Кольки в немовлят: відмінності між версіями

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{{Infobox medical condition
'''Коліки у немовлят''' визначаються як періоди [[плач]]у впродовж більш ніж трьох годин на день, більш ніж три дні на тиждень протягом трьох тижнів в загалом здорової дитини. Часто плач відбувається ввечері. Зазвичай не призводить до довготермінових проблем.<ref name="Gri2014">{{Cite book|url=https://books.google.ca/books?id=T-XtAwAAQBAJ&pg=PA251|title=The 5-minute clinical consult premium|last=Grimes|first=edited by Frank Domino, Robert A. Baldor, Jeremy Golding, Jill A.|date=2014|publisher=Wolters Kluwer Health|edition=23rd|location=St. Louis|page=251|isbn=9781451192155|archiveurl=https://web.archive.org/web/20150225101212/https://books.google.ca/books?id=T-XtAwAAQBAJ&pg=PA251|archivedate=2015-02-25|deadurl=no}}</ref> Плач може викликати роздратування батьків, {{iw|післяродова депресія|післяродову депресію||Postpartum depression}}, надмірні відвідування лікаря та [[насильство над дітьми]].<ref name="AFP2015">{{Cite journal}}</ref>
| name = Colic
| synonyms =
| image = File:Human-Male-White-Newborn-Baby-Crying.jpg
| caption = Немовля плаче
| field = [[педіатрія]]
| symptoms = [[плач]] понад три години на добу понад три дні на тиждень упродовж трьох тижнів<ref name=AFP2015/>
| complications = фрустрація батьків, {{нп|післяпологова депресія|||postpartum depression}}, [[насильство над дітьми]]<ref name=AFP2015/>
| onset = шість тижнів від народження<ref name=AFP2015/>
| duration = зазвичай минає до віку шести місяців<ref name=AFP2015/>
| types =
| causes = невідомі<ref name=AFP2015/>
| risks =
| diagnosis = симптоматично після перевірки інших можливих причин<ref name=AFP2015/>
| differential = {{нп|Corneal abrasion}}, {{нп|волосяний джгут|||hair tourniquet}}, [[грижа]], {{нп|перекручення яєчка|||testicular torsion}}<ref>{{cite web|title=Colic Differential Diagnoses|url=http://emedicine.medscape.com/article/927760-differential?pa=Pr8zrzc5NCL8kj1NTeavgAJNuweo9M00CAqyE7yf%2B8mq0%2Fc7lXdRmEi8ZDs9CFEy8SIvl8zjYv73GUyW5rsbWA%3D%3D|website=emedicine.medscape.com|accessdate=1 June 2017|language=en|date=3 September 2015|deadurl=no|archiveurl=https://web.archive.org/web/20171105194845/https://emedicine.medscape.com/article/927760-differential?pa=Pr8zrzc5NCL8kj1NTeavgAJNuweo9M00CAqyE7yf%2B8mq0%2Fc7lXdRmEi8ZDs9CFEy8SIvl8zjYv73GUyW5rsbWA%3D%3D|archivedate=5 November 2017|df=}}</ref>
| prevention =
| treatment = {{нп|Conservative treatment}}, підтримка батьків<ref name=Bia2016/><ref name=AFP2015/>
| medication =
| prognosis = немає проблем у довготривалій перспективі<ref name=Gri2014/>
| frequency = ~25% дітей<ref name=AFP2015/>
| deaths =
}}
'''Коліки у немовлят''' визначаються як періоди [[плач]]у впродовж більш ніж трьох годин на день, більш ніж три дні на тиждень протягом трьох тижнів в загалом здорової дитини. Часто плач відбувається ввечері. Зазвичай не призводить до довготермінових проблем.<ref name="Gri2014">{{Cite book|url=https://books.google.ca/books?id=T-XtAwAAQBAJ&pg=PA251|title=The 5-minute clinical consult premium|last=Grimes|first=edited by Frank Domino, Robert A. Baldor, Jeremy Golding, Jill A.|date=2014|publisher=Wolters Kluwer Health|edition=23rd|location=St. Louis|page=251|isbn=9781451192155|archiveurl=https://web.archive.org/web/20150225101212/https://books.google.ca/books?id=T-XtAwAAQBAJ&pg=PA251|archivedate=2015-02-25|deadurl=no}}</ref> Плач може викликати роздратування батьків, {{iw|післяродова депресія|післяродову депресію||Postpartum depression}}, надмірні відвідування лікаря та [[насильство над дітьми]].<ref name="AFP2015">{{cite journal|url=http://www.aafp.org/afp/2015/1001/p577.html|last1=Johnson|first1=JD|last2=Cocker|first2=K|last3=Chang|first3=E|title=Infantile Colic: Recognition and Treatment.|journal=American Family Physician|date=1 October 2015|accessdate=22 July 2017|volume=92|issue=7|pages=577–82|pmid=26447441|deadurl=no|archiveurl=https://web.archive.org/web/20170826234735/http://www.aafp.org/afp/2015/1001/p577.html|archivedate=26 August 2017|df=}}</ref>


