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Despriee ÅW, Småstuen MC, Glavin K, Lødrup Carlsen KC, Magi CAO, Söderhäll C, Hedlin G, Nordhagen L, Jonassen CM, Rehbinder EM, Nordlund B, Skjerven H. Infant colic and abdominal pain; associations with infant multimorbidity and maternal perceived stress up to 3 months postpartum-A cross-sectional/cohort study in the PreventADALL study. J Clin Nurs 2023; 32:7605-7617. [PMID: 37462350 DOI: 10.1111/jocn.16825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/26/2023] [Accepted: 07/03/2023] [Indexed: 09/21/2023]
Abstract
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.
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Affiliation(s)
- Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- VID Specialized University, Oslo, Norway
| | | | | | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Caroline Aleksi Olsson Magi
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | - Christine M Jonassen
- Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Department of Dermatology and Venaerology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Håvard Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Kozhakhmetov S, Meiirmanova Z, Mukhanbetzhanov N, Jarmukhanov Z, Vinogradova E, Mureyev S, Kozhakhmetova S, Morenko M, Shnaider K, Duisbayeva A, Kushugulova A. Compositional and functional variability of the gut microbiome in children with infantile colic. Sci Rep 2023; 13:9530. [PMID: 37308527 DOI: 10.1038/s41598-023-36641-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023] Open
Abstract
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.
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Affiliation(s)
- Samat Kozhakhmetov
- Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, 53 Kabanbay batyr ave., Block S1, Nur-Sultan, Z05H0P9, Republic of Kazakhstan.
| | - Zarina Meiirmanova
- Department of Children's Diseases with Courses in Allergology, Hematology and Endocrinology, NJSC "Astana Medical University", Astana, Z01G6C5, Kazakhstan
| | - Nurislam Mukhanbetzhanov
- Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, 53 Kabanbay batyr ave., Block S1, Nur-Sultan, Z05H0P9, Republic of Kazakhstan
| | - Zharkyn Jarmukhanov
- Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, 53 Kabanbay batyr ave., Block S1, Nur-Sultan, Z05H0P9, Republic of Kazakhstan
| | - Elizaveta Vinogradova
- Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, 53 Kabanbay batyr ave., Block S1, Nur-Sultan, Z05H0P9, Republic of Kazakhstan
| | - Shamil Mureyev
- Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, 53 Kabanbay batyr ave., Block S1, Nur-Sultan, Z05H0P9, Republic of Kazakhstan
| | | | - Marina Morenko
- Department of Children's Diseases with Courses in Allergology, Hematology and Endocrinology, NJSC "Astana Medical University", Astana, Z01G6C5, Kazakhstan
| | - Kseniya Shnaider
- Department of Children's Diseases with Courses in Allergology, Hematology and Endocrinology, NJSC "Astana Medical University", Astana, Z01G6C5, Kazakhstan
| | - Arailym Duisbayeva
- Department of Children's Diseases with Courses in Allergology, Hematology and Endocrinology, NJSC "Astana Medical University", Astana, Z01G6C5, Kazakhstan
| | - Almagul Kushugulova
- Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, 53 Kabanbay batyr ave., Block S1, Nur-Sultan, Z05H0P9, Republic of Kazakhstan.
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Perez A, Göbel A, Stuhrmann LY, Schepanski S, Singer D, Bindt C, Mudra S. Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum. Front Psychol 2022; 12:805543. [PMID: 35153928 PMCID: PMC8826543 DOI: 10.3389/fpsyg.2021.805543] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent-infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic. METHODS As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables. RESULTS Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs. LIMITATIONS Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis. CONCLUSIONS The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.
