Looking for new treatments of Infantile Colic

Francesco Savino, Simone Ceratto, Angela De Marco, Luca Cordero di Montezemolo, Francesco Savino, Simone Ceratto, Angela De Marco, Luca Cordero di Montezemolo

Abstract

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, pharmacological, complementary and behavioral therapies as options for the management of infantile colic. Dietary approach, usually based on the avoidance of cow's milk proteins in breast-feeding mothers and bottle-fed infants, more recently has seen the rise of new special formulas, such as partially hydrolyzed proteins and low lactose added with prebiotics or probiotics: their efficacy needs to be further documented. Investigated pharmacological agents are Simethicone and Cimetropium Bromide: the first is able to reduce bloating while the second could reduce fussing crying, but it has been tested only for severe infantile colic. No other pain relieving agents have been proposed until now, but some clinical trials are ongoing for new drugs.There is limited evidence supporting the use of complementary and alternative treatments (herbal supplements, manipulative approach and acupuncture) or behavioral interventions.Recent studies have focused the role of microbiota in the pathogenesis of this disturb and so new treatments, such as probiotics, have been proposed, but only few strains have been tested.Further investigations are needed in order to provide evidence-based guidelines.

Figures

Figure 1
Figure 1
Treatment in breast-fed colicky infants.
Figure 2
Figure 2
Treatment in formula fed colicky infants.

