Nursing and Midwifery Journal, the resulting paper details a weak but statistically significant relationship between the number of feeds per day and the number of crying bouts for a newborn. It reports that 36 per cent of parents fed for six hours or more per day, with some reportedly feeding up to 11 hours and 70 per cent of parents increasing feeding spells in the evening, known as cluster feeding.
Delve into the parenting world and cluster feeding or frequent feeding is thought to be normal and taught as such. However, Murphy’s research points toward frequent feeding or overfeeding being one of the factors that leads to unsettled behaviour and a possible diagnosis of colic and reflux. She says, ‘The cyclic pattern of overfeeding – unsettled behaviour – comfort feeding – unsettled behaviour and so on, has newborns digestive systems being pushed beyond their biological capabilities and one of the a bi-products of this is baby obesity.’
The WHO commission on Ending Childhood Obesity is currently welcoming suggestions and feedback on their interim report that details young child feeding as an important factor to combat obesity. It states, ‘The increasing rates of childhood obesity cannot be ignored and governments need to accept their central role as the principal agents in addressing the issue. A failure to act will have medical, social and economic consequences of major magnitude.’ The report goes onto say, ‘children are the unwitting actors who become obese as a result of entrapment by contextual factors operating within society.’
Murphy agrees, ‘We live in a society where the health professionals and therefore the parents are greatly focused on weight gain being the ultimate gauge that a newborn is ‘thriving’, even if the baby puts on weight well over recommendations, screams for hours every day and is completely unsettled. The consequences of this belief are already causing major problems for our newborns and their parents, much of which are completely avoidable.’
Some parents expressed their experiences in the survey saying they shouted at their baby or came very close to shaking them. One mother said, ‘There were numerous times when I got so close to shaking him that it scares me. I consider myself a fairly respectable person. I had a good job at the District Court, I paid my bills on time and had a functioning social life. Yet somehow this constant state of distress turned me into one of those people that you see on the news who have shaken their babies. I can completely see how it happens and in only a split second.’ Murphy says, ‘we now have the information needed to prevent and reduce the devastating physical and emotional cost of these behaviours, including baby obesity, because we know there is a direct link between overfeeding and these digestive issues.’
The usage of prescription medicines was also reported in the survey. Supporting a recent paper in The New Zealand Medical Journal by Professor Day, a paediatric gastroenterologist from the University of Otago, results showed that ‘Over half of the parents that had administered prescription medicines had increased the dosage over time. Indications were that the average increase was four times the initial dose for omeprazole and ranitidine.’ According to Day’s paper, this is ‘despite them being unlicensed for use in infancy and acid suppression by PPI’s therapies being associated with important adverse effects.’ Furthermore, reports show ‘there is little evidence that acid plays any role in patterns of unsettledness and irritability in infancy.’ However, of the survey parents that used PPI’s, 82 per cent indicated that their use had proved ‘helpful’ lessening unsettledness. More and more health professionals concur that this viewed ‘improvement’ may be due to the unfavourable mechanisms of acid suppressants.
The results of the survey also reinforced a need for pre-natal education on the causes of colic and reflux with 29 per cent of newborns showing the associated behaviours within a week after birth, increasing to 89 per cent in the first month and 100 per cent by three months of age.’ It is commonly thought that colic behaviour ceases at the age of three months but the survey results contradicted this belief with only a ‘55 per cent reduction by six months, with 18 per cent still exhibiting excessive crying or reflux at 12 months.’ Murphy believes this is partly due to early effects of overloading from misreading cues or continual feeding above biology. ‘I have said it before and for the sake of our babies who can’t speak, will keep doing so - prevention through pre-natal education is key for newborns, parents, society and as stated by the World Health Organisation, governments overall responsibility.’