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Frontiers in Pediatrics 2022Assessment and management of pain are essential components of pediatric care. Pain in pediatric age is characterized by relevant health and socio-economic consequences... (Review)
Review
Assessment and management of pain are essential components of pediatric care. Pain in pediatric age is characterized by relevant health and socio-economic consequences due to parental concern, medicalization, and long-term physical and psychological impact in children. Pathophysiological mechanisms of nociception include several pathways in which also individual perception and gut-brain axis seem to be involved. In this narrative review, we analyze the rational and the current clinical findings of probiotic use in the management of functional gastrointestinal disorders (FGID) in pediatric age, with special focus on infantile colic, irritable bowel syndrome, constipation, and gastroesophageal reflux. Some specific probiotics showed a significant reduction in crying and fussing compared to placebo in breastfed infants with colic, although their exact mechanism of action in this disorder remains poorly understood. In irritable bowel syndrome, a limited number of studies showed that specific strains of probiotics can improve abdominal pain/discomfort and bloating/gassiness, although data are still scarce. As for constipation, whilst some strains appear to reduce the number of hard stools in constipated children, the evidence is not adequate to support the use of probiotics in the management of functional constipation. Similarly, although some probiotic strains could promote gastric emptying with a potential improvement of functional symptoms related to gastroesophageal reflux, current evidence is insufficient to provide any specific recommendation for the prevention or treatment of gastroesophageal reflux. In conclusion, probiotics have been proposed as part of management of pain in functional gastrointestinal disorders in pediatric age, but mechanisms are still poorly understood and evidence to guide clinical practice is currently inadequate.
PubMed: 35252059
DOI: 10.3389/fped.2022.805466 -
The Veterinary Clinics of North... Dec 2022Acupuncture is an inexpensive nonpharmacological modality that has a variety of musculoskeletal, neurologic, and internal medicine applications for the equine... (Review)
Review
Acupuncture is an inexpensive nonpharmacological modality that has a variety of musculoskeletal, neurologic, and internal medicine applications for the equine practitioner. Common uses include back pain colic, laminitis, laryngeal hemiplegia, and suprascapular neuropathy. Although there is a growing body of literature supporting the use of acupuncture in equids, there remains a need for further robust, double-blinded, placebo-controlled clinical efficacy trials.
Topics: Horses; Animals; Horse Diseases; Acupuncture Therapy; Colic; Back Pain; Treatment Outcome
PubMed: 36244942
DOI: 10.1016/j.cveq.2022.07.001 -
The Veterinary Clinics of North... Aug 2023Colic is a common presenting complaint in foals. Unfortunately, evaluation of foals with colic can be difficult due to the common clinical presentation of acute... (Review)
Review
Colic is a common presenting complaint in foals. Unfortunately, evaluation of foals with colic can be difficult due to the common clinical presentation of acute abdominal pain attributable to a wide variety of disorders and a broad range of etiologies. Similar to foals, colic is one of the most common diseases of pregnant and periparturient mares. Several conditions are unique or occur more commonly in broodmares. This article reviews the most commonly encountered types of colic events in neonatal foals and periparturient mares, how to correctly diagnose these conditions, as well as details concerning appropriate medical management and/or surgical intervention.
Topics: Pregnancy; Animals; Horses; Female; Colic; Horse Diseases
PubMed: 37258390
DOI: 10.1016/j.cveq.2023.03.013 -
Journal of Global Health May 2023Probiotics are non-invasive therapies composed of live bacteria and yeast. Administration of prebiotics improved the health status of pregnant and lactating women, as... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Probiotics are non-invasive therapies composed of live bacteria and yeast. Administration of prebiotics improved the health status of pregnant and lactating women, as well as newborns. This review aimed to appraise the evidence concerning the effectiveness of probiotics on the mental health of pregnant women, lactating mother and the microbiota of the newborn.
