Clinical Review Extracts from “Clinical Evidence”

Infantile colic

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7310.437 (Published 25 August 2001) Cite this as: BMJ 2001;323:437

This article has a correction. Please see:

  1. Sally Wade, staff grade community paediatrician ([email protected])a,
  2. Teresa Kilgour, staff grade community paediatricianb
  1. a Archer Street Clinic, Darlington DL3 6LT,
  2. b City Hospitals, Sunderland SR4 7TP
  1. Correspondence to: S Wade

    Background

    Definition Infantile colic is defined as excessive crying in an otherwise healthy baby. The crying typically starts in the first few weeks of life and ends by age 4-5 months. Excessive crying is defined as crying that lasts at least three hours a day, for three days a week, for at least three weeks.1

    Interventions

    Likely to be beneficial:

    Whey hydrolysate milk

    Trade off between benefits and harms:

    Anticholinergic drugs

    Unknown effectiveness:

    Soya substitute milk

    Casein hydrolysate milk

    Low lactose milk

    Sucrose solution

    Herbal tea

    Reduction of stimulation of the infant

    Unlikely to be beneficial:

    Simethicone

    Increased carrying

    Incidence/prevalence Infantile colic causes one in six families to consult a health professional. One population based study (409 breastfed or formula fed infants) found the incidence of infantile colic to be 3.3-17%, depending on the definition used and whether the symptoms were reported prospectively or retrospectively. The incidence was 9% using the definition given above.2 One randomised controlled trial (RCT) (89 breast and formula fed infants) found that, at 2 weeks of age, the incidence of crying more than three hours a day was 43% in formula fed infants and 16% in breastfed infants. The incidence at 6 weeks was 12% and 31% respectively.3

    Aetiology The cause of infantile colic is unclear. It may be part of the normal distribution of crying. Other possible explanations are painful gut contractions, lactose intolerance, gas, or parental misinterpretation of normal crying.1 One large survey found that the social factors that influenced reporting of infantile colic included the age at which the woman had her first child, the time she had spent in full time education, and her occupation. Older women who had spent the longest in full time education and in non-manual occupations were the most likely to report infantile colic.4 …

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