Colic is characterised by inconsolable crying, irritability, and screaming without an obvious cause, and can be frustrating for parents. The cause of colic remains elusive, although theories suggest it may be due to immaturity of the nervous system, sleeping disruption, hypersensitivity to the environment, sensory overload, food allergy, reflux, lower diversity of the gut microbiota, maternal diets containing cow's milk, and psychosocial issues such as poor feeding techniques, maternal smoking, or nicotine replacement therapy, inadequate parental interaction, family tension, and parental anxiety.
Theories of pathophysiology primarily focus on a gastrointestinal process, and the latest research has suggested that having a lower diversity in bacteria may be associated with a diagnosis of colic.
A thorough history, physical examination, and reviewing growth charts are important to rule out more serious issues. The treatment for colic is controversial and inconsistent, making the role of the physician as a counsellor and educator to parents critical. Although colic is a benign and self-limiting condition, it has been linked to maternal postpartum depression and shaken baby syndrome. Therefore, the interprofessional team must work together to improve care coordination and communication to improve outcomes in patients with colic.
Although colic is a benign and self-limiting condition, a thorough history, physical examination, and reviewing growth charts are important to rule out more serious issues.
Several approaches to treating colic in infants are focused on correcting the gut microflora. Studies have shown that bottle-fed infants with colic who receive supplements of Lactobacillus reuteri may experience a reduction in crying time, although some studies have contradicted this finding. However, there is more consistent evidence that L. reuteri supplementation has positive effects on breastfed infants. Probiotic supplementation may be useful for colicky breastfed infants but less effective for bottle-fed infants.
Reducing stimulation may also be effective for some infants with colic, similar to its effectiveness for children with migraines. Techniques such as reducing room lighting, avoiding loud music and noisy toys, keeping siblings and pets in a separate room, avoiding strong odours or perfumes, and gently rocking the baby can have beneficial effects. Feeding the infant in a darkened room may also promote infant sleep.
Studies have compared the effectiveness of massage and rocking in treating infants with colic. While both treatments resulted in a reduction in crying time in one study, the most significant reduction was observed in infants who received regular massage from their mothers. However, other studies on the effects of massage have yielded inconsistent results. Despite this, massage is a safe intervention that may improve parent-infant bonding and can be used in any colic intervention.
Source: Banks JB, Rouster AS, Chee J. Colic. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK518962/
