---
title: "Infant colic"
url: "https://acuiq.com/wiki/evidence/infant-colic"
updated: 2026-10-11
last_verified: 2026-10-11
license: CC-BY-4.0
license_url: "https://creativecommons.org/licenses/by/4.0/"
section: "evidence"
basis: "Modern research"
audience: "Anyone"
published: "2026-10-11"
reading_minutes: 9
sources: 12
---

# Infant colic

_What four Scandinavian trials, an individual-patient-data meta-analysis, later reviews and NICE's colic summary report on acupuncture for babies with colic._

Infant colic is long, inconsolable crying in a baby who is otherwise well and growing. NICE’s [Clinical Knowledge Summary on infantile colic](https://cks.nice.org.uk/topics/colic-infantile/) defines it by crying, fussing or irritability that starts and stops before 5 months of age, has no obvious cause and cannot be prevented or settled by the carers, and calls it self-limiting. Four controlled trials of acupuncture for it exist, all from Sweden and Norway, all comparing a few seconds of needling with no needling while the parents, who recorded the crying, were kept from knowing which their baby had. A [2018 individual-patient-data meta-analysis](https://doi.org/10.1080/02813432.2018.1426146), which pooled the raw records of each infant rather than each trial’s summary figures, is the main synthesis. A Cochrane review is under way and has published only its protocol.

## How the trials were run

None of the trials used a sham needle. In each, a nurse or doctor carried the baby to a separate room, needled or did not needle according to the allocation, and handed the baby back; the parents kept a crying diary throughout. The comparison is therefore acupuncture against no acupuncture, with the parents blinded rather than the infant. Whether the parents stayed blinded was measured, and it decides how far the diaries can be trusted: a parent who guesses that their baby was needled may record crying differently. [Sham acupuncture](/wiki/research/sham-acupuncture) explains the designs that try to separate needling from everything around it.

The needling was light. Most trials used [`LI04`](/points/LI04) (Hegu), on the back of the hand, or [`ST36`](/points/ST36) (Zusanli), below the knee, for seconds at a time, with no further stimulation of the needle.

## The trials

| Trial | Infants and setting | Needling | Main finding on crying |
| --- | --- | --- | --- |
| [Reinthal et al. 2008](https://doi.org/10.1136/aim.26.3.171) | 40 infants recruited from 21 child welfare clinics in western Sweden; quasi-randomised | `LI04` on both hands for about 20 seconds, four times | Parent-rated crying intensity fell more with needling |
| [Landgren et al. 2010](https://doi.org/10.1136/aim.2010.002394) | 90 infants aged 2 to 8 weeks randomised at a private acupuncture clinic in Sweden; 81 completed | `LI04` on one hand for 2 seconds, six visits over 3 weeks | Less fussing and total crying in the first two weeks with needling |
| [Skjeie et al. 2013](https://doi.org/10.3109/02813432.2013.862915) | 90 infants randomised at 13 general practices in southern Norway | `ST36` on both legs, on 3 days | No statistically significant or clinically relevant difference |
| [ACU-COL, Landgren and Hallström 2017](https://doi.org/10.1136/acupmed-2016-011208) | 147 infants at public child health centres in Sweden, in three arms | `LI04` alone, or an individualised choice of `LI04`, `ST36` and Sifeng; twice a week for 2 weeks | Some crying measures favoured acupuncture; the change in total crying did not reach significance |

Reinthal and colleagues allocated infants by a method short of true randomisation. The 2018 meta-analysis excluded the trial for that reason and notes that its two groups differed substantially at the start, a difference the analysis did not adjust for.

Kajsa Landgren and colleagues ran the 2010 trial in a private Swedish clinic that had offered acupuncture to infants with colic for 15 years. The acupuncture group moved out of the colic criteria sooner, and the authors called for research on other points, needle techniques and treatment intervals.

Holgeir Skjeie and colleagues in Norway chose `ST36` because Norwegian medical acupuncture courses teach it for colic. Their protocol set one hour of crying a day as the smallest difference that would matter. They found a 13-minute difference in favour of acupuncture (95% CI −24 to 51 minutes), which was not statistically significant, and checked that parents could not tell which group their baby was in. The authors suggested that acupuncture for infant colic be restricted to clinical trials.

