From the Guidelines
Treatment options for infant colic should prioritize behavioral approaches, such as soothing techniques and feeding adjustments, with probiotics, particularly Lactobacillus reuteri DSL 17938, being a viable medical option, as supported by the most recent and highest quality study 1.
Behavioral Approaches
- Soothing techniques: gentle rocking, swaddling, white noise, or pacifier use
- Holding the baby in different positions, particularly upright or with gentle pressure on the abdomen, to relieve gas
Feeding Adjustments
- For breastfed babies: mothers might eliminate potential trigger foods like dairy, caffeine, or spicy foods from their diet for 1-2 weeks to observe any improvement
- For formula-fed infants: trying a hypoallergenic or hydrolyzed protein formula for 1-2 weeks may help
Medical Options
- Probiotics: Lactobacillus reuteri DSL 17938 (available as BioGaia drops) at a dose of 108 colony-forming units once daily, have shown effectiveness in some studies 1
- Over-the-counter simethicone drops (40-80 mg with each feeding, up to 4 times daily) may help reduce gas, though evidence is limited
- Gripe water, containing herbs like fennel or ginger, is sometimes used but lacks strong scientific support
Important Considerations
- Infant colic is temporary, typically resolving by 3-4 months of age, and doesn't indicate any underlying health problem or parenting failure
- Parents should be aware of the potential risks and benefits of each treatment option, and consult with their healthcare provider before starting any new therapies
- The American Academy of Pediatrics recommends a conservative approach to managing infant colic, focusing on soothing techniques and feeding adjustments, with medication use being reserved for severe cases 1
From the FDA Drug Label
Use for the relief of pressure and bloating commonly referred to as gas The FDA drug label does not answer the question.
From the Research
Treatment Options for Infant Colic
The treatment options for infant colic are varied and can be categorized into several areas, including:
- Dietary changes
- Pharmacological interventions
- Probiotics
- Behavioral therapies
- Complementary and alternative treatments
Dietary Changes
Dietary changes, such as avoiding cow's milk proteins in breast-feeding mothers and bottle-fed infants, have been suggested as a potential treatment for infant colic 2. Additionally, the use of partially hydrolyzed proteins and low lactose formulas with prebiotics or probiotics has been proposed, although further documentation of their efficacy is needed 2. Some studies have reported favorable results for the use of hydrolysed formulas in bottle-fed infants or low-allergen maternal diets in breastfed infants 3.
Pharmacological Interventions
Pharmacological agents, such as Simethicone and Cimetropium Bromide, have been investigated for the treatment of infant colic. Simethicone has been shown to reduce bloating, while Cimetropium Bromide may reduce fussing and crying, although it has only been tested for severe infantile colic 2. However, other studies have reported conflicting results for Simethicone and noted side effects and methodological issues with Dicyclomine hydrochloride and Cimetropium bromide 3.
Probiotics
Probiotics, particularly Lactobacillus reuteri, have been suggested as a potential treatment for infant colic. Some studies have reported that Lactobacillus reuteri can shorten crying times and increase treatment success in breastfed infants with colic 4, 5. However, the evidence for probiotic use in formula-fed infants remains unresolved 6, 4.
Behavioral Therapies
Behavioral therapies, such as decreased stimulation and contingent music, have been investigated for the treatment of infant colic. Some studies have reported favorable results for these interventions, although the methodological rigour of these studies has been questioned 3.
Complementary and Alternative Treatments
Complementary and alternative treatments, such as herbal supplements, manipulative approaches, and acupuncture, have been proposed for the treatment of infant colic. However, there is limited evidence to support the use of these treatments, and further research is needed to fully understand their potential benefits and risks 2. Some studies have reported that fennel extracts may be effective in treating infantile colic 5.