Infant colic is considered to be one of the most frequent reasons parents seek medical attention for their children during the first weeks of life. Despite the benign and self-limiting course, it carries a substantial psychological, emotional and physical burden for the parents. Baby colic can interfere with parent-child bonding, cause strain in a marriage, lead to unnecessary hospitalizations, and in some unfortunate cases, lead to child abuse (16), could be so exhausting for the mothers, that some of them may experience fantasies of infanticide (17). Unlike previously thought, it does not always disappear without a trace, and many children, who suffered from colic in infancy, may experience gastrointestinal problems later in their lives (18). Some families may experience abnormal interaction levels for years (19). Therefore, it is important for health care providers to offer parents of affected baby , simple, inexpensive and effective medical advice and assistance.
The typical therapeutic interventions for infantile colic offered to parents fall into the 4 categories listed below:
1. Dietary Modifications
Dietary manipulations include professional advice on various feeding techniques, or the use of hypoallergenic milk, soy or lactose free formulas, and an early introduction of solids. (20, 21, 22). However, neither the use of soy formulas, or changes in feeding techniques work effectively. A review of the data studying these recommendations showed that use of hypoallergenic formula, such as partially hydrolyzed or amino acid-based, may benefit approximately 25% of infants (23, 24). Occasionally, elimination of offending foods from the maternal diet also may help.
2. Physical Treatment
Physical strategies include carrying, swaddling, applying abdominal pressure, or massaging the baby. Other methods include taking an infant with colic bout for a car ride, use of a car ride stimulator, crib vibrator, or infant swings (25, 26). Another approach is to play recordings of sounds that supposedly soothe the baby. However, a car ride past midnight is an extremely impractical method. There is evidence in the medical literature that physical methods do not work (27).
3. Drug Treatment
Hyoscyamine (levsine™, or gastrosed™) and Dicyclomine are two anticholinergic drugs, (Drugs to atropine. They dilate pupils, increase heart rate, decrease production of saliva, relieve spasms of gastrointestinal and urinary tracts, as well as bronchial trea) which are the only prescription drug on the U.S. market that consistently have been shown to effectively treat infant colic. Unfortunately, up 5% of treated infants may develop side effects, including breathing difficulties, apnea, seizures, passing out, asphyxia, coma and muscular hypotonia (28, 29). In addition, several cases of death have been reported in babies with colic taking dicyclomine (30). It is not surprising that these drugs are rarely prescribed by physician for infant colic (16, 31).
Several sedative or sleep-inducing drugs, including diphenhydramine (benadryl™), phenobarbital, chloral hydrate, and even alcohol have been reported as effective. However, there is the potential for serious side effects associated with these agents, thus limiting their widespread use in treating colic (16, 32). Simethicone (Mylicone), a non-absorbable, over-the-counter drug, which reduces the size of intestinal gas bubbles is frequently recommended, despite several studies that demonstrate the effectiveness of simethicone is no better than placebo (33, 34).
4. Behavioral Treatment
Recommendations for behavioral interventions are the most inconsistent therapies available. Some authors advocate increasing sensory stimulation, while others advocate decreasing such stimulation (16, 31, 35). Other recommendations include early response to crying, or allowing the infant to cry, offering a pacifier, implementation of a routine feeding schedule, using eye contact and interactive playing.
The lack of a safe, effective, practical and affordable therapeutic modality for infant colic has led many physicians to believe that counseling, education, reassurance and empathy are the best forms of colic therapy available (2, 16, 27).
5. Probiotics
The most comprehensive lscientific iterature review called metaanalysis found that probiatics don’t treat infant colic. Probiotics my reduced incidence of colic if taken soon after birth.
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