2023-08-22 14:33:00
All FAQs added
major
All FAQs added with newest literature.
Infantile Colic
•Last Updated: August 22, 2023
“Infantile colic” is characterized by repeated episodes of intense/frequent crying or discontent with an unknown cause. Caregivers need to be reassured that they are often doing nothing wrong, and that colic usually resolves by itself within 3–4 months. However, supplementation with certain probiotics may help.
Infantile Colic falls under thePregnancy & Childrencategory.
Last Updated:August 22, 2023
Infantile colic is characterized by excessive, inconsolable crying in infants under 5 months old; it affects 10% to 40% of infants and often leads to pediatric consultations. It typically occurs within the first 6 weeks of life and resolves by 3 to 4 months.
The main sign of infantile colic is crying, and other possible signs include flushing of the face, clenched fists, drawing up of the legs, and flatulence. These signs are more likely to occur in the late afternoon and evening.
Infantile colic is diagnosed using the Rome IV criteria, which include recurrent crying or fussing without an obvious cause in infants under 5 months. The Wessel criteria are also widely used and define colic as excessive crying lasting over 3 hours a day for more than 3 days per week for 3 or more weeks in otherwise healthy infants aged 2 weeks to 4 months.
The main medical treatments for infantile colic include clinical evaluation, parenting support, continuation of breastfeeding, and probiotic supplements for breastfed infants; pharmacological treatments are rarely indicated. The effectiveness of simethicone is inconclusive, and medications like dicyclomine and cimetropium bromide have potential side effects and are not recommended for infants under 6 months of age.
Probiotics, especially Lactobacillus reuteri, have strong research support for alleviating infantile colic without serious adverse events. Fennel, sucrose, and a combination of herbal supplements and B vitamins may also help reduce crying time, though the quality of evidence varies from very low to moderate.
Diet may influence infantile colic, and some guidelines recommend maternal dietary modifications, such as eliminating common allergens, whereas others do not. Evidence suggests that hypoallergenic formulas may reduce crying time in some infants, and one study indicated that parents who excluded allergens from their diets saw greater improvements in their breastfed babies' colic symptoms compared to those who did not.
Chiropractic medicine and osteopathy have not shown significant effects on infantile colic, and chiropractic manipulation is strongly discouraged due to safety concerns. Other treatments — including acupuncture, increased infant carrying, and car-ride simulators — have also proven ineffective.
The exact cause of infantile colic is not known, but it may be influenced by various factors, including gastrointestinal issues, neurodevelopmental aspects, and maternal behaviors like smoking. Additionally, interactions between these factors could play a role in the condition.
Research FeedRead all studies
- ^Ellwood J, Draper-Rodi J, Carnes DComparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines.BMJ Open.(2020-Feb-25)
- ^Landgren K, Hallström IParents' experience of living with a baby with infantile colic--a phenomenological hermeneutic study.Scand J Caring Sci.(2011-Jun)
