Even before your baby was born, you may have heard about issues like colic, lactose intolerance and cow's milk allergies. But once you learn more about these issues, you'll find they can usually be addressed. The first step is to know what to look for.

Feeding issues can be confusing because so many different situations share similar behaviors, including fussiness, gas, and extensive crying. Spit-up, vomiting, and diarrhea can also overlap in both common and more serious feeding issues. Follow these guidelines and you'll be better equipped to identify colic, lactose intolerance and a cow's milk protein allergy. You'll also see why they're so frequently misunderstood.

Is It Colic or Normal Crying?
Babies cry for a variety of reasons and it's often your baby's way of letting you know something is bothering him. Many times the cause is just mild, passing discomfort. However, when babies cry for extended periods of time, many new parents worry about colic. One of the most difficult things about identifying colic is that it's not considered a medical condition, making it harder to confirm. If your baby cries for long periods of time, even though he's not hungry, tired, or in need of a diaper change, there is a chance he could have colic. In reality, only about 15% of babies who exhibit colic-like behaviors truly deal with the issue.

If you're trying to determine whether your baby's frequent crying could be colic, take a look at the Rule of Threes below.

The Rule of Threes:

Does your baby cry for:

  • three consecutive hours (usually in the evening)
  • three times a week for
  • three weeks straight that usually begins at
  • three weeks of age and ends around
  • three to four months

If you can answer "yes" to most of these general guidelines, it's likely your baby has colic. Consult your baby's pediatrician, who should be able to suggest some ways to ease the discomfort.

Lactose Intolerance vs. Cow's Milk Protein Allergy
There's a lot of confusion between milk intolerance, more commonly called lactose intolerance, and an allergic response to the protein in cow's milk.

Cow's milk protein allergy affects an estimated 3% of babies and lactose intolerance is rare. While these conditions don't affect a huge percentage of babies, the associated issues can be dramatic. For that reason, it's important to know what to look for.

Lactose intolerance is the result of your baby's inability to digest a natural carbohydrate in milk called lactose. This inability can also cause tummy upset. But this digestive issue is rare in infants, and unlike cow's milk allergy, lactose intolerance doesn't engage the immune system and cause allergic reactions like hives, breathing difficulties, or chronic runny noses and coughs. If your baby is sick and also has diarrhea, he may have transient lactose intolerance caused by his other illness. In this case try giving him Enfamil Gentlease® which has just 20% of the lactose found in regular formula until he's better.

The indications of lactose intolerance can include:

  • gas
  • diarrhea
  • bloating
  • infant eczema
  • excessive crying and irritability similar to colic
  • a failure to gain weight

Cow's milk protein allergy can happen when your baby experiences allergic reactions to certain proteins such as casein and whey that are naturally found in milk and other dairy products. Ordinarily, your baby's immune system helps keep him healthy by fending off illness-causing germs. But sometimes, a baby's immune system mistakenly reacts to things that aren't a health threat. For reasons that aren't clear, the immune system of a baby with cow's milk allergy sees milk protein as an unwanted and harmful invader. For protection, your infant's immune system releases chemicals like histamines to fight off the cow's milk protein. This causes an allergic reaction.

Cow's milk allergy affects up to 3% of babies and is a common childhood food allergy. Infants who have cow's milk allergy may react in many different ways to the proteins found in cow's milk. Since a milk protein allergy includes many of the same issues as lactose intolerance it's not always easy for you to tell if your baby is lactose intolerant or allergic to the proteins in milk. However, a cow's milk allergy engages the immune system and leads to more allergic reactions.

Mild to moderate allergic reactions can result in the following:

  • colic
  • reflux
  • diarrhea
  • constipation
  • gas
  • skin rashes
  • upper respiratory difficulties

More severe issues associated with a cow's milk protein allergy include:

  • breathing difficulties
  • rectal bleeding
  • hives or rashes
  • anemia

If you notice any of the above, consult your baby's doctor right away. Your pediatrician might recommend switching to a baby formula that's specially designed for a baby with milk allergies. For example, Nutramigen® is a hypoallergenic formula specially made for infants with cow's milk allergy.

The main takeaway is that you should never hesitate to call your pediatrician with any feeding concern. Only the doctor can diagnose the real cause of your baby's feeding issue. The good news is that there are ways to address these issues and get babies right back on track.