Therapeutic efficacy evaluation of Tuina at points on abdomen and back meridians for infantile colic / 针灸推拿医学（英文版）

Objective: To evaluate the efficacy of Tuina (Chinese therapeutic massage) at points on abdomen and back meridians in the treatment of infantile colic.Methods: A total of 120 infants with intestinal colic were randomly divided into a control group and an observation group, with 60 cases in each group. In the control group, the parents of the infants were given soothing and health education. In addition to the intervention used in the control group, the observation group was treated with Tuina at points on abdomen and back meridians once a day for 5 consecutive days as a course of treatment. The pain scale score and clinical symptoms of the two groups were recorded before and after treatment. Results: After treatment, the total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The pain scale score of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). In the 24 h behavior diary indicators, the daily attack duration, the daily attack times, and the weekly attack days in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: Tuina at points on abdomen and back meridians is effective and safe in the treatment of infantile colic.

Recognition and management of infantile colic / 中国小儿急救医学

Infantile colic(IC)is a common process that occurs in the infants within five months of age.The main characteristic of IC is paroxysm of inconsolable crying.Although IC is a benign self-limiting process, it is a common source of concern for family, and usually bring challenge to doctors.The diagnostic criteria is Roma Ⅳ criteria, which is mainly based on the typical feature and duration of crying.The etiology is unknown.The proposed causes can be classified into gastrointestinal and non-gastrointestinal factors.There is still no standard treatment for IC.The current management includes dietary modification, behavioral modification, pharmacological intervention, manual therapy, and so on.More clinical studies are needed to confirm the effect of these treatment strategies.Pediatricians should be familiar with the main causes and management of IC, and should also be adept at recognizing the individual reasons, managing the infants, and improving the prognosis.

Approach to infantile colic in primary care

Infantile colic is a common self-limiting condition that causes significant distress to parents and caregivers. There is no clear cause, gold standard remedy or preventative action. The role of the family physician is to rule out sinister causes while providing counselling and reassurance for parents. The mainstay of management is parental support and reassurance while looking out for red flags in the baby such as fever, lethargy, distended abdomen and failure to thrive. This article provides a framework to approaching infantile colic and practical pointers to share with parents.

Functional Gastrointestinal Disorders in Infancy: Impact on the Health of the Infant and Family / 대한소아소화기영양학회지

Functional gastrointestinal disorders (FGIDs) such as infantile colic, constipation and colic occur in almost half of the infants. The aim of this paper is to provide a critical and updated review on the management of FGIDs and their impact on the health of the infant and family to health care physicians. Guidelines and expert recommendations were reviewed. FGIDs are a frequent cause of parental concern, impairment in quality of life of infants and relatives, and impose a financial burden to families, health care, and insurance. Therefore, primary management of the FGIDs should be focused on improving the infants' symptoms and quality of life of the family. If more than parental reassurance is needed, available evidence recommends nutritional advice as it is an effective strategy and most of the time devoid of adverse effects. The role of healthcare providers in reassuring parents and proposing the correct behavior and nutritional intervention by avoiding inappropriate use of medication, is essential in the management of FGIDs.

Infantile colic: is it an early sign of an allergy?

Infantile colic is a worrisome problem to the parents and caregivers, characterized by the inconsolable crying of infants that usually occur in the first 4months of life. It constitutes the frequent complaint seen by physicians in early infants' life. The episodes generally disappear by the age of five or six months. However, there was growing evidence demonstrate the later impact of these episodes in later children' life. Many interventions were tried to reduce the symptoms associated with infantile colic and to foresee the etiological backgrounds. The allergic role is implicated to have a major role in the pathophysiology of infantile colic and in the later atopic outcome; however, more intensive reliable studies should be done to strengthen these evidences

Epidemiologic survey on the prevalence and distribution of infants' common gastrointestinal symptoms in 7 cities in China: a population-based study / 中华流行病学杂志

