Current Therapeutic Approaches in Infantile Colic: A Comprehensive Review

Infantile colic (IC) is a functional gastrointestinal disorder of early infancy defined by prolonged crying and irritability in otherwise healthy infants. This review synthesizes current evidence on diagnosis and management, emphasizing feeding strategies, maternal diet, and the clinical relevance of lactose malabsorption with data from Türkiye and worldwide. The authors highlight strain-specific probiotics: for breastfed infants, Lactobacillus reuteri DSM 17938 is associated with fewer crying minutes, whereas for bottle-fed infants, the combination of Bifidobacterium breve BR03 and B. breve B632 shows preventive and symptomatic signals in randomized trials. Lactase enzyme can reduce symptoms when lactose malabsorption is suspected. Simethicone has not shown consistent benefit and is not recommended routinely. In light of the evolving evidence and inconsistent therapeutic outcomes, this review aims to summarize current understanding and evidence-based management strategies for IC.

This narrative review was conducted through a comprehensive search of PubMed, Scopus, and Google Scholar databases for studies published between 2000 and 2025 using the keywords "infantile colic," "functional gastrointestinal disorders," "lactase," "probiotics," and "maternal diet." Relevant randomized controlled trials, meta-analyses, and clinical guidelines were selected and synthesized to summarize current evidence.

Evidence suggests that targeted nutritional approaches, phenotype-guided probiotic use, and maternal dietary adjustments provide measurable reductions in crying duration and caregiver stress. Pharmacologic agents such as simethicone show no consistent efficacy, while lactase enzyme and specific probiotic strains demonstrate moderate benefit. Taken together, the reviewed evidence supports a stepwise, phenotype-guided approach that integrates feeding optimization, limited dietary trials, and targeted probiotic use under clinical supervision.

Infantile colic remains a self-limited but distressing condition; evidence-based, family-centered counseling and phenotype-specific interventions should guide management. We outline red-flag features, a stepwise algorithm, and practical, family-centered guidance to support phenotype-guided care.