Colic Treatment: what does the latest research say about medications and other interventions used for treating infant colic? You will find the answers on this page.

Research studies referred to are randomized controlled trials and systematic reviews of randomized controlled trials, so if I say there is no research, I mean no randomized controlled trials.

No treatment has been found as a perfect colic treatment, but several treatments have been shown to work in some babies some of the time. Time itself will reliably sort out colic, and while you are waiting there are simple measures you can try - to read about simple colic management strategies, click here.

Each section below deals with a different intervention, giving you information on what the research says and then giving comments based on my personal opinion.

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Simethicone (Infacol, Mylicon)

An over-the-counter anti-gas medication
Research says: Simethicone is no better than placebo (dummy medication).
Dr Maud says: Simethicone has a good safety record in babies and is not too expensive, so it is worth trying as a colic treatment. If there is no response after 7-10 days, there is no point continuing.

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Gripe Water / Colic Ease

Over-the-counter colic treatments containing various herbs (including fennel).
Research says: There is no evidence looking at gripe water or colic ease specifically, but there is research that shows benefit from herbal preparations that include fennel.
Dr Maud says: Gripe water & Colic Ease have good safety records in babies and are not too expensive, so they are worth trying. If there is no response after 7-10 days, there is no point continuing.

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Herbs, including Fennel

Various preparations containing herbs have been used in colic treatment, including

• herbal tea containing fennel, lemon balm, chamomile, vervain and liquorice - up to 150 ml/kg/dose offered up to three times a day
• fennel seed oil emulsion
• phytotherapeutic agent (standardized herbal preparation) containing fennel, chamomile and lemon balm (ColiMil) - given twice daily at 2ml/kg/day

Research says: Herbal preparations have been shown to be effective in reducing crying time in babies with colic. There has been concern regarding giving herbal teas to babies as it means they have reduced milk intake (their stomachs can only cope with a certain volume) and this may lead to poor growth. The phyotherapeutic preparations do not involve a large volume and so are not thought to interfere with growth. No adverse side effects have been reported.
Dr Maud says: I like the use of herbs in treating a condition like colic. I would not advise use of the herbal tea as the volumes may interfere with normal feeding, although breast-feeding mothers could try drinking the tea. The phytotherapeutic agents could be tried (read the label to ensure that it can be given to babies).

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Sucrose or Glucose

Sucrose has been used recently for pain relief for procedures, such as blood taking, in infants. Sucrose (and glucose) release natural endorphins in babies.
Research says: Recent studies have shown that sucrose ( 2 ml of 12.5%) and glucose (1 ml of 30% glucose) have reduced crying in infants and that mothers have felt there has been an improvement in symptoms in their babies.
Dr Maud says: This is a safe and relatively cheap intervention and is worth trying. It is important to use the sucrose (or glucose) for a limited time when you baby has colic (so up to 4 months of age or so).
In the long term, it is important for your child to have a healthy diet and not have a sweet tooth (so regular sucrose for crying throughout childhood is not advised).

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Changing the Milk

There are several studies looking at changing the milk (to hydrolysed formula, soy milk or lactose-free formula) as a colic treatment.
Research says: Individual studies have shown some benefit from changes in feeding but most of the studies have not been absolutely conclusive. The best evidence in colic treatment is for whey hydrosylate formula.
Dr Maud says: If your baby is thriving (gaining weight) there is no reason to change the milk and I would always advise breast-feeding over a change in milk. There is not enough evidence to suggest that breast-feeding mothers should avoid dairy, so I wouldn't advise you do that. However, whey or casein hydrolysed formula, soy formula and lactose-free formula have all been shown to be safe, and if you are going to try a change in milk, the evidence supports a whey hydrosylate formula. Give for a 4 week trial and then try stopping. To read more on milk allergy, click here

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Advice to Reduce Stimulation

Mothers were advised to reduce stimulation by not patting, lifting or jiggling the baby or by reducing noise. They were also given permission to leave the baby to cry if they felt stressed.
Research says: One study has shown a reduction in colic from advice to reduce stimulation. On the other hand, advice to increase carrying of the baby has not been shown to decrease colic symptoms.
Dr Maud says: I would agree that calm handling of babies is better than over stimulation. If you are feeling stressed, it is also important you have a break.

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Car Ride Simulator

Many mothers notice their baby falls asleep during car rides and so research has looked at car ride simulators as a colic treatment.
Research says: There was no difference in crying time in those babies who were given a simulated car ride compared to babies whose mothers were given general advice.
Dr Maud says: I would not advise spending money on a car ride simulator even if your baby falls asleep in the car.

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Spinal Manipulation (Chiropractic Treatment)

Research says: There is conflicting evidence with studies that show a reduction in colic with spinal manipulation and studies that don't show a reduction in colic, so more research is needed on spinal manipulation as a colic treatment. There are no research studies on cranial osteopathy.
Dr Maud says: I've seen spinal manipulation work for crying in my nephew and niece. Make sure you see an appropriately trained chiropractor - my sister takes her children to my sister-in-law!

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Probiotics

Research says: Studies have shown a reduction in colic when probiotics (such as Lactobacillus) were added to the formula.
Dr Maud says: Probiotics are natural and generally safe. It's worth trying probiotics as a colic treatment to see if they work in your baby. Check dosing on the label.

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Dicyclomine

Research says: Dicyclomine has been shown to reduce colic symptoms but it has also been associated with severe side effects.
Dr Maud says: Do not use Dicyclomine for colic or any other condition in a baby under 6 months.

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References

• Wade S. Infantile Colic. Clinical Evidence. BMJ Publishing Group. 2006
• Bandolier. Treatments for Infant Colic. Sep 2000; 79-4
• Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long-term consumption of infant

  formulas containing live probiotic bacteria:tolerance and safety. Am J Clin Nutr 2004;79:261-7

• Savino, F; Pelle, E; Palumeri, E; Oggero, R; Miniero, R. Lactobacillus reuteri (American type culture collection strain 55730) versus simethicone in

  the treatment of infantile colic: A prospective randomized study. PEDIATRICS, 119 (1):

  E124-E130; JAN 2007

• Akçam M, Yilmaz A.Oral hypertonic glucose solution in the treatment of infantile

  colic.Pediatr Int. 2006 Apr;48(2):125-7

• Markestad T.Use of sucrose as a treatment for infant colic.Arch Dis Child. 1997

  Apr;76(4):356-7

• Barr RG, Young SN, Wright JH, Gravel R, Alkawaf R.Differential calming responses to

  sucrose taste in crying infants with and without colic.Pediatrics. 1999 May;103(5):e68

• Weizman Z et al. Efficacy of herbal tea preparation in infantile colic. J Pediatr 993;122:650-2
• Savino F et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Pythother Res 2005;19:335-40
• Rakavitskaya A et al. The effect of fennel seed oil emulsion in infantile colic: a randomized placebo-controlled study. Altern Ther Health Med. 2003 Jul-Aug;9(4):58-61

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Last reviewed 15 April 2008

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