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Background: Colic in infants is defined as excessive crying in an otherwise healthy and thriving baby. Colic is a common but poorly understood and often frustrating problem for caregivers. Objective: To study whether osteopathic treatments of infants with infantile colic / excessive crying (IC/EC) have an impact on the subjectively perceived psychological stress of caregivers compared to usual care. Methods: The study was designed as a prospective, multicenter, randomized controlled trial. Infants aged 1 week to 3 months and who met Rome IV criteria for IC/EC were included. By means of external randomization, infants were allocated to an intervention group or a control group. Infants in the intervention group received three osteopathic treatments at intervals of one weeks. The treatments were custom-tailored and based on osteopathic principles. Controls received their osteopathic treatment after a 3 week untreated period. The primary outcome parameter was the assessment of parental psychological stress (three questions), measured using a numeric rating scale (NRS; 0–10). Furthermore, the average daily crying time (measured using the Likert scale), the crying intensity (measured using the NRS) and the parents' self-confidence (measured using the Karitane Parenting Confidence Scale) were assessed. Results: A total of 103 infants (average age 39.4 ±19.2 days) were included, 52 in the intervention group and 51 in the control group. An inter-group comparison of changes revealed clinically relevant improvements in favor of the intervention group for the main outcome – parameter psychological stress – for all 3 questions (e.g., for question 2 respectively 3, NRS: between group difference of means 3.5; 95% CI: 2.6 to 4.4; p < 0.001). For the secondary outcome parameters of crying intensity and crying time/day, the changes were of similar magnitude. Conclusion: Three osteopathic treatments given over a period of two weeks led to statistically significant and clinically relevant positive changes of parental psychological stress. Trial registration: German Clinical Trials Register: DRKS00025867, registration date 10.08.21. [ABSTRACT FROM AUTHOR]

Objective: Researchers have considered medicinal oils to prevent and treat pediatric diseases. In the traditional Persian medicine (TPM) doctrine, anointment is widely used in order to avoid and treat diseases. This study aimed to evaluate and reconcile the uses of anointment in children in TPM and the new studies. Materials and Methods: Accordingly, TPM documents were scrutinized for anointments and their applications in pediatric disorders. Moreover, new studies were reviewed in Google scholar, PubMed, Medline, Scopus, and Web of Science until June 2022. Results: In the health preservation field, TPM scholars have recommended daily anointment with some oils like sweet almonds in the early months after birth to improve growth, strengthen the body, and prevent dry skin, and new studies have confirmed the effectiveness of some oils accordingly. In the treatment field, various oils are recommended, namely sweet almond oil for weight disorders, violet oil for insomnia, olive oil and chamomile oil for functional constipation, infantile colic and enuresis, and olive oil for diaper rash and atopic dermatitis and new studies have shown their effectiveness. Sweet almond, chamomile, violet, olive, and rose oils are among the most widely used oils in Persian medicine for children, which we have discussed in this study. Conclusion: Due to the non-invasive nature of anointment and the observation of minimal adverse effects in studies, it can be given attention for maintaining pediatric health and treating their diseases. [ABSTRACT FROM AUTHOR]

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Background: Infantile colic is a common condition with limited knowledge about later clinical manifestations. We evaluated the role of the early life gut microbiome in infantile colic and later development of atopic and gastrointestinal disorders. Methods: Copenhagen Prospective Studies on Asthma in Childhood2010 cohort was followed with 6 years of extensive clinical phenotyping. The 1‐month gut microbiome was analyzed by 16S rRNA sequencing. Infantile colic was evaluated at age 3 months by interviews. Clinical endpoints included constipation to age 3 years and prospectively diagnosed asthma and atopic dermatitis in the first 6 years of life, and allergic sensitization from skin prick tests, specific Immunoglobulin E, and component analyses. Results: Of 695 children, 55 children (7.9%) had infantile colic. Several factors were associated with colic including race, breastfeeding, and pets. The 1‐month gut microbiome composition and taxa abundances were not associated with colic, however a sparse Partial Least Squares model including combined abundances of nine species was moderately predictive of colic: median, cross‐validated AUC = 0.627, p =.003. Children with infantile colic had an increased risk of developing constipation (aOR, 2.88 [1.51–5.35], p =.001) later in life, but also asthma (aHR, 1.69 [1.02–2.79], p =.040), atopic dermatitis (aHR, 1.84 [1.20–2.81], p =.005) and had a higher number of positive allergic components (adjusted difference, 116% [14%–280%], p =.012) in the first 6 years. These associations were not mediated by gut microbiome differences. Conclusions: We link infantile colic with risk of developing constipation and atopic disorders in the first 6 years of life, which was not mediated through an altered gut microbiome at age 1‐month. These results suggest infantile colic to involve gastrointestinal and/or atopic mechanisms. [ABSTRACT FROM AUTHOR]

Abstract Background Infantile Colic (IC) poses a significant challenge for parents as it manifests through repeated and extended episodes of fussiness, crying, or irritability occurring before the age of 5 months. The precise cause of IC is currently unknown. The association between IC, a family history of atopy, and the development of individual atopy in the future remains uncertain, given conflicting findings from prior studies. Objectives This study aimed to investigate the impact of parental atopy on IC severity and the effectiveness of the mother’s hypoallergenic Dairy-Free Diet in alleviating pain in infants with colic. Methods This non-randomized trial conducted at Amirkabir Hospital in Arak, Iran, from January 2023 to October 2023, involving 206 eligible IC patients non-randomly assigned to two groups based on parental atopy history. Breastfed infants were prescribed a dairy-free diet, involving the removal of dairy products from the mother’s diet. Pain severity was assessed using the FLACC scale at baseline and after one-month of intervention. Results The research initially involved 206 subjects with an average age of 28.77 ± 9.99 days, evenly distributed based on parental atopy history. However, there was a 28.6% loss to follow-up, resulting in a final analyzed population of 147 individuals. The intervention, a maternal dairy-free diet, demonstrated a significant reduction in pain symptoms within both groups and overall (P = 0.001), with no significant difference in efficacy between infants with and without parental atopy history (P = 0.219). Parental history of atopy did not exhibit a significant association with colic pain severity (P = 0.404). The study revealed that the impact of the diet on colic severity varied, with more pronounced effects observed in cases of severe and moderate colic compared to mild cases. Conclusions Adopting a Dairy-Free Diet significantly reduced colic symptoms, irrespective of parental atopy history. The severity of colic appears unrelated to parental atopy, and the observed improvement with a Dairy-Free diet is potentially attributed to milk intolerance rather than milk allergy.

Background. Functional gastrointestinal disorders in the first year of life are a common problem for the child and parents. In addition to significant discomfort for the family, they often lead to a range of inconsistent behaviors that include duplicate consultations with different health care providers, frequent changes in types and names of infant formula, or the use of expensive non-medication treatments. According to current data, 54.9% of infants exhibit at least one symptom of functional gastrointestinal disorders between 0 and 6 months of age. The most common functional digestive disorders of the first 12 months of life include regurgitation, infantile colic and functional constipation.Objective. The purpose of the study was to assess the safety and tolerability of infant formula containing locust bean gum and prebiotics galacto- and fructooligosaccharides (GOS/FOS). The study assessed the effectiveness of the mixture in reducing symptoms of functional disorders of the gastrointestinal tract in children of the first year of life also.Results. This 4-week, open-label, non-randomized, prospective post-registration study enrolled 40 formula-fed or formula-fed infants aged 2 to 14 weeks. The tested formula contained 0.4 g/100 ml locust bean gum as a thickener and 0.4 g/100 ml prebiotics, short-chain galacto-oligosaccharides (scGOS) and long-chain fructo-oligosaccharides (lsFOS) in a 9:1 ratio. Infants receiving locust bean gum and the prebiotics scGOS/lcFOS 9:1 formula demonstrated a significant reduction in the frequency and intensity of symptoms of functional gastrointestinal disorders, including infantile colic (92%) and regurgitation (100%) over 4 weeks of use. The average parental satisfaction with diet therapy was 9 out of 10 points.Conclusion. An infant formula containing locust bean gum and prebiotics scGOS/lcFOS 9:1 is well tolerated and ensures adequate growth. Analysis of the collected data shows that the formula leads to a decrease in functional gastrointestinal disorders, eliminating regurgitation in 100% of children and infant colic in 92% of children by the end of the study.

