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Diseases

Infantile colic

OVERVIEW

  • Highlights & Basics
  • Images

DIAGNOSIS

  • Diagnostic Approach
  • Risk Factors
  • History & Exam
  • Tests
  • Differential Diagnosis
  • Criteria
  • Screening

TREATMENT

  • Tx Approach
  • Tx Options
  • Emerging Tx
  • Prevention

FOLLOW-UP

  • Overview
  • Complications

REFERENCES

  • Citations
  • Guidelines
  • Credits

PATIENT RESOURCES

  • Patient Instructions

Highlights & Basics

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Key Highlights
  • Infantile colic is characterized by paroxysms of uncontrollable crying in an otherwise healthy and well-fed infant. Typically starts in the first weeks of life and ends by 4-5 months of age.

  • Food allergy may play a role in the pathogenesis.

  • Diagnosis is clinical. Assessment should be directed at excluding alternate causes of distress, although <5% of distressed infants have identifiable medical conditions for their crying.

  • The condition can be very stressful for the family.

  • Managed by supportive counseling, reassurance, and dietary modifications (if indicated).

Quick Reference

  • History & Exam

    • Key Factors

      • Other Factors

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      • Diagnostics Tests

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        • Treatment Options

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          Definition

          Epidemiology

          Etiology

          Pathophysiology

          content by BMJ Group
          Last updated

          Citations

            Key Articles

            • Leung AK, Lemay JF. Infantile colic: a review. J R Soc Promot Health. 2004 Jul;124(4):162-6.[Abstract]

            • Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician. 2015 Oct 1;92(7):577-82.[Abstract][Full Text]

            • Critch J. Infantile colic: is there a role for dietary interventions? Paediatr Child Health. 2011 Jan;16(1):47-9.[Abstract][Full Text]

            Referenced Articles

            • 1. Wessel MA, Cobb JC, Jackson EB, et al. Paroxysmal fussing in infancy, sometimes called "colic." Pediatrics. 1954 Nov;14(5):421-35.[Abstract]

            • 2. Wolke D, Bilgin A, Samara M. Systematic review and meta-analysis: fussing and crying durations and prevalence of colic in infants. J Pediatr. 2017 Jun;185:55-61.e4.[Abstract][Full Text]

            • 3. Canivet C, Hagander B, Jakobsson I, et al. Infantile colic - less common than previously estimated? Acta Paediatr. 1996 Apr;85(4):454-8.[Abstract]

            • 4. Crowcroft NS, Strachan DP. The social origins of infantile colic: questionnaire study covering 76,747 infants. BMJ. 1997 May 3;314(7090):1325-8.[Abstract]

            • 5. Hogdall CK, Vestermark V, Birch M, et al. The significance of pregnancy, delivery and postpartum factors for the development of infantile colic. J Perinat Med. 1991;19(4):251-7.[Abstract]

            • 6. Lee K. The crying pattern of Korean infants and related factors. Dev Med Child Neurol. 1994 Jul;36(7):601-7.[Abstract]

            • 7. Lucassen PL, Assendelft WJ, van Eijk JT, et al. Systematic review of the occurrence of infantile colic in the community. Arch Dis Child. 2001 May;84(5):398-403.[Abstract][Full Text]

            • 8. St. James-Roberts I, Halil T. Infant crying patterns in the first year: normative community and clinical findings. J Child Psychol Psychiatry. 1991 Sep;32(6):951-68.[Abstract]

            • 9. Sondergaard C, Skajaa E, Henriksen TB. Fetal growth and infantile colic. Arch Dis Child Fetal Neonatal Ed. 2000 Jul;83(1):F44-7.[Abstract]

            • 10. Milidou I, Søndergaard C, Jensen MS, et al. Gestational age, small for gestational age, and infantile colic. Paediatr Perinat Epidemiol. 2014 Mar;28(2):138-45.[Abstract]

            • 11. Estep DC, Kulczycki A Jr. Treatment of infant colic with amino acid-based infant formula: a preliminary study. Acta Paediatr. 2000 Jan;89(1):22-7.[Abstract]

            • 12. Hill DJ, Hosking CS. Infantile colic and food hypersensitivity. J Pediatr Gastroenterol Nutr. 2000;30 Suppl:S67-76.[Abstract]

            • 13. Hill DJ, Hudson IL, Sheffield LJ, et al. A low allergen diet is a significant intervention in infantile colic: results of a community-based study. J Allergy Clin Immunol. 1995 Dec;96(6 Pt 1):886-92.[Abstract]

