The Effect of Breastfeeding Position on the Treatment of Infantile Colic in Infants

Abstract

Background: Excessive crying in infants can be challenging for both parents and healthcare providers. Colic is defined as crying for more than 3 hours per day for more than 3 days per week. Although colic is generally benign and self-limiting, appropriate parental education, particularly regarding breastfeeding techniques, may be beneficial. Objectives: We hypothesized that the laid-back breastfeeding position would be more effective than the traditional cradle-hold position in reducing the frequency of infantile colic. Methods: This prospective interventional cohort study was conducted among 50 infants who visited the neonatal clinic of Children’s Medical Center Hospital in Tehran from 2021 to 2024. The sample size of 50 participants (25 per group) was calculated based on a power analysis to achieve 80% power at a 5% significance level, with an anticipated 15% dropout rate based on previous literature. All participants were examined by a neonatologist. The inclusion criteria were breastfed infants with infantile colic. The exclusion criteria were prematurity, underlying disorders, and probiotic use. Eligible participants were referred to a midwifery expert for training in breastfeeding positions. Mothers recorded daily colic frequency and breastfeeding position for 1 week, and the data were collected by a blinded pediatric resident. Infants were allocated to a case group of 25 infants whose mothers were trained in the laid-back breastfeeding position and a control group of 25 infants whose mothers were trained in the cradle-hold position. Colic frequency was recorded and compared between groups. To minimize confounding, infants with different demographic characteristics were analyzed separately, and infants with a gestational age of less than 35 weeks or underlying disorders were excluded. Data were analyzed using the independent t-test, chi-square test, and correlation analysis. Quantitative variables were analyzed using the independent t-test, and potential confounders were controlled through strict eligibility criteria. Results: The mean frequency of colic episodes before education was 5.80 days (± 1.32) in the case group and 5.96 days (± 1.17) in the control group. After training in the respective breastfeeding positions, the mean frequency of colic episodes decreased to 4.32 days (± 1.70) in the case group and to 5.60 days (± 1.00) in the control group. This difference was statistically significant (P = 0.003). Conclusions: The laid-back breastfeeding position appears to be more effective than the cradle-hold position in reducing the frequency of infantile colic. Further studies are needed to confirm the effectiveness of this position in managing colic in infants.