Dietary management for infantile colic: A systematic review

摘要

Background/Aims: Infantile colic, the cause of 10-20% of all early paediatricianvisits, is commonly treated with dietary therapies. A systematicreview was conducted to examine the efficacy of dietary change for infantilecolic.Methods: Twenty four eligible studies since 1960 were identified from sixdatabases. Each was graded for its quality and level of evidence accordingto the NHMRC guidelines.Results: A hypoallergenic maternal diet may be beneficial: one high quality,level II, randomized controlled trial (RCT; n ? 90) reported an absolute riskreduction > 37% and two neutral studies support this finding. Two poorquality studies found no effect. One high quality level IV cross-sectionalstudy (n ? 272), reported that maternal consumption of cruciferous vegetables,cow’s milk and onions was associated with increased colic whilechocolate and garlic had no effect. In formula-fed infants, colic may improveafter changing to a hydrolysed or soy formula (11 high quality studies). Onehigh quality, level II RCT, fibre-supplemented formula study, had no effect.One high quality, level III case-control study found colicky infants fed applejuice had significantly increased breath hydrogen excretion and increasedcrying time and one level II, poor quality study reported no effect usinghydrolysed lactose for breast and formula-fed infants.Conclusions: More commonly colic studies are conducted on formula-fedinfants. The strongest evidence supports the use of hydrolysed formulae,there is some support for use of soy-based formulae and no support for theuse of fibre-supplemented formulae. Evidence to support altering thematernal diet is limited and inconclusive.