DOCSLIB.ORG

Infantile Colic: a Critical Appraisal of the Literature from an Osteopathic Perspective

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Infantile Colic: a Critical Appraisal of the Literature from an Osteopathic Perspective International Journal of Osteopathic Medicine 9 (2006) 94e102 www.elsevier.com/locate/ijosm Review Infantile colic: A critical appraisal of the literature from an osteopathic perspective Kok Weng Lim* European School of Osteopathy/University of Greenwich, Boxley House, Boxley, Maidstone, Kent ME14 3DZ, UK Received 10 November 2005; received in revised form 18 June 2006; accepted 12 July 2006 Abstract The term infantile colic though often used is poorly understood. This common affliction of early infancy, in which crying is the primary symptom, has been the subject of numerous publications over many decades. This appraisal of the literature reveals that lack of consensus on the definition of colic poses difficulties when assessing the outcome and validity of research. In addition, the numerous hypotheses, reviewed here, on the precise cause of infantile colic have resulted in various approaches to treatment and no clear strategy for management. The possibility that mechanical factors play a role in the aetiology of colic underlies the osteopathic approach to treatment which, despite anecdotal success, is poorly documented. This article is designed to appraise osteopaths with an overview of the field to better inform their practice. Ó 2006 Published by Elsevier Ltd. Keywords: Osteopathy; Osteopathic medicine; Aetiology; Literature review 1. Introduction error approach that may compound the distress that is inevitably also suffered by the parents. Infantile colic is often described as a behavioural and This article is based on a review of the literature iden- non-pathological condition in early infancy with crying tified through searching online (Medline) and at aca- being the primary symptom. It is a poorly defined but demic libraries accessible to the author. It is written in common affliction of early infancy, the cause of which the hope that an appraisal of this field will better inform is still currently obscure and controversial and there is osteopathic practice. A historical overview of the subject therefore a lack of an appropriate strategy for the man- is beyond the scope of this paper. agement and treatment of this condition. This lack of a consensus on the aetiology of colic, in spite of over 1.1. Definition of infantile colic six decades of research, has resulted in various treatment approaches of dubious and varying merit, a trial and There is much debate as to what infantile colic actu- ally is. The term colic is derived from the Greek word kolikos, an adjective of kolon meaning the large intes- tine. The word colic suggests that the condition is a man- * St Stephens Practice, 21a St Stephens Road, Norwich NR1 3 SP. ifestation of some type of abdominal or visceral pain, Tel./fax: þ44 (0)1603 630 226. possibly intestinal cramps. This is contentious as the E-mail address: [email protected] implication that the crying of a colicky infant is a result 1746-0689/$ - see front matter Ó 2006 Published by Elsevier Ltd. doi:10.1016/j.ijosm.2006.07.001 K.W. Lim / International Journal of Osteopathic Medicine 9 (2006) 94e102 95 of the infant experiencing pain that is abdominal in crying has been carried out by various workers8e10 but origin is not necessarily true in all infants who cry.1 because of the different methods used to record crying The most universally accepted definition of colic and these results have varied. These studies reinforce the one which is most used in clinical research is that pro- point that crying is a normal developmental phenomenon posed by Wessel et al.,2 in a study involving 180 mothers and that what is termed colic may simply be the upper and their infants. The inclusion criterion for this study spectrum of a natural physiological and developmental was ‘‘paroxysms of irritability, fussing or crying lasting process or behavioural response in normal infants. That for a total of more than 3 h a day and occurring on is to say, colic may not necessarily be a disorder but the more than three days in any one week’’ in an infant extreme of normal early infant behaviour. who was otherwise ‘‘healthy and well fed’’. The study Brazelton’s (1962) work in which 80 mothers docu- stated that if an infant ‘‘had no such paroxysms or if mented their infants’ crying in a diary for 12 weeks is of- the paroxysms were less than the above in total duration ten cited as the referenced norm for crying.8 He reported he was classified as contented’’. There was therefore an that at two weeks of age, the median amount of crying arbitrary fixing of a threshold for colic in this study, was 1.75 h a day, at six weeks it was 2.75 h, decreasing which did not include infants who were mildly fussy. thereafter to less than 1 h by the 12th