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Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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LenglarT L, Caula C, Moulding T, Lyles A, Wohrer D, Titomanlio L. Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine. J Neurogastroenterol Motil 2021; 27:482-494. [PMID: 34642268 PMCID: PMC8521460 DOI: 10.5056/jnm20290] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
Migraine is one of the most frequent causes of primary headache and 9% of children suffer from migraines. Most children will continue to experience migraine attacks as adults, therefore it is imperative that we have a thorough understanding of this major health issue. This article considers the so-called abdominal variants of migraine, which are more commonly seen in children rather than adults: abdominal migraine, cyclic vomiting syndrome, and infantile colic. Other functional abdominal pain disorders such as irritable bowel syndrome and functional dyspepsia have also been linked to migraine in clinical studies. The common pathophysiological root of these diseases seems to be the gut-brain axis mechanism. Abdominal variants of migraine are considered pediatric precursors of migraine whereas the functional abdominal pain disorders related to migraine seem to share a pathophysiological root with no temporarily link as for today. In this review we aim to describe the epidemiological background, the current pathophysiological theories and the relationship of each disease to migraine. This review is the first to compile abdominal variants of migraine and functional abdominal pain disorders associated with migraine and we endeavor to elucidate the broad spectrum of migraine-related episodes in children.
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Affiliation(s)
- Léa LenglarT
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Caroline Caula
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Thomas Moulding
- Department of Specialty and Integrated Medicine, The Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Annabel Lyles
- Department of Oncology, The Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Delphine Wohrer
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Luigi Titomanlio
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France.,Pediatric Migraine and Neurovascular Diseases Unit, APHP - Hopital Robert Debré, Paris, France.,Paris University, INSERM U1141, DHU Protect, Paris, France
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Huang Y, Tan SY, Parikh P, Buthmanaban V, Rajindrajith S, Benninga MA. Prevalence of functional gastrointestinal disorders in infants and young children in China. BMC Pediatr 2021; 21:131. [PMID: 33731059 PMCID: PMC7968152 DOI: 10.1186/s12887-021-02610-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China. METHODS A prospective, cross-sectional, community-based survey was conducted among healthy infants and young children between the ages of 0-4 years in Jinhua and Shanghai, China. A total of 2604 subjects (1300 subjects from Jinhua and 1304 subjects from Shanghai) completed a validated questionnaire on pediatric gastrointestinal symptoms. FGIDs in infants and young children were diagnosed using the Rome IV criteria. RESULTS According to the Rome IV criteria, the prevalence of having a FGID in Chinese infants and young children is 27.3%. Infant regurgitation (33.9%) was the most common FGID among the 0-6 months old while functional constipation (7.0%) was the most common among the 1-4 years old. Risk factor analysis revealed that prevalence of infantile colic was higher with better maternal education and low birth weight. Prevalence of infantile regurgitation was significantly greater in males, living in a rural area, being exclusively breast fed at least up to 4 months and starting formula feeds within the first month. The risk of functional constipation was lower for infants who were delivered vaginally. CONCLUSIONS Infantile regurgitation was the most common FGID in Chinese infants while functional constipation was most prevalent among young Chinese children. TRIAL REGISTRATION Netherlands Trial Registry Identifier: NL6973/NTR7161 .
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Affiliation(s)
- Ying Huang
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, P.R. China
| | - Serene Yaling Tan
- FrieslandCampina, Amersfoort, The Netherlands.
- FrieslandCampina Development Centre AMEA, 89 Science Park Drive, #02-05/06/08 The Rutherford B, Science Park 1, Singapore, 118261, Singapore.
| | | | | | - Shaman Rajindrajith
- Department of Pediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Marc Alexander Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Academic Medical Center, Amsterdam, 1105, AZ, The Netherlands
- Academic Medical Center, Amsterdam, 1105, AZ, The Netherlands
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Baldassarre ME, Di Mauro A, Salvatore S, Tafuri S, Bianchi FP, Dattoli E, Morando L, Pensabene L, Meneghin F, Dilillo D, Mancini V, Talarico V, Tandoi F, Zuccotti G, Agosti M, Laforgia N. Birth Weight and the Development of Functional Gastrointestinal Disorders in Infants. Pediatr Gastroenterol Hepatol Nutr 2020; 23:366-376. [PMID: 32704497 PMCID: PMC7354866 DOI: 10.5223/pghn.2020.23.4.366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. METHODS This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. RESULTS Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. CONCLUSION We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.