Health claims for many probiotic‐labeled products are poorly substantiated. This technical review addressed the clinical question: “Do probiotics have a role in the management of the following conditions in childhood?” Evidence supports efficacy for probiotic strains of Saccharomyces boulardii, Lactobacillus reuteri, and Lactobacillus rhamnosus GG for improving outcomes of acute gastroenteritis, of S. boulardii and L. rhamnosus GG for antibiotic‐associated diarrhea, and of S. boulardii for Clostridium difficile diarrhea. For functional constipation and GERD, a role for probiotics is questionable as evidence of efficacy is either absent or marginal and as existing treatments are effective. For infantile colic and chronic abdominal pain, where existing treatments have limited efficacy and some important side effects, the use of probiotics, given their safety, is recommended, notwithstanding the evidence is low to moderate. While there is some evidence that probiotics could improve outcomes in the management of celiac disease, obesity, and, to a lesser extent, promotion of growth, their role is adjunctive as dietary management is fundamental. The evidence also supports an adjunctive role for probiotics in the treatment of Helicobacter pylori infection and ulcerative colitis. Decisions on probiotic prescription need to take into account disease tempo, severity, and burden, as well as probiotic strain and dose. Any potential advantage will have to be weighed against the complexity and costs of an additional treatment. [ABSTRACT FROM AUTHOR]

Background: Infantile Colic (IC) poses a significant challenge for parents as it manifests through repeated and extended episodes of fussiness, crying, or irritability occurring before the age of 5 months. The precise cause of IC is currently unknown. The association between IC, a family history of atopy, and the development of individual atopy in the future remains uncertain, given conflicting findings from prior studies. Objectives: This study aimed to investigate the impact of parental atopy on IC severity and the effectiveness of the mother's hypoallergenic Dairy-Free Diet in alleviating pain in infants with colic. Methods: This non-randomized trial conducted at Amirkabir Hospital in Arak, Iran, from January 2023 to October 2023, involving 206 eligible IC patients non-randomly assigned to two groups based on parental atopy history. Breastfed infants were prescribed a dairy-free diet, involving the removal of dairy products from the mother's diet. Pain severity was assessed using the FLACC scale at baseline and after one-month of intervention. Results: The research initially involved 206 subjects with an average age of 28.77 ± 9.99 days, evenly distributed based on parental atopy history. However, there was a 28.6% loss to follow-up, resulting in a final analyzed population of 147 individuals. The intervention, a maternal dairy-free diet, demonstrated a significant reduction in pain symptoms within both groups and overall (P = 0.001), with no significant difference in efficacy between infants with and without parental atopy history (P = 0.219). Parental history of atopy did not exhibit a significant association with colic pain severity (P = 0.404). The study revealed that the impact of the diet on colic severity varied, with more pronounced effects observed in cases of severe and moderate colic compared to mild cases. Conclusions: Adopting a Dairy-Free Diet significantly reduced colic symptoms, irrespective of parental atopy history. The severity of colic appears unrelated to parental atopy, and the observed improvement with a Dairy-Free diet is potentially attributed to milk intolerance rather than milk allergy. [ABSTRACT FROM AUTHOR]

Cow's milk protein allergy (CMPA) affects 2% to 3% of infants and is managed with hypoallergenic formulas. The 2022 recalls of infant formulas due to factors including contamination led to specialty formula shortages, highlighting CMPA management challenges. Understanding health care providers' (HCPs) decision-making in transitioning to alternative formulas during shortages is crucial. Limited attention has been given to how pediatric physicians make these choices. This study utilized US HCPs' de-identified survey data to assess driving factors when switching extensively hydrolyzed formulas during shortages. A total of 104 eligible HCPs participated, including general pediatrics, pediatric allergy/immunology, and pediatric gastroenterology specialists. Safety, tolerability, and efficacy were identified as top factors for switching formulas. Formula 1 was considered well-tolerated, patient-accepted, and safe by all HCPs. Most expressed strong belief in Formula 1's safety and effectiveness. Findings inform CMPA management during shortages, offering guidance to HCPs for suitable formula selection and enhanced infant care. [ABSTRACT FROM AUTHOR]

Diagnosis of infant feeding problems can be challenging due to limited examination findings, few options of diagnostic tests and overlying symptoms. While contrasting colic, CMPA and reflux, this article highlights the overlapping symptoms of each condition and seeks to analyse the differences to provide a framework for diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Psychosocial factors such as maternal stress in lactating women were shown to be related to an increased risk of infantile colic because the infants can be affected through breast milk. Therefore, domestic violence against lactating mothers can be effective on the infants' health. It is also demonstrated that domestic violence against women has increased following the COVID-19 pandemic and quarantine. Therefore, this study aims to assess the relationship between domestic violence against breastfeeding women during COVID-19 and the incidence of infantile colic. Methods: This was a case-control study that was conducted on 356 lactating mothers who attended Bentolhoda Hospital in Bojnoord-Iran from November 2021 to August 2022. The participants were exclusively breastfeeding mothers who were under 6 months infants. Mothers with and without infantile colic infants were considered the case and control groups, respectively. Two questionnaires were used for data collection including a demographic questionnaire, and a questionnaire to assess domestic violence against women during the quarantine period of Corona pandemic. The data was analyzed using SPSS-V22 and Pearson Spearman correlation and linear regression tests. Results: The results showed that women in the case group had a significantly higher score for "sexual violence and restraint" than women in the control group [0.59 ± 0.34 versus 0.62 ± 0.25 (Mean ± SD), respectively] (P < 0.05). The chance of infantile colic was higher among the infants of mothers who experienced domestic violence, but it was not statistically significant (OR = 1.236, P = 0.573). Significant relationships were found between the infantile colic and the history of abortion (OR = 1.430, P = 0.028) and cesarean section (OR = 1.723, P = 0.044). Conclusion: Domestic violence during pregnancy can potentially increase infant colic through breast milk. Although our findings need more investigation, it can be recommended to plan the direction of screening for domestic violence and providing the necessary care and counseling to the parents in perinatal care services to prevent infantile colic and improve the infant's health. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the effects of therapeutic touch (TT) on infantile colic symptoms (Infant Colic Scale (ICS) score, crying time and sleep time). Methods: This randomised controlled trial included infants aged 4–12 weeks diagnosed with infantile colic in a pediatric unit of a hospital. Infants were assigned to intervention or control groups using a stratified randomisation method. The intervention group received TT sessions six times, 3 days a week, in addition to usual care for 2 weeks. The control group received the usual care. Data were collected using Mother–Infant Information Form, ICS, Crying and Sleep Time Follow‐Up Forms. The infants were followed up for two weeks. Results: A total of 64 infants who met the criteria were included in the study, including intervention (n = 32) and control (n = 32) groups. There was a statistically significant difference between the groups (intervention and control) in terms of ICS scores (U = 4.5; P < 0.001; d = 3.252; 95% confidence interval (CI) = 2.505–3.999), crying time (F = 57.097; ŋp2 = 0.461; P < 0.001) and sleep time (F = 17.884; ŋp2 = 0.211; P < 0.001). When the intervention group was compared with the control group at all time points, the size of the effect (group × time interaction) was found to be high. Conclusions: TT effectively relieved symptoms, decreased crying time and increased sleep time in infants with infantile colic. TT is recommended to relieve colic in infants. [ABSTRACT FROM AUTHOR]