week. Interest- There is clearly a spectrum of severity of crying and ingly, twenty-five percent of the infants in his study cried the distinction between normal crying and crying that for at least 3.5 h a day at six weeks of age, thus falling signifies colic is unclear. A similar criterion was pro- within the Wessel’s2 definition of colicky crying. posed by Illingworth.3,4 A more recent study by St. James-Roberts and Variations of the above definition can be seen in the Halil10 also established a baseline standard for normal literature, such as a stipulation for crying for at least infant crying with the following characteristics: three weeks,5 crying for at least one week,6 or crying or fussing for at least 90 min each day for six out of Crying is at its maximum in the first three months seven days.6 These different definitions may reflect dif- and an average of about 2 h crying per day is ex- ferent degrees of severity of colic. This lack of a standard pected. This average halves between four and definition in the literature poses a stumbling block when 12 months. comparing the outcome and the validity of much of the Crying peaks at about six weeks, with individual research carried out in this area. In an attempt to over- variation. come this problem, Helseth and Begnum7 proposed a In the first three months, the crying clusters in the comprehensive definition of crying that incorporates late afternoon and evening. The hours between the three categories of crying (intense crying, non-specific 6.00 pm and midnight account for 40% of the 24 h fussing and crying, feeding-related crying) detected in total. their study. They suggest that this proposal may provide an acceptable framework for data collection and assess- Interestingly Brazelton’s study,8 much like the study ment of infants in clinical practice. by St James-Roberts and Halil,10 also showed a pattern It is important to emphasize that a diagnosis of colic of evening clustering of crying in that infants cried most is one of exclusion and that no pathological cause for between 6.00 and 11.00 pm at three weeks of age and the crying can be ascertained. Other possible causes of from 3.00 pm to midnight at six weeks. Although this crying such as hunger, or pathologies such as otitis evening pattern of crying is commonly perceived to be media, intussusception,a anal fissures and urinary tract a diagnostic feature clinically, these two studies have infection need to be ruled out before infants can be con- shown also that infants who are severely colicky tend to sidered colicky. cry throughout the day, rather than just in the evenings. 2.1. Broadening the definition of colic 2. Crying Wessel’s definition of colic2 was based solely on cry- The principal symptom of colic is crying. However, all ing. However, disturbances in sleep, awake and content- neonates and infants cry and there is a daily variation in ment patterns, and disturbances in feeding frequently the amount of crying and the pattern of crying between accompany colic and, therefore, have been used to fur- 4,11,12 infants. Research to determine what constitutes normal ther refine the definition of colic. In addition to crying, other symptoms and signs that may be associated with colic13, 14 include: a Intussusception is the invagination of part of the intestine into itself. The presentation is with a painful cry, drawing up of the knees and going pale, presumably in relation to colic. Vomiting is a common Crying that is difficult to console symptom and the passage of redcurrant jelly stools is frequent. An Feeding problems including spitting, vomiting and abdominal mass is usually papable. crying with feeding 96 K.W. Lim / International Journal of Osteopathic Medicine 9 (2006) 94e102 Poor sleep 1. physiological factors, ranging from cow’s milk intol- Passing a lot of gas erance, immaturity of the gastrointestinal system to immaturity of the central nervous system. Other signs apart from crying that may be reported 2. non-physiological factors, such as difficult infant or observable during a physical examination include: temperament, inappropriate maternal response and deficiencies in parenting. Drawing up of the legs Abdominal distension In addition, mechanical factors may play a part and Hypertonicity these are discussed later as osteopathic considerations Arching in the treatment of infantile colic. Flushing These activities and motor behaviours are non- 3.1. Physiological factors in infantile colic specific and may be observed as accompanying crying in infants in general. But there are some distinguishing 3.1.1. The gastrointestinal tract: pathology features. Mothers often report that colicky infants ap- and physiology pear hungry and that feeding does not always relieve Many physiological reasons for colic are proposed in the crying. Studies have shown too that there are two the medical literature and most relate to the gastrointes- types of crying behaviour.
