Tuesday, February 11, 2014
Colic is a condition known to most parents. In fact, by the time their child is four months old, up to 20% of parents will have reported colicky symptoms in their infants.
A crying child is always distressing, especially when it doesn’t respond to a parent’s usual soothing touch and attention. So is there anything the medical profession can do to help alleviate colic in infants?
This is the question that a new supplement by the Journal of Pediatric Gastroenterology & Nutrition sought to answer when it brought together scientific and clinical evidence into some of the possible causes of colic. Such as:
In the Burns and Thapar review of the embryonic and postnatal events related to the enteric nervous system (ENS), these is evidence that the ENS can be altered in a number of ways after birth due to stress, infections or changes in nutrition.
Indrio et al focus on the non-nutritive pathophysiology of colic; concluding that “little evidence supports a substantial role of gastroesophageal reflux (GER) or GERD in the majority of infants with colic” and the role of hormones such as ghrelin and motilin, as well as the positive effect shown for probiotic supplementation, should be studied further.
Indrio and colleagues also elaborate on the role of probiotics in the management of infant colic and provide recent and exciting data on the clinical benefit of the administration of probiotics when dealing with functional disorders and organic diseases.
Di Lorenzo’s review of early life events raises the issue of the “vulnerable child”, summarizing what is known about factors that predispose an infant to become colicky. There is evidence, for example, that early pain experiences are associated with altered pain responses later in infancy. Identifying ‘at risk’ children may provide an opportunity for interventions that will attenuate or avoid later functional disorders.
Ha-Vinh Leuchter et al discuss the peak shape of the crying behavior found in colicky as opposed to non-colicky babies, observing that babies that show the circadian rhythm of crying are not soothed by ordinary sensory stimulation.
Heine looks at the relation between cow's-milk allergy and infant colic, noting that in breast-fed infants, elimination of cow's milk and other food proteins from the maternal diet was associated with a greater reduction in crying or fussiness duration, before looking at the results of clinical trials involving infants fed with different formula’s.
While the supplement goes on to look at other studies by Bellaïche et al and St James-Roberts et al and look deeper into GI disorders and allergies, it’s conclusion is clear. Whether infantile colic is a normal developmental occurrence, a different central nervous system function, or a result of GI discomfort, it is a self-limiting condition that, when present without any other symptoms or alarming signs, should be looked at with empathy and reassurance.
The full supplement, titled: Infant Colic and Functional Gastrointestinal Disorders: Is There More Than a “Gut Feeling”? is available free of charge at the JPGN website.