- ^Gordon M, Gohil J, Banks SSParent training programmes for managing infantile colic.Cochrane Database Syst Rev.(2019-Dec-03)
- ^Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko SChildhood Functional Gastrointestinal Disorders: Neonate/Toddler.Gastroenterology.(2016-Feb-15)
- ^Johnson JD, Cocker K, Chang EInfantile Colic: Recognition and Treatment.Am Fam Physician.(2015-Oct-01)
- ^Freedman SB, Al-Harthy N, Thull-Freedman JThe crying infant: diagnostic testing and frequency of serious underlying disease.Pediatrics.(2009-Mar)
- ^Savino F, Pelle E, Castagno E, Palumeri E, Oggero RMust infants with colic really be hospitalized?Acta Paediatr.(2007-Jul)
- ^Savino F, Tarasco VNew treatments for infant colic.Curr Opin Pediatr.(2010-Dec)
- ^Lucas A, St James-Roberts ICrying, fussing and colic behaviour in breast- and bottle-fed infants.Early Hum Dev.(1998-Nov)
- ^Camilleri M, Park SY, Scarpato E, Staiano AExploring hypotheses and rationale for causes of infantile colic.Neurogastroenterol Motil.(2017-Feb)
- ^Gordon M, Biagioli E, Sorrenti M, Lingua C, Moja L, Banks SS, Ceratto S, Savino FDietary modifications for infantile colic.Cochrane Database Syst Rev.(2018-Oct-10)
- ^Wolke D, Bilgin A, Samara MSystematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants.J Pediatr.(2017-Jun)
- ^Savino FFocus on infantile colic.Acta Paediatr.(2007-Sep)
- ^Korpela K, Renko M, Paalanne N, Vänni P, Salo J, Tejesvi M, Koivusaari P, Pokka T, Kaukola T, Pirttilä AM, Tapiainen TMicrobiome of the first stool after birth and infantile colic.Pediatr Res.(2020-Nov)
- ^Pärtty A, Kalliomäki M, Salminen S, Isolauri EInfantile Colic Is Associated With Low-grade Systemic Inflammation.J Pediatr Gastroenterol Nutr.(2017-May)
- ^Rhoads JM, Fatheree NY, Norori J, Liu Y, Lucke JF, Tyson JE, Ferris MJAltered fecal microflora and increased fecal calprotectin in infants with colic.J Pediatr.(2009-Dec)
- ^Rhoads JM, Collins J, Fatheree NY, Hashmi SS, Taylor CM, Luo M, Hoang TK, Gleason WA, Van Arsdall MR, Navarro F, Liu YInfant Colic Represents Gut Inflammation and Dysbiosis.J Pediatr.(2018-Dec)
- ^WESSEL MA, COBB JC, JACKSON EB, HARRIS GS, DETWILER ACParoxysmal fussing in infancy, sometimes called colic.Pediatrics.(1954-Nov)
- ^Biagioli E, Tarasco V, Lingua C, Moja L, Savino FPain-relieving agents for infantile colic.Cochrane Database Syst Rev.(2016-Sep-16)
- ^Weissbluth M, Christoffel KK, Davis ATTreatment of infantile colic with dicyclomine hydrochloride.J Pediatr.(1984-Jun)
- ^Hall B, Chesters J, Robinson AInfantile colic: a systematic review of medical and conventional therapies.J Paediatr Child Health.(2012-Feb)
- ^Savino F, Brondello C, Cresi F, Oggero R, Silvestro LCimetropium bromide in the treatment of crisis in infantile colic.J Pediatr Gastroenterol Nutr.(2002-Apr)
- ^Lucassen PColic in infants.BMJ Clin Evid.(2010-Feb-05)
- ^Moore DJ, Tao BS, Lines DR, Hirte C, Heddle ML, Davidson GPDouble-blind placebo-controlled trial of omeprazole in irritable infants with gastroesophageal reflux.J Pediatr.(2003-Aug)
- ^Di Lorenzo, COther Functional Gastrointestinal Disorders in Infants and Young ChildrenPediatric Gastroenterology and Nutrition.(December 2013)
- ^Gieruszczak-Białek D, Konarska Z, Skórka A, Vandenplas Y, Szajewska HNo effect of proton pump inhibitors on crying and irritability in infants: systematic review of randomized controlled trials.J Pediatr.(2015-Mar)
- ^Ong TG, Gordon M, Banks SS, Thomas MR, Akobeng AKProbiotics to prevent infantile colic.Cochrane Database Syst Rev.(2019-Mar-13)
