Infantile Colic: An Update
J Murugu Sarasu1, Manish Narang2, Dheeraj Shah1
1Division of Pediatric Gastroenterology, Hepatology and Nutrition; Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
Insights
Infantile colic, characterized by excessive infant crying, lacks definitive treatments. Parental counseling is the primary approach, as evidence for other interventions like probiotics or dietary changes remains limited.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Infantile colic is a common, self-limiting condition causing parental anxiety and diagnostic challenges for clinicians.
- Effective identification and management strategies are crucial for addressing infant colic.
Purpose of the Study:
- To review the pathophysiology, treatment options, and outcomes of infantile colic.
- To provide clinicians with current information and future prospects for managing infant colic.
Main Methods:
- A comprehensive literature search was conducted using Cochrane Library, PubMed, and Google Scholar.
- Keywords included "Infant colic", "Infantile colic", and "excessive crying in infants".
Main Results:
- Etiology of infantile colic is not fully understood, with multiple unproven theories.
- Current treatments include counseling, dietary changes, probiotics, and pain relievers, but evidence is often weak.
- Simethicone is ineffective, and Dicyclomine is not recommended for infants under six months.
Conclusions:
- Parental counseling on the benign nature of colic is the current first-line management.
- Other treatments are used selectively based on individual cases and parental perception.
Context:
Infantile colic is self-limiting condition but it can be a cause of anxiety for parents and challenge for doctors. The challenge for the doctors lies in correct identification of the condition and appropriate management. The objective of this review article is to summarize the pathophysiology, treatment options and outcome in infantile colic so that clinicians can have a fair idea about the condition, recent updates and future prospects.
Evidence:
A search of the Cochrane Library, PubMed, and Google Scholar was made using the key words "Infant colic", Infantile colic", "excessive crying in infants". All the materials were analyzed and summarized.
Results:
At present, infantile colic is an area of clinical research both in terms of etiology and treatment. Various etiological theories have been proposed but none of them are strong enough to completely describe the condition. Various treatment agents are being tried for colic like counseling and behavioral modification, dietary modification, lactase and probiotic supplementation, pain relieving agents, and chiropathy. Proper counseling of the parents is the first line of management at present. Simethicone has no role in decreasing the symptoms of colic and Dicyclomine is not recommended in children younger than six months. No specific recommendations have been made on the use of pain relieving agents and manipulative therapies in colic. At present strong evidence is lacking regarding the use of probiotics, lactase supplementation and dietary modification.
Conclusions:
Counseling of parents about the benign nature of the condition is considered first line for now until an effective treatment is established. Other treatment options are prescribed on a case-based manner, and based on the parental perception of the condition.
