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Effectiveness of treatments for infantile colic: systematic review.
BMJ 1998; 316(7144):1563-9BMJ

Abstract

OBJECTIVE

To evaluate the effectiveness of diets, drug treatment, and behavioural interventions on infantile colic in trials with crying or the presence of colic as the primary outcome measure.

DATA SOURCES

Controlled clinical trials identified by a highly sensitive search strategy in Medline (1966-96), Embase (1986-95), and the Cochrane Controlled Trials Register, in combination with reference checking for further relevant publications. Keywords were crying and colic.

STUDY SELECTION

Two independent assessors selected controlled trials with interventions lasting at least 3 days that included infants younger than 6 months who cried excessively.

DATA SYNTHESIS

Methodological quality was assessed by two assessors independently with a quality assessment scale (range 0-5). Effect sizes were calculated as percentage success. Effect sizes of trials using identical interventions were pooled using a random effects model.

RESULTS

27 controlled trials were identified. Elimination of cows' milk protein was effective when substituted by hypoallergenic formula milks (effect size 0.22 (95% confidence interval 0.09 to 0.34)). The effectiveness of substitution by soy formula milks was unclear when only trials of good methodological quality were considered. The benefit of eliminating cows' milk protein was not restricted to highly selected populations. Dicyclomine was effective (effect size 0.46 (0.33 to 0.60)), but serious side effects have been reported. The advice to reduce stimulation was beneficial (effect size 0.48 (0.23 to 0.74)), whereas the advice to increase carrying and holding seemed not to reduce crying. No benefit was shown for simethicone. Uncertainty remained about the effectiveness of low lactose formula milks.

CONCLUSIONS

Infantile colic should preferably be treated by advising carers to reduce stimulation and with a one week trial of a hypoallergenic formula milk.

Authors+Show Affiliations

Institute for Research in Extramural Medicine, Free University, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

9596593

Citation

Lucassen, P L., et al. "Effectiveness of Treatments for Infantile Colic: Systematic Review." BMJ (Clinical Research Ed.), vol. 316, no. 7144, 1998, pp. 1563-9.
Lucassen PL, Assendelft WJ, Gubbels JW, et al. Effectiveness of treatments for infantile colic: systematic review. BMJ. 1998;316(7144):1563-9.
Lucassen, P. L., Assendelft, W. J., Gubbels, J. W., van Eijk, J. T., van Geldrop, W. J., & Neven, A. K. (1998). Effectiveness of treatments for infantile colic: systematic review. BMJ (Clinical Research Ed.), 316(7144), pp. 1563-9.
Lucassen PL, et al. Effectiveness of Treatments for Infantile Colic: Systematic Review. BMJ. 1998 May 23;316(7144):1563-9. PubMed PMID: 9596593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of treatments for infantile colic: systematic review. AU - Lucassen,P L, AU - Assendelft,W J, AU - Gubbels,J W, AU - van Eijk,J T, AU - van Geldrop,W J, AU - Neven,A K, PY - 1998/6/6/pubmed PY - 1998/6/6/medline PY - 1998/6/6/entrez SP - 1563 EP - 9 JF - BMJ (Clinical research ed.) JO - BMJ VL - 316 IS - 7144 N2 - OBJECTIVE: To evaluate the effectiveness of diets, drug treatment, and behavioural interventions on infantile colic in trials with crying or the presence of colic as the primary outcome measure. DATA SOURCES: Controlled clinical trials identified by a highly sensitive search strategy in Medline (1966-96), Embase (1986-95), and the Cochrane Controlled Trials Register, in combination with reference checking for further relevant publications. Keywords were crying and colic. STUDY SELECTION: Two independent assessors selected controlled trials with interventions lasting at least 3 days that included infants younger than 6 months who cried excessively. DATA SYNTHESIS: Methodological quality was assessed by two assessors independently with a quality assessment scale (range 0-5). Effect sizes were calculated as percentage success. Effect sizes of trials using identical interventions were pooled using a random effects model. RESULTS: 27 controlled trials were identified. Elimination of cows' milk protein was effective when substituted by hypoallergenic formula milks (effect size 0.22 (95% confidence interval 0.09 to 0.34)). The effectiveness of substitution by soy formula milks was unclear when only trials of good methodological quality were considered. The benefit of eliminating cows' milk protein was not restricted to highly selected populations. Dicyclomine was effective (effect size 0.46 (0.33 to 0.60)), but serious side effects have been reported. The advice to reduce stimulation was beneficial (effect size 0.48 (0.23 to 0.74)), whereas the advice to increase carrying and holding seemed not to reduce crying. No benefit was shown for simethicone. Uncertainty remained about the effectiveness of low lactose formula milks. CONCLUSIONS: Infantile colic should preferably be treated by advising carers to reduce stimulation and with a one week trial of a hypoallergenic formula milk. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/9596593/full_citation L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=9596593 DB - PRIME DP - Unbound Medicine ER -