Supporting the diagnosis of infantile colic by a point of care measurement of fecal calprotectin

Henning Sommermeyer, Malgorzata Bernatek, Marcin Pszczola, Hanna Krauss, Jacek Piatek, Henning Sommermeyer, Malgorzata Bernatek, Marcin Pszczola, Hanna Krauss, Jacek Piatek

Abstract

Background: Infantile colic (IC) is a condition characterized by extensive crying which affects about 20% of all infants during their first months of life. Most pediatricians diagnose IC only based on their clinical experience.

Aim: Investigating if a measurement of fecal calprotectin can support the diagnosis of IC.

Methods: The crying behavior of newborns was assessed using the Wessel's criteria. Fecal calprotectin levels were measured in non-colicky and colicky babies using a standard test that can be used at the time and place of patient care (point of care (PoC) measurement).

Results: Colicky babies were found to have significantly elevated fecal calprotectin levels. Calprotectin levels were not influenced by gender, type of feeding, gestation age or birth weight. However, significantly elevated fecal calprotectin levels were found in cesarean section born babies. Fecal calprotectin ≥100 μg/g correlated with a colicky status of an infant while those <100 μg/g indicated a non-colicky status the error margin was 11.2 and 13.2%, respectively. Combining data of fecal calprotectin with information about the type of delivery made it possible to determine the colicky status in vaginally-born infants with fecal calprotectin ≥100 μg/g with an accuracy of 97.8%. As elevated fecal calprotectin levels in cesarean-born infants can be caused by IC, but also by the disturbed gut microbiota commonly found in these babies, the accuracy of diagnosing the colicky status of a cesarean-born infant with calprotectin levels ≥100 μg/g was less accurate (accuracy rate of 76.5%).

Conclusion: Data from the study suggest that measuring fecal calprotectin should be considered by pediatricians to support the diagnosis of IC.The study was registered at ClinicalTrials.gov under NCT04666324.

Keywords: cesarean section; colicky babies; fecal calprotectin (FC); gut inflammation; gut microbiota; infantile colic; point of care diagnostic; vaginal birth.

Conflict of interest statement

All authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Sommermeyer, Bernatek, Pszczola, Krauss and Piatek.

Figures

Figure 1
Figure 1
Average daily crying duration plotted vs. fecal calprotectin levels in non-colicky and colicky infants.
Figure 2
Figure 2
Influence of gender on fecal calprotectin levels in colicky and non-colicky infants.
Figure 3
Figure 3
Influence of type of delivery on fecal calprotectin levels in colicky and non-colicky infants.
Figure 4
Figure 4
Influence of type of feeding on fecal calprotectin levels in colicky and non-colicky infants.
Figure 5
Figure 5
Conditional inference tree using fecal calprotectin level data to determine the colicky status of an infant.
Figure 6
Figure 6
Conditional inference tree using fecal calprotectin level data and information about the type of delivery to determine the colicky status of an infant.

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