Причина колік невідома. Дехто вважає що це через шлунково-кишковий дискомфорт, на зразок кишкових судом.<ref>{{Cite journal}}</ref> Діагностика потребує виключення інших можливих причин, наприклад [[Гарячка|гарячки]], [[Летаргія|низької активності]], або здутого живота. Менш ніж 5% немовлят з надмірним плачем мають причиною якусь [[Хвороба|хворобу]] ({{lang-en|organic disease}}).
Причина колік невідома.<ref name=AFP2015/> Дехто вважає що це через шлунково-кишковий дискомфорт, на зразок кишкових судом.<ref>{{Cite journal|last=Shamir|first=Raanan|last2=St James-Roberts|first2=Ian|last3=Di Lorenzo|first3=Carlo|last4=Burns|first4=Alan J.|last5=Thapar|first5=Nikhil|last6=Indrio|first6=Flavia|last7=Riezzo|first7=Giuseppe|last8=Raimondi|first8=Francesco|last9=Di Mauro|first9=Antonio|date=2013-12-01|title=Infant crying, colic, and gastrointestinal discomfort in early childhood: a review of the evidence and most plausible mechanisms|journal=Journal of Pediatric Gastroenterology and Nutrition|volume=57 Suppl 1|pages=S1–45|doi=10.1097/MPG.0b013e3182a154ff|issn=1536-4801|pmid=24356023}}</ref> Діагностика потребує виключення інших можливих причин, наприклад [[Гарячка|гарячки]], [[Летаргія|низької активності]], або здутого живота.<ref name=AFP2015/> Менш ніж 5% немовлят з надмірним плачем мають причиною якусь [[Хвороба|хворобу]] ({{lang-en|organic disease}}).<ref name=AFP2015/>


Лікування загалом консервативне, без фармацевтичних засобів або альтернативних терапій.<ref name="Bia2016">{{Cite journal}}</ref> Корисна додаткова підтримка для дітей. <!--Tentative evidence supports certain [[Пробіотик|probiotics]] for the baby and a low-[[Алергени|allergen]] diet by the mother in those who are [[Грудне вигодовування|breastfed]]. Hydrolyzed formula may be useful in those who are [[Дитяча пляшка|bottlefed]].
Лікування загалом консервативне, без фармацевтичних засобів або альтернативних терапій.<ref name="Bia2016">{{cite journal|last1=Biagioli|first1=E|last2=Tarasco|first2=V|last3=Lingua|first3=C|last4=Moja|first4=L|last5=Savino|first5=F|title=Pain-relieving agents for infantile colic.|journal=The Cochrane Database of Systematic Reviews|date=16 September 2016|volume=9|pages=CD009999|pmid=27631535|doi=10.1002/14651858.CD009999.pub2}}</ref> Корисна додаткова підтримка для батьків дітей.<ref name=AFP2015/> <!--Tentative evidence supports certain [[Пробіотик|probiotics]] for the baby and a low-[[Алергени|allergen]] diet by the mother in those who are [[Грудне вигодовування|breastfed]]. Hydrolyzed formula may be useful in those who are [[Дитяча пляшка|bottlefed]].<ref name=AFP2015/>


Colic affects 10–40% of children. It is most common at six weeks of age and typically goes away by six months of age. It rarely lasts up to one year of age.<ref>{{Cite journal}}</ref> It occurs at the same rate in boys and in girls. The first detailed medical description of the problem occurred in 1954.<ref>{{Cite book|url=https://books.google.ca/books?id=1CHFjG6fMasC&pg=PA5|title=Excessive Crying in Infancy|last=Long|first=Tony|date=2006|publisher=John Wiley & Sons|page=5|language=en|isbn=9780470031711|archiveurl=https://web.archive.org/web/20161018200048/https://books.google.ca/books?id=1CHFjG6fMasC&pg=PA5|archivedate=2016-10-18|deadurl=no}}</ref>
Colic affects 10–40% of children.<ref name=AFP2015/> It is most common at six weeks of age and typically goes away by six months of age.<ref name=AFP2015/> It rarely lasts up to one year of age.<ref>{{cite journal |pmid=12444822 |year=2002 |last1=Barr |first1=RG |title=Changing our understanding of infant colic |volume=156 |issue=12 |pages=1172–4 |journal=Archives of Pediatrics & Adolescent Medicine|doi=10.1001/archpedi.156.12.1172}}</ref> It occurs at the same rate in boys and in girls.<ref name=AFP2015/> The first detailed medical description of the problem occurred in 1954.<ref>{{Cite book|url=https://books.google.ca/books?id=1CHFjG6fMasC&pg=PA5|title=Excessive Crying in Infancy|last=Long|first=Tony|date=2006|publisher=John Wiley & Sons|page=5|language=en|isbn=9780470031711|archiveurl=https://web.archive.org/web/20161018200048/https://books.google.ca/books?id=1CHFjG6fMasC&pg=PA5|archivedate=2016-10-18|deadurl=no}}</ref>


