Infant Colic—What works

Tracy Harb, Misa Matsuyama, Michael David, Rebecca J. Hill

To determine the strength of evidence for commonly used interventions for colic in breastfed and mixed fed infants younger than 6 months of age. Searches of PubMed, CINAHL, Embase, AMED and Web of Science databases were conducted from July 2014 to July 2015. Included studies were randomised controlled trials involving mothers and their colicky infants younger than 6 months of age; assessed colic against the Wessel's or modified Wessel's criteria; and included phytotherapies, prescription medicines and maternal dietary interventions. Studies with less than 16 participants were excluded. Meta-analyses were conducted where data were sufficient to enable pooling. Quality was assessed against the Cochrane Risk Bias Assessment Tool. A total of 17 articles met the inclusion criteria for this review. The 6 studies included for sub-group meta-analysis on probiotic treatment, notably L. reuteri, demonstrated that probiotics appear an effective treatment, with an overall mean difference (MD) in crying time at day 21 of -55.8 min/d (95% CI = -64.4 to -47.3, p = 0.001). The 3 studies included for sub-group meta-analysis on preparations containing fennel suggest it to be effective, with an overall MD of -72.1 min/d (95%CI = -126.4 to -17.7, p < 0.001). Probiotics, in particular L. reuteri, and preparations containing fennel oil appear effective for reducing colic, although there are limitations to these findings. The evidence for maternal dietary manipulation, lactase, sucrose, glucose and simethicone is weak. Further well-designed clinical trials are required to strengthen the evidence for all of these interventions.