METHODS
This systematic review and meta-analysis ascertained quantitative studies published in Medline (PubMed), Clinical Key, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and Google scholar. Two authors independently screened and extracted the data from the primary studies that analysed the efficacy of probiotics on the mental health of pregnant and lactating women and the microbiota of the newborn. We adopted Cochrane Collaboration guidelines and reported using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. The qualities of included trials were assessed by Cochrane collaboration's risk of bias tool (ROB-2).
RESULTS
Sixteen trials comprised 946 pregnant women, 524 were lactating mothers, and 1678 were infants. The sample size of primary studies ranged from 36 to 433. Probiotics were administered as interventions, using either a single strain of Bifidobacterium or Lactobacillus or a double-strain combination of Lactobacillus and Bifidobacterium. Probiotics supplementation reduced anxiety in pregnant (n = 676, standardised mean difference (SMD) = 0.01; 95% confidence interval (CI) = -0.28,0.30, P = 0.04, I = 70) and lactating women (n = 514, SMD = -0.17; 95% CI = -1.62,1.27, P = 0.98, I = 0). Similarly, probiotics decreased depression in pregnant (n = 298, SMD = 0.05; 95% CI = -0.24,0.35, P = 0.20, I = 40) and lactating women (n = 518, SMD = -0.10; 95% CI = -1.29,-1.05, P = 0.11, I = 60%). Similarly, probiotics supplementation improved the gut microbiota and reduced the duration of crying, abdominal distension, abdominal colic and diarrhoea.
CONCLUSION
Non-invasive probiotic therapies are more useful to pregnant and lactating women and newborns.
REGISTRATION
The review protocol was registered with PROSPERO (CRD42022372126).
Topics: Infant; Infant, Newborn; Humans; Female; Pregnancy; Depression; Lactation; Probiotics; Anxiety; Gastrointestinal Microbiome
PubMed: 37218177
DOI: 10.7189/jogh.13.04038 -
Global Pediatric Health 2022Infantile colic is the most frequent reason of infant and parental distress. An open-label single-group clinical study was conducted primarily to evaluate the effect of...
Infantile colic is the most frequent reason of infant and parental distress. An open-label single-group clinical study was conducted primarily to evaluate the effect of 14-day colic relief remedy administration (1.25 ml orally during colic episode) on average daily crying time in infants compared to baseline. In addition, the percentage of responders, sleep pattern, frequency and severity of gastrointestinal symptoms, tolerability of the product and percentage population with relapse of symptoms post product discontinuation were evaluated. Thirty infants aged 3 to 16 weeks with no significant clinical illness were enrolled in the study with their caregivers. Daily inconsolable crying time and flatulence were significantly reduced ( < .05) within a week of intervention and a sustained effect was observed after discontinuation of the product. The findings of the present study indicate that this product effectively reduced abdominal distension and pain, resulting in a significant decrease in the daily crying of the infants. The study was registered with the Clinical Trials Registry India (CTRI) (http://ctri.nic.in/Clinicaltrials/login.php) bearing Reg. No: CTRI/2021/03/031762, Date: March 8, 2021.
PubMed: 35936812
DOI: 10.1177/2333794X221100810 -
BMC Pediatrics Oct 2022Our aim was to evaluate infant behavioral state, stool microbiome profile and calprotectin in infants with infantile colic receiving a partially hydrolyzed protein... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Our aim was to evaluate infant behavioral state, stool microbiome profile and calprotectin in infants with infantile colic receiving a partially hydrolyzed protein formula with or without added Lacticaseibacillus (formerly Lactobacillus) rhamnosus GG (LGG).