Objective Regurgitation,infantile colic,and fnnctional constipation are common gastrointestinal symptoms in childhood,the aim of this study was to explore the prevalence and distribution of these symptoms in China.Methods A screening program in infants aged 0 to 3 years selected through stratified cluster random sampling was carried out in 7 citics in China.Questionnaires were filled,and then diagnosis were made according to Rome Ⅳ criteria.Areas,(urban-rural),age and gender distribution of prevalence of childhood common gastrointestinal symptoms were analyzed.Results Totally,20 932 effective questionnaires were returned.The total number of infants aged 0 to 1 years was 10 193.Regurgitation was diagnosed in 1 960 infants,with the prevalence of 19.2％,among infants aged 0 to 3 months that had highest prevalence (29.8％).The prevalence decreased with age,and differences among different age groups showed significant.For infantile colic,4 470 infants aged 0 to 5 months were analyzed and the prevalence of infantile colic was 7.3％.The prevalence of infantile colic was the highest in infants aged 1 to 2 months (10.0％).Age specific difference was significant.Of all the infants,functional constipation was diagnosed in 1 755 infants with the prevalence of 8.4％,and the lowest prevalence was found in infants aged 0 to 3 months (6.2％),and the highest prevalence was in infants aged 30 to 36 months (10.0％).The differences in different age group were significant.Conclusion Symptoms of regurgitation,infantile colic,and functional constipation are common in infants in China,with age specific difference in prevalence of the symptoms.

Epidemiologic survey on the prevalence and distribution of infants' common gastrointestinal symptoms in 7 cities in China: a population-based study / 中华流行病学杂志

Objective Regurgitation,infantile colic,and fnnctional constipation are common gastrointestinal symptoms in childhood,the aim of this study was to explore the prevalence and distribution of these symptoms in China.Methods A screening program in infants aged 0 to 3 years selected through stratified cluster random sampling was carried out in 7 citics in China.Questionnaires were filled,and then diagnosis were made according to Rome Ⅳ criteria.Areas,(urban-rural),age and gender distribution of prevalence of childhood common gastrointestinal symptoms were analyzed.Results Totally,20 932 effective questionnaires were returned.The total number of infants aged 0 to 1 years was 10 193.Regurgitation was diagnosed in 1 960 infants,with the prevalence of 19.2％,among infants aged 0 to 3 months that had highest prevalence (29.8％).The prevalence decreased with age,and differences among different age groups showed significant.For infantile colic,4 470 infants aged 0 to 5 months were analyzed and the prevalence of infantile colic was 7.3％.The prevalence of infantile colic was the highest in infants aged 1 to 2 months (10.0％).Age specific difference was significant.Of all the infants,functional constipation was diagnosed in 1 755 infants with the prevalence of 8.4％,and the lowest prevalence was found in infants aged 0 to 3 months (6.2％),and the highest prevalence was in infants aged 30 to 36 months (10.0％).The differences in different age group were significant.Conclusion Symptoms of regurgitation,infantile colic,and functional constipation are common in infants in China,with age specific difference in prevalence of the symptoms.

Interdisciplinary management of infantile colic / Manejo interdisciplinario del cólico del lactante

Abstract Infantile colic is one of the main reasons for consultation in pediatric gastroenterology and pediatric nutrition services. This pathology has multiple etiologies such as family dysfunction, gastrointestinal alterations, food allergies or intolerances, food imbalance and improper eating habits. It is acute, of sudden onset, and tends to disappear between 3 and 6 months of age. To date there is no consensus on the management protocols of this condition or indicators of therapeutic efficacy. Medications, dietary regimens and dietary supplements specific to this pathology (anti-colic) have been developed for some years to help address this issue. This article presents a structural review of evidence on the fundamentals and progress in the treatment of infantile colic, and compiles the characteristics of this pathology, the medical and nutritional therapeutic measures, the clinical approach and the techniques to help the patient and his family. This study seeks to provide technical tools to health professionals whose target population is children younger than 2 years of age.