== Signs and symptoms ==
== Signs and symptoms ==
Colic is defined as episodes of crying for more than three hours a day, for more than three days a week for a three-week duration in an otherwise healthy child between the ages of two weeks and four months.<ref name="Kh2012">{{Cite journal}}</ref> By contrast, infants normally cry an average of just over two hours a day, with the duration peaking at six weeks. With colic, periods of crying most commonly happen in the evening and for no obvious reason. Associated symptoms may include legs pulled up to the stomach, a flushed face, clenched hands, and a wrinkled brow. The cry is often high pitched (piercing).
Colic is defined as episodes of crying for more than three hours a day, for more than three days a week for a three-week duration in an otherwise healthy child between the ages of two weeks and four months.<ref name="Kh2012">{{cite journal|last=Kheir|first=AE|title=Infantile colic, facts and fiction.|journal=Italian journal of pediatrics|date=Jul 23, 2012|volume=38|pages=34|pmid=22823993|doi=10.1186/1824-7288-38-34|pmc=3411470}}{{retracted|intentional=no}}</ref> By contrast, infants normally cry an average of just over two hours a day, with the duration peaking at six weeks.<ref name=AFP2004/> With colic, periods of crying most commonly happen in the evening and for no obvious reason.<ref name=AFP2015/> Associated symptoms may include legs pulled up to the stomach, a flushed face, clenched hands, and a wrinkled brow.<ref name=AFP2004/> The cry is often high pitched (piercing).<ref name=AFP2004/>


=== Effect on the family ===
===Effect on the family===
An infant with colic may affect family stability and be a cause of short-term anxiety or depression in the father and mother. It may also contribute to exhaustion and stress in the parents.<ref name="Ia2012">{{Cite journal}}</ref>
An infant with colic may affect family stability and be a cause of short-term anxiety or depression in the father and mother.<ref name=AFP2004/> It may also contribute to exhaustion and stress in the parents.<ref name=Ia2012>{{cite journal|last=Iacovou|first=M|author2=Ralston, RA |author3=Muir, J |author4=Walker, KZ |author5= Truby, H |title=Dietary management of infantile colic: a systematic review.|journal=Maternal and child health journal|date=August 2012|volume=16|issue=6|pages=1319–31|pmid=21710185|doi=10.1007/s10995-011-0842-5}}</ref>


Persistent infant crying has been associated with severe marital discord, postpartum depression, early termination of breastfeeding, frequent visits to doctors, and a quadrupling of excessive laboratory tests and prescription of medication for acid reflux.{{Fact}} Babies with colic may be exposed to abuse, especially [[Синдром струшеної дитини|shaken baby syndrome]].
Persistent infant crying has been associated with severe marital discord, postpartum depression, early termination of breastfeeding, frequent visits to doctors, and a quadrupling of excessive laboratory tests and prescription of medication for acid reflux.{{citation needed|date=May 2012}} Babies with colic may be exposed to abuse, especially [[Синдром струшеної дитини|shaken baby syndrome]].<ref name=AFP2004/>


