Infantile colic, characterized by intense nightly crying spells, is a well-known challenge for caregivers. Modern medicine defines infantile colic not as a distinct disease, but as excessive crying lasting more than three hours a day, more than three days a week, for over three weeks, driven by multiple interacting factors.
The primary contributor is an immature digestive system. Newborns are still establishing their gut microbiota, and their digestive enzyme secretion remains limited. Consequently, feeding can lead to incomplete breakdown and intestinal fermentation, producing excess gas that causes abdominal distension and pain. The visceral heat congestion described in the Donguibogam corresponds well to this intestinal fermentation and mild inflammatory response, whereas spleen-stomach deficiency cold aligns with functional dyspepsia and hypomotility of the gastrointestinal tract due to enzyme insufficiency.
The gut-brain axis also plays an important role. The gut and brain communicate bidirectionally through the vagus nerve, meaning abdominal discomfort sends direct stress signals upward. An infant's developing nervous system can amplify these signals, heightening pain sensitivity and triggering crying. Imbalances in neurotransmitters produced in the gut, such as serotonin, can also affect mood and pain tolerance. In addition, ambient stress can influence the gut-brain axis, altering intestinal motility or promoting irritation.
In breastfed infants, maternal diet can impact digestion. Certain compounds from dairy, caffeine, spicy foods, or gas-producing vegetables may pass through breast milk, potentially causing mild allergic reactions or digestive upset. In formula-fed infants, sensitivities to specific proteins should be evaluated. Swallowing air during feeds or feeding too rapidly can also contribute to gas buildup.
Ultimately, infantile colic is a functional syndrome arising from immature digestion, a reactive nervous system, and environmental inputs. Just as the Donguibogam evaluated patterns of heat and cold in the abdomen, modern medicine focuses on the balance between internal physiology and external stimuli.
