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Muller I, Ghio D, Mobey J, Jones H, Hornsey S, Dobson A, Maund E, Santer M. Parental perceptions and experiences of infant crying: A systematic review and synthesis of qualitative research. J Adv Nurs 2023; 79:403-417. [PMID: 36373818 PMCID: PMC10100257 DOI: 10.1111/jan.15492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 10/12/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Excessive infant crying is common and can have a huge impact on families and well-being. Systematically reviewing qualitative studies on infant crying can provide a greater understanding of parental perceptions and experiences. AIM This study sought to systematically review and thematically synthesize qualitative studies exploring parents/carers' views and experiences of infant crying. DESIGN A systematic review and synthesis of qualitative research. DATA SOURCES Electronic databases MEDLINE, EMBASE, PsycINFO and CINAHL were searched from the earliest date available to January 2022. We selected papers focussing on parents/carers' experiences, views, attitudes and beliefs about infant crying. We excluded papers focussing on health professionals' views and children older than 12 months. REVIEW METHODS Thematic synthesis was followed for the analysis of included studies and quality appraisal was conducted. RESULTS We synthesized 22 papers, reporting data from 376 participants in eight countries. Four analytical themes were developed: (1) Experiences and impact of crying; (2) parental management strategies; (3) the role of the health professional; (4) the role of infant feeding and maternal diet. Our findings suggest that infant crying has a substantial emotional impact on parents/carers that often impacts relationships. Parents/carers reported using a range of soothing techniques and coping strategies but were desperate to find effective treatment or cure. Support was often perceived as lacking. Excessive crying and beliefs about the role of maternal diet on breastmilk were reported to undermine parents' confidence in breastfeeding by making them feel their milk is insufficient or harmful, or through pressure from others to stop breastfeeding. CONCLUSION Parents/carers use a range of strategies to interpret and deal with the challenges of infant crying, but there is a need for more information and support. IMPACT Findings can be used to inform future research and interventions to support families experiencing excessive infant crying.
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Affiliation(s)
- Ingrid Muller
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Daniela Ghio
- Department of Psychology, University of Manchester, Manchester, UK
| | - Jasmine Mobey
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Hannah Jones
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Samantha Hornsey
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Amy Dobson
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Emma Maund
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, University of Southampton, Southampton, UK
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Helseth S, Misvær N, Småstuen M, Andenæs R, Valla L. Infant colic, young children's temperament and sleep in a population based longitudinal cohort study. BMC Pediatr 2022; 22:163. [PMID: 35354427 PMCID: PMC8966298 DOI: 10.1186/s12887-022-03231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Colic and sleep problems are common among infants, constitute challenges and distress for parents, and are often reasons for seeking help from health professionals. The literature debates whether infant colic and sleep problems are linked together or not. Further, limited evidence exists on how colic impacts on child temperament and sleep during early childhood. Thus, the purpose of this study was to increase our knowledge of the characteristics of infants with a history of colic compared to infants without, and to study how infant colic is associated with the development of child temperament and sleep over time. Methods The study is based on The Norwegian Mother, Father and Child Cohort Study (MoBa), a population-based cohort study conducted by the Norwegian Institute of Public Health. This sample contains 88,186 mothers and children. Data was retrieved from questionnaires distributed to mothers at recruitment (in pregnancy) and when the child was 6 months, 18 months, 3 years, and 5 years. Data was analysed using linear mixed models and GLM models for repeated measures. Results At 6 months, infants with reported colic are described as fussier, present more sleeping problems, are breastfed less, and the families visit the child health centre more often when compared to the non-colic group. Mothers of children with reported colic perceive their children’s temperament significantly more challenging from the age of 6 months to 5 years. Further, children with reported colic were more likely to sleep less than recommended (22%) and to have more frequent night awakenings (14%) than usual for their age (6 months to 5 years). Conclusion Infant colic often occurs together with other signs of regulatory problems which may amplify the load on the parents. Moderate differences in temperament and sleep-problems across time, between those with colic and those without, indicate that the diagnosis of colic is moderately associated with later behavioural difficulties. However, it is demanding for the parents, and important to be aware of and act upon symptoms of colic in the child health centres to reduce the parents’ load and prevent adverse long-term outcomes.