Introduction: According to current knowledge, at birth, the pineal gland and melatonin receptors are already present and the suprachiasmatic nucleus is largely functional, and noradrenaline, the key pineal transmitter, can be detected in the early foetal period. It is still unclear why the pineal gland is not able to start its own pulsatile synthesis and secretion of melatonin in the first months of life, and as a result, infants during this time are dependent on an external supply of melatonin. Method: The causes and consequences of this physiological melatonin deficiency in human infancy are examined in a systematic review of the literature, in which 40 of 115 initially selected publications were evaluated in detail. The references of these studies were checked for relevant studies on this topic. References from previous reviews by the author were taken into account. Results: The development and differentiation of the pineal gland, the pinealocytes, as the site of melatonin synthesis, and the development and synaptic coupling of the associated predominantly noradrenergic neural pathways and vessels and the associated Lhx4 homebox only occurs during the first year of life. Discussion: The resulting physiological melatonin deficiency is associated with sleep disorders, infant colic, and increased crying in babies. Intervention studies indicate that this deficiency should be compensated for through breastfeeding, the administration of nonpooled donor milk, or through industrially produced chrononutrition made from nonpooled cow's milk with melatonin-poor day milk and melatonin-rich night milk. [ABSTRACT FROM AUTHOR]

Background: Although infantile colic is believed to be a benign and self-limiting condition, it can cause anxiety in both caregivers and infants. Thus, this study aimed to ascertain what pediatric residents know and do regarding this condition. Methods: A cross-sectional facility-based survey was carried out on 113 pediatric residents enrolled in the 4th-year pediatric residence training program. The researchers developed a structured, pretested, and validated questionnaire to gather the data. SPSS version 25 was used for the data analysis. The qualitative data are expressed as frequencies (N) and percentages (%). The quantitative data are expressed as ranges, means, standard deviations, medians, and interquartile ranges (IQRs). Results: The respondent’s mean age was 30.32 ± 3.04 years. Less than half of the participants can identify the clinical criteria for diagnosing infantile colic. Although 97 (85.8%) of the residents suspected infantile colic when examining infants screaming or irritable for no obvious reason, 83 (73.4%) believed that additional laboratory testing was required to confirm the diagnosis. Although 111 (98.2%) of the residents agreed that parent education on the condition’s benign and self-limiting nature is the cornerstone of treatment, most were unsure about alternative treatment approaches. The majority of residents do not always give medications and/or remedies, nor do they promote nonpharmacological treatments for colic. If the infants do not improve with conservative or medical therapy and their parents return them, 64 (56.6%) of the residents will undertake a medical assessment, while 50 (44.2%) would request more investigations. In addition, 70 (61.9%) will continue to provide parental counseling and comfort. Conclusion: The findings of this study highlight the need for substantial efforts to improve resident’s knowledge and practice of infantile colic management. Such research findings are critical for allocating resources, planning, and implementing successful healthcare initiatives and policies.

Fennel (Foeniculum vulgare Mill), a member of the Apiaceae family (Umbelliferaceae), is a hardy and perennial herb, with grooved stems, intermittent leaves, petiole with sheath, usually bisexual flower and yellow umbrella. Although fennel is a typical aromatic plant generally considered native to the Mediterranean shores, it has become widespread in many regions of the world and has long been used as a medicinal and culinary herb. The aim of this review is to collect recent information from the literature on the chemical composition, functional properties and toxicology of fennel. Collected data show the efficacy of this plant in various in vitro and in vivo pharmacological studies including antibacterial, antifungal, antiviral, antioxidant, anti-inflammatory, antimutagenic, antinociceptive, hepatoprotective, bronchodilatory, and memory enhancing activities. It has also been shown to be effective on infantile colic, dysmenorrhea, polycystic ovarian syndrome and milk production. This review also aims to identify gaps in the literature that require to be filled by future research. [ABSTRACT FROM AUTHOR]

(1) Background: Infantile colic (IC) is a functional gastrointestinal disorder that affects around 20% of infants, and postpartum (PPD) depression is a common disorder that affects between 15 and 22% of mothers. In this study, our objective was to evaluate the relationship between the maternal psychological state in the first postpartum year and IC, with the aim of assessing the importance of feeding type in infants and maternal well-being. (2) Methods: A cross-sectional study was conducted in women in their first year postpartum. Demographic, medical, and obstetric data of the mothers and infants were collected, and the type of feeding was identified. The emotional status of the mother was evaluated using the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Colic Severity Questionnaire (ICSQ) was used for IC diagnosis. (3) Results: A total of 528 women were analyzed, of which 170 (32%) were diagnosed with possible PPD. Two-thirds of the women without depression breastfed their babies on demand; therefore, we report that exclusive breastfeeding (EBF) appears to reduce the risk of possible PPD (p < 0.001; OR = 2.353). IC was present in 39% of babies, and around 70% of babies without colic were breastfed on demand. Infants who were not exclusively breastfed showed almost double the risk of developing colic (p = 0.016; OR = 1.577). There was a significant association between the EPDS and ICSQ scores (p < 0.001). More than half of the women with PPD had babies with colic. However, our results show that 75% of babies without colic had mothers who reported optimal postpartum emotional well-being (p < 0.001; OR = 2.105). (4) Conclusions: The results of this study suggest that postpartum maternal psychological well-being reduces the risk of IC. Therefore, we report that EBF on demand, together with a healthy emotional state in new mothers, may be a protective factor against colic in infants. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the knowledge level of first-time mothers regarding digestive health issues in infancy and to examine the utilization of healthcare facilities for such problems. Methods: Data from 119 first-time mothers of infants under 6 months of age were analyzed. Descriptive statistics, t-test, and one-way analysis of variance (ANOVA) were conducted using the SPSS software. Results: The average correct response rate for first-time mothers' knowledge of digestive health problems in infancy was 61.9%. The highest correct response rate was observed for infantile colic, while diarrhea had the lowest. Less than 50% of mothers received education on infant digestive health problems across all categories. Among digestive health problems in infancy, diarrhea exhibited the highest rate of healthcare utilization, whereas infantile colic had the lowest. First-time mothers' knowledge of digestive health problems in infancy varied based on maternal age (t=-3.66, p<.001), education level (t=-2.26, p=.026), and planned pregnancy (t=3.24, p=.002). Moreover, mothers who received education on infant digestive health problems demonstrated better overall knowledge of digestive health problems. Conclusion: The rate of education regarding digestive health problems during infancy among first-time mothers was < 50%. Furthermore, mothers educated on infant digestive health issues exhibited improved knowledge. Therefore, it is necessary to provide appropriate pre-education to primiparous common gastrointestinal health issues in infants. [ABSTRACT FROM AUTHOR]

Background. Complementary medicines (CMs) for infantile colic are widely available on the South African market, in various pharmacies and retail outlets, without the need for a prescription. Pharmacists therefore have an important role to play in educating patients about safe and appropriate use of CM products. Objectives. To investigate the perceptions and prescribing patterns of CMs for infantile colic by pharmacists and pharmacist assistants employed in the greater Johannesburg area. Methods. We used a quantitative approach with a descriptive survey design. A total of 100 pharmacists and pharmacist assistants registered with the South African Pharmacy Council completed a pen-and-paper questionnaire. Results. Many participants reported recommending both conventional and CMs for infantile colic and, overall, positive perceptions of CM were reported. Most participants agreed that they had a responsibility to counsel patients on the use of CM but felt that they needed to expand their own knowledge base. Conclusions. There appears to be a positive shift towards CM for the treatment of infantile colic; however, improved training is needed to ensure pharmacists and pharmacist assistants are better informed regarding CM products in order to give appropriate advice to patients. [ABSTRACT FROM AUTHOR]

