Naturopathic Essentials for the First Year of Life
Jaclyn Chasse, ND
The first year of life is a time of enormous growth and development. In addition to the fact that a child is totally dependent upon their family from birth until walking at one year, the child also triples their birth weight within the first year and their brain grows to almost two-thirds adult size by year two to threei. This makes for a lot of change in a very short period of time, and proper support of the infant can provide a strong foundation for a healthy childhood and adult life.
The purpose of this article is to provide you with the wellness foundations for a strong and healthy infant and also to address some of the common, self-limiting concerns that arrive during early childhood in healthy infants.
Months 1–3: The 4th Trimester
The earliest period of a newborn’s life has been coined the “4th Trimester” to emphasize that in many ways this very early development is an extension of the development in pregnancy. Neurologically, children do not fully integrate until several months after they are born and have complete dependency on their parents, relying on them for food, warmth and comfort. Some of the common complaints that arise during this time include blocked tear ducts, colic, sleep concerns and challenges with breastfeeding and lactation.
Blocked Tear Ducts
Blocked tear ducts can arise in the first days to weeks of life. It is a blockage of the naso-lacrimal duct. When tears are produced (in the upper, outer corner of the eyes) and naturally flow to the duct in the inner corner. A blockage of the naso-lacrimal duct can prevent proper tear flow, causing watering of the eye, sometimes with a “gooping” or crusting of the tears. This usually self-resolves, but can be assisted through the application of a few drops of breastmilk into the affected eye 3–5 times daily and gentle massage of the inner corner of the eye. Breastmilk contains enzymes and immune cells that can assist at dissolving the blocked duct. Warm compresses can also assist with movement of the blockage.
Another treatment option for blocked ducts is the use of homeopathic medicines. Homeopathic remedies are great choices for even the youngest children, as they have a fantastic safety profile. Silica 6C or 12C, as well as Baryta carb 6C or 12C, are indicated for blocked tear ducts. Dissolve two pellets into water and administer one full dropper by mouth three times dailyii. If this doesn’t resolve within six months, a referral to an ophthalmologist is warranted.
About 10% of infants in the western world experience colic. Colic is defined as periods of crying that last more than three hours per day, more than three days per week for more than three weeks. (Normal crying, which peaks between 6–8 weeks, is about two hours per day at two weeks, three hours per day at six weeks and then decreases to one hour per day by three months). Several theories have been proposed around the causes of colic. One theory is that colic is a normal gastro-colic reflex in response to food, increasing peristalsis to make room for incoming foodiii. Another theory is that serotonin-melatonin circadian rhythms trigger colic and have an effect on peristalsis. Others view colic as one of many abnormalities such as GERD, gas or muscular spasms in the colon. It’s important to note that 85–90% of babies with colic have no evidence of GI abnormality, suggesting this is not the most well-supported theoryiv.
Colic has little direct medical consequences, but it does pose significant and real concerns for parents and baby. Colic and prolonged crying are risk factors for maternal and paternal postpartum depression. Mothers of colicky babies are at risk for a shortened duration of nursing and increased rate of insecure attachment to their infants. Colicky babies are at a greater risk of SIDS and shaken baby syndrome, and there is an increased likelihood of unnecessary treatment of the infant with drugs like sedatives, analgesics, antispasmodic medications and proton pump inhibitors. (PPIs have been no more effective than water at reducing infant crying).vi
Another strong theory for colic is the relationship between colic and neonatal microbiota. In a study published in Pediatrics in 2013, the fecal microbiota of 12 infants with colic were compared to that of 12 healthy infants during their first 100 days of life. Children with colic lacked diversity of microbiota compared to the control group and had increased proteobacteria and reduced lactobacilli and bifidobacteria. Especially absent were strains producing butyrate and lactate (Bacteriodetes and Firmicutes)vii. Further studies have demonstrated that probiotics may be an effective treatment of colic in breastfed babies and possibly in formula fed babies. L. reuterii is the most commonly studied strain and has demonstrated effectiveness within 21 daysviii. Furthermore, prophylactic use of probiotics may prevent colic, reduce crying time, reduce regurgitation and increase mean number of bowel movements dailyix . Emerson now carries several “women’s probiotics,” which have heavy prevalence of this strain. It is believed that taking this strain during the 3rd trimester of pregnancy can help to inoculate the mother’s vaginal ecoflora, allowing for inoculation of the child during the birth process. L. reuterii can also be administered as a powder on the areola prior to nursing or mixed into a bottle of formula.
