Opciones de tratamiento del cólico del lactante
Barra lateral del artículo
Publicado:
oct. 1, 2016
Palabras clave:
Cólico, Lactante, Cuidado del lactante, Bienestar del lactante, Nutrición del lactante
Contenido principal del artículo
Resumen
DOI: 10.1016/j.rcpe.2015.10.001
Introducción
El cólico infantil es un problema frecuente en la consulta pediátrica. Su prevalencia mundial es del 15 al 40% en niños menores de cuatro meses, independientemente del tipo de lactancia administrada. Suele generar ansiedad en los cuidadores e, incluso, en los pediatras.
Objetivo
Identificar cuáles son las mejores alternativas para el manejo del cólico del lactante.
Metodología
Se hizo una búsqueda en la web en diferentes bases de datos de artículos científicos (PubMed, EBSCO, MedConsult). Se tuvieron en cuenta las revisiones sistemáticas y los ensayos clínicos. Se revisaron las diferentes alternativas propuestas para el manejo del cólico del lactante y se analizó su efecto en los lactantes.
Resultados
El cólico del lactante es de etiología multifactorial. Las opciones de tratamiento incluyen: fórmulas lácteas a base de proteínas extensamente hidrolizadas; fórmulas lácteas sin lactosa o a base de proteínas de soya; lactancia materna; fármacos como simeticona o diciclomina; terapia conductual; medicina alternativa, y probióticos. Las fórmulas lácteas a base de proteínas extensamente hidrolizadas, son eficaces en lactantes con antecedentes de atopia. La fórmula láctea a base de soya puede generar efectos indeseados en el aparato reproductor y reacción cruzada con las proteínas de la leche de vaca, por lo cual no se recomienda. En algunos estudios se ha demostrado la eficacia de la diciclomina; sin embargo, puede producir efectos secundarios. La administración de Lactobacillusreuteri parece ser una importante opción terapéutica.
Conclusiones
El cólico del lactante es una entidad de curso benigno y resolución espontánea, de etiología multifactorial. Algunos pacientes bien seleccionados podrían beneficiarse de cambios en las fórmulas lácteas, fármacos, medidas conductuales y, recientemente, del probiótico con L. reuteri, dependiendo del factor etiológico.
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Detalles del artículo
Cómo citar
González Coquel, S. del C., & Brochet Bayona, C. (2016). Opciones de tratamiento del cólico del lactante. Pediatría, 48(3), 61–67. Recuperado a partir de https://revistapediatria.org/rp/article/view/36
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Citas
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Paroxysmal fussing in infancy, sometimes called colic
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Medline
2 F. Savino,S. Ceratto,A. De Marco,L. Cordero di Montezemolo
Looking for new treatments of Infantile Colic
Italian journal of pediatrics., 40 (2014), pp. 53 http://dx.doi.org/10.1186/1824-7288-40-53
Medline
3 R.S. Illingworth
Three month's colic; treatment by methylscopolamine nitrate (skopyl)
Acta paediatrica., 44 (1955), pp. 203-208
Medline
4 I. Joanna Briggs
The effectiveness of interventions for infant colic
Australian nursing journal., 16 (2008), pp. 31-34
5 F. Savino,V. Tarasco
New treatments for infant colic
Current opinion in pediatrics., 22 (2010), pp. 791-797 http://dx.doi.org/10.1097/MOP.0b013e32833fac24
Medline
6 J.S. Radesky,B. Zuckerman,M. Silverstein,F.P. Rivara,M. Barr,J.A. Taylor
Inconsolable infant crying and maternal postpartum depressive symptoms
Pediatrics., 131 (2013), pp. e1857-e1864 http://dx.doi.org/10.1542/peds.2012-3316
Medline
7 P. Garg
Infantile colic--unfolded
Indian journal of pediatrics., 71 (2004), pp. 903-906
Medline
8 C.A. Canivet,P.O. Ostergren,A.S. Rosen,I.L. Jakobsson,B.M. Hagander
Infantile colic and the role of trait anxiety during pregnancy in relation to psychosocial and socioeconomic factors
Scandinavian journal of public health., 33 (2005), pp. 26-34 http://dx.doi.org/10.1080/14034940410028316
Medline
9 F. Savino
Focus on infantile colic
Acta paediatrica., 96 (2007), pp. 1259-1264 http://dx.doi.org/10.1111/j.1651-2227.2007.00428.x
Medline
10 P. Lucassen
Colic in infants
BMJ clinical evidence., (2010), pp. 2010
11 D.J. Hill,I.L. Hudson,L.J. Sheffield,M.J. Shelton,S. Menahem,C.S. Hosking
A low allergen diet is a significant intervention in infantile colic: results of a community-based study
The Journal of allergy and clinical immunology., 96 (1995), pp. 886-892
Medline
12 I. Jakobsson,L. Lothe,D. Ley,M.W. Borschel
Effectiveness of casein hydrolysate feedings in infants with colic
Acta Paediatr., 89 (2000), pp. 18-21
Medline
13 Lucassen PL, Assendelft WJ, Gubbels JW, Van Eijk JT, Douwes AC. Infantile colic: Crying time reduction with a whey hydrolysate: A doubleblind, randomized, placebo-controlled trial Pediatrics. 2000;106:1349-54.
