Poor evidence for therapies used in infantile colic

January 01, 0001

Poor evidence for therapies used in infantile colic

Infantile colic is a prevalent and distressing condition for which there is no proven standard therapy. The aim of this paper from researchers from Australia was to review medical and conventional treatments for infantile colic. A systematic literature review was undertaken of studies on medical and conventional interventions for infantile colic from 1980 to March 2009. The results and methodological rigour of included studies were analysed using the CONSORT (Consolidated Standards Of Reporting Trials) 2001 statement checklist and Centre for Evidence Based Medicine critical appraisal tools. Nineteen studies and two literature reviews were included for review.

Pharmacological studies on simethicone gave conflicting results and with dicyclomine hydrochloride and cimetropium bromide results were favourable but side effects were noted along with issues in study methodology. Some nutritional studies reported favourable results for the use of hydrolysed formulas in bottle-fed infants or low-allergen maternal diets in breastfed infants but not for the use of additional fibre or lactase. There were several issues in regards to methodological rigour. Behavioural studies on the use of increased stimulation gave unfavourable results, whereas results from the use of decreased stimulation and contingent music were favourable. These studies demonstrated poor methodological rigour.

The researchers concluded:  "There is some scientific evidence to support the use of a casein hydrolysate formula in formula-fed infants or a low-allergen maternal diet in breastfed infants with infantile colic. However, there is little scientific evidence to support the use of simethicone, dicyclomine hydrochloride, cimetropium bromide, lactase, additional fibre or behavioural interventions. Further research of good methodological quality on low-allergenic formulas and maternal diets is indicated."

Not all therapies have been considered mainly due to lack of appropriate studies.

For the full abstract, click here.

Journal of Paediatrics and Child Health published online 7 April 2011 © 2011 Paediatrics and Child Health Division, Royal Australasian College of Physicians
Infantile colic: A systematic review of medical and conventional therapies. Belinda Hall, Janice Chesters, Anske Robinson. Correspondence to Anske Robinson: [email protected]

Category: D. Digestive. Keywords: infantile colic, medical, conventional, therapies, systematic literature review, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 26 April 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.