ACU-COL was the largest trial. Every family had usual care plus four extra visits with advice and support, and the infants were randomised to standardised needling at `LI04`, to a semi-standardised choice of up to five insertions at `LI04`, `ST36` and Sifeng, or to no needling. Sifeng is a set of four points on the palm side of the fingers, coded [`XU10A`](/points/XU10A) to `XU10D` in the catalogue. Nurses experienced in acupuncture did the needling. At the end of the second week, 38% of the infants given either type of acupuncture still met the colic criteria, against 65% of those given none. The relative fall in total crying from the baseline week to the second week was larger with acupuncture but did not reach statistical significance (p=0.068), while some sub-measures did. Recruitment stopped early, when acupuncture became available to families outside the trial; the trial had planned for 192 infants. In the acupuncture groups, the share of parents who correctly guessed their baby had been needled rose from 45% to 72% over the visits. A [2021 secondary analysis](https://doi.org/10.1177/0964528420920308) found no difference between groups in diary records of stooling, feeding or sleep, although more parents in the acupuncture groups reported that these had changed.

## The reviews

The 2018 meta-analysis, by Skjeie and colleagues with Landgren among its authors, searched English and Chinese databases to February 2017. It found three eligible randomised trials, the 2010, 2013 and 2017 trials above, with 307 infants, and obtained each infant’s data. It set 30 minutes of crying a day as the smallest important difference. Against no acupuncture, crying time was 25 minutes a day lower at mid-treatment (95% CI 4 to 46), 11 minutes lower at the end of treatment and 12 minutes lower at one month in the one trial that followed up, the last two not statistically significant. The mid-treatment difference disappeared when the 2010 trial, in which the parents appeared to know the allocation, was left out. Only the Norwegian trial kept the parents blinded in both groups. The authors rated the evidence on crying time moderate under GRADE, the standard system for rating how far a body of evidence can be trusted, and low for the single trial’s one-month result. Parents of needled infants were more likely to rate the colic as much improved. The authors concluded that needle acupuncture should not be recommended for infant colic on a general basis.

A [2018 review](https://doi.org/10.1155/2018/7526234) by Lee and colleagues searched to January 2017 and included four trials with 357 infants, the three above and the quasi-randomised Swedish one. It judged the trials too different to pool, found most at low risk of bias except in blinding of the people assessing outcomes, and concluded that there was no conclusive evidence on the safety and efficacy of acupuncture for infant colic.

A [2019 overview](https://doi.org/10.1186/s13643-019-1191-5) by Perry and colleagues assessed 16 systematic reviews of complementary therapies for infant colic, searched to September 2018. The 2018 meta-analysis was the only acupuncture review; the overview rated it at low risk of bias on most domains of ROBIS, a tool for judging bias in reviews, but low confidence overall on AMSTAR-2, a checklist for how well a review was conducted, and pointed out that its authors had assessed their own trials. A [2020 review](https://doi.org/10.1111/apa.15247) by Hjern and colleagues, of trials published from 2007 to 2017 with at least 20 infants in each group, found four acupuncture trials, all with no or minimal effect on crying duration, and its authors concluded that acupuncture is not an effective treatment for infant colic.

Cochrane Sweden’s [review protocol](https://doi.org/10.1002/14651858.CD016305), by Lööf and colleagues, was published in October 2025. It plans to include needle and non-needle methods such as laser and acupressure, and to keep its comparisons separate: acupuncture against no treatment, sham or advisory support; against other treatments such as probiotics or spinal manipulation; and one form of acupuncture against another. It has no results yet.

## What the trials recorded of harms

No trial reported a serious adverse event. In the 2010 trial, one of 256 needlings drew a single drop of blood. During the visits, 74% of needled infants cried for more than 10 seconds at least once, against 37% of infants who were carried to the room and not needled; no infant cried for more than 2 minutes. In ACU-COL, the infants did not cry at 200 of 388 treatments, cried for up to a minute at 157 and for longer at 31, a mean of 2.7 minutes. The acupuncturists recorded a single drop of blood on 15 occasions, one parent saw a drop of blood on clothing and one saw a mark on a hand. The 2018 meta-analysis lists two possible events after needling in the Norwegian trial, hiccups and more regurgitation, and eight events among the infants not needled. Reinthal and colleagues noted no side effects.

The meta-analysis authors raise a further point: needling hurts some infants, and an infant cannot consent. [Acupuncture for children](/wiki/safety/acupuncture-for-children) sets out what reviews have counted of adverse events in children generally.