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Affiliation(s)
| | - Antonio Di Mauro
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Silvia Salvatore
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Enzo Dattoli
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Lucia Morando
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Licia Pensabene
- Department of Medical and Surgical Sciences, Pediatric Unit, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Fabio Meneghin
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Dario Dilillo
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | | | - Valentina Talarico
- Department of Medical and Surgical Sciences, Pediatric Unit, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Francesco Tandoi
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Massimo Agosti
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Nam SK, Park S, Lee J, Jun YH. Clinical Characteristics of Infantile Colic. NEONATAL MEDICINE 2019. [DOI: 10.5385/nm.2019.26.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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İnce T, Akman H, Çimrin D, Aydın A. The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic. World J Pediatr 2018; 14:392-398. [PMID: 29508358 DOI: 10.1007/s12519-018-0130-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 09/13/2017] [Accepted: 09/17/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND Despite the high prevalence of infantile colic, the pathogenesis remains incompletely understood. Cortisol and melatonin hormones affect gastrointestinal system development in several ways, and interestingly, both cortisol and melatonin's circadian rhythms begin around the 3rd month in which infantile colic symptoms start to decrease. We hypothesized that infantile colic might associate with desynchronization of normal circadian rhythms of these hormones. In this study, we aimed to investigate the role of melatonin and cortisol in the pathogenesis of infantile colic. METHODS Patients who were diagnosed as infantile colic according to Wessel's "rule of three" were enrolled in the colic group. We measured the saliva melatonin and cortisol levels of colic group and control group infants. In both groups, the saliva samples were taken in mornings and at evenings, at the time of diagnosis and 6th month. RESULTS Fifty-five infants finished the study. Melatonin circadian rhythm developed earlier in the control group than the infantile colic group in our study. We found no significant difference between the daily mean cortisol levels. However, infants with colic had flatter daily cortisol slope than controls which pointed out the probability that they had a less clearly defined cortisol rhythm than infants without colic. CONCLUSIONS We found an association between melatonin levels and infantile colic. However, more research is needed to fully understand the role of hypothalamic-pituitary-adrenal axis and hormone's role on infantile colic physiopathology.
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Affiliation(s)
- Tolga İnce
- Department of Pediatrics Social Pediatrics Unit, Faculty of Medicine, Dokuz Eylül University, 35340, Izmir, Turkey
| | - Hakkı Akman
- Department of Pediatrics, Faculty of Medicine, Dokuz Eylül University, 35340, Izmir, Turkey
| | - Dilek Çimrin
- Department of Biochemistry, Faculty of Medicine, Dokuz Eylül University, 35340, Izmir, Turkey
| | - Adem Aydın
- Department of Pediatrics Social Pediatrics Unit, Faculty of Medicine, Dokuz Eylül University, 35340, Izmir, Turkey.
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Abstract
Infantile colic is characterised by episodes of uncontrollable crying or fussing in an otherwise healthy and well-fed infant less than three months of age. The episodes of crying in an infant with colic last more than three hours per day and more than three days per week for at least three weeks. The condition can be very stressful for the family. Cows’ milk proteins appear to be associated with the prevalence of infantile colic in a significant number of cases. Supportive counselling, reassurance, and dietary modifications if necessary, are the core measures used for the treatment of this condition. In most infants, infantile colic resolves by three to four months of age.
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Affiliation(s)
- Alexander K C Leung
- The University of Calgary, Alberta Children's Hospital, 1820 Richmond Road SW, Calgary T2T 5C7, Canada.
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Degenaar H, Kritzinger A. Suck, swallow and breathing coordination in infants with infantile colic. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2015; 62:e1-e10. [PMID: 26809157 PMCID: PMC5843038 DOI: 10.4102/sajcd.v62i1.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 05/18/2015] [Accepted: 04/27/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND There appears to be a perception amongst parents and in popular literature that infantile colic is caused by feeding difficulties. Limited support for this perception is found in scientific literature. Whilst there is scientific evidence that suck, swallow and breathing are key components of successful feeding, these components and the coordination thereof in infants with colic have not been extensively researched. OBJECTIVE The objective of the study was to explore the suck, swallow and breathing coordination in infants with infantile colic and compare it with infants without the condition. METHOD An assessment protocol for suck, swallow and breathing coordination was compiled from literature. This protocol was performed on a research group of 50 infants, independently diagnosed with infantile colic, and a control group of 28 infants without the condition. All participants were from two rural towns in the North–West province, South Africa, selected with a snowball selection method and strict selection criteria. The study followed a static comparison group design. RESULTS A significant difference in the key components of feeding and the presence of colic in participants of four age categories were found. The correlation between postural control and the presence of infantile colic were sustained in participants from 2–19 weeks old. CONCLUSION Suck, swallow and breathing were found to be significantly associated with infantile colic. The findings should be investigated further. It appears that speech-language therapists may play an expanding role in infantile colic.
