Infant colic, characterised by prolonged and unexplained crying in otherwise healthy babies, is a common concern for new parents. Approximately 20–25% of infants experience colic during their first three months of life [1]. Feeding choices—formula vs breastmilk—are often at the centre of the discussion, as parents seek solutions to soothe their colicky baby.
This blog explores the science behind feeding methods and their connection to colic, with a focus on the benefits of breastfeeding vs formula, potential drawbacks, and practical considerations.
Understanding Colic
Colic is generally defined using the “rule of threes”: crying for more than three hours a day, for more than three days a week, over at least three weeks [2]. Although the exact cause remains unclear, several hypotheses exist:
- Gastrointestinal immaturity and sensitivity [3].
- Alterations in gut microbiota [4].
- Food intolerances or allergies, especially cow’s milk protein allergy [5].
- Psychosocial and neurodevelopmental factors.
Since digestion and feeding play major roles, many parents wonder: is it better to breastfeed or formula feed when managing colic?
Breastfeeding and Colic Relief
Why is Breastfeeding Better than Formula?
Breastmilk is widely recommended as the optimal source of infant nutrition [9]. Its unique composition offers several protective benefits:
- Digestibility – Human milk proteins are easier for infants to digest compared to cow’s milk proteins [7].
- Bioactive compounds – Breastmilk contains hormones, enzymes, and anti-inflammatory agents that support gut and immune health.
- Gut microbiota balance – Breastfed infants typically have more Bifidobacterium and Lactobacillus, which may reduce gas and discomfort [8].
- Reduced allergy risk – Exclusive breastfeeding for at least 4–6 months may lower the risk of cow’s milk protein allergy, a trigger for colic-like symptoms [6].
Clinical studies support these benefits. For example, a randomised trial found that supplementation with Lactobacillus reuteri (naturally present in breastmilk) reduced colic crying time compared to simethicone treatment [4].
Formula Feeding and Colic Relief
While breastfeeding is recommended, when possible, formula feeding can still support colic management, especially when tailored options are used.
When Formula May Help
- Hypoallergenic formulas – Hydrolysed protein formulas have been shown to significantly reduce colic symptoms in infants sensitive to intact cow’s milk proteins [1, 5].
- Consistency – Formula is unaffected by maternal diet, which can remove dietary triggers in some cases.
- Feeding control – Parents can precisely measure intake, which may reduce overfeeding and air swallowing.
However, standard cow’s milk-based formula can worsen colic symptoms in sensitive infants. In such cases, paediatricians may recommend extensively hydrolysed or amino-acid-based formulas.
Formula vs Breastmilk: Key Differences for Colic
| Factor |
Breastmilk |
Formula |
| Digestibility |
Easier to digest due to human-specific proteins |
It may be harder to digest, especially cow’s milk protein |
| Gut microbiota |
Promotes beneficial bacteria (Bifidobacteria, Lactobacilli) |
Depends on formula type; may lack natural probiotics |
| Allergy risk |
Lower risk of cow’s milk protein sensitivity |
The standard formula may trigger colic if CMPA is present |
| Adaptability |
Naturally adjusts to the baby’s needs |
Can use hypoallergenic or hydrolysed formulas when needed |
Practical Considerations for Parents
- Breastfeeding: Best first-line option, when possible, due to its digestibility and natural gut support.
- Formula feeding: Specialised formulas may help if colic is linked to cow’s milk protein sensitivity. Parents should consult a paediatrician before switching formulas.
- Combination feeding: Some parents use both, and adjustments can be made based on infant response.
Conclusion
In the debate of formula vs breastmilk, most evidence suggests that breastfeeding is better than formula for overall health and may reduce colic risk due to its natural digestibility and probiotics. However, formula feeding with hypoallergenic options can be equally effective in managing colic for babies with sensitivities.
Ultimately, colic is often multifactorial and resolves naturally by 3–4 months of age. Feeding choice is one part of management, and individualised care under paediatric guidance is essential.
References
- Lucassen, P. L., Assendelft, W. J., Gubbels, J. W., van Eijk, J. T., Douwes, A. C., & van Geldrop, W. J. (2001). Infantile colic: Crying time reduction with a whey hydrolysate: A double-blind, randomized, placebo-controlled trial. Pediatrics, 107(6), e105.
- Wessel, M. A., Cobb, J. C., Jackson, E. B., Harris, G. S., & Detwiler, A. C. (1954). Paroxysmal fussing in infancy, sometimes called colic. Pediatrics, 14(5), 421–435.
- Miller, J. J., McVeagh, P., Fleet, G. H., Petocz, P., & Brand, J. C. (2000). Breath hydrogen excretion in infants with colic. Archives of Disease in Childhood, 83(1), 53–55.
- Savino, F., Pelle, E., Palumeri, E., Oggero, R., Miniero, R. (2005). Lactobacillus reuteri versus simethicone in the treatment of infantile colic: A prospective randomized study. Pediatrics, 119(1), e124–e130.
- Iacovou, M., Ralston, R. A., Muir, J., Walker, K. Z., & Truby, H. (2012). Dietary management of infantile colic: A systematic review. Maternal & Child Nutrition, 8(4), 382–401.
- Kramer, M. S., & Kakuma, R. (2012). Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews, (8).
- Lönnerdal, B. (2003). Nutritional and physiologic significance of human milk proteins. The American Journal of Clinical Nutrition, 77(6), 1537S–1543S.
- Penders, J., Thijs, C., Vink, C., Stelma, F. F., Snijders, B., Kummeling, I., … & Stobberingh, E. E. (2006). Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics, 118(2), 511–521.
- World Health Organization (WHO). (2020). Infant and young child feeding.
