15. Infantile Colic and Food Allergy

  1. Dean D. Metcalfe MD4,
  2. Hugh A. Sampson MD5,
  3. Ronald A. Simon MD6,7 and
  4. Gideon Lack MBBCh (Oxon), MA (Oxon), FRCPCH8
  1. Ralf G. Heine1,2,3 and
  2. David J. Hill2

Published Online: 24 FEB 2014

DOI: 10.1002/9781118744185.ch15

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

How to Cite

Heine, R. G. and Hill, D. J. (2013) Infantile Colic and Food Allergy, in Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition (eds D. D. Metcalfe, H. A. Sampson, R. A. Simon and G. Lack), John Wiley & Sons Ltd, Chichester, UK. doi: 10.1002/9781118744185.ch15

Editor Information

  1. 4

    Chief, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

  2. 5

    Kurt Hirschhorn Professor of Pediatrics, Dean for Translational Biomedical Sciences, Director, Jaffe Food Allergy Institute Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

  3. 6

    Head, Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA

  4. 7

    Adjunct Professor, Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, CA, USA

  5. 8

    Professor of Paediatric Allergy, King's College London Clinical Lead for Allergy Service, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK

Author Information

  1. 1

    Department of Allergy & Immunology, Royal Children's Hospital, Melbourne, Australia

  2. 2

    Murdoch Childrens Research Institute, Melbourne, Australia

  3. 3

    Department of Paediatrics, The University of Melbourne, Melbourne, Australia

Publication History

  1. Published Online: 24 FEB 2014
  2. Published Print: 10 DEC 2013

ISBN Information

Print ISBN: 9780470672556

Online ISBN: 9781118744185



  • infantile colic;
  • persistent crying;
  • intestinal microbiota;
  • probiotics;
  • non-IgE-mediated food allergy;
  • elimination diet


The term “infantile colic” describes episodes of paroxysmal, unexplained crying and fussing in otherwise healthy infants. Colic symptoms typically start in the first weeks of life and gradually resolve at around 4–5 months of age. Although the etiology of colic is multifactorial, there is increasing evidence linking this condition to food allergy. If colic symptoms are severe, or if symptoms fail to improve beyond 4 months of age, a trial of a hypoallergenic elimination diet may be indicated. In breast-fed infants, elimination of cow's milk and other food proteins from the maternal diet was associated with a greater reduction in cry/fuss duration, compared with untreated infants. Nutritional progress and growth need to be carefully monitored during the elimination diet, and the diet normalized as soon as tolerated. Treatment of formula-fed infants with extensively hydrolyzed formula was also associated with reduced crying in several clinical trials. By contrast, lactose-free formula did not affect crying duration. These studies suggest that infantile colic is part of the extended spectrum of non-IgE-mediated food allergy, while colic is not associated with lactose malabsorption. Two recent randomized, placebo-controlled trials on the effect of probiotic supplementation with Lactobacillus reuteri have demonstrated a significant reduction in crying duration in young infants with colic. However, the role of specific probiotics in the treatment of infantile colic requires further study.