A prospective 10-year study on children who had severe infantile colic. Preventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938. Mothers’ postpartum psychological adjustment and infantile colic MATERNAL DIET AND INFANTILE COLIC IN BREAST-FED INFANTS Effectiveness of Lactobacillus reuteri in infantile colic and colicky induced maternal depression: a prospective single blind randomized trial Treatment of infantile colic with dicyclomine hydrochloride. Cow's milk formula as a cause of infantile colic: a double-blind study. Cow's milk whey protein elicits symptoms of infantile colic in colicky formula-fed infants: a double-blind crossover study. A Pilot Study of St36 Acupuncture for Infantile Colic Cow's milk proteins cause infantile colic in breast-fed infants: a double-blind crossover study. “Minor” feeding problems during the first months of life: effect of a partially hydrolysed milk formula containing fructo‐ and galacto‐oligosaccharides Acupuncture for infantile colic: A blinding-validated, randomized controlled multicentre trial in general practice Effect of minimal acupuncture for infantile colic: a multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL) Effectiveness of Mentha piperita in the Treatment of Infantile Colic: A Crossover Study The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Cimetropium Bromide in the Treatment of Crisis in Infantile Colic Infantile colic and feeding. Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic. Synbiotic in the management of infantile colic: a randomised controlled trial. Infantile colic: child and family three years later. Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. Dicyclomine hydrochloride in infantile colic.
AIM To evaluate the association between infantile colic and gastrointestinal , allergic and psychological disorders in childhood . METHODS A prospect i ve study was conducted on 103 infants aged 31 - 87 d. After 10 y , between 2001 and 2003 , the children were recalled and a paediatrician evaluated the selected disorders by anamnesis , medical examination , laboratory tests and parent interviews . RESULTS Of the 103 infants enrolled , 96 completed the study . There was an association between infantile colic and recurrent abdominal pain ( p=0.001 ) and allergic disorders : allergic rhinitis , conjunctivitis , asthmatic bronchitis , pollenosis , atopic eczema and food allergy ( p<0.05 ) . Sleep disorders , fussiness , aggressiveness and feelings of supremacy are more frequent in children who suffered from colic during early infancy ( p<0.05 ) . A family history of gastrointestinal diseases and atopic diseases was significantly higher in infants with colic than in controls ( p<0.05 ) . CONCLUSION Susceptibility to recurrent abdominal pain , allergic and psychological disorders in childhood may be increased by infantile colic . Our findings confirm that severe infantile colic might be the early expression of some of the most common disorders in childhood Infants were recruited in four centres in North-West Italy . 138 infants were assessed for eligibility , 113 ones underwent r and omisation and 105 completed the study . Newborns aged less than 10 days of life , with gestational age between 37 and 42 weeks , birth weight from 2,500 to 4,300 g and normal physical examination were recruitable . Premature infants and infants affected by outcomes of perinatal hypoxia or necrotising enterocolitis have been excluded . Patients were r and omly assigned to receive five drops containing Lactobacillus reuteri DSM 17938 ( 108 cfu ) with 400 UI of vitamin D3 or only 400 UI of vitamin D3 daily . The primary endpoints concern the administration of pain relieving agents ( cimetropium bromide at least three times per week or simethicone at least five times per week ) from baseline to 12 weeks . Additional analyses were done on the percentage of infants that switched from an exclusive breastfeeding to a partial or exclusive formula feeding from baseline to 12 weeks . Data concerning the number of calls to the paediatricians and the number of visits at paediatricians ' ambulatories due to infantile colic have been collected by paediatrician and analysed . Comparing the two groups , the relative risk was 0.04 ( 95 % confidence interval (CI)=0.01 - 0.31 ) for cimetropium bromide , 0.24 ( 95 % CI=0.14 - 0.41 ) for simethicone and 0.37 ( 95 % CI=0.17 - 0.80 ) for the administration of infant formula , showing a protective action of L. reuteri . The treatment group showed a lower number of paediatric consultations related to episodes of infant colic than the control group ( P<0.0001 ) . L. reuteri DSM 17938 supplementation at the tested dosage could reduce parental discomfort due to infantile colic . The consumption of this probiotic is associated with a reduction of paediatric consultations for infantile colic , as well as use of pain relieving agents and of infant formula Background : Infantile colic is a common problem of early infancy . There is limited data on the relation between postpartum maternal psychological problems and colic . Aim : : To investigate whether infantile colic is associated with postpartum mood disorders or insecure adult attachment style of the mother . Methods : Seventy eight mothers and newborns were enrolled in this prospect i ve , longitudinal study . Maternal depressive symptoms were screened with Edinburgh Postpartum Depression Score ( EPDS ) and maternal anxiety was assessed with State-Trait Anxiety Inventory ( STAI ) . The  Adult Attachment Scale  was used to determine the attachment style of the mother . Infantile colic was defined according to Wessel criteria . Results : Infantile colic was present in 17 infants ( 21.7 % ) ; 12.9 % of the mothers had an EPDS ⩾13 . The mean EPDS of the mothers whose infants had infantile colic ( 10.2±6.0 ) was significantly higher than that of the mothers of infants without colic ( 6.3±4.0 ) . Among infants with infantile colic , 62.5 % had mothers who had insecure attachment style , whereas only 31.1 % of mothers had insecure attachment when the infant did not have infantile colic . Conclusion : Postpartum maternal depressive symptoms and insecure attachment style are associated with infantile colic . Screening and early intervention of postpartum depression might promote the health of both the mother and infant This paper reports the results of placebo-controlled double-blind r and omized cross-over trial design ed to examine the effects of elimination of cow 's milk from maternal diet on rates of infantile colic . Subjects were 20 exclusively breast-fed infants , aged 3 - 18 weeks , with persistent colic . Each mother was given 600 ml drink to be drunk every day ; on 6 of the days the drink contained 300 ml of cow 's milk and 300 ml of soya milk ; on the remaining days it contained 600 ml of soya milk ; the 2 drinks were formulated to be undistinguishable ; the trial days were grouped into blocks of 2 days , r and omly assigned . Mothers were also instructed to record time and duration of any colic , and to record their own daily diet . Avoidance of cow 's milk produced no beneficial effects on the incidence of colic in the babies ; but when frequency of colic was related to days on which specific foods were eaten by the mothers the rates of colic were found to be significantly higher on days on which mothers reported eating chocolate or fruit . These results do not support the contention that elimination of cow 's milk from maternal diet may influence the likelihood of infantile colics ; the source of colic , however , can not be attributed to a single dietary component , but it may involve a combination of foodstuffs Infant colic , excessive crying of unknown cause , is a major burden to families and effects about 10–30 % of infants . Despite decades of research , the exact cause and treatment of infant colic has remained elusive . The use of Lactobacillus reuteri ( DSM 17938 ) in infant colic is somewhat controversial and hence , we design ed this study to evaluate its efficacy in infantile colic . We recruited predominantly or exclusively breastfed infants , aged less than 4 months in a placebo controlled observational r and omized study . Participants ’ were assigned to receive L. reuteri at a dose 108 colony forming units ( n = 21 ) and placebo ( n = 21 ) . Placebo was an identical formulation without live micro-organisms . Treatment was given to subjects for 21 days and they were followed for 4 weeks . Treatment success ( primary outcome ) , daily reduction in crying time , parent satisfaction and reduction in maternal depression ( secondary outcomes ) were assessed at the end of study period . Treatment success was observed in all infants ( 100 % ) of the probiotic group while it was seen in 15.7 % of the placebo group . Mean daily crying time was more significantly reduced to 32.1 ± 8.3 min/day ( P < 0.01 ) from 200.9 ± 6.3 min/day in the probiotic group as compared to the placebo group ( 120.6 ± 20.0 min/day ) . Moreover , throughout the study period , parent ’s satisfaction and improvement in maternal depression ( Edinburgh postnatal depression scale ) was also significantly higher in the probiotic group . In