Cow's-Milk Allergy and Lactose Malabsorption in Infants With Colic

摘要

Infant colic presents with episodes of persistent and inconsolable crying in the first weeks of life, which may place significant stress on families. The young infant often appears to be in significant pain, and medical assistance is commonly sought (1). In the majority of infants with colic, no organic cause is found (2,3). Only a few randomised placebo-controlled studies on the treatment of colic are available. Most treatments initiated at the peak of crying, when the child is approximately 6 weeks of age, are no more effective than placebo, because spontaneous improvement of colic symptoms usually occurs at around 3 to 4 months of age (4). In recent years, elimination of cow's-milk protein from the maternal diet or the use of hypoallergenic formulae have become common strategies in the treatment of infant colic (5). Studies supporting this practice, however, have some methological limitations and are mostly not population based. Because of a lack of clear diagnostic markers for non-immunoglobulin E (IgE)-mediated cow's-milk allergy (CMA) in infancy, the clinical management of colic is often empirical rather than evidence based. Although CMA appears to be increased in infants with persistent crying, the majority of infants with colic do not appear to have underlying food allergies.