METHODS
In this single-center, double-blind, controlled, parallel, prospective study, term infants (14-28 days of age) identified with colic (using modified Wessel's criteria: cried and/or fussed ≥ 3 h/day for ≥ 3 days/week, in a one-week period) were randomized to receive one of two formulas over a three-week feeding period: marketed partially hydrolyzed cow's milk-based infant formula (PHF, n = 35) or a similar formula with added LGG (PHF-LGG, n = 36). Parent-reported infant behavior was recorded at three time points (Study Days 2-4, 10-12, and 18-20). Duration (hours/day) of crying/fussing (averaged over each three-day period) was the primary outcome. Stool samples were collected at Baseline and Study End (Days 19-21) to determine stool LGG colonization (by qPCR) and microbial abundance (using 16S rRNA gene sequencing) and calprotectin (μg/g).
RESULTS
Duration of crying/fussing (mean ± SE) decreased and awake/content behavior increased over time with no significant group differences over the course of the study. There were no group differences in the percentage of infants who experienced colic by study end. Colic decreased by Study End vs Baseline in both groups. Change in fecal calprotectin also was similar between groups. Comparing Study End vs Baseline, LGG abundance was greater in the PHF-LGG group (P < 0.001) whereas alpha diversity was greater in the PHF group (P = 0.022). Beta diversity was significantly different between PHF and PHF-LGG at Study End (P = 0.05). By study end, relative abundance of L. rhamnosus was higher in the PHF-LGG vs PHF group and vs Baseline.
CONCLUSIONS
In this pilot study of infants with colic, both study formulas were well tolerated. Crying/fussing decreased and awake/content behavior increased in both study groups over the course of the study. Study results demonstrate a successful introduction of the probiotic to the microbiome. The partially hydrolyzed protein formula with added LGG was associated with significant changes in the gut microbiome.
TRIAL REGISTRATION
ClinicalTrials.gov, ClinicalTrials.gov Identifier: NCT02340143 . Registered 16/01/2015.
Topics: Animals; Cattle; Colic; Double-Blind Method; Female; Gastrointestinal Microbiome; Humans; Infant Formula; Infant, Newborn; Lacticaseibacillus rhamnosus; Leukocyte L1 Antigen Complex; Pilot Projects; Probiotics; Prospective Studies; RNA, Ribosomal, 16S
PubMed: 36207675
DOI: 10.1186/s12887-022-03647-x -
Journal of Clinical Nursing Oct 2023The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased...
Infant colic and abdominal pain; associations with infant multimorbidity and maternal perceived stress up to 3 months postpartum-A cross-sectional/cohort study in the PreventADALL study.
AIMS AND OBJECTIVES
The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased multimorbidity (common infections, eczema and food sensitivity) compared with infants without these conditions. Secondarily, we aimed to determine whether infant pain symptoms were associated with maternal perceived stress in pregnancy and 3 months postpartum.
BACKGROUND
Infant colic and abdominal pain are common concerns in early infancy. Nevertheless, to our knowledge, little research exists on the relationship between infant pain and common infant infections, eczema and food sensitization as comorbidities, and the impact of infant pain on the development of maternal perceived stress from pregnancy to infancy is inconsistent.
DESIGN
This study was cross-sectional and partly prospective.
METHODS
The sample consisted of mother-infant pairs (N = 1852); information regarding infant pain and multimorbidity was collected from the 3-month questionnaire and postpartum visits in the PreventADALL prospective cohort study. Chi-square tests and regression analyses were conducted. The STROBE checklist was followed.
RESULTS
Our results showed a statistically significant higher proportion of respiratory and other infections in infants with pain symptoms. The odds of infant pain were higher for infants with multimorbidity compared to those with no comorbidity. Mothers of infants with colic and of infants visiting healthcare with pain and other discomforts reported statistically significant higher perceived stress by 3 months compared with mothers of infants with no reported pain.
CONCLUSION
Our results indicate an association between infant pain symptoms and the presence of infections. Mothers of infants with colic and visiting healthcare had higher perceived stress compared to the no pain group.
IMPLICATIONS FOR PRACTICE
Our study indicates that infant pain is associated with infant multimorbidity and maternal perceived stress, which may be useful when planning diagnostic, treatment and coping strategies in infant and family care.