- ^Underwood MAShould we treat every infant with a probiotic?Minerva Pediatr.(2019-Jun)
- ^Skonieczna-Żydecka K, Janda K, Kaczmarczyk M, Marlicz W, Łoniewski I, Łoniewska BThe Effect of Probiotics on Symptoms, Gut Microbiota and Inflammatory Markers in Infantile Colic: A Systematic Review, Meta-Analysis and Meta-Regression of Randomized Controlled Trials.J Clin Med.(2020-Apr-02)
- ^Liu Y, Ma D, Wang X, Fang YProbiotics in the treatment of infantile colic: a meta-analysis of randomized controlled trials.Nutr Hosp.(2022-Oct-17)
- ^Sung V, D'Amico F, Cabana MD, Chau K, Koren G, Savino F, Szajewska H, Deshpande G, Dupont C, Indrio F, Mentula S, Partty A, Tancredi Dto Treat Infant Colic: A Meta-analysis.Pediatrics.(2018-Jan)
- ^Dryl R, Szajewska HProbiotics for management of infantile colic: a systematic review of randomized controlled trials.Arch Med Sci.(2018-Aug)
- ^Dos Reis Buzzo Zermiani AP, de Paula Soares ALPP, da Silva Guedes de Moura BL, Miguel ERA, Lopes LDG, de Carvalho Scharf Santana N, da Silva Santos T, Demarchi IG, Teixeira JJEvidence of Lactobacillus reuteri to reduce colic in breastfed babies: Systematic review and meta-analysis.Complement Ther Med.(2021-Dec)
- ^F Savino, S Ceratto, E Poggi, M E Cartosio, L Cordero di Montezemolo, A GiannattasioPreventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938Benef Microbes.(2015)
- ^Tracy Harb, Misa Matsuyama, Michael David, Rebecca J HillInfant Colic-What works: A Systematic Review of Interventions for Breast-fed InfantsJ Pediatr Gastroenterol Nutr.(2016 May)
- ^, Lavalle L, Sauvageot N, Cercamondi CI, Egli D, Jankovic I, Vandenplas YInfant feeding practice and gastrointestinal tolerance: a real-world, multi-country, cross-sectional observational study.BMC Pediatr.(2022-Dec-14)
- ^Irina Alexandrovich, Olga Rakovitskaya, Elena Kolmo, Tatyana Sidorova, Sergei ShushunovThe effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled studyAltern Ther Health Med.(2003 Jul-Aug)
- ^Arikan D, Alp H, Gözüm S, Orbak Z, Cifçi EKEffectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic.J Clin Nurs.(2008-Jul)
- ^Savino F, Cresi F, Castagno E, Silvestro L, Oggero RA randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants.Phytother Res.(2005-Apr)
- ^Johnson JD, Cocker K, Chang EInfantile Colic: Recognition and Treatment: AAFPAm Fam Physician.(Sept 2015)
- ^Lucassen PL, Assendelft WJ, Gubbels JW, van Eijk JT, Douwes ACInfantile colic: crying time reduction with a whey hydrolysate: A double-blind, randomized, placebo-controlled trial.Pediatrics.(2000-Dec)
- ^Savino F, Palumeri E, Castagno E, Cresi F, Dalmasso P, Cavallo F, Oggero RReduction of crying episodes owing to infantile colic: A randomized controlled study on the efficacy of a new infant formula.Eur J Clin Nutr.(2006-Nov)
- ^Lucassen PColic in infants.BMJ Clin Evid.(2015-Aug-11)
- ^, Agostoni C, Axelsson I, Goulet O, Koletzko B, Michaelsen KF, Puntis J, Rieu D, Rigo J, Shamir R, Szajewska H, Turck DSoy protein infant formulae and follow-on formulae: a commentary by the ESPGHAN Committee on Nutrition.J Pediatr Gastroenterol Nutr.(2006-Apr)
- ^Perry R, Leach V, Penfold C, Davies PAn overview of systematic reviews of complementary and alternative therapies for infantile colic.Syst Rev.(2019-Nov-11)
- ^Hill DJ, Roy N, Heine RG, Hosking CS, Francis DE, Brown J, Speirs B, Sadowsky J, Carlin JBEffect of a low-allergen maternal diet on colic among breastfed infants: a randomized, controlled trial.Pediatrics.(2005-Nov)
