The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic

World J Pediatr. 2018 Aug;14(4):392-398. doi: 10.1007/s12519-018-0130-1. Epub 2018 Mar 5.


Background: Despite the high prevalence of infantile colic, the pathogenesis remains incompletely understood. Cortisol and melatonin hormones affect gastrointestinal system development in several ways, and interestingly, both cortisol and melatonin's circadian rhythms begin around the 3rd month in which infantile colic symptoms start to decrease. We hypothesized that infantile colic might associate with desynchronization of normal circadian rhythms of these hormones. In this study, we aimed to investigate the role of melatonin and cortisol in the pathogenesis of infantile colic.

Methods: Patients who were diagnosed as infantile colic according to Wessel's "rule of three" were enrolled in the colic group. We measured the saliva melatonin and cortisol levels of colic group and control group infants. In both groups, the saliva samples were taken in mornings and at evenings, at the time of diagnosis and 6th month.

Results: Fifty-five infants finished the study. Melatonin circadian rhythm developed earlier in the control group than the infantile colic group in our study. We found no significant difference between the daily mean cortisol levels. However, infants with colic had flatter daily cortisol slope than controls which pointed out the probability that they had a less clearly defined cortisol rhythm than infants without colic.

Conclusions: We found an association between melatonin levels and infantile colic. However, more research is needed to fully understand the role of hypothalamic-pituitary-adrenal axis and hormone's role on infantile colic physiopathology.

Keywords: Children; Circadian rhythm; Cortisol; Infantile colic; Melatonin.

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Biomarkers / metabolism
  • Birth Weight
  • Case-Control Studies
  • Chi-Square Distribution
  • Circadian Rhythm / physiology*
  • Colic / metabolism*
  • Colic / physiopathology*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Hydrocortisone / metabolism*
  • Infant
  • Infant, Newborn
  • Male
  • Melatonin / metabolism*
  • Saliva / chemistry
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors
  • Turkey


  • Biomarkers
  • Melatonin
  • Hydrocortisone