14 D.C. Estep,A. Kulczycki Jr.
Treatment of infant colic with amino acid-based infant formula: a preliminary study
Acta Paediatr., 89 (2000), pp. 22-27
Medline
15 B. Taubman
Parental counseling compared with elimination of cow's milk or soy milk protein for the treatment of infant colic syndrome: a randomized trial
Pediatrics., 81 (1988), pp. 756-761
Medline
16 Chief Medical Officer. Advice issued on soya-based infant formulas london: Department of Health; 2004.[cited 2013 marzo17]. 1-8].
17 G. Iacono,A. Carroccio,G. Montalto,F. Cavataio,E. Bragion,D. Lorello
Severe infantile colic and food intolerance: a long-term prospective study
Journal of pediatric gastroenterology and nutrition., 12 (1991), pp. 332-335
Medline
18 I. Jakobsson,T. Lindberg
Cow's milk proteins cause infantile colic in breast-fed infants: a double-blind crossover study
Pediatrics., 71 (1983), pp. 268-271
Medline
19 D. Infante,O. Segarra,B.L. Luyer
Dietary treatment of colic caused by excess gas in infants: biochemical evidence
World journal of gastroenterology: WJG., 17 (2011), pp. 2104-2108 http://dx.doi.org/10.3748/wjg.v17.i16.2104
Medline
20 M.R. Stahlberg,E. Savilahti
Infantile colic and feeding
Archives of disease in childhood., 61 (1986), pp. 1232-1233
Medline
21 J.J. Miller,P. McVeagh,G.H. Fleet,P. Petocz,J.C. Brand
Effect of yeast lactase enzyme on “colic” in infants fed human milk
The Journal of pediatrics., 117 (1990), pp. 261-263
Medline
22 P.J. Kearney,A.J. Malone
T H. A trial of lactase in the management of infant colic
Journal of human nutrition and dietetics: the official journal of the British Dietetic Association., 11 (1998), pp. 281-285
23 D. Kanabar,M. Randhawa,P. Clayton
Improvement of symptoms in infant colic following reduction of lactose load with lactase
Journal of human nutrition and dietetics: the official journal of the British Dietetic Association., 14 (2001), pp. 359-363
24 C. Dupont,M. Rivero,C. Grillon,N. Belaroussi,A. Kalindjian,V. Marin
Alpha-lactalbumin-enriched and probiotic-supplemented infant formula in infants with colic: growth and gastrointestinal tolerance
European journal of clinical nutrition., 64 (2010), pp. 765-767 http://dx.doi.org/10.1038/ejcn.2010.81
Medline
25 A. Cohen Engler,A. Hadash,N. Shehadeh,G. Pillar
Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin
European journal of pediatrics., 171 (2012), pp. 729-732 http://dx.doi.org/10.1007/s00431-011-1659-3
Medline
26 C.R. Howard,N. Lanphear,B.P. Lanphear,S. Eberly,R.A. Lawrence
Parental responses to infant crying and colic: the effect on breastfeeding duration
Breastfeeding medicine: the official journal of the Academy of Breastfeeding Medicine, 1 (2006 Autumn), pp. 146-155
27 I. Jakobsson,T. Lindberg
Cow's milk as a cause of infantile colic in breast-fed infants
Lancet., 2 (1978), pp. 437-439 http://dx.doi.org/10.1016/S2213-8587(14)70118-4
Medline
28 T.J. Metcalf,T.G. Irons,L.D. Sher,P.C. Young
Simethicone in the treatment of infant colic: a randomized, placebo-controlled, multicenter trial
Pediatrics., 94 (1994), pp. 29-34
Medline
29 B. Hall,J. Chesters,A. Robinson
Infantile colic: a systematic review of medical and conventional therapies
Journal of paediatrics and child health., 48 (2012), pp. 128-137 http://dx.doi.org/10.1111/j.1440-1754.2011.02061.x