== Causes ==
== Causes ==
The cause of colic is generally unknown. Fewer than 5% of infants who cry excessively turn out to have an underlying [[Хвороба|organic disease]], such as constipation, [[Гастроезофагеальна рефлюксна хвороба|gastroesophageal reflux disease]], [[Непереносимість лактози|lactose intolerance]], anal fissures, [[Субдуральна гематома|subdural hematomas]], or infantile [[Мігрень|migraine]]. Babies fed cow's milk have been shown to develop antibody responses to the bovine protein, causing colic.<ref>{{Cite journal}}</ref><ref>{{Cite journal}}</ref> Studies performed showed conflicting evidence about the role of cow's milk allergy. While previously believed to be related to gas pains, this does not appear to be the case. Another theory holds that colic is related to [[Перистальтика|hyperperistalsis]] of the digestive tube (increased level of activity of contraction and relaxation). The evidence that the use of anticholinergic agents improve colic symptoms supports this hypothesis.
The cause of colic is generally unknown. Fewer than 5% of infants who cry excessively turn out to have an underlying [[Хвороба|organic disease]], such as constipation, [[Гастроезофагеальна рефлюксна хвороба|gastroesophageal reflux disease]], [[Непереносимість лактози|lactose intolerance]], anal fissures, [[Субдуральна гематома|subdural hematomas]], or infantile [[Мігрень|migraine]].<ref name=AFP2004/> Babies fed cow's milk have been shown to develop antibody responses to the bovine protein, causing colic.<ref>{{Cite journal|last=Lucassen|first=P. L.|last2=Assendelft|first2=W. J.|last3=Gubbels|first3=J. W.|last4=van Eijk|first4=J. T.|last5=van Geldrop|first5=W. J.|last6=Neven|first6=A. K.|date=1998-05-23|title=Effectiveness of treatments for infantile colic: systematic review|journal=BMJ (Clinical research ed.)|volume=316|issue=7144|pages=1563–1569|issn=0959-8138|pmc=28556|pmid=9596593|doi=10.1136/bmj.316.7144.1563}}</ref><ref>{{Cite journal|last=Delire|first=M.|last2=Cambiaso|first2=C. L.|last3=Masson|first3=P. L.|date=1978-04-13|title=Circulating immune complexes in infants fed on cow's milk|journal=Nature|volume=272|issue=5654|pages=632|issn=0028-0836|pmid=565472|doi=10.1038/272632a0}}</ref> Studies performed showed conflicting evidence about the role of cow's [[milk allergy]].<ref name=AFP2004/> While previously believed to be related to gas pains, this does not appear to be the case.<ref name=AFP2004/> Another theory holds that colic is related to [[Перистальтика|hyperperistalsis]] of the digestive tube (increased level of activity of contraction and relaxation). The evidence that the use of anticholinergic agents improve colic symptoms supports this hypothesis.<ref name=AFP2004/>


Psychological and social factors have been proposed as a cause, but there is no evidence. Studies performed don't support the theory that maternal (or paternal) personality or anxiety causes colic, nor that it is a consequence of a difficult temperament of the baby, but families with colicky children may eventually develop anxiety, fatigue and problems with family functioning as a result. There is some evidence that cigarette smoke may increase the risk. It seems unrelated to breast or bottle feeding with rates similar in both groups.<ref name="Sher2010">{{Cite journal}}</ref> Reflux does not appear to be related to colic.
Psychological and social factors have been proposed as a cause, but there is no evidence. Studies performed don't support the theory that maternal (or paternal) personality or anxiety causes colic, nor that it is a consequence of a difficult temperament of the baby, but families with colicky children may eventually develop anxiety, fatigue and problems with family functioning as a result.<ref name=AFP2004/> There is some evidence that cigarette smoke may increase the risk.<ref name=Kh2012/> It seems unrelated to breast or bottle feeding with rates similar in both groups.<ref name=Sher2010>{{cite journal|last=Shergill-Bonner|first=R|title=Infantile colic: practicalities of management, including dietary aspects.|journal=The journal of family health care|year=2010|volume=20|issue=6|pages=206–9|pmid=21319674}}</ref> Reflux does not appear to be related to colic.<ref name=Ben2016/>


== Diagnosis ==
==Diagnosis==
Colic is diagnosed after other potential causes of crying are excluded.<ref name="AFP2004">{{Cite journal}}</ref> This can typically be done via a history and physical exam, and in most cases tests such as X-rays or blood tests are not needed. Babies who cry may simply be hungry, uncomfortable, or ill.<ref>{{Cite journal}}</ref> Less than 10% of babies who would meet the definition of colic based on the amount they cry have an identifiable underlying disease.<ref>{{Cite journal}}</ref>
Colic is diagnosed after other potential causes of crying are excluded.<ref name=AFP2004>{{cite journal|last=Roberts|first=DM|author2=Ostapchuk, M|author3=O'Brien, JG|title=Infantile colic.|journal=American Family Physician|date=Aug 15, 2004|volume=70|issue=4|pages=735–40|pmid=15338787|url=http://www.aafp.org/afp/2004/0815/p735.html|type=Review|deadurl=no|archiveurl=https://web.archive.org/web/20140828184714/http://www.aafp.org/afp/2004/0815/p735.html|archivedate=2014-08-28|df=}}</ref> This can typically be done via a history and physical exam, and in most cases tests such as X-rays or blood tests are not needed.<ref name=AFP2004/> Babies who cry may simply be hungry, uncomfortable, or ill.<ref>{{cite journal |pmid=9794970 |year=1998 |last1=Barr |first1=RG |title=Colic and crying syndromes in infants |volume=102 |issue=5 Suppl E |pages=1282–6 |journal=Pediatrics}}</ref> Less than 10% of babies who would meet the definition of colic based on the amount they cry have an identifiable underlying disease.<ref>{{cite journal|last1=Hyman|first1=PE|last2=Milla|first2=PJ|last3=Benninga|first3=MA|last4=Davidson|first4=GP|last5=Fleisher|first5=DF|last6=Taminiau|first6=J|title=Childhood functional gastrointestinal disorders: neonate/toddler.|journal=Gastroenterology|date=April 2006|volume=130|issue=5|pages=1519–26|doi=10.1053/j.gastro.2005.11.065|pmid=16678565}}</ref>