our study population , reduction in crying time was significant ( P < 0.01 ) even during first week of initiation of therapy . We conclude that L. reuteri ( DSM 17938 ) reduces daily crying time and maternal depression during infantile colic . We suggest L. reuteri may be a safe and efficacious option for reducing infant colic We performed a prospect i ve , r and omized , double-blind , placebo-controlled clinical trial of dicyclomine hydrochloride using specific diagnostic criteria for infantile colic : spells of unexplained irritability , agitation , fussiness or crying lasting greater than or equal to 3 hours/day , occurring greater than or equal to 3 days/week , and continuing for greater than or equal to 3 weeks .  Dicyclomine eliminated colic in 15 of 24 ( 63 % ) infants , whereas placebo was effective in six of 24 ( 25 % ) ( corrected X2 = 5.42 , P = 0.02 ) . The study also addressed the hypothesis that parental distress caused by infantile colic affects subsequent temperament and sleep patterns . The data fail to document easier temperaments or longer sleep duration s at 4 months in infants whose colic ceased during treatment The role of cow 's milk in infantile colic in formula-fed infants was estimated in a double-blind study . Sixty colicky infants were given a cow 's milk-containing formula ( Enfamil ) and a cow 's milk-free formula based on soy ( ProSobee ) . Eleven infants ( 18 % ) were free of symptoms while receiving soy formula .  Symptoms of 32 infants ( 53 % ) were unchanged or worse when they were fed cow 's milk formula and soy formula , but symptoms disappeared when they were fed a formula containing hydrolyzed casein ( Nutramigen ) . Symptoms of 17 infants ( 29 % ) could not be related to the diet ; these infants were permitted to continue on a cow 's milk-based formula . A challenge with cow 's milk-based formula after one month ( at approximately age 3 months ) produced symptoms of infantile colic in 22 infants ( 36 % ) . At age 6 months , a challenge with cow 's milk was positive in 11 infants ( 18 % ) with epidermal and gastrointestinal symptoms . Eight infants ( 13 % ) at 12 months of age and five infants ( 8 % ) at 16 months of age were still intolerant to cow 's milk . Cow 's milk seems to be a major cause of infantile colic  in formula-fed infants . A dietary treatment is suggested for moderate or severe forms of the colic . Cow 's milk protein intolerance is common later in infancy in these infants There are several causes of infantile colic . The aim of this study was to evaluate , under controlled conditions , whether bovine whey proteins can elicit symptoms of infantile colic in colicky formula-fed infants . The mean age for entering the study was 6.4 weeks and the mean age for colic debut was 3.7 weeks . In 24 of 27 infants with severe colic , the symptoms disappeared when they were given a cow 's milk-free diet ( Nutramigen ) .  These 24 infants were entered into a double-blind crossover study . The infants ( receiving cow 's milk-free diet ) were given the contents of identical capsules with each meal during day 6 . The same procedure was repeated on day 10 . The capsules contained either whey protein powder ( with Nutramigen added ) or human albumin powder ( with Nutramigen added ) . Eighteen infants receiving the whey protein-containing capsules reacted with colic , two infants receiving placebo reacted with colic ( P less than .001 ) , and four infants did not react at all . Crying hours per day for the 24 infants were 5.6 hours for formula-fed infants and 0.7 hour for cow 's milk-free diet-fed infants ( P less than .001 ) . Crying hours per day were 3.2 hours for the infants receiving whey protein capsules and 1.0 hour for those receiving placebo ( P less than .001 ) . In conclusion , bovine whey protein can elicit symptoms of infantile colic in colicky formula-fed infants Objective To conduct a pilot study to assess the feasibility of a proposed design of an acupuncture trial to relieve symptoms of  infantile colic .  Method An open r and omised single-blinded controlled trial , using st and ardised bilateral treatment of the acupuncture point ST36 . Infants fulfilling Wessel 's definition of infantile colic were included . Patients were r and omised to active treatment or to no-treatment control .  