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Clinical inquiries. What is the best treatment for infants with colic?
Charles A Crotteau1, Sarah Towner Wright, Anne Eglash
1University of Illinois at Chicago, Chicago, IL, USA.
Insights
Infantile colic, characterized by excessive crying in healthy infants, has limited evidence-based treatments. Time is the only proven remedy, with symptoms typically resolving by six months of age.
Area of Science:
- Pediatrics
- Neonatology
- Infant Health
Background:
- Infantile colic is a common yet distressing condition in healthy infants, often leading parents to seek various treatments.
- Despite numerous interventions, robust evidence supporting their efficacy is often lacking.
Purpose of the Study:
- To review the evidence for various infantile colic treatments.
- To identify effective and safe interventions for managing excessive infant crying.
Main Methods:
- A review of small studies and randomized controlled trials (RCTs) examining different colic treatments.
- Evaluation of evidence for hypoallergenic formulas, maternal dietary changes, reduced stimulation, dicyclomine, and herbal teas.
Main Results:
- Some evidence suggests benefit from hypoallergenic formulas, maternal low-allergen diets, and reduced infant stimulation.
- Dicyclomine shows effectiveness but carries significant safety concerns and is contraindicated.
- An herbal tea demonstrated efficacy in a small RCT, but practicality is limited by required volume.
Conclusions:
- Few treatments for infantile colic are supported by strong evidence.
- Time is the only consistently effective intervention, with colic naturally resolving by 6 months.
- Further research is needed to establish safe and effective treatments for infantile colic.
Abstract:
Infantile colic, defined as excessive crying in an otherwise healthy baby, is a distressing phenomenon, but there is little evidence to support the many treatments offered. Several small studies report some benefit from use of a hypoallergenic (protein hydrolysate) formula, maternal diet adjustment (focusing on a low-allergen diet), and reduced stimulation of the infant. While dicyclomine has been shown to be effective for colic, there are significant concerns about its safety, and the manufacturer has contraindicated its use in this population. An herbal tea containing chamomile, vervain, licorice, fennel, and balm-mint was also effective in a small RCT, but the volume necessary for treatment limits its usefulness (strength of recommendation: B, inconsistent or limited-quality patient-oriented evidence). The one proven treatment is time, as this behavior tends to dissipate by 6 months of age.
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