Cause for concern include: an elevated temperature, a history of breathing problems or a child who is not appropriately gaining weight.
Cause for concern include: an elevated temperature, a history of breathing problems or a child who is not appropriately gaining weight.<ref name=AFP2004/>


"Red flag" indicating that further investigations may be needed include:<ref name="Karp">{{Cite book|title=The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer|last=Karp|first=Harvey|year=2003|publisher=Bantam|location=New York|isbn=978-0-553-38146-7}}{{Page needed}}</ref>
"Red flag" indicating that further investigations may be needed include:<ref name="Karp">{{cite book |last1=Karp |first1=Harvey |title=The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer |location=New York |publisher=Bantam |year=2003 |isbn=978-0-553-38146-7}}{{page needed|date=May 2012}}</ref>


* Vomiting (vomit that is green or yellow, bloody or occurring more than 5/day)
* Vomiting (vomit that is green or yellow, bloody or occurring more than 5/day)
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* Poor weight gain (gaining less than 15&nbsp;grams a day)
* Poor weight gain (gaining less than 15&nbsp;grams a day)


Problems to consider when the above are present include:
Problems to consider when the above are present include:<ref name="Karp" />

* Infections (e.g. ear infection, urine infection, meningitis, appendicitis)
* Infections (e.g. ear infection, urine infection, meningitis, appendicitis)
* Intestinal pain (e.g. food allergy, acid reflux, constipation, intestinal blockage)
* Intestinal pain (e.g. food allergy, acid reflux, constipation, intestinal blockage)
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* Others (e.g. migraine headache, heart failure, hyperthyroidism)
* Others (e.g. migraine headache, heart failure, hyperthyroidism)


Persistently fussy babies with poor weight gain, vomiting more than 5 times a day, or other significant feeding problems should be evaluated for other illnesses (e.g. urinary infection, intestinal obstruction, acid reflux).<ref name="Heine">{{Cite journal}}</ref>
Persistently fussy babies with poor weight gain, vomiting more than 5 times a day, or other significant feeding problems should be evaluated for other illnesses (e.g. urinary infection, intestinal obstruction, acid reflux).<ref name="Heine">{{cite journal |doi=10.1111/j.1440-1754.2006.00812.x |title=Clinical predictors of pathological gastro-oesophageal reflux in infants with persistent distress |year=2006 |last1=Heine |first1=Ralf G |last2=Jordan |first2=Brigid |last3=Lubitz |first3=Lionel |last4=Meehan |first4=Michele |last5=Catto-Smith |first5=Anthony G |journal=Journal of Paediatrics and Child Health |volume=42 |issue=3 |pages=134–9 |pmid=16509914}}</ref>


== Treatment ==
== Treatment ==
Management of colic is generally conservative and involves the reassurance of parents. Calming measures may be used and include: swaddling with the legs flexed, holding the baby on its side or stomach, swinging the baby side to side or back and forth while supporting the head, making a shushing sound, and breast feeding or the use of a pacifier. Eye contact, talking, and holding the infant are also reasonable measures, although it is not entirely clear if these actions have any effect beyond [[Плацебо|placebo]].<ref name="Ches2012">{{Cite journal}}</ref>
Management of colic is generally conservative and involves the reassurance of parents.<ref name=AFP2004/> Calming measures may be used and include: [[swaddling]] with the legs flexed, holding the baby on its side or stomach, swinging the baby side to side or back and forth while supporting the head, making a shushing sound, and breast feeding or the use of a pacifier.<ref name=Kh2012/> Eye contact, talking, and holding the infant are also reasonable measures,<ref name=Kh2012/> although it is not entirely clear if these actions have any effect beyond [[плацебо|placebo]].<ref name=AFP2004/><ref name=Ches2012>{{cite journal|last=Hall|first=B|author2=Chesters, J |author3=Robinson, A |title=Infantile colic: a systematic review of medical and conventional therapies.|journal=Journal of paediatrics and child health|date=February 2012|volume=48|issue=2|pages=128–37|pmid=21470331|doi=10.1111/j.1440-1754.2011.02061.x}}</ref>


