Dietary interventions in the infant with colic. A frequent, self-limiting disorder but of great impact on parents and difficult to manage. From scientific research the news to improve the dietary approach
Francesco Savino, Raffaele Vitale
1Città della Salute e della Scienza di Torino, Presidio Ospedale Infantile Regina Margherita S.S.D. Subintensiva Allargata della prima infanzia
Infantile colic is a common disturbance occurring in the first three months of life. This condition begins in the first week of life and it is one of the main causes of pediatric consultation in the early part of life because of its great impact on family life. Some pediatricians are prone to undervalue this issue mainly because of the lack of evidence based medicine guidelines. Up to now, there is no consensus concerning management and treatment. While the aetiology of infantile colic is unknown, it appears to relate to both the immaturity of the infant gut, gut microbiota and also the composition of the infant’s diet. Current treatment methods are diverse and controversial,and involve a range of behavioural, pharmaceutical, and dietary strategies. Dietary interventions are one of the most common treatment approaches and present opportunity for simple, drug-free therapeutic management,an obvious first choice for parents, and growing evidence reports data about the effectiveness of dietary intervention for the management of infantile colic. As both breastfed and formula-fed infants suffer from infantile colic, dietary change must encompass both the maternal diet in breastfed infants and change to infant formulae in formula-fed infants. For breastfed colicky infants dietary approach, usually is based on the avoidance of cow’s milk proteins in breast-feeding mothers and bottle-fed infants. For artificially colicky a recent Cochrane review indicates that hydrolyzed formula can be effective. While the efficacy of new special formulas proposed for colicky infants, such as partially hydrolyzed proteins and low lactose added with prebiotics or probiotics needs to be further documented. No other pain relieving agents drug have been proposed until now, and there is limited evidence supporting the use of complementary and alternative treatments (herbal supplements, manipulative approach and acupuncture) or behavioral interventions. Further investigations are needed in order to provide more dietary evidence-based data.