- ^Dobson D, Lucassen PL, Miller JJ, Vlieger AM, Prescott P, Lewith GManipulative therapies for infantile colic.Cochrane Database Syst Rev.(2012-Dec-12)
- ^Cabanillas-Barea S, Jiménez-Del-Barrio S, Carrasco-Uribarren A, Ortega-Martínez A, Pérez-Guillén S, Ceballos-Laita LSystematic review and meta-analysis showed that complementary and alternative medicines were not effective for infantile colic.Acta Paediatr.(2023-Jul)
- ^Côté P, Hartvigsen J, Axén I, Leboeuf-Yde C, Corso M, Shearer H, Wong J, Marchand AA, Cassidy JD, French S, Kawchuk GN, Mior S, Poulsen E, Srbely J, Ammendolia C, Blanchette MA, Busse JW, Bussières A, Cancelliere C, Christensen HW, De Carvalho D, De Luca K, Du Rose A, Eklund A, Engel R, Goncalves G, Hebert J, Hincapié CA, Hondras M, Kimpton A, Lauridsen HH, Innes S, Meyer AL, Newell D, O'Neill S, Pagé I, Passmore S, Perle SM, Quon J, Rezai M, Stupar M, Swain M, Vitiello A, Weber K, Young KJ, Yu HThe global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.Chiropr Man Therap.(2021-Feb-17)
- ^R G Barr, S J McMullan, H Spiess, D G Leduc, J Yaremko, R Barfield, T E Francoeur, U A HunzikerCarrying as colic "therapy": a randomized controlled trialPediatrics.(1991 May)
- ^Parkin PC, Schwartz CJ, Manuel BARandomized controlled trial of three interventions in the management of persistent crying of infancy.Pediatrics.(1993-Aug)
- ^McKenzie STroublesome crying in infants: effect of advice to reduce stimulation.Arch Dis Child.(1991-Dec)
- ^Lucassen PL, Assendelft WJ, Gubbels JW, van Eijk JT, van Geldrop WJ, Neven AKEffectiveness of treatments for infantile colic: systematic review.BMJ.(1998-May-23)
- ^Nocerino R, Pezzella V, Cosenza L, Amoroso A, Di Scala C, Amato F, Iacono G, Canani RBThe controversial role of food allergy in infantile colic: evidence and clinical management.Nutrients.(2015-Mar-19)
- ^Fiocchi A, Brozek J, Schünemann H, Bahna SL, von Berg A, Beyer K, Bozzola M, Bradsher J, Compalati E, Ebisawa M, Guzman MA, Li H, Heine RG, Keith P, Lack G, Landi M, Martelli A, Rancé F, Sampson H, Stein A, Terracciano L, Vieths SWorld Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines.World Allergy Organ J.(2010-Apr)
- ^Ralf G HeineGastroesophageal reflux disease, colic and constipation in infants with food allergyCurr Opin Allergy Clin Immunol.(2006 Jun)
- ^Merras-Salmio L, Pelkonen AS, Kolho KL, Kuitunen M, Mäkelä MJCow's milk-associated gastrointestinal symptoms evaluated using the double-blind, placebo-controlled food challenge.J Pediatr Gastroenterol Nutr.(2013-Sep)
- ^F Savino, L Cordisco, V Tarasco, R Calabrese, E Palumeri, D MatteuzziMolecular identification of coliform bacteria from colicky breastfed infantsActa Paediatr.(2009 Oct)
- ^Oosterloo BC, van Elburg RM, Rutten NB, Bunkers CM, Crijns CE, Meijssen CB, Oudshoorn JH, Rijkers GT, van der Ent CK, Vlieger AMWheezing and infantile colic are associated with neonatal antibiotic treatment.Pediatr Allergy Immunol.(2018-Mar)
- ^Duong QA, Pittet LF, Curtis N, Zimmermann PAntibiotic exposure and adverse long-term health outcomes in children: A systematic review and meta-analysis.J Infect.(2022-Sep)
- ^Høgdall CK, Vestermark V, Birch M, Plenov G, Toftager-Larsen KThe significance of pregnancy, delivery and postpartum factors for the development of infantile colic.J Perinat Med.(1991)
- ^Hashemi A, Villa CR, Comelli EMProbiotics in early life: a preventative and treatment approach.Food Funct.(2016-Apr)