Objective: The hypothalamic-pituitary-gonadal axis is active during minipuberty, the timing of which coincides with infantile colic. To the best of our knowledge, the relationship between these entities has not been previously investigated. Methods: Saliva samples were collected from 15- to 60-day-old term infants (n=139) between 9 am and 5 pm. Group 1 included infants with infantile colic (n=68, 54.4% female) while the remaining healthy infants constituted Group 2 (n=71, 47.9% female). Salivary levels of estradiol (Esal) in females and testosterone (Tsal) in males were measured by ELISA in duplicate. Results: The median (25th-75th centile) age and birth week for all infants were 33 (29-43) days and 39 (38.1-40) weeks, respectively. Levels of Tsal in males [Group 1, 73.35 (59.94-117.82) pg/mL vs Group 2, 77.66 (56.49-110.08) pg/mL, p=0.956] and Esal in females [Group 1, 3.91 (2.76-5.31) pg/mL vs Group 2, 4.03 (1.63-12.1) pg/mL, p=0.683] were similar. However, in subjects with infantile colic (Group 1), Esal and body mass index (BMI) standard deviation scores of females were slightly correlated (Group 1, rs = 0.393, p=0.016 vs. Group 2, rs = 0.308, p=0.076) and there was a significant correlation between the sampling time and Tsal in males (Group 1, rs = 0.469, p=0.009 vs. Group 2, rs = -0.005, p=0.976). Conclusion: Random salivary sex steroid levels were similar in infants with and without infantile colic. However, in subjects with infantile colic, Esal levels in females were positively correlated with BMI and Tsal levels were higher later in the day among males. Thus, sex steroid production may be altered during minipuberty in subjects with infantile colic. [ABSTRACT FROM AUTHOR]

Purpose: Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents. Methods: A questionnaire was distributed amongst 1,256 physicians. Results: We received 800 replies. Wessel and Rome IV criteria were used by most physicians for diagnosis; however, the response "any infant who cries a lot" was selected by older physicians (48% of those over 60 years), physicians in rural areas (32%), physicians practicing in private clinics (27%), and general physicians (30%). Estimated prevalence of infantile colic ranges from 21-40%. Reassurance was the most widely recommended management strategy followed by herbal teas (51%), switching to a different formula (49%), probiotics (28%) and antibiotics (26%), discontinuation of breastfeeding (14%), elimination of dairy products from the breastfeeding mothers' diet (6%), and the administration of colic drops (1%). Most physicians considered the negative impact of colic on their personal lives and the parents as mild-to-moderate. Notably, 38% of percent of physicians routinely screened for maternal depression, and 45% of physicians were aware of the association between infantile colic and shaken baby syndrome. Conclusion: Most physicians in Pakistan diagnose and manage infantile colic according to the established guidelines. However, the guidelines pertaining to treatment planning are not followed. Educational efforts directed toward general physicians and doctors practicing in rural areas and clinics must be implemented to avoid unnecessary testing and treatment burden. [ABSTRACT FROM AUTHOR]

Infantile functional gastrointestinal disorders, such as colic, constipation, diarrhea, and gastroesophageal reflux (regurgitation), often occur in early infancy and, representing one of the causes of significant parental anxiety, lead to a significant strain on the healthcare resources. In this study, we aimed to evaluate the effects of Lactobacillus reuteri drops (L. reuteri NCIMB 30351) on the symptoms of infantile colic, constipation, diarrhea, and gastroesophageal reflux, as well as on the levels of intestinal microbiota in full-term newborns during the first months of life. A randomized, placebo-controlled, single-masked (blinded), post-marketing clinical study was conducted in two clinical units—Children's City Clinical Hospital of Moscow and Medical Center "St. Andrew's Hospitals-NEBOLIT" from March 2020 to May 2022 in 90 infants aged from 1 to 4 months (mean age (± SD) 12.3 ± 5.09 weeks; 53.3% females, 46.7% males). Patients with colic, regurgitation (single symptom or combination of several symptoms), and constipation or diarrhea were randomly allocated in two parallel arms to receive either 5 drops (2 × 108 colony forming unit) of L. reuteri NCIMB 30351 (n = 60) or masked placebo (n = 30) for 25 consecutive days. Two treatment arms had equal numbers of patients with constipation and diarrhea (n = 30 each). Daily crying times and their duration, evacuations, and regurgitations were recorded in a structured diary. The levels of gut microbiota were analyzed by deep sequencing of bacterial 16S rRNA gene. Infants with colic receiving supplementary L. reuteri NCIMB 30351 for 25 days had significant reduction in the numbers of colic (change from baseline − 6.3 (7.34) vs − 3.0 (7.29) in placebo, P < 0.05) and numbers of crying cases and mean duration of crying (decrease from baseline − 144 (70.7) minutes, lower in the diarrhea subgroup than in constipation infants, compared with − 80 (58.9) in placebo, P < 0.0001), as well as regurgitation numbers (decreased by − 4.8 (2.49) with L. reuteri vs − 3 (7.74) with placebo). We also observed increased numbers of evacuations in infants with constipation (L. reuteri 2.2 (2.4) vs 0.9 (1.06) in placebo, P < 0.05). There was a remarkable reduction of evacuations in infants with diarrhea, while not statistically significant. The analysis of bacterial 16S rRNA gene in the collected samples showed that L. reuteri positively influences the proportions of prevalent species, while it negatively affects both conditionally pathogenic and commensal microbes. Additional in vitro test for formation of Clostridium colonies in the presence of the probiotic demonstrated that L. reuteri effectively inhibits the growth of pathogenic Clostridium species. No adverse events were reported in this study. Conclusion: The uptake of L. reuteri NCIMB 30351 leads to a significant reduction in the number of regurgitations, feeding-induced constipations, and diarrhea as well as mean daily numbers of crying and crying duration in infants during the first months of life. Our results suggest that L. reuteri NCIMB 30351 represents a safe and effective treatment for colic in newborns. Trial registration: ClinicalTrials.gov: NCT04262648. What is Known: • Infantile functional gastrointestinal disorders, such as colic, constipation, diarrhea, and gastroesophageal reflux (regurgitation), often occur in early infancy and, represent one of the causes of significant parental anxiety. • A number of studies have shown that both the composition and diversity of the intestinal microbiota play important roles in the development and function of the gastrointestinal tract. What is New: • The uptake of L. reuteri NCIMB 30351 leads to a significant reduction in the number of regurgitations, feeding-induced constipations, and diarrhea as well as mean daily numbers of crying and crying duration in infants during the first months of life. • L. reuteri positively influences the proportions of prevalent species, while it negatively affects both conditionally pathogenic and commensal microbes in gut microbiota. [ABSTRACT FROM AUTHOR]