=== Medication ===
===Medication===
No medications have been found to be both safe and effective. Simethicone is safe but does not appear to work, while dicyclomine works but is not safe. Evidence does not support the use of cimetropium bromide, and there is little evidence for alternative medications or techniques.<ref>{{Cite journal}}</ref> While medications to treat reflux are common, there is no evidence that they are useful.<ref name="Ben2016">{{Cite journal}}</ref>
No medications have been found to be both safe and effective.<ref name=Kh2012/> [[Simethicone]] is safe but does not appear to work, while [[dicyclomine]] works but is not safe.<ref name=AFP2004/> Evidence does not support the use of [[cimetropium bromide]],<ref name=Ches2012/> and there is little evidence for alternative medications or techniques.<ref>{{cite journal|last=Perry|first=R|author2=Hunt, K |author3=Ernst, E |title=Nutritional supplements and other complementary medicines for infantile colic: a systematic review.|journal=Pediatrics|date=April 2011|volume=127|issue=4|pages=720–33|pmid=21444591|doi=10.1542/peds.2010-2098}}</ref> While medications to treat reflux are common, there is no evidence that they are useful.<ref name=Ben2016>{{cite journal|last1=Benninga|first1=MA|last2=Faure|first2=C|last3=Hyman|first3=PE|last4=St James Roberts|first4=I|last5=Schechter|first5=NL|last6=Nurko|first6=S|title=Childhood Functional Gastrointestinal Disorders: Neonate/Toddler.|journal=Gastroenterology|date=15 February 2016|doi=10.1053/j.gastro.2016.02.016|pmid=27144631}}</ref>


=== Diet ===
===Diet===
Dietary changes by infants are generally not needed. In mothers who are breastfeeding, a hypoallergenic diet by the mother—not eating milk and dairy products, eggs, wheat, and nuts—may improve matters,<ref name="NocerinoPezzella2015">{{Cite journal}}</ref> while elimination of only cow's milk does not seem to produce any improvement. In formula-fed infants, switching to a soy-based or hydrolyzed protein formula may help. Evidence of benefit is greater for hydrolyzed protein formula with the benefit from soy based formula being disputed.<ref>{{Cite journal}}</ref><ref name="Savino2010">{{Cite journal}}</ref> Additionally both these formulas have greater cost and are not as palatable. Supplementation with fiber has no benefit.
Dietary changes by infants are generally not needed.<ref name=AFP2004/> In mothers who are breastfeeding, a hypoallergenic diet by the mother—not eating milk and dairy products, eggs, wheat, and nuts—may improve matters,<ref name=AFP2004/><ref name=Ia2012/><ref name=NocerinoPezzella2015>{{cite journal|author1=Nocerino R |author2=Pezzella V |author3=Cosenza L |author4=Amoroso A |author5=Di Scala C |author6=Amato F |display-authors=etal | title=The controversial role of food allergy in infantile colic: evidence and clinical management. | journal=Nutrients | year= 2015 | volume= 7 | issue= 3 | pages= 2015–25 | pmid=25808260 | doi=10.3390/nu7032015 | pmc=4377897 | type=Review }}</ref> while elimination of only cow's milk does not seem to produce any improvement.<ref name=NocerinoPezzella2015 /> In formula-fed infants, switching to a [[Soy-based infant formula|soy-based]] or hydrolyzed protein formula may help.<ref name=Ia2012/> Evidence of benefit is greater for hydrolyzed protein formula with the benefit from soy based formula being disputed.<ref>{{cite journal|last=Bhatia|first=J |author2=Greer, F |author3=American Academy of Pediatrics Committee on Nutrition |title=Use of soy protein-based formulas in infant feeding.|journal=Pediatrics|date=May 2008|volume=121|issue=5|pages=1062–8|pmid=18450914|doi=10.1542/peds.2008-0564}}</ref><ref name=Savino2010>{{cite journal|last=Savino|first=F|author2=Tarasco, V|title=New treatments for infant colic.|journal=Current Opinion in Pediatrics|date=December 2010|volume=22|issue=6|pages=791–7|pmid=20859207|doi=10.1097/MOP.0b013e32833fac24}}</ref> Additionally both these formulas have greater cost and are not as palatable.<ref name=Savino2010/> Supplementation with fiber has no benefit.<ref name=Ia2012/>