## What guidelines say

NICE’s Clinical Knowledge Summary on infantile colic, last revised in December 2022 and current, bases its [management advice](https://cks.nice.org.uk/topics/colic-infantile/management/management/) mainly on NICE’s postnatal care guideline and Cochrane reviews. It advises information, support and reassurance for parents, and lists treatments not to recommend: simeticone or lactase drops, changes to the mother’s diet or the formula, probiotic and herbal supplements, and spinal manipulation or cranial osteopathy. Acupuncture does not appear in it. [Clinical guidelines](/wiki/evidence/clinical-guidelines) sets out other bodies’ positions on acupuncture.

## What the reviews could not settle

The trials compare needling with no needling, so they cannot separate an effect of the needle from the extra handling and attention; the infant is not the one blinded, and in two of the three randomised trials some parents worked out the allocation. Colic resolves on its own, crying fell steeply in treated and untreated groups alike in the trials Hjern and colleagues read, and the pooled differences fell short of the 30 minutes a day the meta-analysis set as the smallest that would matter. Only one trial followed infants up after treatment ended. All the trials come from Sweden and Norway and used a few points with very light needling, so the reviews could not say anything about other styles. The Cochrane review, once complete, would be the first to rate non-needle methods alongside needling.

AcuiQ’s [infant colic](/symptoms/infant-colic) and [excessive crying](/symptoms/crying-excessive) pages list the protocols individual studies prescribed, each with its citation. [Reading a protocol](/wiki/method/reading-a-protocol) explains each field of an entry.

### Sources

1. Skjeie H, Skonnord T, Brekke M, Klovning A, Fetveit A, Landgren K, Hallström IK, Brurberg KG, Acupuncture treatments for infantile colic: a systematic review and individual patient data meta-analysis of blinding test validated randomised controlled trials, Scandinavian Journal of Primary Health Care 2018;36:56-69 — https://doi.org/10.1080/02813432.2018.1426146
2. Lööf E, Skogman BH, Cabano R, Sylvan R, Bruschettini M, Acupuncture for the treatment of infantile colic (protocol), Cochrane Database of Systematic Reviews 2025 — https://doi.org/10.1002/14651858.CD016305
3. Lee D, Lee H, Kim J, Kim T, Sung S, Leem J, Kim TH, Acupuncture for infantile colic: a systematic review of randomised controlled trials, Evidence-Based Complementary and Alternative Medicine 2018;2018:7526234 — https://doi.org/10.1155/2018/7526234
4. Perry R, Leach V, Penfold C, Davies P, An overview of systematic reviews of complementary and alternative therapies for infantile colic, Systematic Reviews 2019;8:271 — https://doi.org/10.1186/s13643-019-1191-5
5. Hjern A, Lindblom K, Reuter A, Silfverdal SA, A systematic review of prevention and treatment of infantile colic, Acta Paediatrica 2020;109:1733-44 — https://doi.org/10.1111/apa.15247
6. Reinthal M, Andersson S, Gustafsson M, Plos K, Lund I, Lundeberg T, Rosén KG, Effects of minimal acupuncture in children with infantile colic: a prospective, quasi-randomised single blind controlled trial, Acupuncture in Medicine 2008;26:171-82 — https://doi.org/10.1136/aim.26.3.171
7. Landgren K, Kvorning N, Hallström I, Acupuncture reduces crying in infants with infantile colic: a randomised, controlled, blind clinical study, Acupuncture in Medicine 2010;28:174-9 — https://doi.org/10.1136/aim.2010.002394
8. Skjeie H, Skonnord T, Fetveit A, Brekke M, Acupuncture for infantile colic: a blinding-validated, randomized controlled multicentre trial in general practice, Scandinavian Journal of Primary Health Care 2013;31:190-6 — https://doi.org/10.3109/02813432.2013.862915
9. Landgren K, Hallström I, Effect of minimal acupuncture for infantile colic: a multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL), Acupuncture in Medicine 2017;35:171-9 — https://doi.org/10.1136/acupmed-2016-011208
10. Landgren K, Hallström I, Tiberg I, The effect of two types of minimal acupuncture on stooling, sleeping and feeding in infants with colic: secondary analysis of a multicentre RCT in Sweden (ACU-COL), Acupuncture in Medicine 2021;39:106-15 — https://doi.org/10.1177/0964528420920308
11. NICE Clinical Knowledge Summaries, Colic: infantile, National Institute for Health and Care Excellence, last revised December 2022 — https://cks.nice.org.uk/topics/colic-infantile/
12. NICE Clinical Knowledge Summaries, Colic: infantile, Scenario: management, National Institute for Health and Care Excellence, last revised December 2022 — https://cks.nice.org.uk/topics/colic-infantile/management/management/