Functional gastrointestinal disorders (FGIDs) are characterized by a variety of symptoms that are frequently age-dependent, chronic, or recurrent and are not explained by structural or biochemical abnormalities. There are studies in the literature reporting different results regarding the relationship between prematurity and FGIDs. The main objective of this study was to compare the frequency of FGIDs between preterm and term infants. The secondary objective was to evaluate whether there was any association between neonatal characteristics and development of FGIDs. A multicenter prospective cohort study that included preterm infants born before 37 weeks of gestation and healthy term infants was carried out. At 1, 2, 4, 6, 9, and 12 months of age, infants were assessed for the presence of FGIDs using the Rome IV criteria. In preterm infants, an additional follow-up visit was made at 12 months corrected age. 134 preterm and 104 term infants were enrolled in the study. Infantile colic, rumination syndrome, functional constipation, and infant dyschezia were more common in preterm infants. Incidence of other FGIDs (infant regurgitation, functional diarrhea and cyclic vomiting syndrome) were similar among preterm and term infants. Preterm infants who are exclusively breastfeed in the first 6 months of life have a lower incidence of infantile colic (18.8% vs 52.1%, p = 0.025). In terms of chronological age, FGIDs symptoms started later in preterm infants; this difference was statistically significant for infantile colic and regurgitation (median age 2 months vs 1 month, p < 0.001). Conclusions: Preterm infants have a higher prevalence of FGIDs compared with term controls. Therefore, especially if they have gastrointestinal complaints, they should be screened for FGIDs. Possibly due to maturational differences, the time of occurrence of FGIDs may differ in preterm infants. Infantile colic incidence decreases with exclusive breastfeeding. What is Known: • The functional gastrointestinal disorders are a very common in infancy. • Data on preterm infants with FGIDs are currently very limited. What is New: • Preterm infants have a higher incidence of infantile colic, rumination syndrome, functional constipation and infant dyschezia when compared to term infants. • Preterm infants who are exclusively breastfed during the first 6 months of life experience a lower incidence of infantile colic. [ABSTRACT FROM AUTHOR]

Introduction: Infantile colic is a functional gastrointestinal disorder found in 20%-30% of infants aged <5 months which is characterized by recurrent prolonged periods of infant irritability, fussing, or crying without obvious cause and cannot be prevented or resolved by parents. Infantile colic is often associated with higher mothers' depression and lower quality of life. Mothers' knowledge and behavior of infantile colic varies greatly. This research investigates the knowledge and behavior of Indonesian mothers regarding infantile colic and related factor Methods: A cross-sectional analytic observational study with a target of 100 mothers with babies aged 0-12 months was performed using an electronic questionnaire in Google Forms. The questionnaire consists of multiple-choice questions regarding the mothers' knowledge and behavior of infantile colic. Results: As many as 82% of mothers understand that infantile colic is recurrent prolonged periods of crying that occur without obvious cause and cannot be prevented or resolved by parents, however only 12% of mothers know that most infantile colic will disappear by the age of 5 months. Forty percent of mothers had babies with infantile colic; 97.5% of them were worried about their baby's condition and 7.5% of the mothers gave them medication. There was no significant difference between mothers' age and the number of children with inadequate mother-infant interaction (P = 0.770 and P = 0.647) Conclusion: The knowledge and behavior of mothers in Indonesia regarding infantile colic is quite good, however, parental reassurance still needs to be improved, especially to reduce maternal anxiety. [ABSTRACT FROM AUTHOR]

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Infantile colic can be distressing for infants, parents, and providers. Infants with colic display prolonged periods of inconsolable crying. This creates stress in families at a critical time in bonding and development. Furthermore, colic does not have a known etiology or standard treatment outside of reassurance and coping strategies for parents. The etiology of colic is likely multifactorial; however, recent evidence has demonstrated a relationship between colic and the gastrointestinal microbiome. The purpose of this article is to summarize the available information about colic's link to the gastrointestinal microbiome so that providers can equip parents with the knowledge and skills to care for their infant with colic appropriately. [ABSTRACT FROM AUTHOR]

There is a general consensus that crying makes up a substantial proportion of infants' early communicative repertoire. The authors examine what is currently known about the range of 'normal' crying. This is difficult to establish because of the wide variability in cry patterns recorded from healthy infants even within the same families. In addition, across countries, cultural differences in parenting practices and expectations are also thought to shape the amount of crying infants do. Nevertheless excessive crying is a cause of distress for many parents and some strategies for coping are put forward. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of nocturnal crying (NC) and infantile colic (IC). Methods: Total effective rate, crying time and adverse events were used as outcome indicators. To assess the quality, the risk of bias was determined for each study by two authors, using the Cochrane Collaboration's risk of bias tool. RevMan 5.0 was used for data analysis. A total of 98 articles were identified from 6 electronic databases. Results: Among them, twenty-seven studies which included 13 NC and 14 IC were included. Meta-analysis showed favorable effects tuina therapy on total effective rate (TER) of NC (RR: 1.20 [95% CI 1.05 to 1.37], p = 0.007), chiropractic therapy on crying time change of IC (SMD: -0.83 [95% CI -1.61 to -0.06], p = 0.04) and massage on total crying time of IC (SMD: -0.86 [95% CI -1.09 to -0.63], p < 0.00001). This systematic review compares different manual therapies for the treatment of NC and IC. While tuina, chiropractic, and massage show results in alleviating symptoms, the overall evidence remains limited due to the low quality and heterogeneity of the included studies. Conclusion: Therefore, further high-quality research with unified control groups is needed to establish manual therapy as a recommended treatment option for NC and IC. Protocol registration number is CRD42022348143 01/08/2022.

Migraine is one of the most common causes of primary headache in the pediatric population. In addition to pain manifestations, episodic syndromes are also found in children, which often lack cephalgic manifestations and are difficult to verify in clinical practice.Objective: to determine the characteristics of the migraine and episodic syndromes associated with migraine in children of different age groups.Material and methods. The study included 250 children complaining of headaches (166 girls and 84 boys aged 5 to 18 years, mean age 13 years). The patients were divided into groups: Group 1 – preschool age (5–6 years) and elementary school age (7–10 years) – 20.8% (n=52) of patients; Group 2 – middle school age (11–14 years) – 45.2% (n=113) of patients; Group 3 – high school age (15–18 years) – 34% (n=85) of patients. A structured diagnostic interview was conducted with all study participants (or their parents) and pain and anxiety were assessed using special scales and tests adapted for children (visual analog scale (VAS); Digital Pain Rating Scale (DPS); Verbal Rating Pain Scale (VRPS), Faces Pain Scale (FPS), MIDAS scales, Hands scale, depression scales adapted by T.I. Balashova, Spielberger-Khanin anxiety scale).Results. The average age at onset of headache in the general structure was 11 [9; 13] years. Migraine was diagnosed in 40.4% (n=21) of the patients in Group 1, in 31.9% (n=36) of the patients in Group 2 and in 29.4% (n=25) of the patients in Group 3. An increase in age by 1 year leads to a 1.17-fold decrease in complaints for headache in combination with vomiting. With an increase in the age of the patients by 1 year, excessive sleep is significantly less likely to be a factor provoking headaches. A statistically significant inverse association was found between age and FPS scores (ρ =-0.13, 95% CI: -0.25; -0.002; p=0.0457), VAS (ρ =-0.13, 95% CI: -0.25; -0.004, p=0.0425) and Balashova scale score (ρ =-0.14, 95% CI: -0.26; -0.01, p=0.0327). The mean values for the intensity and severity of headaches decrease with age. Analysis of the prevalence of episodic syndromes associated with migraine revealed that in the general group, intestinal colic in infancy was found in 49.6% (n=124) of cases, in Group 1 – in 51.9% (n=27), in Group 2 – in 47.8% (n=54) and in Group 3 – in 50.6% (n=43) of patients. In the general group, torticollis was found in 14.4% (n=36) of patients, which increased slightly with age. Intermittent abdominal pain was found in a total of 33.2% (n=83) and spontaneous vomiting in 18% of children, and its prevalence decreased with age.Conclusion. The prevalence of migraine in children of different age groups suffering from headache varies between 40.4% and 29.4% of cases. Frequency of gastrointestinal symptoms accompanying a headache attack and the provoking effect of sleep decrease continuously with increasing age. Episodic childhood syndromes associated with migraine may vary in their characteristics between different age groups of pediatric patients.