Medline
30 P.L. Lucassen,W.J. Assendelft,J.W. Gubbels,J.T. van Eijk,W.J. van Geldrop,A.K. Neven
Effectiveness of treatments for infantile colic: systematic review
BMJ., 316 (1998), pp. 1563-1569
Medline
31 Drug, Therapeutics B. Management of infantile colic. Bmj. 2013; 347:f4102. PubMed PMID: 23843563.
32 M.M. Garrison,D.A. Christakis
A systematic review of treatments for infant colic
Pediatrics., 106 (2000), pp. 184-190
Medline
33 S. McKenzie
Troublesome crying in infants: effect of advice to reduce stimulation
Archives of disease in childhood., 66 (1991), pp. 1416-1420
Medline
34 R. Perry,K. Hunt,E. Ernst
Nutritional supplements and other complementary medicines for infantile colic: a systematic review
Pediatrics., 127 (2011), pp. 720-733 http://dx.doi.org/10.1542/peds.2010-2098
Medline
35 I. Alexandrovich,O. Rakovitskaya,E. Kolmo,T. Sidorova,S. Shushunov
The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study
Alternative therapies in health and medicine., 9 (2003), pp. 58-61
Medline
36 Z. Weizman,S. Alkrinawi,D. Goldfarb,C. Bitran
Efficacy of herbal tea preparation in infantile colic
The Journal of pediatrics., 122 (1993), pp. 650-652
Medline
37 F. Savino,F. Cresi,E. Castagno,L. Silvestro,R. Oggero
A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants
Phytother Res., 19 (2005), pp. 335-340 http://dx.doi.org/10.1002/ptr.1668
Medline
38 D. Arikan,H. Alp,S. Gozum,Z. Orbak,E.K. Cifci
Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic
Journal of clinical nursing., 17 (2008), pp. 1754-1761
Medline
39 F. Savino,L. Cordisco,V. Tarasco,E. Palumeri,R. Calabrese,R. Oggero
Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial
Pediatrics., 126 (2010), pp. e526-e533 http://dx.doi.org/10.1542/peds.2010-0433
Medline
40 V. Sung,H. Hiscock,M. Tang,F.K. Mensah,R.G. Heine,A. Stock
Probiotics to improve outcomes of colic in the community: protocol for the Baby Biotics randomised controlled trial
BMC Pediatr., 12 (2012), pp. 135 http://dx.doi.org/10.1186/1471-2431-12-135
Medline
41 K. Chau,M. Lau,S. Greenberg,J. Jacobson,P. Jazdani-Brojeni,N. Verma
Probiotics for Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial Investigating Lactobacillus reuteri DSM 17938
The Journal of pediatrics., 166 (2015), pp. 74-78 http://dx.doi.org/10.1016/j.jpeds.2014.09.020
Medline
42 T.B. Brazelton
Crying in infancy
Pediatrics., 29 (1962 Apr), pp. 579-588
Medline
43 R.S. Illingworth
Crying in infants and children
British medical journal., 1 (1955), pp. 75-78
Medline
44 R.G. Barr,M.S. Kramer,C. Boisjoly,L. McVey-White,I.B. Pless
Parental diary of infant cry and fuss behaviour
Archives of disease in childhood., 63 (1988), pp. 380-387
Medline
45 R.G. Barr
Colic and crying syndromes in infants
Pediatrics., 102 (1998), pp. 1282-1286
Medline
46 S.R. Poole
The infant with acute, unexplained, excessive crying
Pediatrics., 88 (1991), pp. 450-455
Medline
47 American Academy of Pediatrics. Committee on Nutrition
Hypoallergenic infant formulas
Pediatrics., 106 (2000), pp. 346-349
Medline
48 Bhatia J, F. G, American Academy of Pediatrics, Committee on Nutrition. Use of soy protein-based formulas in infant feeding. Pediatrics. 121. 2008.(1062-11068).
49 Leung A, A. O, Canadian Paediatric Society, Nutrition Committee. Concerns for the use of soy-based formulas in infant nutrition Paediatr Child Health. 2009;14:109-13.