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Affiliation(s)
- Hanlie Degenaar
- Institute of Psychology and Wellbeing, North-West University, Potchefstroom Campus, South Africa
| | - Alta Kritzinger
- Department of Speech-language Pathology and Audiology, University of Pretoria, South Africa
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Milidou I, Søndergaard C, Jensen MS, Olsen J, Henriksen TB. Gestational age, small for gestational age, and infantile colic. Paediatr Perinat Epidemiol 2014; 28:138-45. [PMID: 24261325 DOI: 10.1111/ppe.12095] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Preterm and growth restricted infants may have developmental delays and deviations from normal organ function related to the gastrointestinal tract and the central nervous system. Since both organ systems are hypothesised to be involved in the pathogenesis of infantile colic, a condition characterised by excessive crying during the first months of life, impaired fetal growth and preterm birth may be risk factors for infantile colic. METHODS A total of 62,761 liveborn singletons from the Danish National Birth Cohort (1996 to 2002) were studied. Infantile colic was defined according to Wessel's modified criteria based on maternal interview conducted at 6 months post-partum. RESULTS A total of 2605 (4.2%) infants were born preterm, 54,441 (86.7%) at term, and 5715 (9.1%) post-term. A total of 4964 (7.9%) infants fulfilled Wessel's modified criteria for infantile colic. The risk for infantile colic increased with decreasing gestational age after adjustment for covariates. The highest odds [odds ratio (95% confidence interval)] was observed for infants born before 32 completed gestational weeks (1.5 [95% CI 1.0, 2.2], reference: 40 gestational weeks). Small for gestational age infants (birthweight below 10th percentile) had an increased odds of infantile colic (1.2 [95% CI 1.1, 1.3]) in all gestational age groups. CONCLUSIONS We observed an increased risk of infantile colic in preterm and small for gestational age infants in a large cohort. Our results suggest that the aetiology of infantile colic may be found in the prenatal, perinatal, and neonatal period.
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Affiliation(s)
- Ioanna Milidou
- Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
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Bolten MI, Fink NS, Stadler C. Maternal self-efficacy reduces the impact of prenatal stress on infant's crying behavior. J Pediatr 2012; 161:104-9. [PMID: 22289357 DOI: 10.1016/j.jpeds.2011.12.044] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 12/06/2011] [Accepted: 12/28/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether prenatal stress is associated with behavioral and emotional regulation problems (crying/fussing) in infants, after controlling for confounding factors. Furthermore, the study investigated the stress-buffering effect of maternal self-efficacy. STUDY DESIGN Data were collected in 120 pregnant women (29 ± 3.2 weeks gestation) and their infants at 6 weeks of age. Expecting mothers completed a structured interview and self-report questionnaires on prenatal stress and self-efficacy. Crying/fussing data were obtained with a validated parental diary. RESULTS After controlling for confounding variables, multiple regression analyses show that prenatal stress and self-efficacy accounted for 20% of the variance of infant's fussing and crying behavior. Results suggest a mediating role of self-efficacy. Babies of mothers reporting high levels of prenatal stress cried less when their mother had high levels of self-efficacy compared with mothers with low self-efficacy. In addition, mothers of infants with excessive crying reported more symptoms of stress, depression, and anxiety in pregnancy. CONCLUSION To foster the development of well-adapted parent-infant relationships and potentially to reduce infant crying in the early postpartum phase, health care professionals need special education about the effects of prenatal stress and interventions that promote self-efficacy.
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Affiliation(s)
- Margarete I Bolten
- Department of Developmental Psychopathology, Child and Adolescents Psychiatric Clinic, University of Basel, Basel, Switzerland.
