Study Clarifies Why Most Colic Isn’t Caused By Cow’s Milk Allergy

New grounds shows that colic is usually a benign gut–brain relationship disorder, and only infants pinch further allergic symptoms should acquisition a system cow’s-milk elimination and reintroduction trial.

Study: Infantile Colic: When to Suspect Cow’s Milk Allergy. Image Credit: Jirapong Manustrong / Shutterstock

In a caller reappraisal published successful nan journal Nutrients, researchers evaluated existing grounds connected whether cow’s beverage allergy (CMA) contributes to babe colic and examined erstwhile CMA should beryllium suspected successful infants pinch excessive crying.

They concluded that CMA is improbable to origin colic successful different patient infants without different allergic symptoms. However, erstwhile modular colic guidance fails and allergic signs are present, a short diagnostic elimination fare followed by reintroduction whitethorn thief corroborate CMA, and better-designed tests are urgently needed.

Concerns complete Infant Colic

Infantile colic affects 20–30% of infants worldwide and is characterized by periods of excessive, unexplained crying successful nan first fewer months of life. Although crying is simply a normal shape of communication, immoderate infants outcry much intensely aliases much frequently, causing distress for caregivers and, successful uncommon instances, expanding nan consequence of parental frustration.

Cultural and socioeconomic factors power what caregivers see “excessive,” and parental worry tin perpetuate crying done a feedback cycle. Importantly, galore studies do not intelligibly separate normal crying from crying caused by underlying aesculapian conditions, which must beryllium ruled retired earlier diagnosing colic.

CMA is comparatively communal successful infancy, though its existent prevalence varies depending connected diagnostic methods. Previous guidelines person concisely touched connected whether colic whitethorn service arsenic a denotation of non-immunoglobulin-E (IgE)-mediated CMA, but nan narration remains debated.

To reside this, nan authors searched 3 aesculapian databases done June 2025 for English-language studies connected cow’s beverage allergy and babe colic, yet identifying 135 papers, including 18 objective tests evaluating cow’s beverage elimination diets.

Recommended guidance successful infantile colic.

Features of Colic

Infantile colic is now classified arsenic a upset of gut–brain interaction, reflecting its analyzable and multifactorial nature. Historically attributed to intestinal gas, colic is characterized by excessive crying accompanied by behaviors specified arsenic limb flexion, backmost arching, and abdominal distension.

The updated Rome IV criteria specify colic arsenic repeated episodes of unexplained crying aliases irritability successful different patient infants nether 5 months old. Earlier duration-based thresholds were removed owed to their arbitrary nature, and position for illustration “paroxysmal” were eliminated because crying patterns do not reliably disagree from normal babe crying.

The reappraisal further highlights that galore infants do not coming pinch isolated colic but alternatively acquisition colic arsenic portion of broader clusters of symptoms of disorder-of-gut–brain-interaction.

Possible Causes of Colic

Evidence points to a operation of gastrointestinal and non-gastrointestinal factors. Non-gastrointestinal contributors see suboptimal feeding practices, parent–infant relationship issues, neurodevelopmental immaturity, and biology exposures specified arsenic maternal smoking.

Gastrointestinal explanations see motility disturbances, visceral hypersensitivity, gut dysbiosis, and some IgE- and non-IgE-mediated nutrient allergies, particularly CMA. Some hormonal differences, specified arsenic elevated motilin and ghrelin, propose that transient neural–gut dysregulation whitethorn origin hyperperistalsis.

Microbiota studies consistently show that infants pinch colic person reduced Bifidobacteria and Lactobacillus and accrued Enterobacteriaceae, perchance contributing to state formation, inflammation, and discomfort. Lactose intolerance has besides been proposed, fixed higher intestinal hydrogen accumulation successful immoderate colicky infants, though astir word infants nutrient capable lactase.

However, nan reappraisal emphasises that lactase drops and lactose-reduced formulas are not routinely recommended, arsenic nan supporting grounds is inconsistent and insufficient for cosmopolitan use.

Long Term Outcomes

Although colic typically resolves by 4–5 months, it tin importantly impact families. Long-term follow-up studies propose mixed associations pinch later outcomes. Some cohorts recovered nary accrued consequence of asthma aliases wheezing, while others reported higher rates of eczema, allergic rhinitis, and nutrient allergy successful children pinch a history of colic.

Concurrent atopic conditions besides look much communal successful immoderate populations. Colic terrible capable to require hospitalization has been linked to later intelligence wellness concerns, though inconsistently.

Relationship Between Colic and CMA

CMAs coming crossed a wide objective spectrum, making test challenging. IgE-mediated allergy tin beryllium supported by tegument prick tests aliases circumstantial IgE levels, but confirmation still requires an elimination fare followed by an oral nutrient challenge. Non-IgE-mediated CMA lacks reliable laboratory markers, truthful test relies connected denotation patterns and consequence to dietary elimination pinch planned reintroduction.

Because colic and CMA stock overlapping symptoms specified arsenic abdominal discomfort, regurgitation, and distressed crying, CMA is often considered successful infants pinch persistent colic. However, galore early studies suggesting a beardown nexus were constricted by anemic design, deficiency of controlled challenges, and retrospective reporting.

More caller grounds indicates that colic unsocial is seldom nan only manifestation of CMA. Breastfeeding studies person not consistently supported a nexus betwixt maternal dairy intake and colic, and ample cohort information show akin colic rates crossed feeding methods.

The authors besides be aware clinicians to debar overdiagnosing CMA, noting that relying connected azygous symptoms, including crying, tin lead to unnecessary elimination diets.

Conclusions

Infant colic is fundamentally a benign upset of gut–brain interaction, and crying patterns dangle heavy connected caregiver cognition and reporting. Most infants amended pinch wide soothing strategies, and regular usage of anti-reflux medications, lactase drops, aliases lactose-restricted formulas is not recommended erstwhile crying is nan only symptom.

CMA plays an uncertain domiciled successful colic but whitethorn beryllium considered erstwhile persistent crying occurs alongside different allergic features. In specified cases, a short, system elimination fare followed by reintroduction is basal for confirmation.

The reappraisal underscores that soy look is not recommended for colic, arsenic supporting grounds for use is lacking.

Additionally, definite probiotics, peculiarly Limosilactobacillus reuteri DSM 17938 and Bifidobacterium animalis BB-12, person demonstrated use successful breastfed infants and correspond nan strains pinch nan strongest supporting evidence.

More rigorous objective tests are needed to explain nan roles of CMA, lactose, and microbiota successful colic.