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Affiliation(s)
- Sølvi Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Nina Misvær
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Milada Småstuen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Randi Andenæs
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lisbeth Valla
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Chen K, Liu C, Li H, Lei Y, Zeng C, Xu S, Li J, Savino F. Infantile Colic Treated With Bifidobacterium longum CECT7894 and Pediococcus pentosaceus CECT8330: A Randomized, Double-Blind, Placebo-Controlled Trial. Front Pediatr 2021; 9:635176. [PMID: 34568236 PMCID: PMC8461252 DOI: 10.3389/fped.2021.635176] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Colic is a common condition in infants <4 months of age. Attempts to treat infantile colic with probiotics have shown variable efficacy and overall low evidence of success. In this work, we tested the hypothesis that oral administration of Bifidobacterium longum CECT7894 (KABP042) and Pediococcus pentosaceus CECT8330 (KABP041) mix (1 × 109 colony forming units) would improve the symptoms of infantile colic. Methods: A total of 112 exclusively breastfed or mixed fed infants aged <2 months and meeting the ROME IV criteria for infantile colic were recruited. The infants were randomized in a double-blind, placebo-controlled trial to receive orally administered probiotics (intervention group, IG, n = 48) or placebo (placebo group, PG, n = 42) daily for 21 days. Results: Infants in the IG had significantly shorter crying time (p < 0.001) on day 7 [IG vs. PG, median (25-75th percentile): 38 (3.5-40.5) vs. 62 (40-108) min/day], day 14 [IG vs. PG: 20 (0-40) vs. 50 (30-75) min/day], and day 21 [IG vs. PG: 14 (0-33) vs. 40 (28-62) min/day]. Higher responder ratio and fewer crying/fussing episodes on days 7, 14, and 21 and better stool consistency on day 21 were observed in the IG (p < 0.01) as compared to the PG. Conversely, no significant effects on stool frequency or quality of life were observed. Conclusions: In summary, daily oral administration of B. longum CECT7894 (KABP042) and P. pentosaceus CECT8330 (KABP041) was an effective treatment for shortening crying time due to infantile colic and for improving fecal consistency. This trial was registered retrospectively in December 2019 with a trial number of ISRCTN92431452.
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Affiliation(s)
- Ke Chen
- Department of Nutrition, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Child Health Care, Angel Children's Hospital, Chengdu, China
| | - Changqi Liu
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, United States
| | - Hua Li
- Department of Child Health Care, Qingbaijiang Maternal and Child Health Hospital, Chengdu, China
| | - Yuehua Lei
- Department of Child Health Care, Qingbaijiang Maternal and Child Health Hospital, Chengdu, China
| | - Chenggui Zeng
- Department of Child Health Care, Chengdu Caojiaxiang Community Healthcare Center, Chengdu, China
| | - Shuhong Xu
- Department of Child Health Care, Huili Maternity and Child Care Center, Huili, China
| | - Jianqiu Li
- Department of Child Health Care, Angel Children's Hospital, Chengdu, China
| | - Francesco Savino
- Department of Paediatrics, S.S.D. Subintensive Neonatal Care, Children Hospital 'Regina Margherita', Turin, Italy
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Landgren K, Hallström I, Tiberg I. The effect of two types of minimal acupuncture on stooling, sleeping and feeding in infants with colic: secondary analysis of a multicentre RCT in Sweden (ACU-COL). Acupunct Med 2020; 39:106-115. [PMID: 32375501 PMCID: PMC7961620 DOI: 10.1177/0964528420920308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Evidence for the effect of minimal acupuncture in infants with colic is limited. Aim To compare the effect of standardized minimal acupuncture, individualized acupuncture (where traditional acupuncture points were chosen according to the infant’s symptoms) and no acupuncture on objective measures of stooling, feeding and sleeping in infants with colic (based on diaries) and perceived changes in these parameters (based on parental questionnaires). Methods This was a secondary analysis of a multicentre randomized controlled three-armed trial conducted in four counties in Sweden between January 2013 and May 2015 (ACU-COL). The effect on crying has already been published and showed a decrease in crying time for the acupuncture groups. Infants, 2–8 weeks old, who cried and fussed for more than 3 h/day for more than 3 days/week, and thereby fulfilled the criteria for infantile colic, received four extra visits to their ordinary child health centre. The infants (n = 147) were randomly allocated via a computer-generated list to standardized minimal acupuncture at LI4 for 5 s (group A, n = 48), semi-standardized individual acupuncture with a maximum of five insertions for up to 30 s (group B, n = 49), or no acupuncture (group C, n = 48). The parents and the ordinary staff were blinded. Data were collected using: (1) diaries at baseline, during the two intervention weeks and 1-week follow-up; and (2) questionnaires with quantitative and qualitative components used at the second and fourth visits and during a follow-up telephone call. Outcomes were the changes in frequency of stooling and in hours of sleep per day. Results There were no differences between groups for stooling, feeding, or sleeping at any time point according to data from the diaries. At the follow-up phone call, more parents in groups A and B (compared to group C) perceived that feeding and sleep had changed and that the symptoms of colic had improved.
