Infant Crying, Colic, and Gastrointestinal Discomfort in Early Childhood

Shamir, Raanan; James‐Roberts, Ian St; Lorenzo, Carlo Di; Burns, Alan J.; Thapar, Nikhil; Indrio, Flavia; Riezzo, Giuseppe; Raimondi, Francesco; Mauro, Antônio Orlando Di; Francavilla, Ruggiero; Leuchter, Russia Ha Vinh; Darqué, Alexandra; Hüppi, Petra Susan; Heine, Ralf G.; Bellaïche, M.; Levy, Michaël; Jung, Camille; Alvarez, Marissa; Hovish, Kimberly

doi:10.1097/mpg.0b013e3182a154ff

Cited by 60 publications

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“…There are gastrointestinal and behavioural hypotheses for infantile colic 18, 19. Gastrointestinal hypotheses involve immaturity of the gut function, dysmotility, imbalance of the intestinal microbiota, changes in gut hormones and food hypersensitivities or allergies.…”

Section: Aetiology At a Glancementioning

confidence: 99%

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

et al. 2018

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AimRegurgitation, infantile colic and functional constipation are common functional gastrointestinal disorders (FGIDs) during infancy. Our aim was to carry out a concise review of the literature, evaluate the impact of these common FGIDs on infants and their families, and provide an overview of national and international guidelines and peer‐reviewed expert recommendations on their management.MethodsNational and international guidelines and peer‐reviewed expert recommendations on the management of regurgitation, infantile colic and functional constipation were examined and summarised.ResultsRegurgitation, infantile colic and functional constipation cause frequent parental concerns, lead to heavy personal and economic costs for families and impose a financial burden on public healthcare systems. Guidelines emphasise that the first‐line management of these common FGIDs should focus on parental education, reassurance and nutritional advice. Nutritional advice should stress the benefits of continuing breastfeeding, while special infant formulas may be considered for non‐breastfed infants with common FGIDs. Drug treatment is seldom required, with the exception of functional constipation.ConclusionBy providing complete and updated parental education, reassurance and nutritional advice, healthcare professionals can optimise the management of FGIDs and related symptoms and reduce the inappropriate use of medication or dietary interventions.

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Section: Aetiology At a Glancementioning

confidence: 99%

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

et al. 2018

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“…FGIDs are a frequent reason for paediatric consultations in infants under four months of age, with around 23–28% of medical visits being motivated by gastrointestinal symptoms, mainly colic and regurgitation, according to French and Spanish studies 2, 3. In some children, infantile colic may be associated with functional disorders later in life 4.…”

Section: Introductionmentioning

confidence: 99%

Multiple functional gastrointestinal disorders are frequent in formula‐fed infants and decrease their quality of life

et al. 2018

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AimThis prospective study evaluated the incidence of functional gastrointestinal disorders (FGIDs) during infancy, on their own or combined with other symptoms.MethodsWe asked 273 French paediatricians with a specific interest in FGIDs to provide feedback on 2757 infants aged zero to six months from March 2013 to January 2014. Gastrointestinal health status was assessed by two questionnaires at inclusion and at a four‐week follow‐up visit. FGIDs were assessed according to the Rome III criteria and quality of life (QoL) was monitored.ResultsCombined FGIDs were diagnosed in 2145 (78%) infants: 63% with two disorders and 15% with three or more disorders. The most frequently combined FGIDs were gas/bloating and colic (28%), colic and regurgitation (17.0%) and gas/bloating and regurgitation (8%). Compared to infants with a single FGID, combined FGID were associated with lower body weight (4.63 vs 4.79 kg, p = 0.009), shorter breastfeeding duration (33 vs 43 days, p < 0.001), a decreased QoL score (5.9 vs 6.5, p < 0.001), more frequent drug prescriptions (25% vs 13%, p < 0.001) and significantly greater improvements in QoL scores after four weeks (p = 0.003).ConclusionCombined FGIDs were extremely common in infants up to six months of age and had a negative impact on breastfeeding, weight gain and QoL.

