Excessive crying in infants

Abstract

Objective: Review the literature on excessive crying in young infants, also known as infantile colic, and its effects on family dynamics, its pathophysiology, and new treatment interventions. Data source: The literature review was carried out in the Medline, PsycINFO, LILACS, SciELO, and Cochrane Library databases, using the terms ''excessive crying,'' and ''infantile colic,'' as well technical books and technical reports on child development, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years. Summary of the findings: Excessive crying is a common symptom in the first 3 months of life and leads to approximately 20% of pediatric consultations. Different prevalence rates of excessive crying have been reported, ranging from 14% to approximately 30% in infants up to 3 months of age. There is evidence linking excessive crying early in life with adaptive problems in the preschool period, as well as with early weaning, maternal anxiety and depression, attention deficit hyperactivity disorder, and other behavioral problems. Several pathophysio-logical mechanisms can explain these symptoms, such as circadian rhythm alterations, central nervous system immaturity, and alterations in the intestinal microbiota. Several treatment alternatives have been described, including behavioral measures, manipulation techniques, use of medication, and acupuncture, with controversial results and effectiveness. Conclusion: Excessive crying in the early months is a prevalent symptom; the pediatrician's attention is necessary to understand and adequately manage the problem and offer support to exhausted parents. The prescription of drugs of questionable action and with potential side effects is not a recommended treatment, except in extreme situations. The effectiveness of dietary treatments and use of probiotics still require confirmation. There is incomplete evidence regarding alternative treatments such as manipulation techniques, acupuncture, and use of the herbal supplements and behavioral interventions. Choro excessivo; Lactente; Ritmo circadiano; Cólicas do lactente Choro excessivo do lactente Resumo Objetivo: Revisar a literatura sobre choro excessivo em bebês pequenos, cólicas infantis, e suas repercussões na família e a fisiopatologia e estratégias de tratamentos. Fonte dos dados: Revisadas as principais bases de dados, Medline, PsycINFO, LILACS e SciELO e Cochrane Library utilizando ''choro excessivo do lactente'' e ''cólicas do lactente''. Foram selecionadas as publicações mais relevantes com ênfase nos últimos cinco anos. Síntese dos dados: É um sintoma comum nos primeiros meses de vida e é motivo de cerca de 20% das consultas pediátricas. As prevalências de choro excessivo variam de 14 a 30% nestes lactentes. Existem evidências ligando o choro excessivo nos primeiros meses de vida com prob-lemas futuros bem como ao desmame precoce, ansiedade, depressão materna, TDAH e outros problemas comportamentais. Distintos mecanismos fisiopatológicos podem explicar esse...

Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines

“…The natural history of infantile colic is favourable with symptoms gradually disappearing by the time the infant is 4 months old 9. However, the impact of excessive infant crying on healthcare services is the most common reason for paediatric consultations and hospital emergency department visits in the first weeks of life 10. The consequences of having an excessively crying infant in the family are harmful to relationships and health 11.…”

Effectiveness and Safety of a Probiotic-Mixture for the Treatment of Infantile Colic: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial with Fecal Real-Time PCR and NMR-Based Metabolomics Analysis

“…Infantile colic has been classified as a functional gastrointestinal disorder whose pathogenesis remains unknown, despite decades of research [ 3 ]. Consequently, various treatments have been tried to alleviate this condition [ 4 ].…”

Postnatal care of newborns in the family context: an integrative review

“…Doubts about crying are common, considering that it is a common symptom in the first three months of life and responsible for about 20% of pediatric consultations. Although it is mostly of benign etiology, it is often a source of concern (38,40) .…”