50 H. Raiha,L. Lehtonen,T. Korhonen,H. Korvenranta
Family life 1 year after infantile colic
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51 G. Molin,B. Jeppsson,M.L. Johansson,S. Ahrne,S. Nobaek,M. Stahl
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53 V. Cleusix,C. Lacroix,S. Vollenweider,G. Le Blay
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FEMS microbiology ecology., 63 (2008), pp. 56-64 http://dx.doi.org/10.1111/j.1574-6941.2007.00412.x
Medline
Paroxysmal fussing in infancy, sometimes called colic
Pediatrics., 14 (1954), pp. 421-435 http://dx.doi.org/10.3171/2014.7.PEDS13376
Medline
2 F. Savino,S. Ceratto,A. De Marco,L. Cordero di Montezemolo
Looking for new treatments of Infantile Colic
Italian journal of pediatrics., 40 (2014), pp. 53 http://dx.doi.org/10.1186/1824-7288-40-53
Medline
3 R.S. Illingworth
Three month's colic; treatment by methylscopolamine nitrate (skopyl)
Acta paediatrica., 44 (1955), pp. 203-208
Medline
4 I. Joanna Briggs
The effectiveness of interventions for infant colic
Australian nursing journal., 16 (2008), pp. 31-34
5 F. Savino,V. Tarasco
New treatments for infant colic
Current opinion in pediatrics., 22 (2010), pp. 791-797 http://dx.doi.org/10.1097/MOP.0b013e32833fac24
Medline
6 J.S. Radesky,B. Zuckerman,M. Silverstein,F.P. Rivara,M. Barr,J.A. Taylor
Inconsolable infant crying and maternal postpartum depressive symptoms
Pediatrics., 131 (2013), pp. e1857-e1864 http://dx.doi.org/10.1542/peds.2012-3316
Medline
7 P. Garg
Infantile colic--unfolded
Indian journal of pediatrics., 71 (2004), pp. 903-906
Medline
8 C.A. Canivet,P.O. Ostergren,A.S. Rosen,I.L. Jakobsson,B.M. Hagander
Infantile colic and the role of trait anxiety during pregnancy in relation to psychosocial and socioeconomic factors
Scandinavian journal of public health., 33 (2005), pp. 26-34 http://dx.doi.org/10.1080/14034940410028316
Medline
9 F. Savino
Focus on infantile colic
Acta paediatrica., 96 (2007), pp. 1259-1264 http://dx.doi.org/10.1111/j.1651-2227.2007.00428.x
Medline
10 P. Lucassen
Colic in infants
BMJ clinical evidence., (2010), pp. 2010
11 D.J. Hill,I.L. Hudson,L.J. Sheffield,M.J. Shelton,S. Menahem,C.S. Hosking
A low allergen diet is a significant intervention in infantile colic: results of a community-based study
The Journal of allergy and clinical immunology., 96 (1995), pp. 886-892
Medline
12 I. Jakobsson,L. Lothe,D. Ley,M.W. Borschel
Effectiveness of casein hydrolysate feedings in infants with colic
Acta Paediatr., 89 (2000), pp. 18-21
Medline
13 Lucassen PL, Assendelft WJ, Gubbels JW, Van Eijk JT, Douwes AC. Infantile colic: Crying time reduction with a whey hydrolysate: A doubleblind, randomized, placebo-controlled trial Pediatrics. 2000;106:1349-54.
14 D.C. Estep,A. Kulczycki Jr.
Treatment of infant colic with amino acid-based infant formula: a preliminary study
Acta Paediatr., 89 (2000), pp. 22-27
Medline
15 B. Taubman
Parental counseling compared with elimination of cow's milk or soy milk protein for the treatment of infant colic syndrome: a randomized trial
Pediatrics., 81 (1988), pp. 756-761
Medline
16 Chief Medical Officer. Advice issued on soya-based infant formulas london: Department of Health; 2004.[cited 2013 marzo17]. 1-8].