Load more

Recommended publications
  • IV Lidocaine for Analgesia in Renal Colic
    UAMS Journal Club Summary October 2017 Drs. Bowles and efield Littl Faculty Advisor: Dr. C Eastin IV Lidocaine for Analgesia in Renal Colic Clinical Bottom Line Low-dose IV lidocaine could present a valuable option for treatment of pain and nausea associated with renal colic as an adjunct or alternative to opioids as it has relative minimal cost, side effects, and addictive potential. However, the data does not show any difference in lidocaine as a replacement or an adjunct to morphine. Higher quality studies showing a benefit will be needed before we should consider routine use of lidocaine in acute renal colic. PICO Question P = Adult ED patients with signs/symptoms of renal colic I = IV Lidocaine (1.5 mg/kg) with or without IV Morphine (0.1 mg/kg) C = placebo with or without IV Morphine (0.1mg/kg) O = Pain, nausea, side effects Background Renal colic affects 1.2 million people and accounts for 1% of ED visits, with symptom control presenting one of the biggest challenges in ED management. Classic presentation of acute renal colic is sudden onset of pain radiating from flank to lower extremities and usually accompanied by microscopic hematuria, nausea, and vomiting. Opioid use +/- ketorolac remains standard practice for pain control, but the use of narcotics carries a significant side effect profile that is often dose- dependent. IV lidocaine has been shown to have clinical benefits in settings such as postoperative pain, neuropathic pain, refractory headache, and post-stroke pain syndrome. Given the side effects of narcotics, as well as the current opioid epidemic, alternatives to narcotics are gaining populatiry.
    [Show full text]
  • Acute Onset Flank Pain-Suspicion of Stone Disease (Urolithiasis)
    Date of origin: 1995 Last review date: 2015 American College of Radiology ® ACR Appropriateness Criteria Clinical Condition: Acute Onset Flank Pain—Suspicion of Stone Disease (Urolithiasis) Variant 1: Suspicion of stone disease. Radiologic Procedure Rating Comments RRL* CT abdomen and pelvis without IV 8 Reduced-dose techniques are preferred. contrast ☢☢☢ This procedure is indicated if CT without contrast does not explain pain or reveals CT abdomen and pelvis without and with 6 an abnormality that should be further IV contrast ☢☢☢☢ assessed with contrast (eg, stone versus phleboliths). US color Doppler kidneys and bladder 6 O retroperitoneal Radiography intravenous urography 4 ☢☢☢ MRI abdomen and pelvis without IV 4 MR urography. O contrast MRI abdomen and pelvis without and with 4 MR urography. O IV contrast This procedure can be performed with US X-ray abdomen and pelvis (KUB) 3 as an alternative to NCCT. ☢☢ CT abdomen and pelvis with IV contrast 2 ☢☢☢ *Relative Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate Radiation Level Variant 2: Recurrent symptoms of stone disease. Radiologic Procedure Rating Comments RRL* CT abdomen and pelvis without IV 7 Reduced-dose techniques are preferred. contrast ☢☢☢ This procedure is indicated in an emergent setting for acute management to evaluate for hydronephrosis. For planning and US color Doppler kidneys and bladder 7 intervention, US is generally not adequate O retroperitoneal and CT is complementary as CT more accurately characterizes stone size and location. This procedure is indicated if CT without contrast does not explain pain or reveals CT abdomen and pelvis without and with 6 an abnormality that should be further IV contrast ☢☢☢☢ assessed with contrast (eg, stone versus phleboliths).
