Potential Relationship Between Infant Colic and Migraine
This year’s annual scientific meeting for the American Headache Society occurred in Los Angeles, California on June 26-29, 2014. Among the plethora of exciting research presented was an interesting meta-analysis of several studies on infant colic and early migraine conducted by Dr. Amy Gelfand.1
Per the ICHD-III beta guidelines, colic refers to recurrent episodes of irritability, fussing, or crying. Episodes of colic must last at least 3 hours per day and occur on 3 or more days per week for 3 or more weeks. Colic peaks at 6 to 8 weeks of age and typically resolves by 4 months. A baby with colic can be extremely stressful for parents; according to research cited by Gelfand, 2.2% of parents with 1-month old babies admitted to shaking, slapping, or smothering their child to try to stop him/her from crying, and this actually increased to 5.6% by the time the infant reached 6 months of age. A better understanding of colic and how to treat it is critical.
The underlying cause of infant colic is not fully understood, yet most tend to focus on gastrointestinal (GI) issues. Unfortunately, the body of evidence for the link between GI issues and colic is not convincing. Some speculate that colic may be related to feeding, but research has shown that there is no difference in the incidence of colic between breast milk-fed and formula-fed babies. There is also no strong evidence that lactose intolerance is related to colic incidence, although an allergy to cow’s milk protein may play a role in a certain subset of infants.
In the primary analysis, Gelfand included 3 studies (with a total of 891 study participants). One of the studies included in the meta-analysis was actually conducted by Dr. Gelfand, and results indicated that infants whose mothers had migraines were 2.6 times more likely to have colic. For the meta-analysis, a pooled random effects model indicated a strong association between the infantile colic and migraine (the odds ratio was 5.6 [95% CI, 3.3-9.5; P=0.004]). Gelfand conducted a secondary analysis that added the results from 2 more studies (for a total of 1984 participants), and the association between infantile colic and migraine was also evident (OR 3.2; 95% CI, 1.4-7.5; P=0.007).
In a comment regarding this analysis, Dr. Peter Goadsby noted, “Holding the baby doesn't require [US Food and Drug Administration] approval, and acetaminophen is a regular sort of medicine, so you can start to look at simple, cheap, globally useful things that could be done everywhere tomorrow. If that reduces even by a small amount the number of kids who have a problem like this, I'm happy with that."
Further studies should be conducted to examine the relationship between infantile colic and migraine, as this may provide additional information for physicians and parents in the treatment of infants with colic.
Do you have any experience with an infant with colic? What are your thoughts on this latest research? Please share with us in the comments!
How much has your migraine disease changed or evolved over time?