            • 14. Shenassa ED, Brown MJ. Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics. 2004 Oct;114(4):e497-505.[Abstract]

            • 15. Reijneveld SA, Brugman E, Hirasing RA. Infantile colic: maternal smoking as potential risk factor. Arch Dis Child. 2000 Oct;83(4):302-3.[Abstract]

            • 16. Yalcin SS, Orun E, Mutlu B, et al. Why are they having infant colic? A nested case-control study. Pediatr Perinat Epidemiol. 2010 Nov;24(6):584-96.[Abstract]

            • 17. Howard CR, Lanphear N, Lanphear BP, et al. Parental responses to infant crying and colic: the effect on breastfeeding duration. Breastfeeding Med. 2006 Autumn;1(3):146-55.[Abstract]

            • 18. Cohen Engler A, Hadash A, Shehadeh N, et al. Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin. Eur J Pediatr. 2012 Apr;171(4):729-32.[Abstract]

            • 19. Akman I, Kuşçu K, Özdemir N, et al. Mothers' postpartum psychological adjustment and infantile colic. Arch Dis Child. 2006 May;91(5):417-9.[Abstract][Full Text]

            • 20. Rautava P, Helenius H, Lehtonen L. Psychosocial predisposing factors for infantile colic. BMJ. 1993 Sep 4;307(6904):600-4.[Abstract]

            • 21. Leung AK, Lemay JF. Infantile colic: a review. J R Soc Promot Health. 2004 Jul;124(4):162-6.[Abstract]

            • 22. Treem WR. Infant colic. A pediatric gastroenterologist's perspective. Pediatr Clin North Am. 1994 Oct;41(5):1121-38.[Abstract]

            • 23. Lothe L, Lindberg T, Jakobsson I. Macromolecular absorption in infants with infantile colic. Acta Paediatr Scand. 1990 Apr;79(4):417-21[Abstract]

            • 24. Lehtonen L, Svedstrom E, Korvenranta H. Gallbladder hypocontractility in infantile colic. Acta Paediatr. 1994 Nov;83(11):1174-7.[Abstract]

            • 25. Savino F, Tarasco V. New treatments for infant colic. Curr Opin Pediatr. 2010 Dec;22(6):791-7.[Abstract]

            • 26. Norwegian Knowledge Centre for the Health Services. Treatment of infant colic. Dec 2016 [internet publication].[Full Text]

            • 27. Heine RG. Allergic gastrointestinal motility disorders in infancy and early childhood. Pediatr Allergy Immunol. 2008 Aug;19(5):383-91.[Abstract]

            • 28. Royal Children's Hospital Melbourne. Unsettled or crying babies. August 2019 [internet publication].[Full Text]

            • 29. Rome Foundation. Rome IV criteria. January 2016 [internet publication].[Full Text]

            • 30. Zeevenhooven J, Browne PD, L'Hoir MP, et al. Infant colic: mechanisms and management. Nat Rev Gastroenterol Hepatol. 2018 Aug;15(8):479-96.[Abstract]

            • 31. Gordon M, Gohil J, Banks SS. Parent training programmes for managing infantile colic. Cochrane Database Syst Rev. 2019 Dec 3;12(12):CD012459.[Abstract][Full Text]

            • 32. Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician. 2015 Oct 1;92(7):577-82.[Abstract][Full Text]

            • 33. Gordon M, Biagioli E, Sorrenti M, et al. Dietary modifications for infantile colic. Cochrane Database Syst Rev. 2018 Oct 10;10(10):CD011029.[Abstract][Full Text]

            • 34. Bennett C, Underdown A, Barlow J. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane Database Syst Rev. 2013 Apr 30;(4):CD005038.[Abstract][Full Text]

            • 35. Critch J. Infantile colic: is there a role for dietary interventions? Paediatr Child Health. 2011 Jan;16(1):47-9.[Abstract][Full Text]

            • 36. Chief Medical Officer. Advice issued on soya-based infant formulas. CMO's update 37. January 2004 [internet publication].[Full Text]

            • 37. Nutrition Committee, Canadian Paediatric Society. Concerns for the use of soy-based formulas in infant nutrition. Paediatr Child Health. 2009 Feb;14(2):109-18.[Abstract][Full Text]

            • 38. Management of infantile colic. Drug Ther Bull. 2013 Jan;51(1):6-9.[Abstract]