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Affiliation(s)
- Kajsa Landgren
- Department of Health Sciences, Faculty of Medicine, 5193Lund University, Lund, Sweden
| | - Inger Hallström
- Department of Health Sciences, Faculty of Medicine, 5193Lund University, Lund, Sweden
| | - Iren Tiberg
- Department of Health Sciences, Faculty of Medicine, 5193Lund University, Lund, Sweden
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5
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Gilkerson L, Burkhardt T, Katch LE, Hans SL. Increasing parenting self‐efficacy: The Fussy Baby Network®intervention. Infant Ment Health J 2020; 41:232-245. [DOI: 10.1002/imhj.21836] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Hannula L, Puukka P, Asunmaa M, Mäkijärvi M. A pilot study of parents' experiences of reflexology treatment for infants with colic in Finland. Scand J Caring Sci 2019; 34:861-870. [PMID: 31747081 PMCID: PMC7754469 DOI: 10.1111/scs.12790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/13/2019] [Indexed: 11/28/2022]
Abstract
Background Many infants under 4 months suffer from infantile colic. Infants with colic cry a lot, appear to be in pain, and it is difficult to sooth them. Colic is a painful condition for the infant and very stressful to parents. Parents in Finland get advice to try reflexology treatment for their infant, but there are no studies in Finland to support this advice. Aim The aim of the pilot study was to treat infants with reflexology and find out parents’ experiences of the effects of the treatment on colic symptoms and parental stress. Method A total of 33 parents of 35 infants diagnosed with colic participated to the pilot study. Three certified reflexologists with health care education background and extensive experience in infant reflexology were trained to give the reflexology treatment in a standardised manner. They treated each infant 3–4 times. The whole body reflexology treatment session consisted of gentle pressure treatment of soles and feet, hands, head, face, ears, back, neck and whole stomach area. One treatment session lasted about 20–30 minutes, and treatments were delivered within 8–12 days. The data were collected from the parents with semi‐structured questionnaires. Results The series of the treatments helped reduce the suffering of all the babies with infant colic. The colic symptoms disappeared on 43% of infants and decreased on the remaining 57%. The parents reported having pleasant experiences with the treatment, regardless whether the colic symptoms disappeared or continued. Parents stated that the treatment reduced the most typical colic symptoms; infants’ body tension, colic crying and restless movements, poor sleep quality and irregular bowel movements. Conclusions Reflexology treatment seems to be a safe and effective way to treat infants with colic when conducted by a health care professional with reflexology training and experience.
