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Infant Colic-What works: A Systematic Review of Interventions for Breast-fed Infants.

Published on May 1, 2016in Journal of Pediatric Gastroenterology and Nutrition3.015
· DOI :10.1097/MPG.0000000000001075
Tracy Harb2
Estimated H-index: 2
,
Misa Matsuyama2
Estimated H-index: 2
+ 1 AuthorsRebecca J. Hill15
Estimated H-index: 15
Sources
Abstract
Objectives: To determine the strength of evidence for commonly used interventions for colic in breast-fed and mixed-fed infants younger than 6 months. Methods: Searches of PubMed, CINAHL, Embase, AMED, and Web of Science databases were conducted from July 2014 to July 2015. Included studies were randomised controlled trials involving mothers and their colicky infants younger than 6 months; assessed colic against the Wessel or modified Wessel criteria; and included phytotherapies, prescription medicines, and maternal dietary interventions. Studies with <16 participants were excluded. Meta-analyses were conducted where data were sufficient to enable pooling. Quality was assessed against the Cochrane Risk Bias Assessment Tool. Results: A total of 17 articles met the inclusion criteria for this review. The 6 studies included for subgroup meta-analysis on probiotic treatment, notably Lactobacillus reuteri, demonstrated that probiotics appear an effective treatment, with an overall mean difference in crying time at day 21 of -55.8 min/day (95% CI -64.4 to -47.3, P=0.001). The 3 studies included for subgroup meta-analysis on preparations containing fennel suggest it to be effective, with an overall mean difference of -72.1 min/day (95% CI -126.4 to -17.7, P<0.001). Conclusions: Probiotics, in particular L reuteri, and preparations containing fennel oil appear effective for reducing colic, although there are limitations to these findings. The evidence for maternal dietary manipulation, lactase, sucrose, glucose, and simethicone is weak. Further well-designed clinical trials are required to strengthen the evidence for all of these interventions.
  • References (57)
  • Citations (40)
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References57
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#1Guo-Lin Mi (SDU: Shandong University)H-Index: 1
#2Lei Zhao (Boston Children's Hospital)H-Index: 1
Last. Jin-Ke Xu (CDC: Centers for Disease Control and Prevention)H-Index: 1
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Infant colic, excessive crying of unknown cause, is a major burden to families and effects about 10–30 % of infants. Despite decades of research, the exact cause and treatment of infant colic has remained elusive. The use of Lactobacillus reuteri (DSM 17938) in infant colic is somewhat controversial and hence, we designed this study to evaluate its efficacy in infantile colic. We recruited predominantly or exclusively breastfed infants, aged less than 4 months in a placebo controlled observation...
35 CitationsSource
#1Kim Chau (U of T: University of Toronto)H-Index: 3
#2Eddy Lau (U of T: University of Toronto)H-Index: 2
Last. Gideon KorenH-Index: 79
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Objective To investigate the effectiveness of Lactobacillus reuteri DSM 17938 for the treatment of infantile colic in breastfed Canadian infants, compared with placebo. Study design A randomized, double-blind, placebo-controlled trial was conducted involving 52 infants with colic, according to modified Wessel criteria, who were assigned at random to receive L reuteri DSM 17938 (10 8 colony-forming units) (n = 24) or placebo (n = 28) for 21 days. Daily crying and fussing times were recorded in a ...
68 CitationsSource
#1Hamidreza Kianifar (MUMS: Mashhad University of Medical Sciences)H-Index: 10
#2Hamid Ahanchian (Children's Medical Research Institute)H-Index: 11
Last. Mohammad Ali Kiani (MUMS: Mashhad University of Medical Sciences)H-Index: 14
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Aim: Infant colic is a frequent problem affecting up to 10–30% of infants in first 3 months of life. Results from previous trials have shown that manipulation of gut microbiota can lead to symptomatic improvements. In a randomised clinical trial, we aimed to determine efficacy of synbiotic in reducing average infant crying time at day 7 and day 30 after starting intervention. Methods: Fifty breastfed infants aged 15–120 days with infantile colic randomly assigned to receive either the synbiotic ...
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#1Francesco Savino (UNITO: University of Turin)H-Index: 31
#2Simone Ceratto (UNITO: University of Turin)H-Index: 3
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Infantile colic is a common disturbance occurring in the first three months of life. It is a benign condition and one of the main causes of pediatric consultation in the early part of life because of its great impact on family life. Some pediatricians are prone to undervalue this issue mainly because of the lack of evidence based medicine guidelines. Up to now, there is no consensus concerning management and treatment. Literature reports growing evidence about the effectiveness of dietary, pharm...