Resumen El cólico del lactante es uno de los principales motivos de consulta en los servicios de pediatría, gastroenterología y nutrición pediátrica. Esta patología posee múltiples características etiológicas como disfunción de la mecánica familiar, alteraciones gastrointestinales, alergias o intolerancias alimentarias, desbalance alimentario e inadecuados hábitos alimenticios. Es de carácter agudo, con inicio súbito que tiende a desaparecer entre los 3 y 6 meses de edad. Hasta el momento no existe un consenso sobre los protocolos de manejo de esta condición o sobre sus indicadores de eficacia terapéutica. Desde hace algunos años se han desarrollado fármacos, regímenes dietarios y complementos alimentarios específicos para esta patología (anticólico). Este trabajo es una revisión de la evidencia sobre los fundamentos y avances en el tratamiento del cólico del lactante en el que se recopilan las características de esta patología, las medidas terapéuticas médicas y nutricionales, el abordaje clínico y las técnicas para ayudar al paciente y su entorno familiar. El presente estudio busca brindar herramientas técnicas al profesional de la salud cuya población objeto de atención es menor de 2 años.

Excessive crying in infants / Excessive crying in infants

ABSTRACT Objective: Review the literature on excessive crying in young infants, also known as infantile colic, and its effects on family dynamics, its pathophysiology, and new treatment interventions. Data source: The literature review was carried out in the Medline, PsycINFO, LILACS, SciELO, and Cochrane Library databases, using the terms “excessive crying,” and “infantile colic,” as well technical books and technical reports on child development, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years. Summary of the findings: Excessive crying is a common symptom in the first 3 months of life and leads to approximately 20% of pediatric consultations. Different prevalence rates of excessive crying have been reported, ranging from 14% to approximately 30% in infants up to 3 months of age. There is evidence linking excessive crying early in life with adaptive problems in the preschool period, as well as with early weaning, maternal anxiety and depression, attention deficit hyperactivity disorder, and other behavioral problems. Several pathophysiological mechanisms can explain these symptoms, such as circadian rhythm alterations, central nervous system immaturity, and alterations in the intestinal microbiota. Several treatment alternatives have been described, including behavioral measures, manipulation techniques, use of medication, and acupuncture, with controversial results and effectiveness. Conclusion: Excessive crying in the early months is a prevalent symptom; the pediatrician's attention is necessary to understand and adequately manage the problem and offer support to exhausted parents. The prescription of drugs of questionable action and with potential side effects is not a recommended treatment, except in extreme situations. The effectiveness of dietary treatments and use of probiotics still require confirmation. There is incomplete evidence regarding alternative treatments such as manipulation techniques, acupuncture, and use of the herbal supplements and behavioral interventions.

RESUMO Objetivo: Revisar a literatura sobre choro excessivo em bebês pequenos e cólicas infantis e suas repercussões na família e a fisiopatologia e as estratégias de tratamento. Fonte dos dados: Revisadas as principais bases de dados, Medline, PsycINFO, Lilacs e SciELO e Cochrane Library com o uso das expressões “choro excessivo do lactente” e “cólicas do lactente”. Foram selecionadas as publicações mais relevantes com ênfase nos últimos cinco anos. Síntese dos dados: É um sintoma comum nos primeiros meses de vida e é motivo de cerca de 20% das consultas pediátricas. As prevalências de choro excessivo variam de 14 a 30% nesses lactentes. Existem evidências que ligam o choro excessivo nos primeiros meses de vida com problemas futuros, bem como ao desmame precoce, à ansiedade, à depressão materna, ao transtorno do déficit de atenção/hiperatividade (TDAH) e a outros problemas comportamentais. Distintos mecanismos fisiopatológicos podem explicar esse quadro clínico, como alterações no ritmo circadiano, imaturidade do SNC e alterações na microbiota intestinal. São descritas opções de tratamento, desde medidas comportamentais, técnicas manipulativas e uso de medicação até acupuntura, com resultados e eficácia controversos. Conclusão: Para o choro excessivo nos primeiros meses é necessária a atenção do pediatra para o entendimento e manejo do problema e oferecer apoio para pais em exaustão. A prescrição de drogas de efeitos duvidosos e potenciais efeitos colaterais não é terapêutica preconizada, a não ser em situações extremas. A eficácia dos tratamentos dietéticos e o uso de probióticos ainda necessitam de confirmação. Existem evidências incompletas a respeito de tratamentos opcionais, como técnicas manipulativas, acupuntura, uso de suplemento à base de ervas e intervenções comportamentais.