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Sidor A, Thiel-Bonney C, Kunz E, Eickhorst A, Cierpka M. Das exzessive Schreien bei 5 Monate alten Säuglingen und prä-, peri- und postnatale Belastungen ihrer Mütter in einer Hoch-Risiko-Stichprobe. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2012; 40:239-50. [DOI: 10.1024/1422-4917/a000177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Fragestellung: Zusammenhänge zwischen persistierendem, exzessivem Schreien des Säuglings im fünften Lebensmonat und den prä- und perinatalen Belastungen sowie der postnatalen Befindlichkeit ihrer Mütter zu untersuchen. Methodik: Alle Daten wurden erhoben, als die Kinder im Durchschnitt 18.5 Wochen alt waren. Die Stichprobe von 300 Mutter-Kind-Dyaden war durch psychosoziale Risiken wie Armut, Mangel an sozialer Unterstützung, Minderjährigkeit der Mütter, Substanzmissbrauch oder psychische Störungen der Mutter belastet. Das exzessive Schreien wurde nach der Wessel-Regel erfasst, für die Erhebung von prä-, peri- und postnatalen Belastungen wurden Fragebögen vorgelegt. Ergebnisse: Multivariate Analysen zeigten ein erhöhtes Risiko für soziale Belastung in der Schwangerschaft (OR = 17.66) und für eine unerwünschte Schwangerschaft (OR = 13.77). Postnatal war das persistierende exzessive Schreien mit höheren Ausprägungen einer postpartalen depressiven Symptomatik der Mutter, mütterlicher Stressbelastung, Dysfunktionalität der Mutter-Kind-Interaktion, dem Wahrnehmen des Säuglings als «schwierig» sowie mit Schwierigkeiten bei der emotionalen Beziehungsaufnahme assoziiert. Schlussfolgerungen: Die Ergebnisse unterstreichen den Einfluss erhöhter pränataler Stressbelastung der Mütter und einer unerwünschten Schwangerschaft auf das persistierende exzessive Schreien der Säuglinge. Ein herabgesetztes Wohlbefinden der Mütter sowie ihre Schwierigkeiten bei der emotionalen Beziehungsaufnahme implizieren einen erhöhten Bedarf an Unterstützungsangeboten. Das Zusammenwirken von pränatalen und Beziehungsvariablen spielt eine Rolle für das Auftreten und die Aufrechterhaltung von frühen Regulationsproblemen.
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Affiliation(s)
- Anna Sidor
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Consolata Thiel-Bonney
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Elisabeth Kunz
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Andreas Eickhorst
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
| | - Manfred Cierpka
- Institut für Psychosomatische Kooperationsforschung und Familientherapie, Universitätsklinikum Heidelberg
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Milidou I, Henriksen TB, Jensen MS, Olsen J, Søndergaard C. Nicotine replacement therapy during pregnancy and infantile colic in the offspring. Pediatrics 2012; 129:e652-8. [PMID: 22351887 DOI: 10.1542/peds.2011-2281] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the associations between use of nicotine replacement therapy (NRT) and smoking during pregnancy and infantile colic in the offspring. METHODS We used data from maternal interviews (from pregnancy and at 6 months post partum) from the Danish National Birth Cohort (1996-2002). We included 63 128 live-born singletons with complete information on nicotine exposure during pregnancy and infantile colic symptoms as recorded at 6 months of age. RESULTS A total of 46 660 infants (73.9%) were unexposed to nicotine during pregnancy; 207 (0.3%) were exposed to NRT, 15 016 (23.8%) were exposed to smoking, and 1245 (2.0%) to both. A total of 4974 (7.9%) infants fulfilled Wessel's modified criteria for infantile colic. Prenatal nicotine exposure was associated with elevated risk for infantile colic in the offspring. Compared with the unexposed, NRT users had an adjusted odds ratio (OR) (95% confidence interval) of 1.6 (1.0-2.5; P = .03), smokers had OR = 1.3 (1.2-1.4), and women who both smoked and used NRT had OR = 1.6 (1.3-1.9). Partners' smoking was not associated with infantile colic after adjustment for maternal smoking. CONCLUSIONS We corroborated the association between smoking and infantile colic after adjustment for several possible confounders in a large cohort study. Moreover, we found that infants exposed to NRT prenatally had an increased risk for infantile colic of the same magnitude as those exposed to tobacco smoke. Thus, nicotine may play a role in the pathogenesis of infantile colic.