    [Show full text]
  • Colic: the Crying Young Baby Mckenzie Pediatrics 2007
    Colic: The Crying Young Baby McKenzie Pediatrics 2007 What Is Colic? Infantile colic is defined as excessive crying for more than 3 hours a day at least 3 days a week for 3 weeks or more in an otherwise healthy baby who is feeding and growing well. The crying must not be explained by hunger, pain, overheating, fatigue, or wetness. Roughly one in five babies have colic, and it is perhaps the most frustrating problem faced by new parents. Contrary to widespread belief, a truly “colicky” baby is seldom suffering from gas pains, although every baby certainly has occasions of gas pain and bloating. When Does Colic Occur? The crying behavior usually appears around the time when the baby would be 41-44 weeks post-conception. In other words, a baby born at 40 weeks might first show their colicky nature by 1-4 weeks of age. The condition usually resolves, almost suddenly, by age 3 to 4 months. Most colicky babies experience periods of crying for 1-3 hours once or twice a day, usually in the evening. During the rest of the day, the baby usually seems fine, though it is in the nature of colicky babies to be sensitive to stimuli. A small percentage of colicky babies are known as “hypersensory-sensitive”; these babies cry for what seems to be most of the day, all the while feeding and sleeping well. What Causes Colic? No one fully understands colic. We do know that more often than not, colic is a personality type, rather than a medical problem.
    [Show full text]
  • Appendiceal Colic Caused by Enterobius Vermicularis J Am Board Fam Pract: First Published As 10.3122/Jabfm.9.1.57 on 1 January 1996
    Appendiceal Colic Caused by Enterobius vermicularis J Am Board Fam Pract: first published as 10.3122/jabfm.9.1.57 on 1 January 1996. Downloaded from RogerJ Zoorob, MD, MPH Appendicitis is the most common acute surgical the emergency department before her discharge condition of the abdomen. It occurs at all ages but on symptomatic treatment, and she was advised is rare in the very young. l In contrast, appen­ to follow up with her family physician. diceal colic was first reported in 1980.2 It is char­ Physical examination in the office showed an acterized by recurrent episodes of crampy ab­ adolescent patient with no acute distress. She dominal pain referred either to the right lower was afebrile, had a heart rate of 84 beats per quadrant or to the periumbilical area. There is minute, a blood pressure of 110170 mmHg, and tenderness to deep palpation over the appendix.3 respiratory rate of 16/min. Her lungs were clear. It is theorized that appendiceal colic is due to Her abdomen was soft with good bowel sounds. an incomplete luminal obstruction of the appen­ There was minimum right lower quadrant ten­ dix most often caused by inspissated fecal mate­ derness at McBurney's point with no rebound. rial.3 Other pathologic findings, however, include There was no costovertebral angle tenderness. torsion of the appendix and narrowed appen­ The external genitalia examination showed an diceallumen.4 intact hymenal ring, and the findings on rectal I report a 13-year-old patient with appendiceal examination were normal. colic whose recurrent right lower quadrant ab­ A complete cell count done in the office dominal pain was due to Enterobius vermicularis showed a white cell count of 88001llL with a dif­ infestation of the appendix.
    [Show full text]
  • Sporadic (Nonhereditary) Colorectal Cancer: Introduction
    Sporadic (Nonhereditary) Colorectal Cancer: Introduction Colorectal cancer affects about 5% of the population, with up to 150,000 new cases per year in the United States alone. Cancer of the large intestine accounts for 21% of all cancers in the US, ranking second only to lung cancer in mortality in both males and females. It is, however, one of the most potentially curable of gastrointestinal cancers. Colorectal cancer is detected through screening procedures or when the patient presents with symptoms. Screening is vital to prevention and should be a part of routine care for adults over the age of 50 who are at average risk. High-risk individuals (those with previous colon cancer , family history of colon cancer , inflammatory bowel disease, or history of colorectal polyps) require careful follow-up. There is great variability in the worldwide incidence and mortality rates. Industrialized nations appear to have the greatest risk while most developing nations have lower rates. Unfortunately, this incidence is on the increase. North America, Western Europe, Australia and New Zealand have high rates for colorectal neoplasms (Figure 2). Figure 1. Location of the colon in the body. Figure 2. Geographic distribution of sporadic colon cancer . Symptoms Colorectal cancer does not usually produce symptoms early in the disease process. Symptoms are dependent upon the site of the primary tumor. Cancers of the proximal colon tend to grow larger than those of the left colon and rectum before they produce symptoms. Abnormal vasculature and trauma from the fecal stream may result in bleeding as the tumor expands in the intestinal lumen.
