Is there a role for TummySoft in the management of infantile colic?

TummySoft Has No Proven Role in Infantile Colic Management

There is insufficient evidence to recommend TummySoft for the management of infantile colic, as current guidelines do not support the use of commercial devices or nutritional modifications for this condition.

Understanding Infantile Colic

Infantile colic is characterized by:

• Excessive crying in otherwise healthy infants
• Typically peaks at around 4 months of age
• Lower incidence in breastfed compared to formula-fed infants
• Significant distress for parents and caregivers

Evidence-Based Management Options

Probiotic Therapy

• L. reuteri DSM 17938 is the most evidence-supported intervention, particularly for breastfed infants 1
  • Recommended by the American Academy of Pediatrics
  • Associated with mean reduction of 49-65 minutes of daily crying
  • Effective at doses ≥5 billion CFU per day
  • Treatment should continue for at least 21 days
  • Generally safe with low rates of adverse events

Dietary Interventions

• For breastfed infants:

  • A 2-4 week trial of maternal exclusion diet (restricting at least milk and egg) may be beneficial 2
  • Low-allergen maternal diet if cow's milk protein allergy (CMPA) is suspected 3

• For formula-fed infants:

  • Extensively hydrolyzed protein or amino acid-based formula may be appropriate 2
  • Partially hydrolyzed formula with prebiotics and β-palmitate may be considered if CMPA is not suspected 3

Other Approaches

• Feeding modifications:

  • Reducing feeding volume while increasing frequency 2
  • Thickening formula (with caution in preterm infants due to necrotizing enterocolitis risk) 2

• Positioning:

  • Keeping infants in upright or prone position when awake and supervised 2

Ineffective or Unproven Interventions

• Commercial devices marketed to reduce colic have no evidence supporting their efficacy 2
• There is insufficient evidence to conclude if nutritional modifications are useful or detrimental in reducing infant colic 2
• Simethicone has shown conflicting results in studies 4
• Dicyclomine hydrochloride and Cimetropium bromide have shown favorable results but with concerning side effects 4

Important Considerations

• A comprehensive medical history and physical examination are essential to rule out other conditions

• Warning signs requiring further investigation include:

  • Consistently forceful vomiting
  • Fever
  • Lethargy
  • Abdominal tenderness or distension
  • Poor weight gain

• Parental education and reassurance are crucial components of management 5

• Infantile colic is self-limiting but may have behavioral and somatic sequelae into childhood

Conclusion

While several interventions show promise for managing infantile colic, particularly L. reuteri probiotics in breastfed infants, there is no evidence supporting the use of TummySoft for this condition. Parents should be counseled on evidence-based approaches and reassured about the self-limiting nature of the condition.