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Affiliation(s)
- Ioanna Milidou
- Department of Pediatrics, Herning Regional Hospital, Herning, Denmark.
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Kaley F, Reid V, Flynn E. The psychology of infant colic: A review of current research. Infant Ment Health J 2011; 32:526-541. [DOI: 10.1002/imhj.20308] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kurth E, Spichiger E, Cignacco E, Kennedy HP, Glanzmann R, Schmid M, Staehelin K, Schindler C, Stutz EZ. Predictors of Crying Problems in the Early Postpartum Period. J Obstet Gynecol Neonatal Nurs 2010; 39:250-62. [DOI: 10.1111/j.1552-6909.2010.01141.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Canivet CA, Östergren PO, Jakobsson IL, Dejin-Karlsson E, Hagander BM. Infantile colic, maternal smoking and infant feeding at 5 weeks of age. Scand J Public Health 2008; 36:284-91. [DOI: 10.1177/1403494807086981] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Many parents seek help from health professionals because of their infants' persistent crying in the early months. The aetiology of this condition, often labelled ``infantile colic'', is still unclear. Aims: To assess whether smoking during pregnancy, and/or smoking at infant age 5 weeks, is associated with infantile colic, and to describe how feeding at infant age 5 weeks and smoking are related to colic. Methods: This was a community-based study, with telephone interviews in late pregnancy, and at infant age 5 weeks, covering 1,625 mother—infant dyads, i.e. 86% of the eligible population. Results: Daily maternal smoking in pregnancy was related to subsequent colic, with an age-adjusted odds ratio (OR) of 1.74 (95% confidence interval 1.08—2.82). In the multivariate model, the OR was largely unaltered. The association between smoking at infant age 5 weeks and colic did not reach statistical significance. The subgroups based on smoking and infant feeding were small, but the results suggest that exclusive breast-feeding was protective against colic, including for infants of smoking mothers. Conclusions: This study presents yet another argument why smoking in pregnancy should be discouraged — some cases of infantile colic may be avoided. With regard to mothers who are not able to give up smoking, the results add some support for the conclusion that if a mother is worried about colic, she certainly should not refrain from breast-feeding even if she smokes.
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Affiliation(s)
- Catarina A. Canivet
- Division of General Practice, Department of Clinical Sciences Malmö, Lund University, Sweden,
| | - Per-Olof Östergren
- Division of Social and Global Health, Department of Health Sciences, Lund University, Sweden
| | - Iréne L. Jakobsson
- Division of Paediatrics, Department of Clinical Sciences Lund, Lund University, Sweden
| | | | - Barbro M. Hagander
- Division of General Practice, Department of Clinical Sciences Malmö, Lund University, Sweden
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Søndergaard C, Olsen J, Friis-Haschè E, Dirdal M, Thrane N, Sørensen HT. Psychosocial distress during pregnancy and the risk of infantile colic: a follow-up study. Acta Paediatr 2007. [DOI: 10.1111/j.1651-2227.2003.tb02538.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kelmanson IA, Adulas EI. Massage therapy and sleep behaviour in infants born with low birth weight. Complement Ther Clin Pract 2006; 12:200-5. [PMID: 16835031 DOI: 10.1016/j.ctcp.2005.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 11/27/2005] [Accepted: 11/29/2005] [Indexed: 11/20/2022]
Abstract
This study attempts to evaluate the impact of massage therapy on sleep behaviour in infants born with low birth weight (LBW) in St. Petersburg, Russia. Fifty infants (22 boys, 28 girls) who were born in St. Petersburg between 2000 and 2002 and defined as LBW babies (<2500g at birth) were enrolled onto the study at the age of 2 months. Of these, 41 (19 boys, 22 girls) were light and pre-term infants (gestational age < or =36 weeks), and 9 (3 boys, 6 girls) born light at term. The control group consisted of 50 healthy infants born with LBW who were cross-matched with an experimental group of babies and controlled for gender, gestational age, weight and date of birth. The groups were also matched for proximal geographical distribution in the city. Babies in the experimental group were assigned massage intervention therapy that include gentle rubbing, stroking, passive movements of the limbs and other means of kinaesthetic stimulation performed by professionals until the infant is 8 months old. The findings suggest that 8-month-old LBW infants who received massage intervention were less likely to snore during sleep, required less feeding on waking-up at night, and appeared more alert during the day. These apparent correlations remained significant after adjustment was made for major potential confounders. No statistically significant difference was found in sleep behaviour between LBW infants exposed to massage therapy who were either born pre-term or at term. It is suggested that massage may be a valuable approach to improve quality of sleep and reduce sleep-disordered breathing in infants born with LBW. It is acknowledged that whilst this study does not represent a large sample, it is felt that the findings suggest further investigation and offer an insight into an area previously relatively unexplored.
