Infant Colic: Is a Solution at Hand?

Jordi Cuñé, PhD; Jonathan Santas, PhD

Disclosures

March 19, 2014

What Treatments Have Been Tried for Infant Colic?

Infant colic, also referred to as excessive crying syndrome, is one of the most common causes of visits to a healthcare provider during the first year of an infant's life. It has a significant effect on the quality of life of infants and their family. Despite the prevalence and costs in both dollars and stress of this condition, its etiology is still elusive. No clearly effective and safe treatment or management option is currently available.

Traditionally, different drug therapies have been used for reduction of crying and fussing, especially in "colicky infants." Simethicone has been commonly proposed as a potential treatment option, but it has been shown to be no more effective than placebo.[1] Other drug-based treatments, including dicyclomine hydrochloride and cimetropium bromide, have been considered more efficacious. However, their use is limited, especially in infants younger than 6 months of age, due to undesirable side effects such as gassiness, abdominal distention, drowsiness, and -- in some extreme cases -- life-threatening events that may include respiratory distress and apnea.[2,3,4]

Other more "natural" treatments have been proposed for crying relief. These include herbal remedies including plant extracts (ie, Matricaria chamomilla [chamomile], Foeniculum vulgare [fennel], Melissa officinalis [lemon balm], and Mentha piperita [peppermint oil]). These, too, have been shown to be of limited efficacy and are also associated with several secondary effects, including sleepiness, constipation, and loss of appetite.[5,6,7] Similarly, although it has been reported that sucrose solutions may ameliorate crying syndrome,[8] there are important concerns regarding the poor quality of the scientific evidence and sucrose's nutritional effects.

Based on the theory that infantile colic can result from food allergies or digestion problems, several nutritional interventions have been proposed. Infant formulas designed to overcome food allergies (eg, partially hydrolyzed whey proteins) have been reported to reduce crying episodes.[9] However, these formulas may benefit only those infants whose excessive crying is ascribed to known food allergies. Lactase therapy adds a galactosidase (lactase) to an infant's formula to reduce the level of lactose in the milk. While some improvement in symptoms has been noted, results are conflicting.[2,10] High-fiber or fiber-enriched formulas have also been proposed as a possible treatment, but no significant differences in symptoms have been found when compared with standard formula.[11]

Complementary therapies such as massage or chiropractic treatment have also been advocated as treatment options for relieving crying symptoms. Evaluation of these options is challenging due to the absence of good quality clinical trials.[5]

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