Gastrointestinal consequences of cesarean section birth: A systematic review of short- and long-term effects in infancy and beyond

Table 4 Key modifiers of effects of cesarean section and delivery on infant colic identified across studies

Modifier	Effect on infant colic
Cesarean section delivery	Consistently associated with a higher risk of colic across most studies
Neonatal antibiotic use	Associated with increased gut dysbiosis, leading to higher colic risk
Feeding type	Formula feeding and a lack of exclusive breastfeeding increased the risk
Maternal psychological status	Maternal postpartum depression and insecure attachment increased colic incidence
Prematurity	Associated with a higher prevalence of IC and other FGIDs
Probiotics	Mixed results—some studies suggest probiotics may worsen symptoms like constipation

Clinical Pearls 1: Infantile colic is more common in Cesarean-delivered infants, likely due to early gut microbiota disruption. Factors such as formula feeding, antibiotic exposure, and maternal stress increase risk. Colic severity often peaks around 6-12 weeks and may be associated with increased gut inflammation. Promoting breastfeeding and judicious use of antibiotics are key modifiable strategies to reduce colic risk in cesarean section-born infants. FGID: Functional gastrointestinal disorder; IC: Infant colic.