Colic comes in many shapes and sizes, from the evening-only screamer to the all-day fusser. Some babies have mild to moderate colic for only a month or two, and others suffer through several months of severe symptoms. While some babies may not have an identifiable cause of their colic and will outgrow it by four months of age, most babies with colic have a physical cause that is creating the painful intestinal symptoms. As a doctor, I take colic very seriously and do everything I can with every patient to determine a cause and find relief for the baby and his parents.
While there are many possible causes of colic, in my experience the two most common causes of colic are cow’s milk protein allergy and transient lactase deficiency (TLD). If eliminating cow’s milk protein from a nursing mom’s diet, and from the infant’s diet, doesn’t create improvements, then I will consider TLD as a likely cause.
TLD is a recently-recognized contributor to colic. Research has shown that 38% infant colic cases can be attributed to a temporary insufficiency of lactase enzyme, an intestinal enzyme that digests the lactose sugar in milk (breast milk or cow’s milk formula). The undigested sugar will ferment and create lactic acid and hydrogen gas, which can contribute to colicky symptoms. Such infants will usually begin producing more lactase enzyme by four months of age, but the intervening months can be very uncomfortable. This can be improved by adding lactase digestive enzyme drops to an infant’s formula or breast milk. I have seen these drops work well in many of my little colicky patients.