Aim: This study is a systematic review and meta‐analysis of randomised controlled trials that employed probiotics and symbiotics for treating infantile colic. Methods: We performed electronic systematic literature searches in Embase, PubMed and Web of Science, to identify articles published between 1950 and April 2023. Only RCT involving infants with infantile colic under 3 months were included. The treatment plan comprised 15 probiotics, which included Lactobacillus reuteri DSM 17938 and Bifidobacterium animalis lactis BB‐12. The probiotics were administered alone or in combination with a prebiotic, vs. no intervention or a placebo. Results: Probiotics resulted in an average reduction of 51 min of crying per day (p = 0.001). Further analysis of subgroups showed that the reduction was −39.30 min for vaginal delivery (p = 0.003), −64.66 min for Lactobacillus reuteri DSM 17938 (p = 0.03), −40.45 min for other strains (p < 0.00001), −74.28 min for exclusively breastfed infants (p = 0.0003) and −48.04 min for mixed feeding (p < 0.00001). Conclusion: All probiotic strains seem effective in treating infantile colic. Exclusively breastfed infants have demonstrated more significant reduction in crying time. However, the available evidence on the effectiveness of probiotics in formula‐fed and caesarean‐born infants is limited. [ABSTRACT FROM AUTHOR]

Different nutraceuticals are often considered by parents of infants and children with abdominal pain and disorders of the gut–brain interaction. Herb extracts and natural compounds have long been used in traditional medicine, but clinical pediatric trials are very limited. This narrative review based on relevant studies identified through a search of the literature in Pubmed and Medline updated to October 2023 focused on the effect of nutraceuticals in infantile colic, functional abdominal pain, and irritable bowel syndrome in children and adolescents. Significant reductions in colic episodes and crying time were reported in two studies on fennel (seeds oil or tea), in three studies on different multiple herbal extracts (all including fennel), in one study on Mentha piperita, and in at least two double-blind randomized controlled studies on Lactobacillus reuteri DSM 17938 and Bifidobacterium lactis BB-12 (108 CFU/day for at least 21 days) in breast-fed infants. Compared to a placebo, in children with functional abdominal pain or irritable bowel syndrome, a significant reduction in pain was reported in two studies supplementing peppermint oil capsules or psyllium fibers, and in one study on corn fiber cookies, partial hydrolyzed guar gum, a specific multiple herbal extract (STW-5), or vitamin D supplementation. To date, there is moderate-certainty evidence with a weak grade of recommendation on Lactobacillus reuteri DSM 17938 (108 CFU/day) in reducing pain intensity in children with functional abdominal pain and for Lactobacillus rhamnosus GG (1–3 × 109 CFU twice daily) in reducing pain frequency and intensity in children with IBS. Further large and well-designed pediatric studies are needed to prove the efficacy and safety of different herbal extracts and prolonged use of studied products in infants and children with pain disorders of the gut–brain interaction. [ABSTRACT FROM AUTHOR]

Background: Primary stabbing headache (PSH) is an idiopathic headache disorder characterized by head pain occurring as a transient and localized single stab or a series of stabs. The present study aimed to examine the characteristics of childhood PSH and whether they fit the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. We also investigated the association with migraine and episodic syndromes. Methods: In this retrospective study, we included 60 patients seen at two headache clinics (Rome and Bari) between 2016 and 2022. A headache-focused history was obtained. All patients had normal neurological examination. PSH was defined according to ICHD-3 criteria. Results: Twenty-three patients were male (38%) and median (range) age at disease onset was 8 (3–17) years. Stabs recurred with irregular frequency and their duration varied from a few seconds up to 30 minutes. Stabs were located in different head regions. Twenty-five patients (42%) underwent neuroimaging exams. Five children reported a limitation of daily activities and none had a chronic pattern. Forty-seven patients (78%) reported a family history of primary headache, especially migraine, and forty-three had episodic syndromes (i.e. infantile colic, benign paroxysmal vertigo, motion sickness, recurrent abdominal pain, cyclic vomiting). Twenty patients had an associated primary headache: 16 suffered from migraine and four suffered from tension type-headache. According to ICHD-3 criteria, thirty-one patients had a diagnosis of probable PSH as a result of a duration of stabs longer than a few seconds (>3 seconds). Conclusions: Features of childhood PSH can vary widely. As seen in previous studies, several patients reported a stab duration longer than a few seconds and this might suggest that current ICHD-3 criteria may need adjustments to be suitable for children. High frequency of associated migraine and episodic syndromes could suggest a common pathophysiological mechanism between PSH and migraine. We can hypothesize that PSH and migraine attacks may be part of a spectrum of the same disease, although further evidence is needed. Larger studies with long-term follow-up are needed to improve understanding of this condition. [ABSTRACT FROM AUTHOR]

Introduction: Infant colic, causing excessive crying, poses anxiety for parents and a challenge for pediatricians and nurses. The Infant Colic Scale (ICS) serves to assess the severity and causal factors of colic. Despite its significance, the psychometric properties of ICS have not been evaluated in the Iranian population. This study seeks to address this gap by assessing the psychometric properties of ICS in Iran. Methods: A sample of 220 mothers with 2-16-week-old term infants diagnosed with infantile colic was selected through convenience sampling. Following forward and back-translation, the face validity, content validity, and construct validity of ICS were systematically evaluated. Reliability was examined through both internal consistency (Cronbach's alpha) and test-retest stability methods. Results: Content validity index (CVI) and content validity ratio (CVR) values for ICS were 0.94 and 0.81, respectively. The good fit indices confirmed the validity of the five-factor structure. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were 0.71 and 0.94, respectively. Conclusion: The Persian version of ICS is a valid and reliable tool, suitable for assessing infantile colic in the Iranian population. Future studies and clinical practice can utilize this tool to identify major causes of this disorder in the Iranian context. [ABSTRACT FROM AUTHOR]

This review article will address the frequently encountered functional gastrointestinal disorders (FGIDs) occurring in infancy. The clinical features and management of infant regurgitation, infant colic, infant dyschezia, and functional constipation are discussed with reference to the most recent literature and evidence. Management should be focused on ruling out organic causes with careful history and examination, and then reassurance for the caregiver in this often very stressful period of parenting. There is often no or minimal pharmacological treatment necessary for FGIDs and treatment should be individualised for each patient and family. [ABSTRACT FROM AUTHOR]

The combination of Bifidobacterium longum and Pediococcus pentosaceus is a clinically effective probiotic formulation for alleviating infantile colic; however, their utilization characteristics and mechanism of action surrounding their combined use of sugar sources remains unclear. Using in vitro simulation technology, this study set up individual and mixed cultures of the two probiotics at unique concentrations, and different types of prebiotics, carbohydrates and polyols were added. Gas and short-chain fatty acid production, substrate utilization, as well as growth of the individual and mixed probiotics were detected at the beginning of fermentation, 24 h, and 48 h. Further, the mechanism of the syntrophic effect of the two probiotics was explored based on their growth characteristics. It was found that neither strain produced gas after 24 h and 48 h of cultivation, but could synergistically utilize fructo oligosaccharides (FOS) when mixed. There was an increasing trend of acetic acid production for B. longum in yeast extract, casitone and fatty acid (YCFA) and FOS medium with increasing of bacterial concentrations at 24 h and 48 h; whereas the trend for P. pentosaceus was less obvious. When bacterial concentrations were >5 billion CFU·g−1, the mixed culture showed significantly lower acetic acid production than B. longum alone. By adding lactic and acetic acids to the YCFA medium and observing P. pentosaceus growth, the results suggested that Pediococcus pentosaceus could use the acetic acid and lactic acid produced by Bifidobacterium longum for growth. When the bacterial concentration was 5 billion CFU·g−1, the acetic acid production of B. longum was significantly higher in the mixed cultures in lactulose, lactose, FOS, galactooligosaccharide, and inulin medium; whereas the reverse was true for culturing in xylitol, carboxymethyl cellulose sodium, and sorbitol medium. Further, the mixed cultures produced significantly more acetic acid than B. longum alone. In summary, through in vitro simulation experiments, the optimal ratio and potential interaction mechanisms between B. longum and P. pentosaceus were revealed here, offers a basis for understanding how the probiotic combinations may improve infant colic symptoms by influencing the gut pH and regulating the gut microbiota mechanisms.