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“…Infant colic has been included in the list of childhood functional gastrointestinal disorders of the Rome III Coordinating Committee with diagnostic criteria based on infant crying time (Hyman et al, 2006). Infant pain and discomfort behaviours can also be measured objectively using validated pain scales and infant distress behaviour can be assessed by trained observers using behaviour logs or rating scales, supported by evidence for their validity (Shamir et al, 2013). The Rome III criteria and validated tools can be used to assess gastrointestinal discomfort in infants once other causes of crying, pain or distress have been excluded.…”

Section: Relevance Of the Claimed Effect To Human Healthmentioning

confidence: 99%

“…Unexplained bouts of crying in young infants, traditionally, have been attributed to gastrointestinal disturbances and pain (Shamir et al, 2013). A specific term, infant colic, is commonly used to reflect this situation in young infants.…”

Section: Relevance Of the Claimed Effect To Human Healthmentioning

confidence: 99%

Scientific Opinion on the substantiation of a health claim related to beta-galactosidase fromStreptococcus thermophilusand reduction of gastrointestinal discomfort pursuant to Article 14 of Regulation (EC) No 1924/2006

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EFSA Journal

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Following an application from Specialised Nutrition Europe (formerly IDACE), submitted for authorisation of a health claim pursuant to Article 14 of Regulation (EC) No 1924No /2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to beta-galactosidase from Streptococcus thermophilus and reduction of gastrointestinal discomfort. According to the applicant, the food constituent which is the subject of the claim is beta-galactosidase from Streptococcus thermophilus. Streptococcus thermophilus is added to infant formulae in the production process for fermentation purposes and the live organisms are inactivated after the fermentation process. The Panel considers that the food constituent, beta-galactosidase from Streptococcus thermophilus, under the conditions of use proposed by the applicant, is sufficiently characterised. The claimed effect proposed by the applicant is "reduction of gastro-intestinal discomfort". The target population proposed by the applicant is infants and young children. The Panel considers that reduction of gastrointestinal discomfort is a beneficial physiological effect. No human studies from which conclusions could be drawn for the scientific substantiation of the claim were provided by the applicant. The Panel concludes that a cause and effect relationship has not been established between the consumption of beta-galactosidase which is produced by Streptococcus thermophilus (subsequently inactivated) during fermentation of an infant formula and reduction of gastrointestinal discomfort. The scope of the application was proposed to fall under a health claim referring to children's development and health.According to the applicant, the food constituent which is the subject of the claim is "microbial betagalactosidase present as an endogenous component of some infant nutrition products". Following a request for clarification from EFSA during the validation period of the application, the applicant explained that the food constituent which is the subject of the claim is beta-galactosidase from Streptococcus thermophilus. Streptococcus thermophilus is added to infant formulae in the production process for fermentation purposes and the live organisms are inactivated after the fermentation process. The Panel considers that the food constituent, beta-galactosidase from Streptococcus thermophilus, under the conditions of use proposed by the applicant, is sufficiently characterised.The claimed effect proposed by the applicant is "reduction of gastro-intestinal discomfort". The target population proposed by the applicant is infants and young children. The Panel considers that reduction of gastrointestinal discomfort is a beneficial physiological effect.The Panel notes that no human studies from which conclusions could be drawn for the scientific substantiation of the claim were provided by the applicant.The Panel concludes that a cause and effect relat...

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Infant Crying, Colic, and Gastrointestinal Discomfort in Early Childhood

Cited by 60 publications

References 0 publications

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

Multiple functional gastrointestinal disorders are frequent in formula‐fed infants and decrease their quality of life

Scientific Opinion on the substantiation of a health claim related to beta-galactosidase fromStreptococcus thermophilusand reduction of gastrointestinal discomfort pursuant to Article 14 of Regulation (EC) No 1924/2006

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