Infant Colic – Symptoms, Causes, and Treatment. How to Manage Baby Colic?

For over five decades, researchers have conducted systematic investigations into infantile colic, yet despite extensive study, the primary etiology of this condition remains unresolved. Consequently, it has been categorized among functional disorders—those in which distinctive clinical symptoms are present, but no detectable structural abnormalities exist within the organism. In practical terms, infantile colic is characterized by sudden, intense, and difficult-to-soothe episodes of crying or screaming in otherwise healthy infants who exhibit normal growth and weight gain. Epidemiological estimates suggest that this condition affects between 10% and 40% of infants, with no significant gender-based differences observed. Symptoms typically emerge between the third day and third week of life, peak in intensity during the late afternoon, evening, or nighttime hours, and gradually subside between the fourth and fifth months. During daylight hours, affected infants generally remain calm, while crying episodes are predominantly concentrated in the late afternoon, evening, and nocturnal periods.

Infantile colic in babies typically presents in a cyclical pattern during the evening hours, most commonly between 6:00 PM and 10:00 PM, with episodes frequently extending into the night. This condition represents a significant source of distress for the infant, as intense abdominal discomfort triggers forceful reactions—namely, the baby begins emitting piercing screams or cries that, due to the protracted nature of the symptoms, may persist uninterrupted for several hours. The onset of a colic episode is marked by noticeable facial flushing, a pain-contorted grimace, and an instinctive drawing-up of the legs toward the abdomen, indicative of heightened muscular tension. In the subsequent phase, the crying escalates, becoming increasingly difficult to soothe through conventional calming techniques. Additionally, the infant may exhibit a distended and tense abdomen, often accompanied by the passage of stool or excessive flatulence. A critical diagnostic consideration is that colic does not coincide with fever or infectious symptoms; however, food allergies—particularly to cow’s milk protein or soy—cannot be ruled out, as these may exacerbate the condition.

Prior to implementing any interventions, it is essential to consult a pediatrician to rule out potential underlying conditions and confirm that persistent crying is indeed attributable to infantile colic. Parents should be guided to differentiate between various types of crying—those indicating hunger, fatigue, or general discomfort versus the distinctive paroxysmal crying associated with colic. The approaches to alleviating symptoms are largely contingent upon the infant’s feeding method. Breastfeeding remains the gold standard, and colic alone does not justify its discontinuation. Mothers should refrain from self-imposed elimination diets without medical supervision, as these may lead to significant nutritional deficiencies and compromise maternal health. In select cases, a temporary dairy-free diet with calcium supplementation from alternative sources may be considered for approximately two weeks—provided there is a clear improvement in the infant’s symptoms. Scientific evidence indicates that maternal supplementation with lactase or proton pump inhibitors yields no beneficial effects. A 2005 study suggested efficacy in eliminating milk, eggs, wheat, fish, soy, and nuts from the maternal diet; however, such restrictive measures adversely affect maternal psychological well-being and nutritional status and are therefore not currently recommended. For formula-fed infants, hypoallergenic preparations based on protein hydrolysates may be beneficial, potentially indicating a causal link between colic and cow’s milk protein allergy. Fermented milk formulas containing metabolites from lactic acid bacteria are also available and may help mitigate symptoms. A safe and well-documented remedy is the administration of fennel tea, though traditional herbal infusions are preferable to commercial "baby teas," which often contain excessive sugar. Ensuring a calm feeding environment and adhering to a consistent meal schedule are equally important. Infantile colic represents a profoundly distressing experience for both the baby and caregivers. Implementing a multifaceted approach is advisable to alleviate the abdominal discomfort, which is as agonizing for the child as it is heartbreaking for parents to witness their infant’s suffering.