General practitioners ( GPs ) educated in Western medical acupuncture did the interventions . Parents and GPs ’ assistants were blinded . Active treatment was the bilateral insertion of 0.20 × 15 mm Seirin needles to 12 mm depth at ST36 . The intervention consisted of daily treatments of 30 s duration for three consecutive workdays . Blinding was done with a red point mark on the skin and circular adhesive dressing covering . The parents were asked two blinding validation questions in the course of the study period . The primary end point was the effect of the intervention assessed as change in crying time per 24 h measured with a crying registration form . Results The authors improved the st and ardisation and changed the blinding procedure as a result of the pilot study . Blinding validation questions were considered necessary . The changes made in the main study protocol are discussed . Conclusion The pilot study led to important changes that were implemented into the final trial protocol . Blinding validation is essential in no-treatment controlled trials of acupuncture on infants , where the parents are blinded assessors of symptom reduction . The authors suggest that blinding validation questions , and the answers to these questions , should be reported . Clinical Trial Registry Identifier : NCT00907621 Sixty-six mothers of 66 breast-fed infants with infantile colic were put on a diet free from cow 's milk . The colic disappeared in 35 infants ; it reappeared on at least two challenges ( cow 's milk to mother ) in 23 infants ( 35 % ) . A double-blind crossover trial with cow 's milk whey protein was performed in 16 of these 23 mothers and infants . Six infants had to be taken out of the study for various reasons ; of the remaining ten infants , nine reacted with colic after their mothers ' intake of whey protein-containing capsules . Sequential analysis showed a high correlation between infantile colic in breast-fed infants and their mothers ' consumption of cow 's milk protein . A diet free of cow 's milk is suggested for the mothers as a first trial of treatment of infantile colic in breast-fed infants Background : Colic , regurgitation and constipation are common feeding problems in formula‐fed infants that might benefit from dietary treatment . A formula containing fructo‐ and galacto‐oligosaccharides , partially hydrolysed proteins , low levels of lactose and palmitic acid in the β position and higher density has been tested to reduce the occurrence of these symptoms . The aim of this prospect i ve study was to describe the effects of such a formula in infants with minor gastrointestinal disorders . Methods : An observational prospect i ve trial involving practising Italian paediatricians was performed .  Formula fed‐infants up to 90 d of age with minor gastrointestinal problems such as infantile colics and /or regurgitation and /or constipation were enrolled in the study from January 2001 to May 2001 . The study was completed within 14 d of treatment . On days 1 , 7 and 14 the infants were visited by the paediatricians . Parents were given a structured diary to record daily episodes of colic , regurgitation and type and number of stools . Results : Of the 932 infants enrolled , 604 completed the study . Of the 214 infants with colic , 169 ( 79 % ) demonstrated a reduction in frequency of colic from 4.1 ± 2.0 per day at the beginning of the study to 2.0 ± 1.8 at the end of the study ( I.C. 95 % : 1.72–2.39 ; p < 0.005 ) . A reduction in the number of episodes of colic of 1.8 per day at the beginning of the study ( I.C. 95 % : 1.49–2.11 ; p < 0.05 ) was recorded between day 1 and day 7 , and of 0.26 ( I.C. 95 % : 0.15–0.37 ; p < 0.05 ) between day 7 and day 14 . Of the 201 infants with regurgitation problems , 141 ( 70 % ) demonstrated a reduction of frequency of the symptoms from 4.2 ± 2.0 per day at the beginningof the study to 2.1 ± 2.2 at the end of the study ( I.C. 95 % : 1.75–2.35 ; p < 0.005 ) . A reduction of 1.87 in the number of regurgitation episodes was reported between day 1 and day 7 ( I.C. 95 % : 1.57–2.16 ; p < 0.05 ) and of 0.18 ( I.C. 95 % : 0.06–0.31 ; p < 0.05 ) between day 7 and day 14 . Of the 232 infants with constipation , 147 ( 63 % ) demonstrated an increase in the daily number of stools of 0.42 ( I.C. 95 % : 0.5–0.3 ; p < 0.005 ) . An increase in stool frequency of 0.41 ( I.C. 95 % : 0.51–0.23 ; p < 0.05 ) was reported between day 1 and day 7 , and of 0.04 ( I.C. 95 % : 0.22–0.14 ; p= ns ) between day 7 and day 14 . Parents’evaluation of the formula was 7.9 ± 1.8 ( score 0–10 ) ; 550 parents ( 91 % ) gave a positive judgement ( score > 6 ) . The evaluation by the paediatricians of the improvement in symptoms after the treatment was 8.2 ± 1.5 ; 574 ( 95 % ) a positive effect ( score > 6 ) Abstract Objective . Infantile colic is a painful condition in the first months of infancy . Acupuncture is used in Sc and inavia as a treatment for infantile colic . A r and omized controlled trial was carried out with the aim of testing the hypothesis that acupuncture treatment has a clinical ly relevant effect for this condition . Design . A prospect i ve , blinding-vali date d , r and omized controlled multicentre trial in general practice . Research assistants and parents were blinded . Setting . 