Intended for healthcare professionals

Clinical Review From Drug and Therapeutics Bulletin

Management of infantile colic

BMJ 2013; 347 doi: (Published 10 July 2013) Cite this as: BMJ 2013;347:f4102
  1. Drug and Therapeutics Bulletin
  1. 1Drug and Therapeutics Bulletin Editorial Office, London WC1H 9JR, UK
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Although infantile colic is considered to be a self limiting and benign condition, it is often a frustrating problem for parents and caregivers. It is a frequent source of consultation with healthcare professionals and is associated with high levels of parental stress and anxiety.1 2

Several published reviews of the literature have explored dietary, pharmacological, complementary, and behavioural therapies as options for the management of infantile colic.1 3 Here, we assess whether these management options are supported by the literature and if there are any novel treatment options.

About infantile colic

Infantile colic has been defined as paroxysmal uncontrollable crying in an otherwise healthy infant less than 3 months of age, with more than three hours of crying per day in more than three days a week and for more than three weeks.4 5 It is known to have a significant impact on infants and their families, with up to one in six families with children with symptoms of colic consulting healthcare professionals.6


Despite the prevalence of the condition, the pathogenesis remains incompletely understood. One hypothesis has suggested that infantile colic is caused by the impact of abnormal gastrointestinal motility and pain signals from sensitised pathways in the gut viscera.2 Another hypothesis is that inadequate amounts of lactobacilli and increased amounts of coliform bacteria in the intestinal microbiota influences gut motor function and gas production, which subsequently contributes to the condition.2

More controversially, behavioural issues such as family tension, parental anxiety, or inadequate parent-infant interaction have also been explored as causative factors for infantile colic.1 In addition, little is known about concomitant risk factors; however, maternal smoking, increased maternal age, and firstborn status are thought to be associated with the development of infantile colic. No association with feeding method has been noted.1

As a consequence …

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