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Affiliation(s)
- Leena Hannula
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Pauli Puukka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Marjut Asunmaa
- Faculty of Health and Social Care, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
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Botha E, Joronen K, Kaunonen M. The consequences of having an excessively crying infant in the family: an integrative literature review. Scand J Caring Sci 2019; 33:779-790. [PMID: 31058351 DOI: 10.1111/scs.12702] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The consequences of having an excessively crying infant in the family are acknowledged in research, yet to our knowledge, no literature review has been made regarding the overall consequences to the family and infant. This integrative review fills the gap with the aim to review and synthesise current research. AIMS To identify, describe and synthesise previous studies on the consequences of having an excessively crying infant in the family. DESIGN An integrative review of literature published between January 2008 and April 2018. The search was conducted in the following databases: MEDLINE, CINAHL, PsycINFO, Medic and Journals@Ovid. Empirical literature reporting the consequences of having an excessively crying infant in the family was eligible for inclusion. Quality appraisal was performed using CASP tools and JBI checklists. The extracted data were analysed using thematic analysis. FINDINGS Thirty-one articles were included in the review. Ten themes were identified: The consequences of having an excessively crying infant in the family create desperation. It ruins everyday life, impairs breastfeeding, isolates and casts parents into loneliness, strains and breaks family relationships with feelings of failure as a parent. The excessively crying infant in the family brings a struggle that can lead to physical and mental exhaustion. The infant may have problems later in childhood. Parents are actively trying to solve the problem and to adjust. Time allows survival with traces of negative symptoms, feelings and memories. CONCLUSIONS The consequences of having an excessively crying infant in the family are harmful to relationships and health. Caring for the crying infant can lead to exhaustion, which might escalate into abuse. These findings help professionals understand this complex phenomenon and encourage actions for concrete support. Further research is required to explore evidence-based interventions that can help excessively crying infants and their families.
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Affiliation(s)
- Elina Botha
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Katja Joronen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, General Administration, Pirkanmaa Hospital District, Tampere University, Tampere, Finland
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Skjeie H, Skonnord T, Brekke M, Klovning A, Fetveit A, Landgren K, Hallström IK, Brurberg KG. Acupuncture treatments for infantile colic: a systematic review and individual patient data meta-analysis of blinding test validated randomised controlled trials. Scand J Prim Health Care 2018; 36:56-69. [PMID: 29338487 PMCID: PMC5901442 DOI: 10.1080/02813432.2018.1426146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/19/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Needle acupuncture in small children has gained some acceptance in Western medicine. It is controversial, as infants and toddlers are unable to consent to treatment. We aimed to assess its efficacy for treating infantile colic. DESIGN A systematic review and a blinding-test validation based on individual patient data from randomised controlled trials. Primary end-points were crying time at mid-treatment, at the end of treatment and at a 1-month follow-up. A 30-min mean difference (MD) in crying time between acupuncture and control was predefined as a clinically important difference. Pearson's chi-squared test and the James and Bang indices were used to test the success of blinding of the outcome assessors [parents]. Eligibility criteria and data sources: We included randomised controlled trials of acupuncture treatments of infantile colic. Systematic searches were conducted in Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, and in the Chinese language databases CNKI, VIP, Wang fang, SinoMed and Chinese Clinical Trial Registry. RESULTS We included three randomised controlled trials with data from 307 participants. Only one of the included trials obtained a successful blinding of the outcome assessors in both the acupuncture and control groups. The MD in crying time between acupuncture intervention and no acupuncture control was -24.9 min [95% confidence interval, CI -46.2 to -3.6; three trials] at mid-treatment, -11.4 min [95% CI -31.8 to 9.0; three trials] at the end of treatment and -11.8 min [95% CI -62.9 to 39.2; one trial] at the 4-week follow-up. The corresponding standardised mean differences [SMDs] were -0.23 [95% CI -0.42 to -0.06], -0.10 [95% CI -0.29 to 0.08] and -0.09 [95% CI -0.48 to 0.30]. The heterogeneity was negligible in all analyses. The statistically significant result at mid-treatment was lost when excluding the apparently unblinded study in a sensitivity analysis: MD -13.8 min [95%CI -37.5 to 9.9] and SMD -0.13 [95%CI -0.35 to 0.09]. The registration of crying during treatment suggested more crying during acupuncture [odds ratio 7.7; 95% CI 2.7-20.6; one trial]. GRADE-Moderate quality evidence. CONCLUSIONS Percutaneous needle acupuncture treatments should not be recommended for infantile colic on a general basis. Systematic review registration: PROSPERO 2015:CRD42015023253 Key points The role of acupuncture in the treatment of infantile colic is controversial. Available trials are small and present conflicting results. There were no clinically important differences between infants receiving acupuncture and no acupuncture control in this IPD meta-analysis of randomised controlled trials. The data indicate that acupuncture induces some treatment pain in many of the children. The study results indicate that percutaneous needle acupuncture should not be recommended for treatment of infantile colic on a general basis.