    [Show full text]
  • Evaluation of Acute Abdominal Pain in Adults Sarah L
    Evaluation of Acute Abdominal Pain in Adults SARAH L. CARTWRIGHT, MD, and MARK P. kNUDSON, MD, MSPh Wake Forest University School of Medicine, Winston-Salem, North Carolina Acute abdominal pain can represent a spectrum of conditions from benign and self-limited disease to surgical emergencies. Evaluating abdominal pain requires an approach that relies on the likelihood of disease, patient history, physical examination, laboratory tests, and imag- ing studies. The location of pain is a useful starting point and will guide further evaluation. For example, right lower quadrant pain strongly suggests appendicitis. Certain elements of the history and physical examination are helpful (e.g., constipation and abdominal distension strongly suggest bowel obstruction), whereas others are of little value (e.g., anorexia has little predictive value for appendicitis). The American College of Radiology has recommended dif- ferent imaging studies for assessing abdominal pain based on pain location. Ultrasonography is recommended to assess right upper quadrant pain, and computed tomography is recom- mended for right and left lower quadrant pain. It is also important to consider special popula- tions such as women, who are at risk of genitourinary disease, which may cause abdominal pain; and the elderly, who may present with atypical symptoms of a disease. (Am Fam Physi- cian. 2008;77(7):971-978. Copyright © 2008 American Academy of Family Physicians.) bdominal pain is a common pre- disease (e.g., vascular diseases such as aor- sentation in the outpatient setting tic dissection and mesenteric ischemia) and and is challenging to diagnose. surgical conditions (e.g., appendicitis, cho- Abdominal pain is the present- lecystitis).
    [Show full text]
  • Long Standing Biliary Colic Masking Chylous Ascites in Laparoscopic Roux-En-Y Gastric Bypass; a Case Report Louai R
    Zaidan et al. BMC Surgery (2018) 18:43 https://doi.org/10.1186/s12893-018-0374-7 CASE REPORT Open Access Long standing biliary colic masking chylous ascites in laparoscopic roux-en-Y gastric bypass; a case report Louai R. Zaidan1,2, Elhaitham K. Ahmed1,2, Bachar Halimeh1, Yasser Radwan2 and Khalil Terro1,2* Abstract Background: Chylous ascites is considered to be an intra-abdominal collection of creamy colored fluid with triglyceride content of > 110 mg/dL. Chylous ascites is an uncommon but serious complication of numerous surgical interventions. However, it is a rare complication of LRYGB. An internal hernia limb defect is thought to be the underlying etiology, where the hernia will cause lymphatic vessel engorgement and lymphatic extravasation. Case presentation: We report a case of a 29 years old male with a 9 year history of laparoscopic Roux en y gastric bypass (LRGYB), presenting with recurrent abdominal pain for 2 months radiating to the right shoulder. Ultrasound examination revealed gallstones and the patient was subsequently admitted for laparoscopic cholecystectomy. Intraoperatively, whitish colored fluid, high in triglycerides content was aspirated. During exploration, an internal hernia limb defect was found and corrected. Conclusion: Post LRGYB patients with symptoms of recurrent abdominal pain should be suspected for chylous ascites reflecting an internal hernia. Keywords: LRYGB, Chylous ascites, Internal hernia, Biliary colic, Abdominal pain Background commonly has the appearance of a turbid, milky fluid Chyloperitoneum is defined as the accumulation of with no odor [1]. lymphatic fluid in the peritoneum due to leakage/break Chylous ascites has been reported to be most com- in the lymphatic system.