13 GPs ’ offices in Southern Norway . Intervention . Three days of bilateral needling of the acupuncture point ST36 , with no treatment as control . Subjects . 113 patients were recruited ; 23 patients were excluded , and 90 r and omized ; 79 diaries and 84 interviews were analysed . Main outcome measures . Difference in changes in crying time during the trial period between the intervention and control group . Results . The blinding validation questions showed a r and om distribution with p = 0.41 and 0.60 , indicating true blinding . We found no statistically significant difference in crying time reduction between acupuncture and control group at any of the measured intervals , nor in the main analysis of differences in changes over time ( p = 0.26 ) . There was a tendency in favour of the acupuncture group , with a non-significant total baseline-corrected mean of 13 minutes ( 95 % CI –24 to + 51 ) difference in crying time between the groups . This was not considered clinical ly relevant , according to protocol . Conclusion . This trial of acupuncture treatment for infantile colic showed no statistically significant or clinical ly relevant effect . With the current evidence , the authors suggest that acupuncture for infantile colic should be restricted to clinical trials Background Evidence for treating infantile colic with acupuncture is contradictory . Aim To evaluate and compare the effect of two types of acupuncture versus no acupuncture in infants with colic in public child health centres ( CHCs ) . Methods A multicentre , r and omised controlled , single-blind , three-armed trial ( ACU-COL ) comparing two styles of acupuncture with no acupuncture , as an adjunct to st and ard care , was conducted . Among 426 infants whose parents sought help for colic and registered their child 's fussing/crying in a diary , 157 fulfilled the criteria for colic and 147 started the intervention . All infants received usual care plus four extra visits to CHCs with advice/support ( twice a week for 2 weeks ) , comprising gold st and ard care . The infants were r and omly allocated to three groups : ( A ) st and ardised minimal acupuncture at LI4 ; ( B ) semi-st and ardised individual acupuncture inspired by Traditional Chinese Medicine ; and ( C ) no acupuncture . The CHC nurses and parents were blinded . Acupuncture was given by nurses with extensive experience of acupuncture . Results The effect of the two types of acupuncture was similar and both were superior to gold st and ard care alone . Relative to baseline , there was a greater relative reduction in time spent crying and colicky crying by the second intervention week ( p=0.050 ) and follow-up period ( p=0.031 ) , respectively , in infants receiving either type of acupuncture . More infants receiving acupuncture  cried <3 hours/day , and thereby no longer fulfilled criteria for colic , in the first ( p=0.040 ) and second ( p=0.006 ) intervention weeks . No serious adverse events were reported . Conclusions Acupuncture appears to reduce crying in infants with colic safely . Trial registration number NCT01761331 ; Results Background . Infantile colic is a distressing and common condition for which there is no proven st and ard treatment . Objective . To compare the efficacy of Mentha piperita with simethicone in treatment for infantile colic . Methods . A double-blind crossover study was performed with 30 infants attending IMIP , Recife , Brazil . They were r and omized to use Mentha piperita or simethicone in the treatment of infantile colic during 7 days with each drug . Primary outcomes were mother_s opinion about responses to the treatment , number of daily episodes of colic , and time spent crying , measured by a chronometer . Mann-Whitney and chi-square tests were used to compare the results . This study was previously approved by the Ethical Committee in Research at IMIP . Results . At baseline daily episodes of infantile colic was 3.9 ( ±1.1 ) and the mean crying time per day was 192 minutes ( ±51.6 ) . At the end of the study daily episodes of colic fell to 1.6 ( ±0.6 ) and the crying duration decreased to 111 ( ±28 ) minutes . All mothers reported decrease of