Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical Characteristics of Infantile Colic

  • Nam, Soo Kyung (Department of Pediatrics, Inha University Hospital, Inha University School of Medicine) ;
  • Park, Sangmi (Department of Pediatrics, Inha University Hospital, Inha University School of Medicine) ;
  • Lee, Juyoung (Department of Pediatrics, Inha University Hospital, Inha University School of Medicine) ;
  • Jun, Yong Hoon (Department of Pediatrics, Inha University Hospital, Inha University School of Medicine)
  • Received : 2018.08.22
  • Accepted : 2018.12.26
  • Published : 2019.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To diagnose infantile colic from parent questionnaires, as well as investigating the risk factors and clinical course of infantile colic. Methods: We retrospectively reviewed the medical records of 462 infants, with a corrected age of <4 months at the time of visiting Inha University Hospital from January to December 2017. Parents responded to a 10-line questionnaire consisting of seven items relating to colic symptoms and three further items relating to underlying disease. The score was based on the number of days each symptom was evident during the preceding week. We defined infantile colic as the sum total being greater than seven points; if at least one of the three symptoms suggesting underlying disease was present, the infant was excluded from the diagnosis. Results: One hundred and sixty-seven infants (36.1%) satisfied the criteria. The lower the gestational age, the more infantile colic they developed (P<0.001). The prevalence of colic was higher in infants born with a birth weight <2.5 kg (62.7% vs. 24.4%, P<0.001) and in infants small for their gestational age, in the <10th percentile (54.5% vs. 33.7%, P=0.003). The prevalence of colic was significantly different according to the type of feeding (P=0.001), being the lowest in breast-only feeding (29.8%), 32.8% in mixed feeding with breast milk and formula, and 49.7% in formula-only feeding. Colic symptoms improved by administering hydrolyzed formula (87.5%), low-lactose formula (47.1%), galactosidase (44.4%), and the probiotic Lactobacillus reuteri (34.5%). Conclusion: The prevalence of infantile colic was over 30%. Prematurity, lower birth weight, and small for gestational age were the risk factors of infantile colic. Clinical improvement was observed when active intervention was performed.

Keywords

Acknowledgement

이 논문은 인하대병원의 지원에 의하여 연구되었습니다.