Aims and Objectives: The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased multimorbidity (common infections, eczema and food sensitivity) compared with infants without these conditions. Secondarily, we aimed to determine whether infant pain symptoms were associated with maternal perceived stress in pregnancy and 3 months postpartum. Background: Infant colic and abdominal pain are common concerns in early infancy. Nevertheless, to our knowledge, little research exists on the relationship between infant pain and common infant infections, eczema and food sensitization as comorbidities, and the impact of infant pain on the development of maternal perceived stress from pregnancy to infancy is inconsistent. Design: This study was cross‐sectional and partly prospective. Methods: The sample consisted of mother–infant pairs (N = 1852); information regarding infant pain and multimorbidity was collected from the 3‐month questionnaire and postpartum visits in the PreventADALL prospective cohort study. Chi‐square tests and regression analyses were conducted. The STROBE checklist was followed. Results: Our results showed a statistically significant higher proportion of respiratory and other infections in infants with pain symptoms. The odds of infant pain were higher for infants with multimorbidity compared to those with no comorbidity. Mothers of infants with colic and of infants visiting healthcare with pain and other discomforts reported statistically significant higher perceived stress by 3 months compared with mothers of infants with no reported pain. Conclusion: Our results indicate an association between infant pain symptoms and the presence of infections. Mothers of infants with colic and visiting healthcare had higher perceived stress compared to the no pain group. Implications for Practice: Our study indicates that infant pain is associated with infant multimorbidity and maternal perceived stress, which may be useful when planning diagnostic, treatment and coping strategies in infant and family care. Patient or Public Contribution: The PreventADALL is a collaborative study with governmental and patient organisation representation. Selected infants with parents were also contributing during calibrating courses on eczema assessment for the data collectors. Trial Registration: The study was approved by the Regional Committee in Norway (2014/518) and Sweden (2014/2242–31/4) and registered at clinicaltrial.gov (NCT02449850). Link for clinical trials: https://clinicaltrials.gov/ct2/show/NCT02449850 [ABSTRACT FROM AUTHOR]

Background: Infant colic is a multifactorial syndrome for which various therapeutic strategies have been proposed. In this study, we evaluate the effectiveness of osteopathic manual therapy in treating symptoms related to infant colic. Method: A prospective, randomised, blinded clinical trial was conducted of patients diagnosed with infant colic. The treatment group were given osteopathic manual therapy, and their parents received two sessions of counselling. The control group received no such therapy, but their parents attended the same counselling sessions. The non-parametric Mann–Whitney U test was applied to determine whether there were significant differences between the groups for the numerical variables considered. For the qualitative variables, Fisher's exact test was used. The threshold assumed for statistical significance was 0.05. Results: A total of 42 babies were assigned to each group. Those in the experimental group presented less severe infant colic with a trend towards statistical significance after the first session (p = 0.09). In sucking, excretion, eructation and gas there were no significant differences between the groups. Crying was a statistically significant dimension both after the first intervention (p = 0.03) and two weeks after (p = 0.04). Regurgitation values were significantly lower in the experimental group during the three weeks of follow-up (p = 0.05). Values for sleep were lower in the experimental group, but the differences were not statistically significant. In both groups, colic severity decreased over time, with no side effects. Conclusions: Treatment with osteopathic manual therapy alleviates the symptoms of infant colic and could be recommended for this purpose from the onset of the condition. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the frequency and the factors that can cause postpartum depression (PPD) in the mothers who gave birth at Şan Med Hospital in Şanlıurfa. Material and Methods: The study was performed on volunteer mother-baby couples who were born in Şanlıurfa Şan Med Hospital and were admitted to Şan Med Hospital Pediatrics Polyclinic between September 2017 and December 2017. Participants were asked to provide some information about themselves and their babies, as well as their babies' crying and sleeping patterns. The Edinburgh postpartum depression scale (EPDS) was administered to the mothers. Results: It was determined that the frequency of PPD increased by 2.73-folds for mothers whose babies cried excessively, and by 2.79-folds for the mothers whose babies had unconsolable crying/restlessness lasting 2-3 hours a day. The results indicated that the risk of PPD was 6.86-folds higher in mothers of infants who awoke frequently, as compared to the mothers of infants who had regular sleep patterns. Conclusion: Infantile colic and prolonged crying are associated with higher maternal depression scores. [ABSTRACT FROM AUTHOR]

Objectives: Digestive system diseases have evolved into a growing global burden without sufficient therapeutic measures. Lactobacillus reuteri (L. reuteri) is considered as a new potential economical therapy for its probiotic effects in the gastrointestinal system. We have provided an overview of the researches supporting various L. reuteri strains' application in treating common digestive system diseases, including infantile colic, diarrhea, constipation, functional abdominal pain, Helicobacter pylori infection, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases. Methods: The summarized literature in this review was derived from databases including PubMed, Web of Science, and Google Scholar. Results: The therapeutic effects of L. reuteri in digestive system diseases may depend on various direct and indirect mechanisms, including metabolite production as well as modulation of the intestinal microbiome, preservation of the gut barrier function, and regulation of the host immune system. These actions are largely strain-specific and depend on the activation or inhibition of various certain signal pathways. It is well evidenced that L. reuteri can be effective both as a prophylactic measure and as a preferred therapy for infantile colic, and it can also be recommended as an adjuvant strategy to diarrhea, constipation, Helicobacter pylori infection in therapeutic settings. While preclinical studies have shown the probiotic potential of L. reuteri in the management of functional abdominal pain, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases, its application in these disease settings still needs further study. Conclusion: This review focuses on the probiotic effects of L. reuteri on gut homeostasis via certain signaling pathways, and emphasizes the importance of these probiotics as a prospective treatment against several digestive system diseases. [ABSTRACT FROM AUTHOR]

Abstract Background Signs of feeding intolerance, such as gastrointestinal (GI) symptoms, are frequently observed in otherwise healthy formula-fed infants in the first months of life. The primary objective of this observational study was to examine GI tolerance in formula-fed infants (FFI) vs. breastfed infants (BFI) in a real-world setting with a secondary objective being the comparison of infants fed formula with pre- and/or probiotics (FFI_PP) and those fed formula without any pre- and/or probiotics (FFI_noPP) as well as BFI. Methods A six-country, cross-sectional study in full-term exclusively/predominantly FFI (n = 2036) and BFI (n = 760) aged 6–16 weeks was conducted using the validated Infant Gastrointestinal Symptom Questionnaire (IGSQ) and a Feeding Practice and Gut Comfort Questionnaire. Results The IGSQ composite score in FFI was non-inferior compared to BFI (mean difference [95%CI]: 0.17 [-0.34, 0.67]; non-inferiority p-value

