[Which treatments for infantile colics?]

Area of Science:

• Pediatrics
• Gastroenterology
• Evidence-based Medicine

Background:

• Infantile colic, characterized by excessive crying, is a common parental stressor and a frequent primary care concern.
• The syndrome lacks a universally agreed-upon definition and consistent measurement methods in research.

Purpose of the Study:

• To systematically review and assess the effectiveness of various treatments for infantile colic.
• To identify evidence-based therapeutic options for managing excessive crying in infants.

Main Methods:

• A systematic review of randomized controlled trials (RCTs) and meta-analyses was conducted.
• Searches were performed in Medline, Cochrane, and Embase databases, including studies published in English or French.
• Thirty-one RCTs and one meta-analysis met the inclusion criteria for therapeutic assessment.

Main Results:

• Allopathic medications like simethicone and lactase demonstrated no effectiveness, while dicyclomine posed risks of adverse reactions.
• Partially hydrolyzed or soy-based formulas showed efficacy, though soy carries an allergy risk.
• Probiotics (Lactobacillus reuteri) and herbal mixtures with fennel extracts showed likely effectiveness.
• Sucrose solutions offered some benefit with low-level evidence.
• Manual therapies (osteopathy, acupuncture) and behavioral interventions lacked sufficient evidence.

Conclusions:

• The most validated treatments for infantile colic include substituting cow's milk with hydrolyzed formula, and utilizing Lactobacillus reuteri and fennel extracts.
• Variable trial quality and inconsistent methodologies, including a lack of double-blind procedures in several studies, limit definitive conclusions.
• Further high-quality research is needed to establish definitive treatment guidelines for infantile colic.