Infantile Colic: An Update
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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.
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.
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.
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.
KeywordsCounseling Crying Lactase Management Probiotics
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- 2.Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954;14:421–35.Google Scholar
- 9.Høgdall CK, Vestermark V, Birch M, Plenov G, Toftager-Larsen K. The significance of pregnancy, delivery and postpartum factors for the development of infantile colic. J Perinat Med. 1991;19:251–7.Google Scholar
- 11.Liu W, Xiao LP, Li Y, Wang XQ, Xu CD. Epidemiology of mild gastrointestinal disorders among infants and young children in Shanghai area. Zhonghua Er Ke Za Zhi. 2009; 47:917–21 [Chinese].Google Scholar
- 21.Illingworth. Infantile colic revisited. Arch Dis Child. 1985;60:981-5.Google Scholar
- 23.Abdo-Bassols F, Lifshitz F, Del Castillo ED, Martinez-Garza V. Transient lactose intolerance in premature infants. Pediatrics. 1971;48:816–21.Google Scholar
- 29.Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23:293–7.Google Scholar
- 30.Taylor WC. A study of infantile colic. Can Med Assoc J. 1957;76:458–61.Google Scholar
- 40.Biagioli E, Tarasco V, Lingua C, Moja L, Savino F. Painrelieving agents for infantile colic. Cochrane Database Syst Rev. 2016;16;9:CD009999.Google Scholar
- 41.Dobson D, Lucassen PL, Miller JJ, Vlieger AM, Prescott P, Lewith G. Manipulative therapies for infantile colic. Cochrane Database Syst Rev. 2012;12:CD004796.Google Scholar
- 42.Thomas MR, Gordon M, Banks SSC, Wallace C. Parent training programmes for managing infantile colic (Protocol). Cochrane Database Syst Rev. 2016;12:CD012459.Google Scholar
- 43.Savino F, Tarasco V, Sorrenti M, Lingua C, Moja L, Gordon M, et al. Dietary modifications for infantile colic (Protocol). Cochrane Database Syst Rev. 2014;3:CD011029.Google Scholar
- 44.Banks SSC, Thomas MR, Gordan M, Wallace C, Alobeng AK. Probiotics to prevent infantile colic (Protocol). Cochrane Database Syst Rev. 2016;12:CD012473.Google Scholar
- 45.Praveen V, Praveen G, Deshpande G, Patole SK. Oral probiotics for infantile colic (Protocol). Cochrane Database Syst Rev. 2014; CD010986.Google Scholar
- 47.Taubman B. Parental counseling compared with elimination of cow’s milk or soy milk protein for the treatment of infant colic syndrome: A randomized trial. Pediatrics. 1988;81:756–61.Google Scholar
- 56.Koletzko S, Niggemann B, Arato A, Dias JA, Heuschkel R, Husby S, et al. European Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Diagnostic Approach and Management of Cow’s-milk Protein Allergy in Infants and Children: ESPGHAN GI Committee Practical Guidelines. J Pediatr Gastroenterol Nutr. 2012;55:221–9.CrossRefGoogle Scholar
- 57.Vandenplas Y, Ludwig T, Bouritius H, Alliet P, Forde D,. Peeters S, et al. Randomised controlled trial demonstrates that fermented infant formula with short chain galacto oligosaccharides and long chain fructo oligosaccharides reduces the incidence of infantile colic. Acta Paediatr. 2017;106:1150–8.CrossRefGoogle Scholar
- 58.Jain K, Gunasekaran D, Venkatesh C. Gripe water administration in infants 1–6 months of age-A crosssectional study. J Clin Diagn Res. 2015;9:6–8.Google Scholar
- 59.Vandenplas Y, Rudolph CD, Di Lorenzo C, Hassall E, Liptak G, Mazur L, et al. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2009;49:498–547.CrossRefGoogle Scholar