33 CitationsSource
#1Magdalena Urbańska (Medical University of Warsaw)H-Index: 6
#2Hania Szajewska (Medical University of Warsaw)H-Index: 67
We aimed to systematically evaluate evidence on the effectiveness of Lactobacillus reuteri DSM 17938 (L. reuteri) for treating and preventing diseases in infants and children. MEDLINE and the Cochrane Library were searched in December 2013, with no language restrictions, for relevant randomized controlled trials (RCTs) and meta-analyses. The search was updated in April 2014. One systematic review and 14 RCTs met the inclusion criteria. The use of L. reuteri may be considered in the management of...
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#1Sung (University of Melbourne)H-Index: 1
#2Harriet Hiscock (University of Melbourne)H-Index: 34
Last. Melissa Wake (University of Melbourne)H-Index: 59
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Objective To determine whether the probiotic Lactobacillus reuteri DSM 17938 reduces crying or fussing in a broad community based sample of breastfed infants and formula fed infants with colic aged less than 3 months. Design Double blind, placebo controlled randomised trial. Setting Community based sample (primary and secondary level care centres) in Melbourne, Australia. Participants 167 breastfed infants or formula fed infants aged less than 3 months meeting Wessel’s criteria for crying or fus...
123 CitationsSource
#1Valerie Sung (University of Melbourne)H-Index: 8
#2Sarsha Maree Collett (Monash University)H-Index: 1
Last. Melissa Wake (University of Melbourne)H-Index: 59
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Importance Excessive infant crying is common, distressing, but without proven effective prevention or management options. Probiotics may be a promising solution. Objective To examine whether probiotics are effective in the prevention/management of crying (“colic”) in infants 3 months or younger. Data Sources A systematic search of MEDLINE, EMBASE, and the Cochrane Library, supplemented by the metaRegister of Controlled Trials. Study Selection Studies that randomized infants 3 months or younger t...
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#1Hania Szajewska (Medical University of Warsaw)H-Index: 67
#2Ewa Gyrczuk (Medical University of Warsaw)H-Index: 1
Last. Andrea Horvath (Medical University of Warsaw)H-Index: 19
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Objective To determine whether administration of Lactobacillus reuteri ( L reuteri ) DSM 17938 is beneficial in breastfed infants with infantile colic. Study design Eighty infants aged 50%) breastfed were randomly assigned to receive L reuteri DSM 17938 (10 8 colony-forming units) (n = 40) or an identically appearing and tasting placebo (n = 40), both orally, in 5 drops, 1 time daily, for 21 days. The primary outcome measures were the treatment success, defined as the percentage of children achi...
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The article presents data on the prevalence of infant colic, etiological factors, diagnostic criteria, differential diagnosis and therapy with justification of approaches to the choice of formula in children on artificial feeding. When choosing a formula, it is necessary to take into account the compositional features aimed at overcoming the functional immaturity of the gastrointestinal tract, enteric nervous system, and the ongoing formation of the intestinal microbiome – the presence of a part...
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Infantile colic is a distressing condition characterised by excessive crying in the first few months of life. The aim of this research was to update the synthesis of evidence of complementary and alternative medicine (CAM) research literature on infantile colic and establish what evidence is currently available. Medline, Embase and AMED (via Ovid), Web of Science and Central via Cochrane library were searched from their inception to September 2018. Google Scholar and OpenGrey were searched for g...
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Abstract Objectives Infantile colic is a common benign disease occurring in early infancy that may have a great impact on family life. In the present study, the effectiveness and safety of the complex homeopathic medicine Enterokind was compared with Simethicone for treating infantile colic. Design and setting Current data were drawn from a prospective, multicenter, randomized, open-label, controlled clinical trial that was conducted in 2009 in 3 Russian outpatient clinics. Children received eit...
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Summary The gastrointestinal microbiome is a hot topic in clinical research. Beneficial effects of selected probiotics in the prevention of gastrointestinal disorders are mainly restricted to acute gastroenteritis, antibiotic-associated diarrhoea, infantile colic, and necrotising enterocolitis. However, no broad consensus exists to recommend the use of probiotics in the prevention of these conditions, mainly because of the different design of the studies done so far, resulting in little evidence...
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