- ^Zhou L, Qiu W, Wang J, Zhao A, Zhou C, Sun T, Xiong Z, Cao P, Shen W, Chen J, Lai X, Zhao LH, Wu Y, Li M, Qiu F, Yu Y, Xu ZZ, Zhou H, Jia W, Liao Y, Retnakaran R, Krewski D, Wen SW, Clemente JC, Chen T, Xie RH, He YEffects of vaginal microbiota transfer on the neurodevelopment and microbiome of cesarean-born infants: A blinded randomized controlled trial.Cell Host Microbe.(2023-Jul-12)
- ^de Weerth C, Fuentes S, de Vos WMCrying in infants: on the possible role of intestinal microbiota in the development of colic.Gut Microbes.(2013)
- ^Maria G Dominguez-Bello, Elizabeth K Costello, Monica Contreras, Magda Magris, Glida Hidalgo, Noah Fierer, Rob KnightDelivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newbornsProc Natl Acad Sci U S A.(2010 Jun 29)
- ^Kamphorst K, Carpay NC, de Meij TGJ, Daams JG, van Elburg RM, Vlieger AMClinical outcomes following pre-, pro- and synbiotic supplementation after caesarean birth or antibiotic exposure in the first week of life in term born infants: A systematic review of the literature.Front Pediatr.(2022)
- ^Hofman D, Kudla U, Miqdady M, Nguyen TVH, Morán-Ramos S, Vandenplas YFaecal Microbiota in Infants and Young Children with Functional Gastrointestinal Disorders: A Systematic Review.Nutrients.(2022-Feb-25)
- ^Kirjavainen J, Jahnukainen T, Huhtala V, Lehtonen L, Kirjavainen T, Korvenranta H, Mikola H, Kero PThe balance of the autonomic nervous system is normal in colicky infants.Acta Paediatr.(2001-Mar)
- ^Milidou I, Henriksen TB, Jensen MS, Olsen J, Søndergaard CNicotine replacement therapy during pregnancy and infantile colic in the offspring.Pediatrics.(2012-Mar)
- ^McCreedy A, Bird S, Brown LJ, Shaw-Stewart J, Chen YFEffects of maternal caffeine consumption on the breastfed child: a systematic review.Swiss Med Wkly.(2018-Sep-24)
- ^Iacono G, Merolla R, D'Amico D, Bonci E, Cavataio F, Di Prima L, Scalici C, Indinnimeo L, Averna MR, Carroccio A,Gastrointestinal symptoms in infancy: a population-based prospective study.Dig Liver Dis.(2005-Jun)
- Infant crying - Francesco Savino, Emanuela Pelle, Elisabetta Palumeri, Roberto Oggero, Roberto MinieroLactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized studyPediatrics.(2007 Jan)
- Infant crying - Sung V, Hiscock H, Tang ML, Mensah FK, Nation ML, Satzke C, Heine RG, Stock A, Barr RG, Wake MTreating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trialBMJ.(2014 Apr 1)
- Infant crying - Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, Roos S, Matteuzzi DLactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trialPediatrics.(2010 Sep)
- Infant crying - Roos S, Dicksved J, Tarasco V, Locatelli E, Ricceri F, Grandin U, Savino F454 pyrosequencing analysis on faecal samples from a randomized DBPC trial of colicky infants treated with Lactobacillus reuteri DSM 17938PLoS One.(2013)
- Infant crying - Sung V, Collett S, de Gooyer T, Hiscock H, Tang M, Wake MProbiotics to prevent or treat excessive infant crying: systematic review and meta-analysisJAMA Pediatr.(2013 Dec)
- Infant crying - Szajewska H, Gyrczuk E, Horvath ALactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trialJ Pediatr.(2013 Feb)
- Infant crying - Indrio F, Di Mauro A, Riezzo G, Civardi E, Intini C, Corvaglia L, Ballardini E, Bisceglia M, Cinquetti M, Brazzoduro E, Del Vecchio A, Tafuri S, Francavilla RProphylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trialJAMA Pediatr.(2014 Mar)