Infant colic: mechanisms and management
Judith Zeevenhooven1, Pamela D Browne2,3,4, Monique P L'Hoir5
1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, Netherlands. j.zeevenhooven@amc.uva.nl.
Insights
Infant colic, characterized by excessive crying, lacks a clear definition and cause. Management focuses on parental support and reassurance due to limited evidence for specific treatments.
Area of Science:
- Pediatrics
- Gastroenterology
- Developmental Psychology
Background:
- Infant colic is a common, distressing condition with unclear etiology.
- Lack of consensus exists regarding its definition, pathogenesis, and optimal management.
- The Rome IV criteria (2016) are the most current diagnostic guidelines.
Purpose of the Study:
- To review the definition and diagnostic criteria for infant colic.
- To explore potential contributing factors to colic's pathophysiology.
- To summarize current management strategies and their evidence base.
Main Methods:
- Literature review focusing on infant colic definition, causes, and treatments.
- Analysis of diagnostic criteria, particularly the Rome IV criteria.
- Synthesis of evidence for various management interventions.
Main Results:
- The Rome IV criteria provide a framework for diagnosing infant colic.
- Potential contributing factors include neurogenic, gastrointestinal, microbial, and psychosocial elements.
- Parental education and reassurance are key management components.
- Limited high-quality trials hinder strong recommendations for specific therapies.
Conclusions:
- Accurate diagnosis relies on clinical history and examination, excluding alarm symptoms.
- Comprehensive management involves parental support and tailored interventions.
- Further high-quality research is needed to establish evidence-based treatments for infant colic.
Abstract:
Infant colic is a commonly reported phenomenon of excessive crying in infancy with an enigmatic and distressing character. Despite its frequent occurrence, little agreement has been reached on the definition, pathogenesis or the optimal management strategy for infant colic. This Review aims to delineate the definitional entanglement with the Rome IV criteria, which were published in 2016, as the leading, most recent diagnostic criteria. Moreover, neurogenic, gastrointestinal, microbial and psychosocial factors that might contribute to the pathophysiology of infant colic are explored. This Review underlines that a comprehensive medical history and physical examination in the absence of alarm symptoms serve as guidance for the clinician to a positive diagnosis. It also highlights that an important aspect of the management of infant colic is parental education and reassurance. Management strategies, including behavioural, dietary, pharmacological and alternative interventions, are also discussed. Owing to a lack of large, high-quality randomized controlled trials, none of these therapies are strongly recommended. Finally, the behavioural and somatic sequelae of infant colic into childhood are summarized.
Related Concept Videos
01:29Drug Dosing: Infants and Children
03:06Reaction Mechanisms
For instance, the decomposition of ozone appears to follow a mechanism with two steps:
01:26Tonsillitis II: Management
01:58Mechanical Protein Functions
01:29Impression Management Techniques I: Managing Appearances
01:19Managing Impressions