Current Therapeutic Approaches in Infantile Colic: A Comprehensive Review

Area of Science:

• Pediatrics
• Gastroenterology
• Nutritional Science

Background:

• Infantile colic (IC) is a common functional gastrointestinal disorder characterized by prolonged crying in healthy infants.
• Current management strategies for IC often yield inconsistent therapeutic outcomes.
• There is a need for evidence-based, phenotype-guided approaches to manage IC.

Purpose of the Study:

• To synthesize current evidence on the diagnosis and management of infantile colic.
• To emphasize feeding strategies, maternal diet, and the role of lactose malabsorption.
• To provide an evidence-based summary for managing IC.

Main Methods:

• A narrative review of studies published between 2000 and 2025.
• Searches conducted in PubMed, Scopus, and Google Scholar using keywords related to infantile colic, functional gastrointestinal disorders, lactase, probiotics, and maternal diet.
• Selection and synthesis of relevant randomized controlled trials, meta-analyses, and clinical guidelines.

Main Results:

• Targeted nutritional approaches, phenotype-guided probiotic use, and maternal dietary adjustments reduce crying duration and caregiver stress.
• Specific probiotic strains (Lactobacillus reuteri DSM 17938 for breastfed; Bifidobacterium breve strains for bottle-fed) and lactase enzyme show moderate benefit.
• Simethicone demonstrates no consistent efficacy and is not routinely recommended.

Conclusions:

• Infantile colic is a self-limited but distressing condition requiring family-centered counseling and phenotype-specific interventions.
• A stepwise, phenotype-guided approach integrating feeding optimization, dietary trials, and targeted probiotics is supported by evidence.
• Practical guidance and red-flag features aid in phenotype-guided care for infantile colic.