frequency and duration of the episodes of infantile colic and there were no differences between responses to Mentha piperita and simethicone . Conclusions . These findings suggest that Mentha piperita may be used to help control infantile colic . However , these results must be repeated by others studies CONTEXT Despite its benign , natural course , colic is a significant problem in infants and imparts a psychological , emotional , and physical burden to parents . Dicyclomine hydrochloride is the only pharmacological treatment for infantile colic that has been consistently effective . Unfortunately , 5 % of infants treated with dicyclomine hydrochloride develop serious side effects , including death .  Fennel seed oil has been shown to reduce intestinal spasms and increase motility of the small intestine . However , there have not been any clinical studies of its effectiveness . OBJECTIVES To determine the effectiveness of fennel seed oil emulsion in infantile colic . DESIGN R and omized placebo-controlled trial . SETTING S Two large multi-specialty clinics . SUBJECTS 125 infants , 2 to 12 weeks of age , who met definition of colic . INTERVENTION Fennel seed oil emulsion compared with placebo . OUTCOME MEASURE Relief of colic symptoms , which was defined as decrease of cumulative crying to less than 9 hours per week . RESULTS The use of fennel oil emulsion eliminated colic , according to the Wessel criteria , in 65 % ( 40/62 ) of infants in the treatment group , which was significantly better than 23.7 % ( 14/59 ) of infants in the control group ( P < 0.01 ) . There was a significant improvement of colic in the treatment group compared with the control group [ Absolute Risk Reduction ( ARR ) = 41 % ( 95 % CI 25 to 57 ) , Number Needed to Treat ( NNT ) = 2 ( 95 % CI 2 to 4 ) ] . Side effects were not reported for infants in either group during the trial . CONCLUSION Our study suggests that fennel seed oil emulsion is superior to placebo in decreasing intensity of infantile colic Background Treatment of infantile colic remains an open issue . In Italy , cimetropium bromide is used extensively to treat infantile colic . The aim of this r and omized , double-blind , placebo-controlled clinical trial was to investigate the effectiveness and side effects of cimetropium bromide in the treatment of infants with colic crisis . Methods Ninety-seven infants with colic were enrolled . The diagnosis of infantile colic in healthy infants with regular growth , aged 15 to 60 days was made according to the criteria of Wessel . The infants were divided into two groups , one treated with cimetropium bromide ( 1.2 mg/kg ) and the other treated with placebo at onset of each crisis for 3 days . Duration of crying and side effects were recorded daily in a structured diary for the 3 days of therapy . Statistical analysis was performed using the chi-square and t tests . Results Eighty-six infants completed the trial .  The average duration of crying for each crisis was 17.3 ± 12.6 minutes in the cimetropium bromide group and 47.5 ± 28.5 minutes in the placebo group ( P < 0.005 ) . Response to cimetropium bromide was 74 % . Response to placebo was 33 % ( P < 0.05 ) . Side effects did not differ significantly between the two groups , except sleepiness , which increased in the infants treated with cimetropium bromide . Conclusion Cimetropium bromide was more effective than placebo in reducing the duration of crying in children with infantile colic . The use of the anticholinergic drugs , aside from the dicyclomine because of its dangerous side effects , should be revaluated for treating infantile colic In a double blind crossover study 10 children with infantile colic were fed breast milk and cow 's milk formula , untreated and treated with lactase .  Colic was present on 71 % of breast milk and 89 % of cow 's milk days . Daily duration and severity of colic did not differ for milk preparations AIM AND OBJECTIVE The aim of the study was to evaluate the effectiveness of massage , sucrose solution , herbal tea or hydrolysed formula , each used individually in the treatment of infantile colic . BACKGROUND The term colic describes a group of symptoms that occur frequently in infants , consisting of paroxysmal abdominal pain and severe crying . Infant colic is of importance for both parents and the community health services that provide families with care , and is therefore an important clinical problem that is amenable to nursing interventions . DESIGN This prospect i ve and r and omised-controlled study involved 175 infants in Turkey . METHODS Data were gathered by using Wessel criteria ; parents wrote a daily structured diary , recording the onset and duration of crying . Patients were assigned r and omly into four different intervention groups ( massage , sucrose solution , herbal tea and hydrolysed formula ) and control group .  