Infantile colic: Possible Treatments

Behavioural interventions:

• Decrease stimulation
• Offer an atmosphere of security (“calmness, closeness, cuddling”)

Physical interventions:

• Carrying / rocking / jiggling the baby
• Provide gentle warmth
• Try baby massage: gently massage the belly of your baby with two fingers in a clockwise circular motion

Dietary interventions:

• Try an hypoallergenic formula
• Adapt diet in breast-feeding mothers (e.g. avoid carbonated drinks / food which can cause flatulence / potential allergenic food)
• Consult your physician for lactase enzyme supplementation
• Change feeding practices

Pharmaceutical interventions:

• Simethicone
• Probiotics

Naturopathic interventions:

• Herbal teas (e.g. fennel) for mother and/or baby
• Homeopathic medicines such as e.g. Colikind^®

Local interventions:

• Rub or massage baby's gums with a clean finger
• Offer teething aids (“teethers”) such as teething rings, toys or biscuits to chew on
• Offer chilled foods, such as yoghurt or purred fruits
   

Good dental care is starting with baby´s first tooth:

• clean the baby´s teeth once a day with a soft, wet washing cloth
• at 12 months of age, a small soft toothbrush with water can be used
• add a small dab of toothpaste (there are special preparations for children) as the child grows older

Avoid continuous and extended exposure to sugared liquids (“baby bottle tooth decay”). First dental visit should occur by the age of one or within 6 months after eruption of first tooth.

Pharmaceutical interventions:

• Local anaesthetics in teething gels to rub on the painful and swollen baby´s gums
• Analgetics (e.g. paracetamol, ibuprofen)

Behavioural interventions:

• Try to calm down the child by offering an atmosphere of security (“calmness, closeness, cuddling”)
• Avoid causing the child additional stress

Naturopathic interventions:

• Homeopathic medicines such as e.g. Dentokind^®

Behavioural interventions:

• Encourage more outdoor activities and exercises - children should spend at least 1-2 h a day outdoor independent of weather conditions (⇒ take care of appropriate clothing dependent on seasonal weather and temperature conditions)
• Take care that your child gets enough sleep

Environmental interventions:

• Avoid smoking in presence of your child
• Try to spend a vacation at the seaside with its stimulating climate on the immune system
• Children should grow up in a safe and secure environment (“happy kids are healthier”)

Dietary interventions:

• Provide a healthy, well-balanced diet rich in vitamins and minerals
• Give supplementary vitamins and minerals only if necessary
• Prefer fresh food and reduce the intake convenience food to a minimum

Naturopathic interventions:

• Phytotherapy (e.g. echinacea purpurea)
• Homeopathic remedies such as e.g. Immunokind^®

Behavioural interventions:

• Follow the “5 S” approach (swaddling, side/stomach position, *shhhh* sound, swinging, sucking) according to Dr. Harvey Karp to calm a baby
• Establish calming “bedtime routines” (e.g. reading a book or talking about the day) in infants and children
• Avoid games, computer and IPad use, that can cause too much excitement, in the evening
• Adjust daytime napping to the child’s age and developmental needs as too much sleep during daytime will affect sleepiness and sleep duration at night

Environmental interventions:

• Adjust the environment of the room in which the child sleeps ensuring that it is comfortable, quiet and cool (max. 18 ºC)
• Keep the television out of the child´s bedroom

Dietary interventions:

• Avoid caffeinated drinks or other stimulants (e.g. coffee, Coke^®, energy drinks) in general and particularly for at least 3-4 h before bedtime
• Avoid heavy foods 1-2 h before bedtime

Naturopathic interventions:

• Herbal teas
• Phytotherapy (e.g. valerian, balm, chamomile, lavender, hops)
• Relaxation techniques (e.g. autogenic training, progressive muscle relaxation)
• Acupuncture
• Homeopathic remedies such as e.g. Dormikind^®

Behavioural interventions:

• Education and explanation of pain experience as well as reassurance after confident diagnosis of the FGID by the physician
• Acquisition of stress management techniques (i.e. reducing pain-induced tension and increasing a relaxed state via progressive relaxation, autogenic training etc.)
• Cognitive behavioural therapy (i.e. developing strategies to improve dealing with symptoms)
• Offering distractions to the child, especially for the management of acute pain

Dietary interventions:

• Low lactose / fructose diet in presence of documented intolerance
• Fiber supplementation and osmotic laxative if constipation symptoms are prevalent

Pharmaceutical interventions:

• Symptomatic drugs such as antispasmodics, antidiarrhoeal or laxative agents
• Low-dose antidepressants or SSRIs (CAVE: effectiveness well documented in adults with FGID, in children not recommended in general due to possible side-effects)
• Probiotics

Naturopathic interventions:

• Phytotherapy
• Chiropractic treatments
• Homeopathic medicines such as e.g. Gastrokind^®

Behavioural interventions:

• Training of social skills
• Positive reinforcement, i.e. desirable behaviour is reinforced by positive consequences
• Offering distractions to the child, especially for the management of acute pain
• General behavioural recommendations for parents:
     Show your child lots of affection.
     Praise your child.
     Be patient.
     Try to maintain a reliable daily structure and routine.
     If your child breaks a “rule”, respond immediately and consistently.
     Establish clear “rules” and set boundaries.
     Do not use force.
     Take a break yourself.

Environmental interventions:

• Education and counselling of parents and / or teachers

Dietary interventions:

• Increase the intake of essential fatty acids, especially omega-3- and omega-6-fatty acids
• Reduce or eliminate the intake of foods which are generally thought to increase hyperactivity (e.g. sugar, caffeine, artificial food colors, additives)

Pharmaceutical interventions, if other interventions alone are not offering satisfactory improvement:

• Stimulants (e.g. Methylphenidate (Ritalin^®), Amphetamine)
• Non-stimulants (e.g. Atomoxetine)

Naturopathic interventions:

• Phytotherapy
• Homeopathic remedies such as e.g. Kindinorm^®