Cólico infantil: detección de necesidades de educación para el cuidado del recién nacido, a través de una encuesta dirigida a mujeres embarazadas / Infantile colic: detection of educational needs for the care of newborns, through a survey of pregnant women

Introducción: El cólico del lactante se caracteriza por episodios de llanto intenso, presente desde las primeras semanas de vida con una etiología multifactorial. Objetivo: Determinar el grado de conocimiento de embarazadas acerca del cólico infantil y detectar los aspectos del tema en que se debe hacer énfasis en los cursos de capacitación a mujeres gestantes. Material y métodos: Se realizó un estudio observacional, transversal, con la aplicación de una encuesta a pacientes embarazadas. La encuesta se construyó para identificar causas de cólico, síntomas y signos, tiempo de duración del cólico, edad más frecuente de presentación y tratamiento. El conocimiento materno se clasificó en: adecuado, moderado y una idea acerca del tema. Se utilizó estadística descriptiva y para la comparación de grupos la prueba de χ². Resultados: Se aplicaron 124 encuestas. El 50% fueron primigestas y 19 embarazadas (15.3%) resultaron adolescentes. El signo que se relacionó con mayor frecuencia con el cólico fue la expresión de dolor en la cara del niño. Un conocimiento adecuado se tuvo en cuatro mujeres (3.2%), un conocimiento moderado en 63 (50.8%) y 57 (46%) tuvieron una idea acerca del tema. El grupo de adolescentes tuvo menos conocimiento del tema (p = 0.04). Conclusiones: Es necesario proporcionar información y capacitar a las embarazadas en los aspectos de duración del cólico, signos y síntomas. Se debe hacer énfasis en los beneficios de la leche materna.

Introduction: Infantile colic is characterized by episodes of intense crying. It is present since the first weeks of life with a multifactorial etiology. Objective: To determine the degree of knowledge of pregnant women about infant colic, by using a survey and identify topics of this theme that should be emphasized in prenatal training courses. Material and methods: We performed an observational, cross-sectional survey in pregnant patients. We designed a survey to explore mother's knowledge about causes of infantile colic, symptoms and signs, duration of colic, frequent presentation age and treatment. The maternal knowledge was classified as: adequate (9-12 hits), moderate (5-8 hits) and an idea about the subject (1-4 hits). Descriptive statistics were used, to compare groups we used χ2 test. Results: 124 surveys were applied. Of the pregnant women studied, 50% were nulliparous and 19 (15.3%) were in teenage. The sign that is most often associated with colic was the pained expression on the face of the babe. Of the 124 surveys, adequate knowledge was identified in 4 women (3.2%), moderate knowledge in 63 (50.8%) and 57 (46%) only have an idea about the subject. The group with less knowledge was the teenagers (p = 0.04). Conclusions: It is necessary give information to pregnant women, in the topic of infantile colic, and emphasize of the benefits of breast feeding.

Infantile Colic: The Mysterious Crying.

Infantile colic is a distressing condition in infants, pathogenesis of which is still not clear. Several treatment strategies have been attempted before, but only some of them proven successful. The aim of this paper is to review studies on treatment options for infantile colic. For this, a systematic literature review was done on studies regarding pathophysiology, medical and conventional interventions for infantile colic from 1954 to March 2011. Forty nine articles included in Cochrane database were reviewed. Fourteen studies on pathophysiology and risk factors, 7 studies on effect of infantlie colic on parents and family, 19 studies on management, 5 studies on other related factors and 4 literature reviews were included for review. Pathophysiology has been described in various ways in different studies and yet not conclusive. Regarding studies on management, simethicone could not significantly control colic, dicyclomine hydrochloride had serious side effects and cimetropium bromide results were favourable, but milder side effects were noted. Some nutritional studies reported low-allergen maternal diets in breastfed infants but suitability of these methods are questionable in Bangladesh. Behavioural studies on the use of decreased stimulation and contingent music were favourable in some studies. Mixed herbal tea and probiotic like Lactobacillus reuteri studies showed encouraging results. There are some scientific evidences to support a low-allergen maternal diet in breastfed infants with infantile colic. Some encouraging results exist for mixed herbal tea, cimetropium bromide and probiotics.