Duration of crying following each intervention was recorded in the diary by parents for a one week period . RESULTS There was a significant reduction in crying hours per day in all intervention groups . The difference between mean duration of total crying ( hours/day ) before and after the intervention infants in hydrolysed formula group was found higher than massage , sucrose and herbal tea group . The difference between mean duration of total crying(hours/day ) before and after the intervention infants in massage group was found lower than other intervention groups and all groups . CONCLUSION Our findings demonstrated that varied interventions such as administration of massage , sucrose solution , herbal tea and hydrolysed formula are effective in the treatment of colic . The difference between mean duration of total crying ( hours/day ) before and after the intervention in hydrolysed formula group was found higher than other intervention groups . Hydrolysed formula was the most effective in reducing the duration of crying ( hours/day ) when compared with the other intervention groups . Massage intervention yielded the least symptomatic improvement among all the interventions . RELEVANCE TO CLINICAL PRACTICE Colic treatment models used in this study can be used by nurses in neonatal and primary healthcare setting s as an aid to families for the treatment of infantile colic AIM Infant colic is a frequent problem affecting up to 10 - 30 % of infants in first 3 months of life . Results from previous trials have shown that manipulation of gut microbiota can lead to symptomatic improvements . In a r and omised clinical trial , we aim ed to determine efficacy of synbiotic in reducing average infant crying time at day 7 and day 30 after starting intervention . METHODS Fifty breastfed infants aged 15 - 120 days with infantile colic r and omly assigned to receive either the synbiotic sachet containing 1 billion CFU of : Lactobacillus casei , L. rhamnosus , Streptococcus thermophilus , Bifidobacterium breve , L. acidophilus , B. infantis , L. bulgaricus and fructooligosacharide ( Protexin Healthcare , Somerset , UK ) , or placebo daily for 30 days . Parents were asked to record details of crying times in a symptoms diary . The primary outcome measure was the treatment success ( reduction in the daily crying time > 50 % ) and the secondary outcome measure was symptom resolution ( reduction in the daily crying time > 90 % ) . RESULTS The treatment success was significantly higher in synbiotic group ( 82.6 % ) compared with placebo ( 35.7 % ) at day 7 ( P < 0.005 ) . At day30 , treatment success was 87 % and 46 % in synbiotic and placebo group , respectively ( P < 0.01 ) . Symptom resolution was also higher in synbiotic group ( 39 % ) compared with placebo ( 7 % ) at day 7 ( P < 0.03 ) but not at day 30 ( 56 % vs.36 % , P = 0.24 ) . We encountered no complication related to synbiotic use . CONCLUSION This synbiotic ( a mixture of seven probiotic strains plus FOS ) significantly improved colic symptoms in comparison with placebo OBJECTIVE To assess differences in family functioning or child-rearing attitudes within families with previously colicky infants and to assess whether the children differed in their behavior , development , or frequency of allergies . STUDY DESIGN A controlled , prospect i ve study with infants ( 3 months to 3 years of age ) and their families . PARTICIPANTS Three hundred thirty-eight infants with and 866 infants without exhibited colic and their families . METHODS Question naires to mothers and nurses regarding infantile colic ( 3 months of age ) ; question naires to mothers , fathers , and nurses regarding  interactions  within the family , parents ' satisfaction with daily life , child caring , child behavior , and development ( 3 years old ) ; the Denver Developmental Screening Test ( parents filled out at home during the whole 3 years of infant development ) ; the  Achenbach Behavior Checklist  for 2- to 3-year-old children ( the 3-year visit at a well baby clinic ) . RESULTS The families of previously colicky infants demonstrated more dissatisfaction with the arrangements of daily family responsibilities and with the amount of both leisure time and shared activities . The children in the colic group had more sleeping problems and