Abstract

MOREIRA, Ana Clara; CASTRO, Joana Catarina; BARREIRA, Joana Filipa  and  COIMBRA, Raquel. Treatment of infantile colic: an evidence-based review. Rev Port Med Geral Fam [online]. 2019, vol.35, n.5, pp.367-380. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i5.12128.

Objectives: The aim is to review the effectiveness of therapeutic interventions in infantile colic, since it is a frequent reason for consultation, its treatment is challenging, and it is a source of frustration for parents and health care professionals. Data sources: National Guideline Clearinghouse, Canadian Medical Association Practice Guidelines Infobase, NICE, Cochrane, DARE, Bandolier and MEDLINE. Methods of review: We searched for meta-analysis (MA), systematic reviews (SR), randomised controlled trials (RCT), clinical guidelines, and other original studies published in Portuguese, English and Spanish between January 2006 and October 2016, using the MeSH term ‘infantile colic’. The Jadad Scale was used to assess the quality of clinical trials and the Strength of Recommendation Taxonomy Scale (SORT) for assigning the level of evidence and strength of recommendation. Results: Of the 185 articles obtained, 17 met the inclusion criteria (four MA, seven SR, three RCT and three guidelines). Almost all articles evaluated crying time as the primary outcome. Hydrolysed formulas have demonstrated efficacy, but should not be used indiscriminately. The evidence is more consistent about the use of probiotics (L. reuteri DSM 17938), which showed a reduction in the daily mean crying time, either in preventive or therapeutic regimen. Simethicone, that is frequently used, did not show benefits. In complementary therapies, there is some evidence in favor of the use of fennel-based herbal medicine. Conclusions: There are some strategies that seem to present benefit in the treatment of infantile colic, however the evidence is poor and inconsistent. Further studies with larger samples and standardised diagnostic criteria are needed. Since it is a self-limiting process, in the absence of robust evidence on the effectiveness of treatments, expectant management may be a strategy to consider.

Keywords : Infantile colic; Newborn; Infant; Primary health care.

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