Aprendendo a lidar com a cólica do filho / Learning on how to deal with the child´s colic

A cólica infantil, caracterizada por choro excessivo e inconsolável do bebê, é um problema comum no período inicial da vida, causando angústia e preocupação às mães. Apesar de ser uma manifestação comum, sua causa ainda é desconhecida. Assim, é necessário propor intervenções ao assistir as mães desses bebês, considerando as necessidades e dificuldades desta clientela no sentido de auxiliá-la a enfrentar e superar este problema. Este estudo teve como objetivo compreender a experiência materna de ter um filho com cólica no período precoce da vida. Optou-se por uma abordagem qualitativa, a Teoria Fundamentada nos Dados e como referencial teórico para análise e interpretação dos dados, o Interacionismo Simbólico. O método de análise de conteúdo baseou-se em 12 discursos de mães que tinham ou tiveram filhos que sofreram de cólica no período inicial da vida e que frequentavam o seguimento de puericultura e pediatria de um Centro de Saúde Escola, situado na zona oeste da cidade de São Paulo. Os dados foram obtidos por meio de entrevista e observação do contexto, cuja análise permitiu compreender a experiência materna do fenômeno CONVIVENDO COM UM FILHO COM CÓLICA e a categoria central revelou-se como APRENDENDO A LIDAR COM A CÓLICA DO FILHO. O modelo teórico mostra que ter um filho com cólica é uma vivência angustiante e independe de ser mãe de primeiro filho. A compreensão da experiência materna de conviver com um filho acometido de cólica aponta para a necessidade dos profissionais reverem as práticas implementadas no manejo da cólica infantil. O acompanhamento do binômio mãe-filho por meio de atendimento de seguimento no mínimo até o terceiro mês de vida do bebê, incluindo atendimentos domiciliares e a promoção de estratégias de apoio implementadas pelos serviços de saúde podem contribuir para o estabelecimento saudável do vínculo mãe-filho.

The infantile colic, which is characterized by excessive and disconsolate baby's cry, is a common problem during the initial period of life. It causes the mothers' distress and worry. Although it is a common manifestation, its cause is still unknown. Then, considering these babies' mothers' needs and difficulties, it is necessary to propose an intervention while assisting them, in order to help them to face and overcome the problem. The aim of this study was to understand the experience of the mothers who had a baby with colic during the early period of life. The Theory Based on the Data was the qualitative approach used and the Symbolic Interaction was used as the theoretical reference to analyze and interpret the data. The method used to analyze the content was based on 12 speeches given by mothers who have or had their babies with colic during the initial period of life. These mothers attended the puerile and pediatric segment of a School Health Center located in the west zone of São Paulo city. The data were collected by interviews and observation of the context. The data analysis allowed the understanding of the maternal experience and the phenomenon is LIVING WITH A CHILD WHO HAS COLIC and the central category is LEARNING TO DEAL WITH THE CHILD'S COLIC. The theoretical model shows that having a baby with colic is a distressful experience and it does not matter if it is the mother's first child or not. The understanding of the mother's experience who has a child with colic points out that the professionals need to check the practices used while dealing with a child who has colic. The process of following the binomial mother-son by giving them assistance at least until the baby's third month of life, including homecare and the promotion of supporting strategies implemented by the health services and contributing to the healthy establishment of the mother-child bond.

Analgesic Effect of Sugar Solution in Infantile Colic

PURPOSE: Infantile colic is one of the most commonly encountered problems, characterized by excessive crying in apparently healthy young infants within the first 3 months of life. It is commonly assumed that the infant with colic has distress and possible pain. In recent investigations, it has been found that sucrose has an analgesic effect in newborn infants. The purpose of this study is to examine if sugar solution as sucrose also has an analgesic effect on infant colic. METHODS: This prospective randomized, double-blind placebo controlled study examined healthy term infants aged 4 to 12 weeks with colic. A total of 40 infants were randomly assigned into two groups who visited Daedong Hospital from June 1999 to June 2001. Each group received sugar solution or sterile water. All data from parental diaries and interviews were recorded and analysed blindly. RESULTS: The daily crying time and the colic improvement score were significantly better in sugar solution group as compared with the control(P=0.019, 0.045). No significant differences were noted between groups regarding the number of night wakenings(P=0.173). CONCLUSION: We conclude that sugar solution has an analgesic effect on infantile colic.