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Affiliation(s)
- Holgeir Skjeie
- Department of General Practice, Institute of Health and Society University of Oslo, Oslo, Norway
| | - Trygve Skonnord
- Department of General Practice, Institute of Health and Society University of Oslo, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Institute of Health and Society University of Oslo, Oslo, Norway
| | - Atle Klovning
- Department of General Practice, Institute of Health and Society University of Oslo, Oslo, Norway
| | - Arne Fetveit
- Department of General Practice, Institute of Health and Society University of Oslo, Oslo, Norway
| | - Kajsa Landgren
- Faculty of Medicine Department of Health Sciences, Lund University, Lund, Sweden
| | | | - Kjetil Gundro Brurberg
- Norwegian Institute of Public Health Division for Health Services, Oslo, Norway
- Western Norway University for Applied Sciences Centre for Evidence Based Practice, Bergen, Norway
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9
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Landgren K, Hallström I. Effect of minimal acupuncture for infantile colic: a multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL). Acupunct Med 2017; 35:171-179. [PMID: 28093383 PMCID: PMC5466913 DOI: 10.1136/acupmed-2016-011208] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2016] [Indexed: 12/15/2022]
Abstract
Background Evidence for treating infantile colic with acupuncture is contradictory. Aim To evaluate and compare the effect of two types of acupuncture versus no acupuncture in infants with colic in public child health centres (CHCs). Methods A multicentre, randomised controlled, single-blind, three-armed trial (ACU-COL) comparing two styles of acupuncture with no acupuncture, as an adjunct to standard care, was conducted. Among 426 infants whose parents sought help for colic and registered their child's fussing/crying in a diary, 157 fulfilled the criteria for colic and 147 started the intervention. All infants received usual care plus four extra visits to CHCs with advice/support (twice a week for 2 weeks), comprising gold standard care. The infants were randomly allocated to three groups: (A) standardised minimal acupuncture at LI4; (B) semi-standardised individual acupuncture inspired by Traditional Chinese Medicine; and (C) no acupuncture. The CHC nurses and parents were blinded. Acupuncture was given by nurses with extensive experience of acupuncture. Results The effect of the two types of acupuncture was similar and both were superior to gold standard care alone. Relative to baseline, there was a greater relative reduction in time spent crying and colicky crying by the second intervention week (p=0.050) and follow-up period (p=0.031), respectively, in infants receiving either type of acupuncture. More infants receiving acupuncture cried <3 hours/day, and thereby no longer fulfilled criteria for colic, in the first (p=0.040) and second (p=0.006) intervention weeks. No serious adverse events were reported. Conclusions Acupuncture appears to reduce crying in infants with colic safely. Trial registration number NCT01761331; Results.
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Affiliation(s)
- Kajsa Landgren
- Faculty of Medicine, Department of Health Science, Lund University, Lund, Sweden
| | - Inger Hallström
- Faculty of Medicine, Department of Health Science, Lund University, Lund, Sweden
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Dubois NE, Gregory KE. Characterizing the Intestinal Microbiome in Infantile Colic: Findings Based on an Integrative Review of the Literature. Biol Res Nurs 2015; 18:307-15. [PMID: 26721871 DOI: 10.1177/1099800415620840] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Approximately 20% of newborns will develop symptoms of infantile colic starting around 2 weeks of age. While health care providers have a greater understanding of the impact that inconsolable crying has on family dynamics, maternal-infant bonding, and health care resources, opportunities for study still exist in the area of intestinal microbiome research. Advances in molecular technologies utilizing 16S ribosomal RNA and ribosomal DNA created the opportunity for researchers to index the intestinal microbial composition to better understand its association with infantile colic. This integrative review provides a synopsis of the findings from five recent studies that utilized nonculture-based approaches to characterize the intestinal microbiome of infants with colic. Articles were identified through PubMed, CINAHL, and Google Scholar using the search terms colic, crying, fussiness, microbiome, and microbiota. The general aim of the research studies was to better understand the potential association of intestinal dysbiosis with the development of colic symptoms. The research found that infants who expressed symptoms of colic were colonized with significantly higher levels of Proteobacteria and exhibited lower bacterial diversity when compared to their unaffected counterparts. Additionally, colonization levels of Actinobacteria Bifidobacterium and Firmicute Lactobacilli were inversely related to the amount of crying and fussiness in newborns. The observed association of an imbalanced colonization of the intestines by noncommensal bacteria with the expression of infantile colic symptoms warrants further exploration.
