Functional gastro‐intestinal disorder algorithms focus on early recognition, parental reassurance and nutritional strategies

Vandenplas, Yvan; Benninga, Marc A.; Broekaert, Ilse; Falconer, Jackie; Gottrand, Frédéric; Guarino, Alfredo; Lifschitz, Carlos; Lionetti, Paolo; Orel, Rok; Papadopoulou, Alexandra; Ribes-Koninckx, Carmen; Ruemmele, Frank M; Salvatore, Silvia; Shamir, Raanan; Schäppi, Michela; Staiano, Annamaria; Szajewska, Hania; Thapar, Nikhil; Wilschanski, Michael

doi:10.1111/apa.13270

Cited by 71 publications

(108 citation statements)

References 59 publications

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“…The aim of this study was to evaluate the efficacy of a formula containing a partially hydrolyzed whey protein (pWH), reduced lactose content, the probiotic Bifidobacterium lactis BB12 and the prebiotic galacto-oligosaccharide (GOS) in formula fed infants suffering from IC. Data from Savino et al suggested with a comparable formula that this kind of dietary intervention may be of benefit [11]. The formula in the study by Savino and the intervention formula in this trial both contain a pWH, reduced lactose and GOS as prebiotic.…”

Section: Introductionmentioning

confidence: 92%

Innovative Dietary Intervention Answers to Baby Colic

Xinias

Analitis

Mavroudi

et al. 2017

Pediatr Gastroenterol Hepatol Nutr

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PurposeThe purpose of this paper is to evaluate the efficacy of a lactose- reduced synbiotic partial whey hydrolysate in formula fed infants presenting with colic and the impact of this dietary intervention in mean crying time and quality of life.MethodsForty infants with infantile colic were treated during one month with parental reassurance and the intervention formula (partial whey hydrolysate, reduced lactose, Bifidobacterium lactis BB12 and galacto-oligosaccharides) and were compared to a control group of 20 infants with infantile colic treated with parental reassurance and a standard infant formula. Parents completed a quality of life (QoL) questionnaire assessing the burden of infantile colic. Wilcoxon test, t-test and Mann-Whitney test were used to compare QoL scores before and after intervention as well as between the intervention and control group.ResultsAt inclusion, duration of crying did not differ between both groups. Crying duration decreased with 2.7 hours (from 3.2 to 0.5 hours) in the intervention group while duration of crying decreased only with 1.2 hours in the control group (p<0.001). Stool composition became looser in the intervention group, but defecation frequency did not change. The median scores of the QoL questionnaire improved significantly in the intervention group for all parameters. In the control group, parameters improved significantly also but not for the parent-child and social interaction. The score changes were significantly greater in the intervention than in the control group.ConclusionThe intervention formula (partial whey hydrolysate, synbiotic, reduced lactose) significantly reduced the duration of crying and improved QoL of the parents and infants.

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Section: Introductionmentioning

confidence: 92%

Innovative Dietary Intervention Answers to Baby Colic

Xinias

Analitis

Mavroudi

et al. 2017

Pediatr Gastroenterol Hepatol Nutr

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“…Physiological regurgitation should not be diagnosed in infants with vomiting and poor weight gain 22, 23.…”

Section: Management Of Regurgitationmentioning

confidence: 99%

“…Parents can be reassured that crying peaks at about 4–6 weeks after birth and then steadily diminishes until 12 weeks 4, 24. If there is no evidence of cows’ milk protein allergy or warning signs of organic disease, the feeding technique should be evaluated and the caregivers should be reassured and supported 22.…”

Section: Management Of Infantile Colicmentioning

confidence: 99%

“…Parental reassurance and follow‐up laxatives may still be required if an organic condition, such as Hirschsprung's disease or cystic fibrosis, is excluded and there are no accompanying signs, such as failure to thrive, intermittent diarrhoea or abdominal distension 22.…”

Section: Management Of Functional Constipationmentioning

confidence: 99%

“…In addition, changes in society changes have raised parents’ expectations for instant solutions, which results in healthcare professionals being placed under enormous pressure to act and to investigate or prescribe pharmacological products. This often results in infants undergoing unnecessary investigations and medical treatment, which do not offer any significant improvements 22.…”

Section: Pharmacological Management Of Fgids In Early Lifementioning

confidence: 99%

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Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

et al. 2018

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AimRegurgitation, infantile colic and functional constipation are common functional gastrointestinal disorders (FGIDs) during infancy. Our aim was to carry out a concise review of the literature, evaluate the impact of these common FGIDs on infants and their families, and provide an overview of national and international guidelines and peer‐reviewed expert recommendations on their management.MethodsNational and international guidelines and peer‐reviewed expert recommendations on the management of regurgitation, infantile colic and functional constipation were examined and summarised.ResultsRegurgitation, infantile colic and functional constipation cause frequent parental concerns, lead to heavy personal and economic costs for families and impose a financial burden on public healthcare systems. Guidelines emphasise that the first‐line management of these common FGIDs should focus on parental education, reassurance and nutritional advice. Nutritional advice should stress the benefits of continuing breastfeeding, while special infant formulas may be considered for non‐breastfed infants with common FGIDs. Drug treatment is seldom required, with the exception of functional constipation.ConclusionBy providing complete and updated parental education, reassurance and nutritional advice, healthcare professionals can optimise the management of FGIDs and related symptoms and reduce the inappropriate use of medication or dietary interventions.

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Algorithms for Common Gastrointestinal Disorders

Vandenplas

2016

J. pediatr. gastroenterol. nutr.

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Regurgitation, infantile colic and, or, constipationare frequent during the first 12 months of life, and although they aremost of the time functional disorders, these conditions can also be related to cow's milk. Practical algorithms for their management are presented. Management consists of exclusion of warning signs for organic disease, parental reassurance and nutritional strategies. The proposed algorithms will assist healthcare providers to manage frequent gastrointestinal and cows’ milkrelated symptoms in infants.

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Functional gastro‐intestinal disorder algorithms focus on early recognition, parental reassurance and nutritional strategies

Cited by 71 publications

References 59 publications

Innovative Dietary Intervention Answers to Baby Colic

Innovative Dietary Intervention Answers to Baby Colic

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

Algorithms for Common Gastrointestinal Disorders

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