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Infantile colic: Management and outcome

Authors
Teri Lee Turner, MD, MPH, MEd
Shea Palamountain, MD
Section Editor
Marilyn Augustyn, MD
Deputy Editor
Mary M Torchia, MD

INTRODUCTION

Persistent or excessive crying is one of the most distressing problems of infancy. It is distressing for the infant, the parents, and the clinician [1]. The parents of the infant may view the crying as an indictment of their caregiving ability or as evidence of illness in their child [2]. Colic is a benign, self-limited condition that resolves with time. However, the family's beliefs concerning the cause of crying and their interactions with the health care system related to the crying may affect the way in which they view the child and the health care system long after the crying has resolved.

The management of infantile colic is reviewed here. The clinical features, proposed etiologies, and diagnosis are discussed separately. (See "Infantile colic: Clinical features and diagnosis".)

TERMINOLOGY

We broadly define colic as crying for no apparent reason (eg, hunger, soiled diaper, etc) that lasts for ≥3 hours/day and occurs on ≥3 days per week in an otherwise healthy infant <3 months of age. Stricter definitions include criteria for minimum duration (eg, three weeks) or associated clinical features. Other terms that are interchangeable with colic include "cry-fuss behavior," "excessive crying," "unsettled infant behavior," and "period of PURPLE crying" [3,4]. (See "Infantile colic: Clinical features and diagnosis", section on 'Definitions'.)

NATURAL HISTORY

Colic improves spontaneously with time [5-9]. Symptoms resolve in 60 percent of infants by three months of age and in 80 to 90 percent of infants by four months of age [6-9]. The presumptive diagnosis of colic is confirmed after it resolves.

MANAGEMENT

Overview — Management of the otherwise well infant with prolonged or excessive crying is individualized based upon the history, examination, and family characteristics [10,11]. Some parents and families tolerate crying better than others.

                          

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Literature review current through: Nov 2016. | This topic last updated: Tue Oct 18 00:00:00 GMT+00:00 2016.
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