Infantile colic is a benign self limited condition. There is no proven therapy for it. Parental reassurance is the main measure to manage an infant with colic.
Probiotics & Medications
Recent meta-analyses and one systematic review found that L. reuteri significantly decreased colic only in Exclusively breastfed infants but it increases crying or fussing in formula fed infants.
So, L. reuteri (DSM 17938) (Protectis*) may be considered as a treatment option for exclusively breastfed infants only and not in formula-fed or infants on mixed feeding, that too in selected cases if parental distress persists despite of reassurance.
There is no role of semethicone, proton pump inhibitors in infant with colic.
Dicyclomine is better than placebo but it is safety in infants less than 6 months of age is not established so its not FDA approved for use in < 6 months.
Prevalence of colic is similar in breastfed and top fed infants. So suggesting a modification(except in cases of suspected CMPA) will bring more stress than any benefit. Elimination of food allergens from maternal diet in breastfed infants with colic and role of hypoallergen formula in infantile colic is also controversial.
Colic is often reported more during late evening to early morning hours, which are the hours of wakefulness of many infants and absence of routine day time distractions.
Providing distractions to an Infant, like light rocking, lying on tummy, traditional practice of applying oil/heeng on navel, soothing music, creating background white noises often help many parents to handle the situation better.
Also, it has been hypothesized that daily regular exposure of Infant to Sunshine may modify the Circadian rhythms of Melatonin- Serotonin and phase of colic may get shortened Though, there is lack of any scientific studies on these hypotheses.
Drafted on Inputs from by Dr Mridul Das, Pediatric Gastroenterologist, Formerly at BLK Centre for Child Health.
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