Last updated September 2011. Planned review date: September 2013

Issues with digestion (constipation, colic, reflux)
If your premature baby is unwell or is suffering from discomfort such as constipation it's important to seek expert advice. However, there are also things you can do to help him feel better.
Constipation
Constipation tends to affect premature babies more than term babies. This is partly because it's more common in babies who are bottle fed. It may also relate to poor muscle tone or immature gut function.
What you can do about constipation
The usual advice for constipation is to give a little cooled boiled water between feeds, and to gently push your baby's knees into his tummy one at a time, to help get his bowels moving. However, talk to your healthcare team, who may alter the mix of the formula you are using, or may prescribe glycerine suppositories.
Reflux
Gastro-oesophageal reflux, usually known simply as 'reflux', is the name for when the contents of the stomach come back up into the foodpipe or mouth. This may just cause posseting (bringing up small amounts of milk after feeding), but in more severe cases the baby may vomit, cough or choke, and it can sometimes cause soreness or problems with sleeping or feeding. It is very common among babies - especially those born prematurely.
What you can do about reflux
Try nursing your baby on a tilt, with his head much higher than the rest of his body. Sometimes the healthcare team may prescribe a thickener to add to his milk. However, this is not a trouble-free option, as it can cause diarrhoea, coughing and feeding problems. Reflux tends to ease naturally over time as your baby's digestive tract grows.
Colic
Colic is the name for frequent episodes of prolonged crying in a baby who seems otherwise healthy. It is very common in young babies. We do not know exactly what causes it, but it may be linked to an immature digestive system. Many parents feel that their baby is crying because he is in pain, often around the time of feeding. The problem usually resolves itself after three or four months.
What you can do about colic
If you decide to go to your GP, they may suggest:
- trying drops to help with wind or to help digest the lactose in milk
- changing your baby's diet - either by cutting dairy out of your own diet if you are breastfeeding, or by switching to a hyper-allergenic formula, if your baby is bottle fed.
Try a treatment for one week, and if it doesn't help with the crying, move on to the next. Your GP is unlikely to refer you to a paediatrician unless there are any other signs that your baby is unwell, or if the problem is getting worse or continues beyond four months.
Ways to soothe your crying baby
- Keep the room quiet and dimly lit.
- Cuddle him or give kangaroo care.
- Take him for a drive or a walk in the buggy, the movement may soothe him.
- Give him something to suck.
- Gently push his knees into his tummy in a cycling motion, to help with wind.
- Swaddle him.
- Rock him or gently walk around the room with him.
- Bathe him in warm water.
In this section
Taking your baby home:
You can also read about
The following organisations can give you more information about the topics covered in this section.
Sources
Brodsky D, Ouellette MA (2008) Primary care of the premature infant, p90
Cabana MD (2010) New treatments for infant colic, Paediatrics, Vol 22, No 6, p791–797
http://www.cks.nhs.uk/colic_infantile#289832004
http://www.cks.nhs.uk/gord_in_children/evidence
http://www.nhs.uk/Conditions/Constipation/Pages/Causes.aspx
http://www.nhs.uk/Conditions/Constipation/Pages/Treatment.aspx#notweaned
http://www.ncbi.nlm.nih.gov/pubmed/21455007
Meeks M, Hallsworth M, Yeo H (2010) Nursing the neonate, Chichester, Wiley-Blackwell, p353
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