Treatment choices for infant colic

Abstract

DOI: 10.1016/j.rcpe.2015.10.001

Introduction

Infant colic is a common problem in paediatric practice. It has a worldwide prevalence between 15% and 40% in children younger than four months old, independently of the type of breast feeding administered. It usually leads to anxiety in caregivers, and even in paediatricians.

Objective

To identify the best alternative for infant colic management.

Methodology

A search was performed on the Web in different databases of scientific articles (PubMed, EBSCO, and Med Consult). Systematic reviews and clinical trials were considered. A review of the various alternatives for the management of colic was performed by analysing the response in infants.

Results

Infantile colic is multifactorial. Treatment options include the use of milk-based extensively hydrolysed proteins, lactose-free or soy protein-based milk, breastfeeding, use of drugs such as simethicone, dicyclomine, behavioural therapy, alternative medicine, and probiotics. Milks based on extensively hydrolysed proteins are effective in infants with an atopic history. Soy milk can produce unwanted effects in the reproductive system and cross-reacts with proteins in cow's milk, thus is not recommended. Some studies have shown the efficiency of dicyclomine, however there may be adverse effects. Lactobacillus reuteri administration appears to be an important therapeutic option.

Conclusion

Colic is a benign condition of multifactorial aetiology, and which has a self-limiting course. Some selected patients may benefit from using changes in infant formula, drugs, and behavioural measures, and recently probiotic L. reuteri, depending on which of the factors is the trigger.