    [Show full text]
  • History & Physical Format
    History & Physical Format SUBJECTIVE (History) Identification name, address, tel.#, DOB, informant, referring provider CC (chief complaint) list of symptoms & duration. reason for seeking care HPI (history of present illness) - PQRST Provocative/palliative - precipitating/relieving Quality/quantity - character Region - location/radiation Severity - constant/intermittent Timing - onset/frequency/duration PMH (past medical /surgical history) general health, weight loss, hepatitis, rheumatic fever, mono, flu, arthritis, Ca, gout, asthma/COPD, pneumonia, thyroid dx, blood dyscrasias, ASCVD, HTN, UTIs, DM, seizures, operations, injuries, PUD/GERD, hospitalizations, psych hx Allergies Meds (Rx & OTC) SH (social history) birthplace, residence, education, occupation, marital status, ETOH, smoking, drugs, etc., sexual activity - MEN, WOMEN or BOTH CAGE Review Ever Feel Need to CUT DOWN Ever Felt ANNOYED by criticism of drinking Ever Had GUILTY Feelings Ever Taken Morning EYE OPENER FH (family history) age & cause of death of relatives' family diseases (CAD, CA, DM, psych) SUBJECTIVE (Review of Systems) skin, hair, nails - lesions, rashes, pruritis, changes in moles; change in distribution; lymph nodes - enlargement, pain bones , joints muscles - fractures, pain, stiffness, weakness, atrophy blood - anemia, bruising head - H/A, trauma, vertigo, syncope, seizures, memory eyes- visual loss, diplopia, trauma, inflammation glasses ears - deafness, tinnitis, discharge, pain nose - discharge, obstruction, epistaxis mouth - sores, gingival bleeding, teeth,
    [Show full text]
  • THE ACUTE ABDOMEN Postgrad Med J: First Published As 10.1136/Pgmj.22.248.149 on 1 June 1946
    THE ACUTE ABDOMEN Postgrad Med J: first published as 10.1136/pgmj.22.248.149 on 1 June 1946. Downloaded from By H. W. S. WRIGHT. M.S., F.R.C.S. "Our Natures are the Physicians of our Diseases."-Epidemics, VI. 5. "Those Diseases that Medicines do not cure are cured by the Knife."-Aphorisms, VII. 87. HIPPOCRATES. The acute abdomen may be defined as an It is not proposed in this article to describe in intra-abdominal lesion which, apart from appro- detail abdominal conditions which are adequately priate treatment, immediately threatens the life of dealt with in all standard textbooks, but rather to a patient. In England, with a population of analyse their symptomatology and its mechanism in nearly 42 millions, considerably more than I2,000 such a way that a clinical pattern emerges quite people die annually from what is called "an acute simply from a mosaic of apparently unrelated abdomen." The annual crude death4ate from symptoms, and to show that the treatment sug- appendicitis is 62 per million, and from hernia gested is a logical sequence to pathological findings. and intestinal obstruction IO9 per million. In greater The symptoms and signs which give evidence of London, with a population of nearly nine million an acute intra-abdominal lesion are as a rule few persons, at least Io,ooo per annum are -admitted and simple. They are pain, superficial and deep with a diagnosis which implies a major abdominal tenderness, rigidity, and vomiting. With these are catastrophe. Because they are incomplete, these associated the general effects of the lesion on the figures underestimate the magnitude of a problem whole organism, such as temperature changes, and which claims a large and important share of every alterations both absolute and relative, in the surgeon's time and attention.
