Knowledge, attitudes, and practices of pediatricians on infantile colic in the Middle East and North Africa region

Abstract

BackgroundRegional evidence-based guidelines for the prophylaxis and management of infantile colic are not available for the Middle East and North Africa (MENA) region. The Allied Against Infantile Functional GI Disorders (ACT) Working Group was created in January, 2015 to determine the knowledge gaps and the current management practices of infantile colic by physicians in the MENA region. The ACT group determined the need for a survey to address these questions. The objectives of the survey were to highlight current clinical practices on the management of infantile colic and to raise awareness on colic severity in the MENA region.MethodsThe ACT working group developed the survey which included respondent characteristics and closed questions on practice in colic prevention. The survey was subject to validation and ethics committee approval in all countries.ResultsA total of 1628 physicians (mostly pediatricians (75.4%), neonatologists (2.4%) and general practitioners (19.8%)) responded to the survey. The 5 most represented countries were KSA (27.9%), Kuwait (22.1%), Morocco (13.8%), Lebanon (10.6%), and Iraq (7.4%). Most of the respondents (77.8%) practiced in governmental settings. A majority of respondents (91.7%) reported that colic is diagnosed predominantly by clinical examination. Above 63%, of pediatricians surveyed, believed that the colic prevalence rate was >40%, which is greater than the 20% rate reported in worldwide surveys. Yet, most of the responding physicians (73%) prefer to simply reassure parents rather than prescribe a therapeutic agent. Most physicians were either neutral (58%) or did not endorse (18.4%) colic prophylaxis. Of those who prescribed formulae for non-breastfed children, a majority (64.3%) chose “Comfort” formulae over hydrolyzed or lactose-free formulae or formulae with probiotics.ConclusionsThe results of this survey suggest that a substantial proportion of responding physicians from the selected MENA countries do not advocate for prophylaxis of colic. The findings of this survey suggest that more educational efforts are required to increase awareness of the strong body of evidence supporting the efficacy of probiotics in the prevention and management of infantile colic.Electronic supplementary materialThe online version of this article (10.1186/s12887-017-0939-0) contains supplementary material, which is available to authorized users.

Childhood colic management under the optics of mothers and of the family health team

“…This statement is supported by a study developed in the Middle East and north Africa, which demonstrated that physicians prioritize as a strategy to promote the tranquility of parents. Other actions are related to breastfeeding and the use of formulas, as well as natural therapies (21) .…”

Child health advocacy in Saudi Arabia: Traditional medicine as a model

“…In one study, pediatricians and general practitioners across middle-eastern and northern Africa have found that 25% of parents reported giving their babies herbal medications, and 0.8% reported cauterizing their babies before seeking medical help to relieve infantile colic. 18 Another study has reported that 51.8% of mothers use herbal medications for infantile colic. 19 Anzaroot ( Astragalus sarcocolla Dymock) is a well-known herb in KSA used to treat infantile colic, abdominal pain, and the common cold.…”

Management of the Most Common Functional Gastrointestinal Disorders in Infancy: The Middle East Expert Consensus

“…Although clear estimates from the Middle East and North Africa (MENA) region are lacking, available data point toward a much higher prevalence of FGIDs. In a recent survey of pediatricians from the MENA region, the majority of the participants stated that the prevalence of infant colic <4 months of age exceeded 40% [ 9 ]. A survey of Saudi mothers found that their major reasons for changing an infant formula were colic and gas (32%), constipation (23.6%), and gastroesophageal reflux (20.4%) [ 10 ].…”