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Recent Advances in Understanding and Managing Infantile Colic

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Recent Advances in Understanding and Managing Infantile Colic

Siel Daelemans et al. F1000Res.

Abstract

A newborn brings joy to the family. Crying belongs to the spectrum of normal behaviour of young infants. However, although it occurs in about 20% of all infants, unsoothable and persistent crying in young infants distresses the family, although it is usually benign. The aetiology of infantile colic remains unknown, although an unbalanced gastro-intestinal microbiome, increased intestinal permeability, and chronic inflammation are involved, as well as behavioural factors, including over- and under-stimulation. It is a challenge for healthcare professionals to decide when organic disease needs to be excluded. Parental stress is a reason for babies to cry more, inducing a vicious cycle. Therefore, parental reassurance with explanatory guidance is the cornerstone of management. The placebo effect is estimated to be as high as 50%. If an intervention is felt to be necessary to offer further support to the baby and family, it is important to choose the options for which there is some efficacy without adverse effects. There is evidence that some specific probiotic strains such as Lactobacillus reuteri DSM 19378, especially in breastfed infants, are effective. However, there are also promising data for some synbiotics and/or killed or tyndallized bacteria, as well as substances decreasing intestinal permeability. Formula management with extensive and/or partial hydrolysates may also bring relief. But, above all, offering parental support remains imperative.

Keywords: Infant; colic; crying; distress.

Conflict of interest statement

Competing interests: Yvan Vandenplas has participated as a clinical investigator, advisory board member, consultant, and/or speaker for Abbott Nutrition, Biocodex, Danone, Nestle Health Science, Nestle Nutrition Institute, Nutricia, Mead Johnson, Phacobel, and United Pharmaceuticals. The other authors declare that they have no competing interests. Competing interests: Francesco Savino has published with Yvan Vandenplas once in the last 3 years on a paper on 'Thickened infant formula: What to know' (doi: 10.1016/j.nut.2017.10.010). No competing interests were disclosed.

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Cited by 2 PubMed Central articles

References

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Grant support

The author(s) declared that no grants were involved in supporting this work.

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