References

  1. Illingworth RS. Infantile colic revisited. Arch Dis Child 1985;60: 981-5. https://doi.org/10.1136/adc.60.10.981
  2. Lindberg T. Infantile colic: aetiology and prognosis. Acta Paediatr 2000;89:1-2 https://doi.org/10.1111/j.1651-2227.2000.tb01174.x
  3. Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics 1954;14:421-35.
  4. Canivet C, Hagander B, Jakobsson I, Lanke J. Infantile colic: less common than previously estimated? Acta Paediatr 1996;85:454-8. https://doi.org/10.1111/j.1651-2227.1996.tb14060.x
  5. Raiha H, Lehtonen L, Korhonen T, Korvenranta H. Family life 1 year after infantile colic. Arch Pediatr Adolesc Med 1996;150:1032-6. https://doi.org/10.1001/archpedi.1996.02170350034005
  6. Forsyth BW. Colic and the effect of changing formulas: a doubleblind, multiple-crossover study. J Pediatr 1989;115:521-6. https://doi.org/10.1016/S0022-3476(89)80274-4
  7. Treem WR, Hyams JS, Blankschen E, Etienne N, Paule CL, Borschel MW. Evaluation of the effect of a fiber-enriched formula on infant colic. J Pediatr 1991;119:695-701. https://doi.org/10.1016/s0022-3476(05)80282-3
  8. Miller AR, Barr RG. Infantile colic. Is it a gut issue? Pediatr Clin North Am 1991;38:1407-23. https://doi.org/10.1016/S0031-3955(16)38227-X
  9. Treem WR. Infant colic. A pediatric gastroenterologist's perspective. Pediatr Clin North Am 1994;41:1121-38. https://doi.org/10.1016/S0031-3955(16)38848-4
  10. Geertsma MA, Hyams JS. Colic: a pain syndrome of infancy? Pediatr Clin North Am 1989;36:905-19. https://doi.org/10.1016/S0031-3955(16)36728-1
  11. Balon AJ. Management of infantile colic. Am Fam Physician 1997;55:235-46.
  12. Savino F, Castagno E, Bretto R, Brondello C, Palumeri E, Oggero R. A prospective 10-year study on children who had severe infantile colic. Acta Paediatr Suppl 2005;94:129-32. https://doi.org/10.1111/j.1651-2227.2005.tb02169.x
  13. Hill DJ, Roy N, Heine RG, Hosking CS, Francis DE, Brown J, et al. Effect of a low-allergen maternal diet on colic among breastfed infants: a randomized, controlled trial. Pediatrics 2005;116:e709-15. https://doi.org/10.1542/peds.2005-0147
  14. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, et al. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics 2010;126:e526-33. https://doi.org/10.1542/peds.2010-0433
  15. 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. https://doi.org/10.1016/j.jpeds.2012.08.004
  16. 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;167:1150-7. https://doi.org/10.1001/jamapediatrics.2013.2572
  17. Anabrees J, Indrio F, Paes B, AlFaleh K. Probiotics for infantile colic: a systematic review. BMC Pediatr 2013;13:186. https://doi.org/10.1186/1471-2431-13-186
  18. Sung V, Hiscock H, Tang ML, Mensah FK, Nation ML, Satzke C, et al. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ 2014;348:g2107. https://doi.org/10.1136/bmj.g2107
  19. Urbanska M, Szajewska H. The efficacy of Lactobacillus reuteri DSM 17938 in infants and children: a review of the current evidence. Eur J Pediatr 2014;173:1327-37. https://doi.org/10.1007/s00431-014-2328-0
  20. Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician 2015;92:577-82.
  21. Chau K, Lau E, Greenberg S, Jacobson S, Yazdani-Brojeni P, Verma N, et al. Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938. J Pediatr 2015;166:74-8. https://doi.org/10.1016/j.jpeds.2014.09.020
  22. Blass EM, Hoffmeyer LB. Sucrose as an analgesic for newborn infants. Pediatrics 1991;87:215-8.
  23. Haouari N, Wood C, Griffiths G, Levene M. The analgesic effect of sucrose in full term infants: a randomised controlled trial. BMJ 1995;310:1498-500. https://doi.org/10.1136/bmj.310.6993.1498
  24. Lucassen PL, Assendelft WJ, van Eijk JT, Gubbels JW, Douwes AC, van Geldrop WJ. Systematic review of the occurrence of infantile colic in the community. Arch Dis Child 2001;84:398-403. https://doi.org/10.1136/adc.84.5.398
  25. Saavedra MA, da Costa JS, Garcias G, Horta BL, Tomasi E, Mendonca R. Infantile colic incidence and associated risk factors: a cohort study. J Pediatr (Rio J) 2003;79:115-22. https://doi.org/10.1016/S0022-3476(71)80068-9
  26. Fazil M. Prevalence and risk factors for infantile colic in District Mansehra. J Ayub Med Coll Abbottabad 2011;23:115-7.
  27. Talachian E, Bidari A, Rezaie MH. Incidence and risk factors for infantile colic in Iranian infants. World J Gastroenterol 2008;14:4662-6. https://doi.org/10.3748/wjg.14.4662
  28. Milidou I, Sondergaard C, Jensen MS, Olsen J, Henriksen TB. Gestational age, small for gestational age, and infantile colic. Paediatr Perinat Epidemiol 2014;28:138-45. https://doi.org/10.1111/ppe.12095
  29. Sondergaard C, Skajaa E, Henriksen TB. Fetal growth and infantile colic. Arch Dis Child Fetal Neonatal Ed 2000;83:F44-7. https://doi.org/10.1136/fn.83.1.F44
  30. Belson A, Shetty AK, Yorgin PD, Bujanover Y, Peled Y, Dar MH, et al. Colonic hydrogen elimination and methane production in infants with and without infantile colic syndrome. Dig Dis Sci 2003;48:1762-6. https://doi.org/10.1023/A:1025595029795
  31. Rautava P, Helenius H, Lehtonen L. Psychosocial predisposing factors for infantile colic. BMJ 1993;307:600-4. https://doi.org/10.1136/bmj.307.6904.600
  32. Miller JJ, McVeagh P, Fleet GH, Petocz P, Brand JC. Breath hydrogen excretion in infants with colic. Arch Dis Child 1989;64:725-9. https://doi.org/10.1136/adc.64.5.725
  33. Roggero P, Mosca F, Motta G, Mangiaterra V, Perazzani M, Offredi ML, et al. Sugar absorption in healthy preterm and full-term infants. J Pediatr Gastroenterol Nutr 1986;5:214-9. https://doi.org/10.1097/00005176-198603000-00009
  34. Barr RG, Hanley J, Patterson DK, Wooldridge J. Breath hydrogen excretion in normal newborn infants in response to usual feeding patterns: evidence for "functional lactase insufficiency" beyond the first month of life. J Pediatr 1984;104:527-33. https://doi.org/10.1016/S0022-3476(84)80541-7
  35. Infante Pina D, Badia Llach X, Arino-Armengol B, Villegas Iglesias V. Prevalence and dietetic management of mild gastrointestinal disorders in milk-fed infants. World J Gastroenterol 2008;14:248-54. https://doi.org/10.3748/wjg.14.248
  36. Valeur N, Engel P, Carbajal N, Connolly E, Ladefoged K. Colonization and immunomodulation by Lactobacillus reuteri ATCC 55730 in the human gastrointestinal tract. Appl Environ Microbiol 2004;70:1176-81. https://doi.org/10.1128/AEM.70.2.1176-1181.2004
  37. Spinler JK, Taweechotipatr M, Rognerud CL, Ou CN, Tumwasorn S, Versalovic J. Human-derived probiotic Lactobacillus reuteri demonstrate antimicrobial activities targeting diverse enteric bacterial pathogens. Anaerobe 2008;14:166-71. https://doi.org/10.1016/j.anaerobe.2008.02.001
  38. Hunter C, Dimaguila MA, Gal P, Wimmer JE Jr, Ransom JL, Carlos RQ, et al. Effect of routine probiotic, Lactobacillus reuteri DSM 17938, use on rates of necrotizing enterocolitis in neonates with birthweight < 1000 grams: a sequential analysis. BMC Pediatr 2012;12:142. https://doi.org/10.1186/1471-2431-12-142
  39. Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005;115:5-9. https://doi.org/10.1542/peds.2004-1815
  40. 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. https://doi.org/10.1542/peds.2006-1222