            • 39. Iacovou M, Ralston RA, Muir J, et al. Dietary management of infantile colic: a systematic review. Matern Child Health J. 2012 Aug;16(6):1319-31.[Abstract]

            • 40. Biagioli E, Tarasco V, Lingua C, et al. Pain-relieving agents for infantile colic. Cochrane Database Syst Rev. 2016 Sep 16;9(9):CD009999.[Abstract][Full Text]

            • 41. Hjern A, Lindblom K, Reuter A, et al. A systematic review of prevention and treatment of infantile colic. Acta Paediatr. 2020 Sep;109(9):1733-44.[Abstract][Full Text]

            • 42. Harb T, Matsuyama M, David M, et al. Infant colic - what works: a systematic review of interventions for breast-fed infants. J Pediatr Gastroenterol Nutr. 2016 May;62(5):668-86.[Abstract][Full Text]

            • 43. Skonieczna-Żydecka K, Janda K, Kaczmarczyk M, et al. The effect of probiotics on symptoms, gut microbiota and inflammatory markers in infantile colic: a systematic review, meta-analysis and meta-regression of randomized controlled trials. J Clin Med. 2020 Apr 2;9(4):999.[Abstract][Full Text]

            • 44. Sung V, D'Amico F, Cabana MD, et al. Lactobacillus reuteri to treat infant colic: a meta-analysis. Pediatrics. 2018 Jan;141(1):e20171811.[Abstract][Full Text]

            • 45. Ong TG, Gordon M, Banks SS, et al. Probiotics to prevent infantile colic. Cochrane Database Syst Rev. 2019 Mar 13;3(3):CD012473.[Abstract][Full Text]

            • 46. Ellwood J, Draper-Rodi J, Carnes D. Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines. BMJ Open. 2020 Feb 25;10(2):e035405.[Abstract][Full Text]

            • 47. Vaz SR, Tofoli MH, Avelino MAG, et al. Probiotics for infantile colic: is there evidence beyond doubt? A meta-analysis and systematic review. Acta Paediatr. 2024 Feb;113(2):170-82.[Abstract][Full Text]

            • 48. ​National Institute for Health and Care Excellence. Scenario: management of infantile colic. Dec 2022 [internet publication]. [Abstract]

            • 49. Indrio F, Enninger A, Aldekhail W, et al. Management of the most common functional gastrointestinal disorders in infancy: the middle east expert consensus. Pediatr Gastroenterol Hepatol Nutr. 2021 Jul;24(4):325-36.[Abstract][Full Text]

            • 50. Schneider R, Sant'Anna A. Using probiotics in paediatric populations. [in fre]. Paediatr Child Health. 2022 Dec;27(8):482-502.[Abstract][Full Text]

            • 51. ​The Royal Children's Hospital Melbourne. Unsettled or crying babies. Aug 2019 [internet publication]. ​[Abstract]

            • 52. Iacovou M, Craig SS, Yelland GW, et al. Randomised clinical trial: reducing the intake of dietary FODMAPs of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical diet. Aliment Pharmacol Ther. 2018 Nov;48(10):1061-73.[Abstract]

            • 53. Raiha H, Lehtonen L, Korhonen T, et al. Family life 1 year after infantile colic. Arch Pediatr Adolesc Med. 1996 Oct;150(10):1032-6.[Abstract]

            • 54. Raiha H, Lehtonen L, Korhonen T, et al. Family functioning 3 years after infantile colic. J Dev Behav Pediatr. 1997 Oct;18(5):290-4.[Abstract]

            • 55. Savino F, Castagno E, Bretto R, et al. A prospective 10-year study on children who had severe infantile colic. Acta Paediatr Suppl. 2005 Oct;94(449):129-32.[Abstract]

            • 56. Joseph AY, Lupu GH. Recurrent abdominal pain and infantile colic. Am J Dis Child. 1984 Oct;138(10):990-1.[Abstract]

            • 57. Castro-Rodriguez JA, Stern DA, Halonen M, et al. Relation between infantile colic and asthma/atopy: a prospective study in an unselected population. Pediatrics. 2001 Oct;108(4):878-82.[Abstract]

            • 58. Helseth S, Misvær N, Småstuen M, et al. Infant colic, young children's temperament and sleep in a population based longitudinal cohort study. BMC Pediatr. 2022 Mar 30;22(1):163.[Abstract][Full Text]

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