PATIENT OR PUBLIC CONTRIBUTION
The PreventADALL is a collaborative study with governmental and patient organisation representation. Selected infants with parents were also contributing during calibrating courses on eczema assessment for the data collectors.
TRIAL REGISTRATION
The study was approved by the Regional Committee in Norway (2014/518) and Sweden (2014/2242-31/4) and registered at clinicaltrial.gov (NCT02449850). Link for clinical trials: https://clinicaltrials.gov/ct2/show/NCT02449850.
Topics: Female; Pregnancy; Infant; Humans; Colic; Prospective Studies; Cohort Studies; Multimorbidity; Cross-Sectional Studies; Postpartum Period; Mothers; Abdominal Pain; Stress, Psychological; Eczema
PubMed: 37462350
DOI: 10.1111/jocn.16825 -
MMW Fortschritte Der Medizin Sep 2022
Topics: Colic; Humans
PubMed: 36064933
DOI: 10.1007/s15006-022-1887-7 -
BMC Pediatrics Jan 2021Sleep and colic problems in infancy have been linked to adverse health outcome, but there is limited knowledge of the association between sleep and colic problems in...
BACKGROUND
Sleep and colic problems in infancy have been linked to adverse health outcome, but there is limited knowledge of the association between sleep and colic problems in infancy and subsequent development, emotional and behavior problems in young children. The aim of the present study was to examine whether there is an associations between infants' crying and sleep problems at 6 months and behavioral and development problems at 18 months, 3 and 5 years.
METHODS
This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa), conducted at the Norwegian Institute of Public Health from June 1999 to December 2008. A total of 86,724 children were included. Colic and sleep (sleep duration, nocturnal awakenings and easy to put to bed) was assessed by mother-reports. Z-scores were used to assess differences between groups of children (e.g. having colic or not, having a sleep problem or not). Emotional and behavioral problems were measured with items from the Child Behavior Checklist. Development problems were measured with items from The Ages and Stages Questionnaire.
RESULTS
Infants with colic scored significantly lower on development at 5 years (B=-0.10, CI [- 0.14 to - 0.06]) and higher on internalizing problems both at 3 years (B=0.15. CI [0.11 to 0.18]) and 5 years (B=0.17. CI [0.12 to 0.21]) than the reference population. Children who awoke frequently and were more difficult to put to bed at 6 months scored significantly lower on development at 18 months and 3 and 5 years, and higher on internalizing behavior problems at 3 and 5 years (B=0.18 and B=0.16). Children with shorter sleep duration at 6 months had more internalizing behavior problems at 3 years (B=0.14. CI [0.07 to 0.21]) and 5 years (B=0.15. CI [0.05 to 0.25]) than the reference population.
CONCLUSIONS
Colic and sleep problems early in life should be taken into account as risk factors for development and behavioral problems within the first 5 years of a child's life.
Topics: Child; Child, Preschool; Cohort Studies; Colic; Female; Humans; Infant; Longitudinal Studies; Norway; Sleep; Sleep Wake Disorders
PubMed: 33407244
DOI: 10.1186/s12887-020-02483-1 -
The Veterinary Clinics of North... Aug 2023The fecal microbiome of the horse is reflective of the large colon and plays an important role in the health of the horse. The microbes of the gastrointestinal tract... (Review)
Review
The fecal microbiome of the horse is reflective of the large colon and plays an important role in the health of the horse. The microbes of the gastrointestinal tract digest fiber and produce energy for the host. Healthy horses have Firmicutes, Bacteroidetes, and Verrucromicrobia as the most common phyla. During gastrointestinal disease such as colic or colitis, the microbiome shows less diversity and changes in bacterial community composition.
Topics: Horses; Animals; Colic; Horse Diseases; Microbiota; Bacteria; Feces
PubMed: 37121786
DOI: 10.1016/j.cveq.2023.03.004