Luke Voytas is a pediatrician and author in Portland, Oregon. His posts combine research and common sense to help parents be calm and confident in raising their kids.

Hope For Colic? Finally?

Hope For Colic? Finally?

.Colic is a bugger. It’s basically lots of crying in a baby who is otherwise thriving, and it affects about one out of five infants under three months old. A good definition is crying for over three hours per day on three or more days per week, for at least three weeks. We actually don’t know very much about colic. It usually resolves by about three months, but the effects on new sleep-deprived parents can be substantial. Furthermore, there is some evidence that children who experience colic can have increased behavior problems such as ADHD when they are older, perhaps due to general trouble with self-regulation. (1) When your baby cries, it raises your heart rate and your blood-pressure. It increases your adrenaline and basically puts you in a state of "fight or flight" – great when you're running from a lion for three minutes, but no so ideal for two straight months. Pediatricians have never had a lot to offer these desperate parents. Oh sure, you can bicycle her little legs, or rub her tummy, but these are honestly more designed for you to feel like you’re doing something to help.

However, we know from multiple studies that the gut microbiomes (bacteria) are different in infants with and without colic. Over the past decade a handful of studies have shown that a specific type of probiotic called Lactobacillus reuteri might reduce colic symptoms, but the studies were kind of small and the results were mixed. This new study in the journal Pediatrics is more powerful because it combines four high-quality double-blind placebo-controlled trials to total about 345 infants. (2) They found that breastfed (but not formula-fed) infants receiving the probiotic were about twice as likely to have “treatment success” (defined as at least a 50% reduction in crying) at 21 days after starting the trial.

So we now have pretty good evidence that a benign treatment can help treat a condition that causes a lot of frustration and desperation in parents. More work needs to be done, especially bigger trials looking at formula-fed infants. But I am now comfortable offering L. reuteri as an option for my breastfeeding families who are struggling with colic. You can buy it over-the-counter as "Gerber Colic Soothe Drops."

1. Associations between problems with crying, sleeping, and/or feeding in infancy and long-term behavioural outcomes in childhood: a meta-analysis. Hemmi MH et al. Archives of Disease in Childhood. 2011;96:622-629. http://adc.bmj.com/content/96/7/622

2. Lactobacillus reuteri to treat infant colic: a meta-analysis. Sung V et al. Pediatrics. 2017;141(1):e20171811. doi:10.1542/peds.2017-1811

Be Aware of Your Placebo Effect

Be Aware of Your Placebo Effect