Diaper rash is the most common skin condition in infants, and is most common between nine and 12 months. Urine increases hydration of the skin and increases the pH. Increased skin hydration leaves the skin more permeable and susceptible to irritants, abrasions and infection . Some treatment options include bathing the child in a bath with one tablespoon of baking soda added or applying barrier creams or salves containing comfrey or calendula. If there is suspected infection, parents can add tea tree oil, ketoconazole or nystatin (for suspected Candida), goldenseal root powder (Hydrastis) or Oregon Grape Root (Mahonia) for suspected bacterial growth.
Teething normally starts around 4–6 months of age, with a first tooth erupting around six months. While teething and teething pain are a normal expectation in this age group, several options are available to provide relief. One of my favorites is a Teething Tea, made by combining 0.5 teaspoons each of dried catnip (Nepata cataria), chamomile (Matricaria recutita), passionflower (Passiflora incarnata) and lemonbalm (Melissa off.) into two cups of hot water. Cool, strain and give to the child in a cup, mixed into milk, by the dropper or even on a facecloth. Facecloths dipped into this tea and frozen make a great teether for infants.
Homeopathic remedies can provide significant relief to children. In particular, homeopathic Chamomile 6C or 12C has been used by many parents to provide relief to their teething infants, often in combination with other homeopathics. Emerson sells Teething and Tooth Support tabs by Similisan (S20002) which contain chamomile.
If you treat children, you’ve likely seen that in the last year the FDA issued several warnings against homeopathic teething tablets available over the counter, citing several serious adverse events from their use due to the presence of belladonna. Hylands, a leading manufacturer, pulled their products from the market and concurrently issued statements assuring their safety. Dr. Ron Whitmont, the President of the American Institute of Homeopathy, provided a detailed analysis of these reports in a 2017 Issue of the American Journal of Homeopathic Medicine, which points to several flaws in the data used to justify the FDA’s warning. US Poison Control and Health Canada have not reported similar concerns with the same products. The article is worth a read, whether you choose to use the remaining homeopathic teething tablets or not.xi
Thrush is an oral infection of Candida albicans, which appears as a thick white coat on the tongue or buccal mucosa. The white patches can be scraped off, leaving a lightly bleeding area. Thrush is very common in the first weeks of life, especially after antibiotic treatmentxii. It can be worse in infants using pacifiers. In breastfeeding mothers, it can be passed back and forth between mother’s breast and baby’s mouth, so it is essential to treat the mother-child dyad. Thrush is often treated conventionally with Nystatin oral suspension or other antifungals. Oral infant probiotic powders can also help to support the health of the microbiome within the infant’s mouth and digestive tract to help to maintain a health microflora balance.
Reflux and Regurgitation
The regurgitation of milk or formula is highly reported and diagnosed in infants. The etiology, while often assumed to be acid reflux, is diverse and the majority of burden is actually non-acid reflux related. Proton pump inhibitors, the primary treatment approach for infants with reflux, have a high rate of side effects, often don’t help and should be avoided in most cases . Some treatment options include left side-lying, modifying dietary intake of the mother (if nursing) and demulcent herbs and nutrients such as slippery elm, marshmallow and L-glutamine.
When treating the youngest of patients, it’s essential to consider safety first and also keep in mind that often, what you provide is counseling and reassurance to the parents that they are doing okay! I have found that much of my visit time is discussion on parenting choices (sleep, diaper choices, food introduction, etc.) and it’s good to remind parents that there is no one “right” way, even if you share your own preferences.
ii Hay et al. Current Diagnosis and Treatment in Pediatrics. 18th edition. Lange Medical Boods/McGraw Hill. 2007
ii Castro, M. Homeopathy for Pregnancy, Birth, and Your Baby’s First Year. St. Martin’s Press. NY. 1993.
iii Canivet C, Jakobsson I, Hagander B. Colicky infants according to maternal reports in telephone interviews and diaries: a large Scandinavian study. J Dev Behav Pediatr 2002;23:1-8.
iv Karp H. The fourth trimester: A framework and strategy for understanding and resolving colic. Contemporary Peds 2001; 21:92-114.
v Lucassen P, Assendelft WJ, Gubbels JW, van Eijk JT, van Geldrop WJ, Neven AK. Effectiveness of treatments for infantile colic: systematic review. BMJ 1998;16:1563-1569.
vi Chasse, J. Natural Medicine Journal. 2011 Sept 7. http://www.naturalmedicinejournal.com/article_content.asp?edition=1§ion=3&article=232
vii deWeerth, C et al. Pediatrics. 2013 Sept.
viii Sung et al. JAMA Pediatrics. 2013 Dec 1;167(12):1150-7.<style=”line-height:100%”>