    [Show full text]
  • Acute Abdomen
    Acute Abdomen Andreas M Kluftinger MD FRCSC Kelowna General Hospital Disclosure • Heeadsoyaernia Advisory Panel – Ethicon, Johnson & Johnson • Funding – nil, zilch, zippo, nada, zero Objectives • Understand the Pathophysiology and Etiology of the acute abdomen • Approch to acute abdomen in rural practice • Case presentations Stedman' s Medical Dictionary 27th Edition “any serious acute intra-abdominal condition attended by pain, tenderness, and muscular rigidity, and for which emergency surgery must be considered." Acute Abdominal Pain • 5-10 % of ER visits • Complex “black box” • De lays in diagnos is can increase mor bidity • Excessive consultations (+/- transport) and imaging can be costly and tax resources. • Primaryygy assessment and triage are key History & Physical • Onset, nature, duration, location, radiation • Aggravating and relieving factors • Assoc ia te d GI or GU sympt oms • Past history (Surg and Med) • Review of Systems • Full physical exam Stereotypes of Pain Onset and Associated Pathology •SddSudden onset •RidRapid onset •GdGradual onset (full pain in seconds) (initial sensation to (hours) full pain over minutes or hours) •Perforated ulcer •Strangulated hernia •Appendicitis •Mesenteric infarction •Volvulus •Strangulated hernia •Ruptured abdominal •Intussusception •Chronic pancreatitis aortic aneurysm •Acute pancreatitis •Peptic ulcer disease •Ruptured ectopic •Biliary colic •Inflammatory bowel disease pregnancy •Diver ticu litis •MtilhditiMesenteric lymphadenitis •Ovarian torsion or •Ureteral and renal •Cystitis and
    [Show full text]
  • Gas and Colic
    GAS AND COLIC Gas is also extremely very common in the first month of life. Most of the times, it is not related to the kind of formula, but occasionally, it is due to the lactose in cow's milk formula not being digested completely. Gas is so common, though, that changing the cow's milk formula for every baby with gas means changing it for most babies. Lactose intolerance has other signs and symptoms like vomiting, diarrhea, and severe diaper rash. In the absence of these signs and the negative family history, lactose intolerance is unlikely and changing the formula should be a last resort not the first thing that comes to mind. Sometimes no action is smarter than a jerky change in formula every time the baby spits, is constipated, or have a bad day of gas. Excessive crying and gas more than three hours a day is called colic. Gas can cause bloating, which is uncomfortable enlargement of the abdomen. Bloating is not dangerous by itself, but if it is associated with vomiting, not spitting, can be a sign of the dangerous bowel obstruction. In the absence of vomiting, gas and bloating are not dangerous, and should not be a cause of panic. PREVENTION Gas can be prevented partially by: 1. using special bottles 2. burping the baby often every half an ounce 3. preventing the baby from feeding too fast 4. using nipples with large holes 5. avoiding overfeeding and underfeeding 6. feeding the baby upright 7. if you are breastfeeding, avoid certain foods like onions, garlic, beans, peas, spices, and chicken TREATMENT It can be treated with: 1.
    [Show full text]
  • Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: a Systematic Review
    Herbal Medicines for Gastrointestinal Dennis Anheyer, MA, BSc, a Jane Frawley, PhD, b Anna Katharina Koch, MSc, a, c Romy Lauche, PhD, a,b DisordersJost Langhorst, MD, a, c Gustav Dobos, in MD, Children a Holger Cramer, PhDa, b and Adolescents: A Systematic Review CONTEXT: abstract Gastrointestinal disorders are common childhood complaints. Particular types of complementary and alternative medicine, such as herbal medicine, are commonly used OBJECTIVES: among children. Research information on efficacy, safety, or dosage forms is still lacking. To systematically summarize effectiveness and safety of different herbal DATA SOURCES: treatment options for gastrointestinal disorders in children. Medline/PubMed, Scopus, and the Cochrane Library were searched through July STUDY SELECTION: 15, 2016. – Randomized controlled trials comparing herbal therapy with no treatment, placebo, or any pharmaceutical medication in children and adolescents (aged 0 18 years) DATA EXTRACTION: with gastrointestinal disorders were eligible. Two authors extracted data on study design, patients, interventions, control RESULTS: interventions, results, adverse events, and risk of bias. FourteenPotentilla trials with erecta 1927 participants suffering from different acute and functional gastrointestinalMatricaria disorders chamomilla were included in this review. Promising evidence for effectiveness was found for , carob bean juice, and an herbal compound preparation including in treating diarrhea. Moreover, evidence was found for peppermint oil in decreasing duration, frequency, and severity of pain in children suffering from undifferentiated functional abdominal pain. Furthermore, evidence for effectiveness was found for different fennel preparations (eg, oil, tea, herbal compound) in treating LIMITATIONS: children with infantile colic. No serious adverse events were reported. Few studies on specific indications, single herbs, or herbal preparations could be CONCLUSIONS: identified.
    [Show full text]