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Infantile Colic –treatment

Richeller YLING, Neonatologist

There is no proven treatment for colic and drugs are not recommended. Management is generally conservative and involves reassurance of parents.
1. Changing milk- Incidence of colic in breastfed and bottle-fed infants is the same. There is even no need to change formulas unless the infant is proven to be intolerant to cow’s milk. Breastfeeding moms may avoid caffeine, chocolates, eggs, wheat and nuts.
2. Drugs- Simethicone is safe and has been promoted to reduce gas. However randomized trials showed effects of treatment with this drug and placebo have no difference.
3.Dicyclomine is an anticholinergic was found to be effective but with the significant side effect of apnea and seizures thus is not anymore recommended.
4.Cimetropium may decrease duration of crying but can increase sleepiness.

5. Herbal Teas- Due to lack of standardized strength and dosage, and potential interference to feeding,parents should be cautioned about their use.
6. Probiotics- These may have a role in the treatment of colic but results of studies are conflicting.
7. Spinal Manipulation- This is a traditional form of treatment used by chiropractors, osteopaths and physical therapists to treat musculoskeletal problems. Evidence on its efficacy in treating colic is inconclusive.

Comforting the Baby
As there is no proven specific treatment for colicky babies, it will not hurt to try to comfort them using the 5S approaches:
1. Swaddling- some babies feel comfortable when swaddled but avoid overheating and covering the head.
2. Side or Stomach position- Use this position only when awake. Sleeping on their stomach puts them at risk of SIDS (sudden infant death syndrome).
3. Shhh sound- Making shush sound near the baby’s ear
4. Swinging the baby with tiny jiggly movements (no more than 1” back and forth) always supporting the head and neck.
5. Sucking- Let the baby suck on the breast or pacifier.
Other tips can be singing lullabies, use of “white noise”,soothing music accompanied by parental attention (eye contact, talking, touching, playing) or even riding a car.