Parental Reassurance and Nutritional Advice in FGID Management: a Review

Title: Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

Authors: Salvatore S, Abkari A, Cai W, Catto-Smith A, Cruchet S, Gottrand F, Hegar B, Lifschitz C, Ludwig T, Shah N, Staiano A, Szajewska H, Treepongkaruna S, Vandenplas Y
Published: April 30, 2018

Acta Paediatrica

Regurgitation, infantile colic and functional constipation are common functional gastrointestinal disorders (FGIDs) during infancy. The FGIDs and their symptoms are often extremely distressing for the infant and parents, leading to a cascade of infant discomfort and crying, parental anxiety, repeated healthcare consultations and escalating healthcare costs.

Despite the first-line management of the most common FGIDs, particularly infantile colic and regurgitation, should focus on parental education and reassurance and nutritional advice; parents are frequently offered conflicting advice on how to manage FGIDs and their related symptoms.

It ranges from personal experience, social media exchanges and recommendations for medications that don’t have any proven efficacy and could induce adverse reactions, to expert opinions and evidence-based guidelines.

Paediatric experts and researchers from Italy, Morocco, China, Australia, Chile, France, Indonesia, Argentina, Singapore, United Kingdom, Poland, Thailand and Belgium carried out a concise review of the literature and evaluated the impact of these common FGIDs on infants and their families. It was also aimed to provide an overview of national and international guidelines and peer‐reviewed expert recommendations on their management.

The review highlighted the short and long term triple impact of regurgitation, infant colic, and functional constipation on the infant, the family, and health care system.

Guidelines emphasise that the first‐line management of the common FGIDs should focus on parental education, reassurance and nutritional advice. Nutritional advice should stress the benefits of continuing breastfeeding, while special infant formulas may be considered for non‐breastfed infants with common FGIDs. Drug treatment is seldom required, with the exception of functional constipation.

“Regurgitation, infantile colic and functional constipation cause frequent parental concerns, lead to heavy personal and economic costs for families and impose a financial burden on public healthcare systems. By providing complete and updated parental education, reassurance and nutritional advice, healthcare professionals can optimise the management of FGIDs and related symptoms,”

said Thomas Ludwig, Principal Scientist Paediatric Gastroenterology at Danone Nutricia Research.

The authors acknowledged the gap between guidelines and practice, and pragmatic recommendations for the primary healthcare setting are emphasized.

For more details about the study, please read the full text of the paper