more frequent temper tantrums ( at 3 years of age ) than the control group . CONCLUSIONS The families with colicky infants had more distress 3 years later . Families with colicky infants should be provided practical support in improving daily family functioning and child rearing . In addition , underlying problems in family relationships should be managed appropriately OBJECTIVE : To test the efficacy of Lactobacillus reuteri on infantile colic and to evaluate its relationship to the gut microbiota . STUDY DESIGN : Fifty exclusively breastfed colicky infants , diagnosed according to modified Wessel 's criteria , were r and omly assigned to receive either L reuteri DSM 17 938 ( 108 colony-forming units ) or placebo daily for 21 days . Parental question naires monitored daily crying time and adverse effects . Stool sample s were collected for microbiologic analysis . RESULTS : Forty-six infants ( L reuteri group : 25 ; placebo group : 21 ) completed the trial . Daily crying times in minutes/day ( median [ interquartile range ] ) were 370 ( 120 ) vs 300 ( 150 ) ( P = .127 ) on day 0 and 35.0 ( 85 ) vs 90.0 ( 148 ) ( P = .022 ) on day 21 , in the L reuteri and placebo groups , respectively . Responders ( 50 % reduction in crying time from baseline ) were significantly higher in the L reuteri group versus placebo group on days 7 ( 20 vs 8 ; P = .006 ) , 14 ( 24 vs 13 ; P = .007 ) , and 21 ( 24 vs 15 ; P = .036 ) . During the study , there was a significant increase in fecal lactobacilli ( P = .002 ) and a reduction in fecal Escherichia coli and ammonia in the L reuteri group only ( P = .001 ) . There were no differences in weight gain , stooling frequency , or incidence of constipation or regurgitation between groups , and no adverse events related to the supplementation were observed . CONCLUSION : L. reuteri DSM 17 938 at a dose of 108 colony-forming units per day in early breastfed infants improved symptoms of infantile colic and was well tolerated and safe . Gut microbiota changes induced by the probiotic could be involved in the observed clinical improvement OBJECTIVE To determine whether there is a short-term effect of spinal manipulation in the treatment of infantile colic . DESIGN A r and omized controlled trial . SETTING A private chiropractic practice and the National Health Service 's health visitor nurses in the suburb Ballerup ( Copenhagen , Denmark ) . SUBJECTS Infants seen by the health visitor nurses , who fulfilled the diagnostic criteria for infantile colic . INTERVENTION One group received spinal manipulation for 2 weeks , the other was treated with the drug dimethicone for 2 weeks . OUTCOME MEASURE Changes in daily hours of crying as registered in a colic diary . RESULTS By trial days 4 to 7 , hours of crying were reduced by 1 hour in the dimethicone group compared with 2.4 hours in the manipulation group ( P = .04 ) . On days 8 through 11 , crying was reduced by 1 hour for the dimethicone group , whereas crying in the manipulation group was reduced by 2.7 hours ( P = .004 ) . From trial day 5 onward the manipulation group did significantly better that the dimethicone group . CONCLUSION Spinal manipulation is effective in relieving infantile colic Dicyclomine hydrochloride is often used to treat infantile colic in Sweden , although in the United Kingdom it is now regarded as being contraindicated in infants aged six months and under . Results from three previous studies suggested its effectiveness.53 In these studies , however , the placebo did not taste like dicyclomine ( in the most recent study , for instance , cherry syrup was used as the placebo3 ) , and thus whether these studies were blind is not clear , as parents often taste their children 's drugs . One aim of the present study was to investigate the effects of dicyclomine compared with a placebo with identical smell , taste , colour , and texture . Another goal was to identify factors , such as  age and rhythm and amount of crying  , that would predict whether treatment would be successful
In breastfed infants , evidence suggests that a hypoallergenic maternal diet may be beneficial for reducing symptoms of colic .
In formula-fed infants , colic may improve after changing from a st and ard cow ’s milk formula to either a hydrolysed protein formula or a soy-based formula .
Fibre-supplemented formulae had no effect .
Infantile colic , the cause of 10–20 % of all early paediatrician visits , can lead to parental exhaustion and stress .
A systematic review was conducted to examine whether dietary change provides an effective therapy for  infantile colic .