Q. I work in a pediatric office, where many of our infant patients cry inconsolably for much of the day, every day. What's your opinion of homeopathic products or probiotics such as lactobacillus reuteri being used to calm fussy babies?
A. When a baby cries inconsolably, it's draining for both parent and child. It can be difficult to figure out the cause of a baby's fussiness, but once you do, soothing the child is often just a matter of finding the right baby-calming technique. Here's my take on natural remedies, along with a few common fuss-busters, from my pediatric practice to yours:
Use homeopathic remedies cautiously. As an MD, I take issue with homeopathic products because of the "I don't know" factor -- we just aren't sure if these remedies are 100 percent effective or even safe. They're simply not studied enough for me, as a medical doctor, to recommend them. Another reason to exercise caution is that young infants, especially in the first months of life, metabolize drugs differently than adults. What may be proven safe for adults may not be safe for babies, which leads me to rely on the wisdom: "When in doubt, leave it out."
Try probiotics. On the other hand, I do believe that probiotics such as lactobacillus reuteri are often effective. We use lactobacillus GG for most intestinal upsets. Probiotics have been shown to improve intestinal health by feeding the "good" bacteria in the gut, boosting immunity, and enhancing digestion.
Think modern. You might have heard a few of these old baby-care gems: "All babies cry a few hours a day," "You're just overreacting," and the worst: "Just let him cry it out -- it's good for his lungs." These are the worst things a healthcare provider can say to parents. Your words will be perceived as dismissive, and you'll come across as old-fashioned and uncaring. It's the kind of advice that prompts patients to switch doctors. Parents expect -- and babies deserve -- an explanation for why baby is crying, and suggestions for effective baby-soothing techniques. I've found it helpful to omit the term "colic" from my medical vocabulary -- instead, I refer to the child as "the hurting baby." This phrase encourages both parent and healthcare provider to keep on searching until they find out why baby is hurting.
Ask parents to keep a diary. Play show and tell. Tell them the importance of keeping a diary, and show them a list of what you expect to see: what triggers baby's crying, what makes it worse, what makes it better, and what may have caused it to worsen or improve. I tell parents in my practice that making the right diagnosis requires a team approach. The parents' job is to act as keen observers and accurate reporters, while the healthcare provider's role is to take the parents' observations and use them as clues to come up with the right diagnosis and treatment.
Share baby-calming resources. Tell parents to:
? Feed baby half as much, twice as often, and keep him upright after feeding to discourage reflux.
? Wear baby for at least a couple of hours a day in a sling-type carrier.
? Refer to my book, The Fussy Baby Book