=== Alternative medicine ===
=== Alternative medicine ===
No clear beneficial effect from spinal manipulation<ref>{{Cite journal}}</ref><ref>{{Cite journal}}</ref> or [[Масаж|massage]] has been shown. Further, as there is no evidence of safety for cervical manipulation for baby colic, it is not advised.<ref name="CamilleriPark2017">{{Cite journal}}</ref> There is a case of a three-month-old dying following manipulation of the neck area.
No clear beneficial effect from [[spinal manipulation]]<ref>{{cite journal|last=Dobson|first=D|author2=Lucassen, PL |author3=Miller, JJ |author4=Vlieger, AM |author5=Prescott, P |author6= Lewith, G |title=Manipulative therapies for infantile colic|journal=Cochrane Database of Systematic Reviews|date=Dec 12, 2012|volume=12|pages=CD004796|pmid=23235617|doi=10.1002/14651858.CD004796.pub2}}</ref><ref>{{cite journal|last=Aase|first=K|author2=Blaakær, J|title=Chiropractic care of infants with colic lacks evidence|journal=Ugeskrift for laeger|date=Feb 11, 2013|volume=175|issue=7|pages=424–8|pmid=23402252}}</ref> or [[massage]] has been shown.<ref name=AFP2004/> Further, as there is no evidence of safety for [[cervical manipulation]] for baby colic, it is not advised.<ref name=CamilleriPark2017>{{cite journal| author=Camilleri M, Park SY, Scarpato E, Staiano A| title=Exploring hypotheses and rationale for causes of infantile colic | journal=Neurogastroenterol Motil | year= 2017 | volume= 29 | issue= 2 | pages= e12943| doi=10.1111/nmo.12943 | pmc=5276723 | pmid=27647578 | type=Review }}</ref> There is a case of a three-month-old dying following manipulation of the neck area.<ref name=CamilleriPark2017 />


Little clinical evidence supports the efficacy of "[[gripe water]]" and caution in use is needed, especially in formulations that include [[спирти|alcohol]] or [[цукор|sugar]].<ref name=AFP2004/> Evidence does not support [[лактаза|lactase]] supplementation.<ref name=Ches2012/> The use of probiotics, specifically ''[[Lactobacillus reuteri]]'', decreases crying time at three weeks by 46 minutes in breastfeed babies but has unclear effects in those who are formula fed.<ref>{{cite journal |last1=Sung |first1=V |last2=D'Amico |first2=F |last3=Cabana |first3=MD |last4=Chau |first4=K |last5=Koren |first5=G |last6=Savino |first6=F |last7=Szajewska |first7=H |last8=Deshpande |first8=G |last9=Dupont |first9=C |last10=Indrio |first10=F |last11=Mentula |first11=S |last12=Partty |first12=A |last13=Tancredi |first13=D |title=<i>Lactobacillus reuteri</i> to Treat Infant Colic: A Meta-analysis. |journal=Pediatrics |date=January 2018 |volume=141 |issue=1 |pages=e20171811 |doi=10.1542/peds.2017-1811 |pmid=29279326|doi-access=free }}</ref> [[Fennel]] also appears effective.<ref name="Harb">{{cite journal |last1=Harb |first1=T |last2=Matsuyama |first2=M |last3=David |first3=M |last4=Hill |first4=RJ |title=Infant Colic-What works: A Systematic Review of Interventions for Breast-fed Infants. |journal=Journal of Pediatric Gastroenterology and Nutrition |date=May 2016 |volume=62 |issue=5 |pages=668–86 |doi=10.1097/MPG.0000000000001075 |pmid=26655941}}</ref><ref>{{cite journal |last1=Anheyer |first1=D |last2=Frawley |first2=J |last3=Koch |first3=AK |last4=Lauche |first4=R |last5=Langhorst |first5=J |last6=Dobos |first6=G |last7=Cramer |first7=H |title=Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review. |journal=Pediatrics |date=June 2017 |volume=139 |issue=6 |pages=e20170062 |doi=10.1542/peds.2017-0062 |pmid=28562281|doi-access=free }}</ref>
No evidence supports the efficacy of so-called "gripe water", and its use poses risks, especially in formulations that include [[Спирти|alcohol]] or [[Цукор|sugar]]. Evidence does not support [[Лактаза|lactase]], or supplementing formula with [[Пробіотик|probiotics]].<ref>{{Cite journal}}</ref> The use of the probiotic ''Lactobacillus reuteri'' in babies who are [[Грудне вигодовування|breastfed]] has tentative evidence.<ref>{{Cite journal}}</ref>


== Prognosis ==
== Prognosis ==
Infants who are colicky do just as well as their non colicky peers with respect to temperament at one year of age.
Infants who are colicky do just as well as their non colicky peers with respect to temperament at one year of age.<ref name=AFP2004/>


== Epidemiology ==
== Epidemiology ==
Colic affects 10–40% of children. occurring at the same rate in boys and in girls.
Colic affects 10–40% of children.<ref name=AFP2015/> occurring at the same rate in boys and in girls.<ref name=Sher2010/>


== Історія ==
== Історія ==
Рядок 74: Рядок 95:
It has been an age-old practice to drug crying infants. During the second century AD, the Greek physician Galen prescribed opium to calm fussy babies, and during the Middle Ages in Europe, mothers and wet nurses smeared their nipples with opium lotions before each feeding. Alcohol was also commonly given to infants.<ref name="Solter 1998">{{Cite book|title=Tears and Tantrums: What to Do When Babies and Children Cry|last=Solter|first=A|year=1998|publisher=Shining Star Press|location=Goleta, CA|isbn=9780961307363}}</ref>
It has been an age-old practice to drug crying infants. During the second century AD, the Greek physician Galen prescribed opium to calm fussy babies, and during the Middle Ages in Europe, mothers and wet nurses smeared their nipples with opium lotions before each feeding. Alcohol was also commonly given to infants.<ref name="Solter 1998">{{Cite book|title=Tears and Tantrums: What to Do When Babies and Children Cry|last=Solter|first=A|year=1998|publisher=Shining Star Press|location=Goleta, CA|isbn=9780961307363}}</ref>


