Colic is excessive crying of unknown cause in babies less than 3 months old.
The scientific definition for colic is:
crying or fussing more than 3 hours of the day for more than 3 days of the week.
Colic is a diagnosis that can only be made after the baby has been examined and it is felt that the baby’s crying is not due to any medical cause.
Colic is very common, affecting around 1 in 5 babies less than 3 months old.
The symptoms of colic usually start within the first few weeks of life, with the crying usually peaking at 6 to 8 weeks, then spontaneously resolving after 3 to 4 months. Parents usually report babies with colic to have unpredictable episodes of crying that are hard to soothe, often occurring in the late afternoons and evenings. The crying babies may look like they are in pain because they often draw up their legs, arch their back and pass wind, often because of swallowing air during crying.
No one knows why babies get colic, despite years of research. Some people think it is the extreme spectrum of normal baby crying. Some people think it is because of pain originating from the gut.Others think it is because of the baby’s temperament, affected by the mother’s mood. None of these theories have scientifically been proven to be true.
The most important and serious effects of colic are maternal depression and child abuse, or the Shaken Baby Syndrome. Mothers with babies with colic are usually sleep deprived, and it can be very stressful and exhausting to look after a baby who cries a lot, especially when it seems that nothing would stop the baby from crying. Mothers with babies with colic often stop breastfeeding early. Many parents try many different kinds of infant formula in the hope that they would find the right one to suit their baby.
Currently, there are no effective treatment options for colic. In a small proportion of babies with colic, who usually have other symptoms in addition to their crying, excluding dairy from their mother’s diet or changing them to a dairy-free formula can sometimes work, but this doesn’t work for all babies with colic. Because nothing really works for colic, parents are often given conflicting and confusing advice. This is not helpful to parents who are already exhausted and stressed out.
Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial
Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis
After conducting the Melbourne trial, Dr Sung led an international collaboration of researchers from 11 institutes around the world to try to establish whether certain groups of babies with colic might benefit from probiotics.
The researchers combined raw data from the Melbourne trial with those from three other similar trials from Italy, Poland and Canada. The team found that amongst breastfed babies with colic, the probiotic group was two times more likely to reduce crying by 50% by the 21st day of treatment compared to the placebo group.
However, the probiotic was not effective for the formula-fed babies with colic.
Recommendations for use of probiotics for infant colic
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International Collaborative Study
Dr Valerie Sung is a General and Developmental / Behavioural Paediatrician practicing at Melbourne Paediatric Specialists.