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Affiliation(s)
- Igor A Kelmanson
- St. Petersburg State Paediatric Medical Academy, Litovskaya 2, St. Petersburg, 194 100, Russia.
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Maxted AE, Dickstein S, Miller-Loncar C, High P, Spritz B, Liu J, Lester BM. Infant colic and maternal depression. Infant Ment Health J 2005; 26:56-68. [PMID: 28682513 DOI: 10.1002/imhj.20035] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The combined impact of infant colic and maternal depression on infant, parent, and family difficulties was examined. The sample included 93 consecutive patients seen at an outpatient Colic Clinic. Most mothers had private insurance and completed high school. Infants were approximately 2 months of age. Questionnaires completed by the mother prior to treatment onset were used to measure depressive symptoms in the mothers, infant cry, sleep and temperament, characteristics, parenting stress, maternal self-esteem, social support, and family function. Moderate to severe depressive symptoms were reported by 45.2% of the mothers. More severe depressive symptoms in the mothers were related to fussy/difficult infant temperament, more parenting stress, lower parental self-esteem, and more family-functioning problems. Pediatric health care providers need to be aware that the combined effects of colic and maternal depression can be problematic for the family. ©2005 Michigan Association for Infant Mental Health.
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Affiliation(s)
| | | | | | - Pamela High
- Rhode Island Hospital, Infant Development Center, Brown Medical School
| | | | - Jing Liu
- Bradley Hospital, Infant Development Center, Brown Medical School
| | - Barry M Lester
- Women and Infants Hospital, Infant Development Center, Brown Medical School
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22
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Rao MR, Brenner RA, Schisterman EF, Vik T, Mills JL. Long term cognitive development in children with prolonged crying. Arch Dis Child 2004; 89:989-92. [PMID: 15499048 PMCID: PMC1719720 DOI: 10.1136/adc.2003.039198] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Long term studies of cognitive development and colic have not differentiated between typical colic and prolonged crying. OBJECTIVE To evaluate whether colic and excessive crying that persists beyond 3 months is associated with adverse cognitive development. DESIGN Prospective cohort study. A sample of 561 women was enrolled in the second trimester of pregnancy. Colic and prolonged crying were based on crying behaviour assessed at 6 and 13 weeks. Children's intelligence, motor abilities, and behaviour were measured at 5 years (n = 327). Known risk factors for cognitive impairment were ascertained prenatally, after birth, at 6 and 13 weeks, at 6, 9, and 13 months, and at 5 years of age. RESULTS Children with prolonged crying (but not those with colic only) had an adjusted mean IQ that was 9 points lower than the control group. Their performance and verbal IQ scores were 9.2 and 6.7 points lower than the control group, respectively. The prolonged crying group also had significantly poorer fine motor abilities compared with the control group. Colic had no effect on cognitive development. CONCLUSIONS Excessive, uncontrolled crying that persists beyond 3 months of age in infants without other signs of neurological damage may be a marker for cognitive deficits during childhood. Such infants need to be examined and followed up more intensively.
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Affiliation(s)
- M R Rao
- Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
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25
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Abstract
Infantile colic is a common complaint for which mothers bring their babies to pediatricians. Though the condition has been a cause of controversy and a subject of extensive research, no consensus is yet reached on its definition, etio-pathogenesis and management. This article reviews the existing literature on present subject.