In past decades, doctors recommended treating colicky babies with sedative medications (e.g. phenobarbital, Valium, alcohol), analgesics (e.g. opium) or anti-spasm drugs (e.g. scopolamine, Donnatal, dicyclomine), but all of these are no longer recommended because of potential serious side-effects, including death.{{Fact}}
In past decades, doctors recommended treating colicky babies with sedative medications (e.g. phenobarbital, Valium, alcohol), analgesics (e.g. opium) or anti-spasm drugs (e.g. scopolamine, Donnatal, dicyclomine), but all of these are no longer recommended because of potential serious side-effects, including death.{{citation needed|date=травень 2012}}
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== Зноски ==
== Примітки ==
{{Reflist}}
{{reflist|2}}


== Посилання ==
== Посилання ==

Версія за 10:26, 28 квітня 2020

Colic
Немовля плаче
Немовля плаче
Спеціальність педіатрія
Симптоми плач понад три години на добу понад три дні на тиждень упродовж трьох тижнів[1]
Ускладнення фрустрація батьків, післяпологова депресія, насильство над дітьми[1]
Початок шість тижнів від народження[1]
Тривалість зазвичай минає до віку шести місяців[1]
Причини невідомі[1]
Метод діагностики симптоматично після перевірки інших можливих причин[1]
Диференціальна діагностика Corneal abrasion[en], волосяний джгут[en], грижа, перекручення яєчка[en][2]
Лікування Conservative treatment[en], підтримка батьків[3][1]
Прогнози немає проблем у довготривалій перспективі[4]
Частота ~25% дітей[1]
Класифікація та зовнішні ресурси
МКХ-11 DD93.1
МКХ-10 R10.4

Коліки у немовлят визначаються як періоди плачу впродовж більш ніж трьох годин на день, більш ніж три дні на тиждень протягом трьох тижнів в загалом здорової дитини. Часто плач відбувається ввечері. Зазвичай не призводить до довготермінових проблем.[4] Плач може викликати роздратування батьків, післяродову депресію[en], надмірні відвідування лікаря та насильство над дітьми.[1]

Причина колік невідома.[1] Дехто вважає що це через шлунково-кишковий дискомфорт, на зразок кишкових судом.[5] Діагностика потребує виключення інших можливих причин, наприклад гарячки, низької активності, або здутого живота.[1] Менш ніж 5% немовлят з надмірним плачем мають причиною якусь хворобу (англ. organic disease).[1]

Лікування загалом консервативне, без фармацевтичних засобів або альтернативних терапій.[3] Корисна додаткова підтримка для батьків дітей.[1]

Примітки

  1. а б в г д е ж и к л м н п Johnson, JD; Cocker, K; Chang, E (1 October 2015). Infantile Colic: Recognition and Treatment.. American Family Physician 92 (7): 577–82. PMID 26447441. Архів оригіналу за 26 серпня 2017. Процитовано 22 липня 2017. 
  2. Colic Differential Diagnoses. emedicine.medscape.com (англ.). 3 September 2015. Архів оригіналу за 5 November 2017. Процитовано 1 June 2017. 
  3. а б Biagioli, E; Tarasco, V; Lingua, C; Moja, L; Savino, F (16 вересня 2016). Pain-relieving agents for infantile colic.. The Cochrane Database of Systematic Reviews 9: CD009999. PMID 27631535. doi:10.1002/14651858.CD009999.pub2. 
  4. а б Grimes, edited by Frank Domino, Robert A. Baldor, Jeremy Golding, Jill A. (2014). The 5-minute clinical consult premium (вид. 23rd). St. Louis: Wolters Kluwer Health. с. 251. ISBN 9781451192155. Архів оригіналу за 25 лютого 2015. 
  5. Shamir, Raanan; St James-Roberts, Ian; Di Lorenzo, Carlo; Burns, Alan J.; Thapar, Nikhil; Indrio, Flavia; Riezzo, Giuseppe; Raimondi, Francesco та ін. (1 грудня 2013). Infant crying, colic, and gastrointestinal discomfort in early childhood: a review of the evidence and most plausible mechanisms. Journal of Pediatric Gastroenterology and Nutrition. 57 Suppl 1: S1–45. ISSN 1536-4801. PMID 24356023. doi:10.1097/MPG.0b013e3182a154ff. 

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