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Affiliation(s)
- Nancy E Dubois
- Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA
| | - Katherine E Gregory
- Harvard Medical School, Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
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Landgren K, Tiberg I, Hallström I. Standardized minimal acupuncture, individualized acupuncture, and no acupuncture for infantile colic: study protocol for a multicenter randomized controlled trial - ACU-COL. Altern Ther Health Med 2015; 15:325. [PMID: 26370560 PMCID: PMC4570710 DOI: 10.1186/s12906-015-0850-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 09/07/2015] [Indexed: 12/23/2022]
Abstract
Background Despite weak evidence, the use of acupuncture has increased in infantile colic. The only three randomized trials conducted evaluated standardized minimal acupuncture in one single point. Two showed effect but one did not so further research is necessary. The aims of the study are 1) to test if results in earlier trials conducted in private acupuncture clinics can be repeated at Child Health Centers (CHC) and 2) to compare the effect of two types of acupuncture and no acupuncture in infants with colic at CHC. Methods/design a multicenter randomized controlled three-armed trial for infantile colic conducted in four regions of Sweden. Alongside the standard program at their regular Child Health Center infants visit a study center twice a week for 2 weeks. The infants are randomly allocated into three groups. According to the power analysis, 144 otherwise healthy infants aged 2–9 weeks old, who – according to parents’ registration in a diary – are crying and/or fussing more than three hours per day, more than 3 days per week will be included. Parents register daily in the diary during the baseline week, two intervention weeks, and one more week directly after the last study visit. At four study visits at the Child Health Center parents meet a nurse for 20–30 min to receive advice and support. The nurse and the parents are blinded for group allocation. Infants are carried to another room, where they spend five minutes with an acupuncturist. Infants randomized to group A receive standardized minimal acupuncture in LI4. Group B receive individualized acupuncture where, according to symptoms, the acupuncturist can choose between the points Sifeng, LI4, and ST36. Group C receives no acupuncture. The primary outcome is relative difference in crying, counted in minutes. Secondary outcomes are number of infants fulfilling the criteria for colic, and changes in sleep and stooling frequency. Adverse events and blinding are recorded. Recruitment started in January 2013. During the first 14 months 93 patients were included. Data collection continues until May 2015. No interim analyses have been conducted. Discussion The study will provide information about the efficacy and safety of acupuncture as a complement to usual care in infants with colic. Trial registration December 29, 2012: ClinicalTrials.gov NCT01761331
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12
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Landgren K. Acupuncture in practice: investigating acupuncturists' approach to treating infantile colic. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:456712. [PMID: 24324513 PMCID: PMC3846151 DOI: 10.1155/2013/456712] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/01/2013] [Accepted: 10/08/2013] [Indexed: 11/17/2022]
Abstract
Infantile colic is common, but no safe and effective conventional treatment exists. The use of acupuncture has increased despite weak evidence. This practitioner survey explores and discusses how infantile colic is regarded and treated in Traditional Chinese Medicine (TCM). The study is based on personal communication with 24 acupuncturists from nine countries. These acupuncturists specialize in pediatric acupuncture and represent different styles of acupuncture. Their experiences are discussed and related to relevant books and articles. Informants claimed good results when treating infants with colic. The TCM patterns commonly described by informants matched the textbooks to a great extent. The most common syndromes were "stagnation of food" and "Spleen Qi Xu." Regarding treatment, some informants followed the teachers' and the textbook authors' advice on differentiated treatment according to syndrome. The points used most often were LI4, ST36, and Sifeng. Other informants treated all infants alike in one single point, LI4. The results demonstrate the diversity of TCM. The use of acupuncture for infantile colic presents an interesting option, but further research is needed in order to optimize the effects and protect infants from unnecessary or less effective treatment.
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Affiliation(s)
- Kajsa Landgren
- Department of Health Science, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden
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