Aim: Osteopathy and chiropractic techniques are used for babies for different reasons, but it is unclear how effective they are. The aim of this study was to evaluate their effectiveness in reducing crying time and increasing sleeping time in babies with infantile colic. Methods: A systematic review and meta‐analysis was conducted on infantile colic studies that used complementary and alternative medicine techniques as interventions. The outcome measures were hours spent crying and/or sleeping. We used the PubMed, Physiotherapy Evidence Database, Cochrane Library, Embase, Web of Science, Scopus, Osteopathic Medicine Digital Database and Google Scholar databases from inception to 11 November 2022. Results: The methodological quality of the randomised control trials ranged from fair to high. We focused on five studies with 422 babies. Complementary treatments failed to decrease the crying time (mean difference −1.08, 95% CI: −2.17 to 0.01, I2 = 92%) and to increase sleeping time (mean difference 1.11, 95% CI: −0.20 to 2.41; I2: 91%), compared with no intervention. The quality of the evidence was rated as very low for both outcome measures. Conclusion: Osteopathy and chiropractic treatment failed to reduce the crying time and increase sleeping time in babies with infantile colic, compared with no additional intervention. [ABSTRACT FROM AUTHOR]

Background: Infantile colic is a benign condition and a common cause that made parents to seek medical advice in the early three months of life. It is defined as paroxysms of crying and fussiness more than three hours per day, more than three days in a week for three weeks in a healthy infant from fourteen days to four months of life .The real cause still unknown but underlying organic causes less than 5%. Aim of the study: To evaluate the mother's attitude about infantile colic. Patient and Method: A cross sectional hospital-based study done on 200 mothers whose baby had infantile colic to evaluate mother’s knowledge about treatment of their problem, the study was done at the Pediatric consulting department of Salah-Alden General Hospital during the period from 2nd January to 30th August 2021 selected not randomly. The Mother’s knowledge were taken by the wards of the mother without interference and without guidance, the source of the knowledge depend whether it is taken from her previous experience, her relatives and friends, health care provider, from social media. Regarding educational level of the mothers were divided into illiterate, read and write, primary school, secondary school and college. Regarding the type of formula, the formulas divided into the types as AC formula, AD formula regardless the name of the company. Results: The study showed that the high rate of males and females children enrolled in this study was in 2 months of age (29.73 and 30.34% respectively). The majority of children were belonged to families lived in urban area. 52% of the mothers consulted physician, 50.5% consulted medical staff. Most of mothers haven’t knowledge about infantile colic 63.5%, and 17% acquired their knowledge from previous experience or relatives and friends. 30% of mothers were completed primary school, 27% were illiterate, 19% read and write and 13% for each of secondary school and college. The high rates of most mothers with variety education levels haven’t previous experience. Conclusions: The study showed that the high rate of children was in 2 months of age and belonged to families lived in urban area. Most of the mothers consulted doctor and health care providers and most of them haven’t experience about infantile colic and manage it by anti-colic drugs and changing of formula. [ABSTRACT FROM AUTHOR]

The inconsolable crying of a child for no apparent reason at an early age is a source of excitement and anxiety for parents. Previous studies have reported that crying may be caused by discomfort associated with the occupation of the intestines of the newborn by microbiota and its vital activity. We conducted a prospective observational study in which 62 newborns and their mothers were recruited. The study comprised two groups, each consisting of 15 infants with colic and 21 controls. Colic and control groups were vaginally born and exclusively breastfed. Fecal samples from children were collected over time from day 1 to 12 months. Full metagenomic sequencing of fecal samples from children and their mothers was carried out. It was determined that the trajectory of the development of the intestinal microbiome of children with colic was different from the group without colic. In the colic group, a depleted relative abundance of Bifidobacterium and enrichment of Bacteroides Clostridiales was found, while the microbial biodiversity in this group was enriched. Metabolic pathway profiling showed that the non-colic group was enriched by amino acid biosynthetic pathways, while the feces microbiome of the colic group was enriched by glycolysis metabolic pathways that correlated with the Bacteroides taxon. This study shows that infantile colic has a definite relationship with the microbiome structure of infants. [ABSTRACT FROM AUTHOR]

Background Infantile colic has a multifactorial etiology; although various treatments have been attempted to manage and alleviate its symptoms, a solution is lacking, adversely affecting mothers and their babies. Recent studies have suggested that dysbiosis may play a role in the pathogenesis of infantile colic and that modulating the gut microbiota, including the use of probiotics, may aid its management. Purpose This single-blind randomized controlled study evaluated the effect of probiotics (Actiregularis, 5×106) added to the diet of mothers on infantile colic symptoms and neonatal gut microbiota content. Methods A probiotic drink containing the Actiregularis (5× 106) strain was added to the diet of mothers in the experimental group once daily for 15 consecutive days. Stool samples were collected from each infant twice, on days 0 and 15, and fecal 16s rRNA gene sequencing and compositional-based metabolomic analyses were performed. The mothers recorded the babies’ crying frequency and severity for 15 days using a daily form created by the researchers. This study was registered at ClinicalTrials.gov (ID: NCT04374955). Results Infants whose mothers were supplemented with Actiregularis for 15 days showed a decreased frequency (P= 0.00) and intensity (P

Abstract Background Given the possible effect of maternal anxiety on the severity of colic pain in infants, this study aimed to investigate the effects of behavioral therapy counseling on infantile colic (primary outcome), maternal anxiety, and mother-infant attachment (secondary outcomes) in anxious mothers with colicky infants. Method This randomized controlled clinical trial was conducted on 46 anxious mothers of 2–6-weeks-old exclusively breastfed colicky infants who had a score of 112 and above according to the Postpartum Specific Anxiety Scale (PSAS), reffered to the pediatric clinics of Al-Zahra, Taleghani and Children Hospitals of Tabriz, Iran. The participants were randomly assigned to the intervention (n = 23) and control (n = 23) groups using randomized block design. Mothers in the intervention group attended 8 systematic desensitization counseling sessions (2–3 sessions per week). Those in the control group received routine care. The researcher completed the Postpartum Specific Anxiety Scale (PSAS), Mother-Infant Attachment Questionnaire (MIAQ), and Infant Colic Scale (ICS) by interviewing the participants before and two weeks after the intervention. Results There was no significant difference between the intervention and control groups in the socio-demographic profile of participants. After the intervention, the mean postpartum anxiety score of women in the intervention group was significantly lower than that of those in the control group (Mean Difference (MD) = 22.5, 95% Confidence Interval (CI) = 2.3 to 42.7; p = 0.029). The mean infant colic score of the infants of mothers in the intervention group was insignificantly lower than that of those in the control group (MD = -2.9, 95% CI = -8.3 to 2.4; p = 0.271). In addition, no significant difference was observed between the two groups in terms of their mean mother-infant attachment scores (MD = -0.04, 95% CI = -3.1 to 0.3; p = 0.976). Conclusion Behavioral therapy counseling effectively reduced postpartum anxiety in women with colicky infants; however, this reduction did not lead to a significant decrease in the infants’ colic pain. Therefore, health care providers are recommended to use this counseling method in combination with other effective counseling approaches to promote mental health of these mothers. Trial Registration IRCT Registration Number: IRCT20111219008459N14, registered on 08/10/2020. https://irct.ir/user/trial/45949/view

Background & Aim: Infantile colic is a stressful tension for the baby and parents, whose cause and certain treatment are still unknown. Therefore, this study was conducted with the aim of comparing the effect of massage and probiotic consumption on infantile colic. Methods & Materials: This clinical trial was conducted in Tehran’s Children Medical Center in 2020-2021, and 75 colicky infants were included in the study based on ROM IV criteria and assigned into two groups of massage and probiotics. A total of 64 infants (34 in the massage group) and 30 in the probiotics group) completed the study. The duration of the intervention was 14 days. The first group received abdominal massage with olive oil twice a day, and the second group received probiotic drops, five drops a day. The study tool was the Barr Child Daily Measurement Scale. The information related to colic measurement, including the average time of colic crying, sleep, and frequency of defecation was analyzed within and between groups on days 1, 7, and 14. Results: Abdominal massage and probiotic consumption both reduced infantile colic (P