History and exam

Key diagnostic factors

common

presence of risk factors

Key risk factors include age <5 months, food sensitivity, exposure to cigarette smoke, lack of breastfeeding, and parental psychosocial factors.

generally well and thriving

Physical examination should confirm the general well-being of an infant with infantile colic. Otherwise, the inconsolable crying may be due to an organic cause. Poor growth suggests the possibility of an underlying infection.

Other diagnostic factors

common

normal urine

Foul-smelling urine suggests a urinary tract infection.

absence of recurrent vomiting

Recurrent vomiting suggests intestinal obstruction, gastro-oesophageal reflux, or recurrent gastroenteritis.

absence of diarrhoea

Prolonged diarrhoea may suggest intractable diarrhoea of infancy, coeliac disease, or cystic fibrosis.

normal temperature

Fever indicates an underlying infection.

absence of abdominal distension

Indicates intestinal obstruction or malabsorption.

normal tympanic membrane

Bulging, hyperaemic tympanic membrane suggests otitis media.

absence of signs of physical trauma

Traumatic injury to the child is an alternative cause of irritability.

Risk factors

strong

infants <5 months of age

Occurs mainly in infants in the first few weeks of life and ends by 4-5 months of age.[2]​[21][25]​​

food sensitivity

There is some evidence that cow's milk proteins may play a role in the pathogenesis of infantile colic.[11][12]

Maternal ingestion of eggs, chocolate, citrus fruits, and certain seafood while breastfeeding may also result in infantile colic.[13]

exposure to cigarette smoke

The prevalence of colic is approximately doubled among infants of smoking mothers.[14][15][16]

lack of breastfeeding

Breastfed infants are less likely to have infantile colic.[17][18]

parental psychosocial factors

There is an association between the incidence of infantile colic and psychological factors in the parents, such as stressful pregnancies, postpartum depression, parental anxiety, dissatisfaction with the sexual relationship, and negative experiences during childbirth, as well as poor parental skills.[5][16][19][20]

weak

increased parental age

A correlation has been observed between infantile colic and increased parental age.[4] This may reflect a higher frequency of reporting or a lower level of tolerance of the symptoms.[21]

high level of parental education

A correlation has been observed between infantile colic and a high level of parental education.[4] This may reflect a higher frequency of reporting or a lower level of tolerance of the symptoms.[21]

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