References

    1. Savino F, Tarasco V. New treatments for infant colic. Curr Opin Pediatr. 2010;22(6):791–7. doi: 10.1097/MOP.0b013e32833fac24.
    1. Radesky JS, Zuckerman B, Silverstein M, Rivara FP, Barr M, Taylor JA, Lengua LJ, Barr RG. Inconsolable infant crying and maternal postpartum depressive symptoms. Pediatrics. 2013;131(6):e1857–64. doi: 10.1542/peds.2012-3316.
    1. Wessel MA, Cobb JC, Jackson EB, Harris GS, Detwilter BA. Paroxysmal fussing in infancy, sometimes called “colic”. Pediatrics. 1954;14(5):421–33.
    1. Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2006;130:1519–26. doi: 10.1053/j.gastro.2005.11.065.
    1. Savino F. Focus on infantile colic. Acta Paediatr. 2007;96(9):1259–64. doi: 10.1111/j.1651-2227.2007.00428.x.
    1. St James-Roberts I, Peachey E. Distinguishing infant prolonged crying from sleep-waking problems. Arch Dis Child. 2011;96(4):340–4. doi: 10.1136/adc.2010.200204.
    1. Savino F, Cordisco L, Tarasco V, Calabrese R, Palumeri E, Matteuzzi D. Molecular identification of coliform bacteria from colicky breastfed infants. Acta Paediatr. 2009;98(10):1582–8. doi: 10.1111/j.1651-2227.2009.01419.x.
    1. de Weerth C, Fuentes S, Puylaert P, de Vos WM. Intestinal microbiota of infants with colic: development and specific signatures. Pediatrics. 2013;131(2):e550–8. doi: 10.1542/peds.2012-1449.
    1. Pärtty A, Kalliomäki M, Endo A, Salminen S, Isolauri E. Compositional development of Bifidobacterium and Lactobacillus Microbiota is linked with crying and fussing in early infancy. PLoS One. 2012;7(3):e32495. doi: 10.1371/journal.pone.0032495.
    1. Savino F, Grassino EC, Guidi C, Oggero R, Silvestro L, Miniero R. Ghrelin and motilin concentration in colicky infants. Acta Paediatr. 2006;95:738–41. doi: 10.1080/08035250500522654.
    1. Kostakis ID, Cholidou KG, Vaiopoulos AG, Vlachos IS, Perrea D, Vaos G. Fecal calprotectin in pediatric inflammatory bowel disease: a systematic review. Dig Dis Sci. 2013;58(2):309–19. doi: 10.1007/s10620-012-2347-5.
    1. Savino F, Castagno E, Calabrese R, Viola S, Oggero R, Miniero R. High faecal calprotectin levels in healthy, exclusively breast-fed infants. Neonatology. 2010;97(4):299–304. doi: 10.1159/000255161.
    1. Olafsdottir E, Aksnes L, Fluge G, Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr. 2002;91(1):45–50. doi: 10.1111/j.1651-2227.2002.tb01638.x.
    1. Rhoads JM, Fatheree NY, Norori J, Liu Y, Lucke JF, Tyson JE, Ferris MJ. Altered fecal microflora and increased fecal calprotectin in infants with colic. J Pediatr. 2009;155(6):823–8. doi: 10.1016/j.jpeds.2009.05.012. e1.
    1. Drug and Therapeutics Bulletin. Management of infantile colic. BMJ. 2013;347:f4102.
    1. Crotteau CA, Wright ST, Eglash A. Clinical inquiries. what is the best treatment for infants with colic? J Fam Pract. 2006;55(7):634–6.
    1. Savino F, Benetti S, Ceratto S. Infantile colic: from symptoms to diagnosis - a practical approach. J Symptoms Signs. 2013;2(4):248–52.
    1. Perry R, Hunt K, Ernst E. Nutritional supplements and other complementary medicines for infantile colic: a systematic review. Pediatrics. 2011;127(4):720–33. doi: 10.1542/peds.2010-2098.
    1. Savino F, Tarasco V, Sorrenti M, Lingua C, Moja L, Gordon M, Biagioli E. Dietary modifications for infantile colic. Cochrane Database Syst Rev. 2014. Art. No.: CD011029.
    1. Shergill-Bonner R. Infantile colic: practicalities of management, including dietary aspects. J Fam Health Care. 2010;20(6):206–9.
    1. Cohen Engler A, Hadash A, Shehadeh N, Pillar G. Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin. Eur J Pediatr. 2012;171(4):729–32. doi: 10.1007/s00431-011-1659-3.
    1. Savino F, Palumeri E, Castagno E, Cresi F, Dalmasso P, Cavallo F, Oggero R. Reduction of crying episodes owing to infantile colic: a randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr. 2006;60(11):1304–10. doi: 10.1038/sj.ejcn.1602457.
    1. Sung V, Collett S, de Gooyer T, Hiscock H, Tang M, Wake M. Probiotics to prevent or treat excessive infant crying: systematic review and meta-analysis. JAMA Pediatr. 2013;167(12):1150–7. doi: 10.1001/jamapediatrics.2013.2572.
    1. Gupta SK. Update on infantile colic and management options. Curr Opin Investig Drugs. 2007;8(11):921–6.
    1. Savino F, Brondello C, Cresi F, Oggero R, Silvestro L. Cimetropium bromide in the treatment of crisis in infantile colic. J Pediatr Gastroenterol Nutr. 2002;34(4):417–9. doi: 10.1097/00005176-200204000-00020.
    1. Preliminary Efficacy and Safety Study of Oral Nepadutant in Infant Colic (no-cry) identifier: NCT01258153
    1. Savino F, Tarasco V, Lingua C, Moja L, Ricceri F, Biagioli E. Pain-relieving agents for infant colic. Cochrane Database Syst Rev. 2012. Art. No.: CD009999.
    1. Savino F, Ceratto S. Advances in Infantile colic and the use of Probiotics. Funct Food Rev. 2012;4(4):152–7.
    1. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007;119:e124–30. doi: 10.1542/peds.2006-1222.
    1. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, Roos S, Matteuzzi D. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics. 2010;126(3):e526–33. doi: 10.1542/peds.2010-0433.
    1. Szajewska H, Gyrczuk E, Horvath A. Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trial. J Pediatr. 2013;162:257–62. doi: 10.1016/j.jpeds.2012.08.004.
    1. Savino F, Cordisco L, Tarasco V, Locatelli E, Di Gioia D, Oggero R, Matteuzzi D. Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants. BMC Microbiol. 2011;11:157. doi: 10.1186/1471-2180-11-157.
    1. Roos S, Dicksved J, Tarasco V, Locatelli E, Ricceri F, Grandin U, Savino F. 454pyrosequencing analysis on faecal samples from a randomized DBPC trial of colicky infants treated with Lactobacillus reuteri DSM 17938. PLoS One. 2013;8(2):e56710. doi: 10.1371/journal.pone.0056710.
    1. Indrio F, Di Mauro A, Riezzo G, Civardi E, Intini C, Corvaglia L, Ballardini E, Bisceglia M, Cinquetti M, Brazzoduro E, Del Vecchio A, Tafuri S, Francavilla R. Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial. JAMA Pediatr. 2014;168(3):228–33. doi: 10.1001/jamapediatrics.2013.4367.
    1. Sung V, Hiscock H, Tang ML, Mensah FK, Nation ML, Satzke C, Heine RG, Stock A, Barr RG, Wake M. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ. 2014;1:348. g2107.
    1. Savino F, Cresi F, Castagno E, Silvestro L, Oggero R. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officialis (ColiMil) in the treatment of breast-fed colicky infants. Phytother Res. 2005;19:335–40. doi: 10.1002/ptr.1668.
    1. Alexandrovich I, Rakovitskaya O, Kolmo E, Sidorova T, Shushunov S. The effect of fennel (Foeniculum vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med. 2003;9:58–61.
    1. Dobson D, Lucassen PLBJ, Miller JJ, Vlieger AM, Prescott P, Lewith G. Manipulative therapies for infantile colic. Cochrane Database Syst Rev. 2012;12:CD004796.
    1. Landgren K, Kvorning N, Hallstrom I. Acupuncture reduces crying in infants with infantile colic: a randomised, controlled, blind clinical study. Acupunct Med. 2010;28:174–9. doi: 10.1136/aim.2010.002394.
    1. Skjeie H, Skonnord T, Fetveit A, Brekke M. Acupuncture for infantile colic: a blinding validated, randomized controlled multicentre trial in general practice. Scand J Prim Health Care. 2013;31(4):190–6. doi: 10.3109/02813432.2013.862915. Epub 2013 Nov 15.
    1. Rosen LD, Bukutu C, Le C, Shamseer L, Vohra S. Complementary, holistic, and integrative medicine: colic. Pediatr Rev. 2007;28(10):381–5. doi: 10.1542/pir.28-10-381.
    1. Underdown A, Barlow J, Chung V, Stewart-Brown S. Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database Syst Rev. 2006;18(4):CD005038.

Source: PubMed

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