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

Abstract

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.

Magnesium Alginate in Gastro-Esophageal Reflux: A Randomized Multicenter Cross-Over Study in Infants

“…Thickened formulas that are available on the market are also a beneficial option for infants with persistent regurgitation, although they may differ in the kind of protein, thickening agent, quantity of lactose, prebiotic, or other components influencing cost and possible clinical efficacy [8]. Thickened formulas are well balanced in terms of both caloric and macro and micronutrient content.…”

“…Reassurance and a behavioral approach are suggested as first steps in FGID management [8]. Nutritional advice and formula changes are also considered to be beneficial in infants with persisting symptoms, whereas pharmacological treatment is not recommended [9].…”

Role of maternology in functional gastrointestinal disorders in infant

“…Regurgitation, infantile colic and functional constipation are the most common FGID in childhood, and it has been shown that more FGID can coexist often in the same child. Infant dyschezia, functional diarrhea, infant rumination syndrome and cyclic vomiting syndrome occur less frequently (4,5).…”

“…Recognizing infant regurgitation can avoid frequent visits to physicians and unnecessary investigations, as well as therapy for gastroesophageal reflux, a disease that can often be confused with infant regurgitation. But we are also usually dealing with an anxious mother, who frequently turns to a pediatrician, because she worries not only about the child's condition but also about her own condition, a state she certainly does not wish to talk about (5). It has been noticed that interaction between physician and the child's mother/caregiver often helps to improve the latter's condition.…”

“…It is mentioned in the literature that there is a link between parents' psychological state (anxiety, depression) and abdominal symptomatology in children, and also that the management of the most common FGID, such as infantile colic and regurgitation, should focus on education and parent reassurance, and nutritional advice, such as recommendations on volume, frequency, feeding techniques (1,5).…”