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Affiliation(s)
- Pankaj Garg
- Shanti Manglick Hospital, Agra, Uttar Pradesh, India.
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26
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Wells JC. Parent-offspring conflict theory, signaling of need, and weight gain in early life. THE QUARTERLY REVIEW OF BIOLOGY 2003; 78:169-202. [PMID: 12825417 DOI: 10.1086/374952] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Human growth in early life has major implications for fitness. During this period, the mother regulates the growth of her offspring through placental nutrition and lactation. However, parent-offspring conflict theory predicts that offspring are selected to demand more resources than the mother is selected to provide. This general issue has prompted the development of begging theory, which attempts to find the optimal levels of offspring demand and parental provisioning. Several models have been proposed to account for begging behavior, whether by biochemical or behavioral pathways, including: (1) blackmail of parents; (2) scramble competition between multiple offspring; (3) honest signaling of nutritional need; and (4) honest signaling of offspring worth. These models are all supported by data from nonhuman animals, with species varying according to which model is relevant. This paper examines the evidence that human suckling and crying signal nutritional demand, need, and worth to the mother. While suckling provides hormonal stimulation of breast milk production and signals hunger, crying fulfills a different role, with evidence suggesting that it signals both worth and need for resources (nutrition and thermoregulation). The role of signaling in nutritional demand is examined in the context of three common health problems that have traditionally been assumed to have physiological rather than behavioral causes: excess weight gain, failure to thrive, and colic. The value of such an evolutionary approach lies in its potential to enhance behavioral management of these conditions.
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Affiliation(s)
- Jonathan C Wells
- MRC Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom
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Abstract
After a prolonged and complicated hospital stay, the NICU graduate enters the world with unique and complex medical problems. A well-coordinated multidisciplinary approach is essential in the follow-up care of these infants. The crucial issues for the pediatrician who cares for these infants are assisting in the catch-up growth and the ongoing healing process with good nutritional supplementation, while preventing further problems by detecting and treating illness early. Timely inclusion of other appropriate health care personnel and facilities in the care may be crucial and rewarding. The role of the pediatrician in helping these infants attain their full physical, neurodevelopmental, emotional, and psychosocial potential by providing optimal care is invaluable. With appropriate support most NICU graduates will become productive and well-adjusted adults. The pediatrician plays a major role in completing this process and contributes to the eventual success of the neonatal intensive care that these infants are subjected to at the very beginning of their lives.
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MESH Headings
- Bronchopulmonary Dysplasia/epidemiology
- Bronchopulmonary Dysplasia/mortality
- Bronchopulmonary Dysplasia/physiopathology
- Continuity of Patient Care/organization & administration
- Continuity of Patient Care/trends
- Humans
- Incidence
- Infant Mortality
- Infant, Newborn
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/mortality
- Infant, Newborn, Diseases/physiopathology
- Infant, Premature/growth & development
- Intensive Care Units, Neonatal
- Intensive Care, Neonatal/methods
- Practice Guidelines as Topic
- United States/epidemiology
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Affiliation(s)
- Rita P Verma
- Division of Neonatology, Department of Pediatrics, Neonatal Follow-up Program, SUNY-Stony Brook, HSC T11-060, Stony Brook, NY 11794-8111, USA
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Kelmanson IA, Adulas EI. Low Birth Weight and Sleep Behaviour in Two-Month-Old Infants. Niedriges Geburtsgewicht und Schlafverhalten zwei Monate alter Sauglinge. SOMNOLOGIE 2002. [DOI: 10.1046/j.1439-054x.2002.02191.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Excessive infantile crying is a widespread problem which exerts a serious impact on families' lives. The prevalence, cause, and treatment of the problem have been addressed in the literature for many years but with varying degrees of success. Variation in definition of excessive crying leads to difficulty when comparing results between studies. Flawed method and inadequate sampling characterise many studies in this field, often seriously limiting the usefulness of the findings. Progress has been made in some aspects of excessive crying, and other approaches hold promise of success, but wide gaps remain with regard to cause and treatment.
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Affiliation(s)
- T Long
- School of Healthcare Studies, University of Leeds, United Kingdom.
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