17 G. Iacono,A. Carroccio,G. Montalto,F. Cavataio,E. Bragion,D. Lorello
Severe infantile colic and food intolerance: a long-term prospective study
Journal of pediatric gastroenterology and nutrition., 12 (1991), pp. 332-335
Medline
18 I. Jakobsson,T. Lindberg
Cow's milk proteins cause infantile colic in breast-fed infants: a double-blind crossover study
Pediatrics., 71 (1983), pp. 268-271
Medline
19 D. Infante,O. Segarra,B.L. Luyer
Dietary treatment of colic caused by excess gas in infants: biochemical evidence
World journal of gastroenterology: WJG., 17 (2011), pp. 2104-2108 http://dx.doi.org/10.3748/wjg.v17.i16.2104
Medline
20 M.R. Stahlberg,E. Savilahti
Infantile colic and feeding
Archives of disease in childhood., 61 (1986), pp. 1232-1233
Medline
21 J.J. Miller,P. McVeagh,G.H. Fleet,P. Petocz,J.C. Brand
Effect of yeast lactase enzyme on “colic” in infants fed human milk
The Journal of pediatrics., 117 (1990), pp. 261-263
Medline
22 P.J. Kearney,A.J. Malone
T H. A trial of lactase in the management of infant colic
Journal of human nutrition and dietetics: the official journal of the British Dietetic Association., 11 (1998), pp. 281-285
23 D. Kanabar,M. Randhawa,P. Clayton
Improvement of symptoms in infant colic following reduction of lactose load with lactase
Journal of human nutrition and dietetics: the official journal of the British Dietetic Association., 14 (2001), pp. 359-363
24 C. Dupont,M. Rivero,C. Grillon,N. Belaroussi,A. Kalindjian,V. Marin
Alpha-lactalbumin-enriched and probiotic-supplemented infant formula in infants with colic: growth and gastrointestinal tolerance
European journal of clinical nutrition., 64 (2010), pp. 765-767 http://dx.doi.org/10.1038/ejcn.2010.81
Medline
25 A. Cohen Engler,A. Hadash,N. Shehadeh,G. Pillar
Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin
European journal of pediatrics., 171 (2012), pp. 729-732 http://dx.doi.org/10.1007/s00431-011-1659-3
Medline
26 C.R. Howard,N. Lanphear,B.P. Lanphear,S. Eberly,R.A. Lawrence
Parental responses to infant crying and colic: the effect on breastfeeding duration
Breastfeeding medicine: the official journal of the Academy of Breastfeeding Medicine, 1 (2006 Autumn), pp. 146-155
27 I. Jakobsson,T. Lindberg
Cow's milk as a cause of infantile colic in breast-fed infants
Lancet., 2 (1978), pp. 437-439 http://dx.doi.org/10.1016/S2213-8587(14)70118-4
Medline
28 T.J. Metcalf,T.G. Irons,L.D. Sher,P.C. Young
Simethicone in the treatment of infant colic: a randomized, placebo-controlled, multicenter trial
Pediatrics., 94 (1994), pp. 29-34
Medline
29 B. Hall,J. Chesters,A. Robinson
Infantile colic: a systematic review of medical and conventional therapies
Journal of paediatrics and child health., 48 (2012), pp. 128-137 http://dx.doi.org/10.1111/j.1440-1754.2011.02061.x
Medline
30 P.L. Lucassen,W.J. Assendelft,J.W. Gubbels,J.T. van Eijk,W.J. van Geldrop,A.K. Neven
Effectiveness of treatments for infantile colic: systematic review
BMJ., 316 (1998), pp. 1563-1569
Medline
31 Drug, Therapeutics B. Management of infantile colic. Bmj. 2013; 347:f4102. PubMed PMID: 23843563.
32 M.M. Garrison,D.A. Christakis
A systematic review of treatments for infant colic
Pediatrics., 106 (2000), pp. 184-190
Medline
33 S. McKenzie
Troublesome crying in infants: effect of advice to reduce stimulation
Archives of disease in childhood., 66 (1991), pp. 1416-1420
Medline
34 R. Perry,K. Hunt,E. Ernst
Nutritional supplements and other complementary medicines for infantile colic: a systematic review
Pediatrics., 127 (2011), pp. 720-733 http://dx.doi.org/10.1542/peds.2010-2098
Medline
35 I. Alexandrovich,O. Rakovitskaya,E. Kolmo,T. Sidorova,S. Shushunov
The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study
Alternative therapies in health and medicine., 9 (2003), pp. 58-61
Medline
36 Z. Weizman,S. Alkrinawi,D. Goldfarb,C. Bitran
Efficacy of herbal tea preparation in infantile colic
The Journal of pediatrics., 122 (1993), pp. 650-652
Medline
37 F. Savino,F. Cresi,E. Castagno,L. Silvestro,R. Oggero
A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants
Phytother Res., 19 (2005), pp. 335-340 http://dx.doi.org/10.1002/ptr.1668
Medline
38 D. Arikan,H. Alp,S. Gozum,Z. Orbak,E.K. Cifci
Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic
Journal of clinical nursing., 17 (2008), pp. 1754-1761
Medline
39 F. Savino,L. Cordisco,V. Tarasco,E. Palumeri,R. Calabrese,R. Oggero
Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial
Pediatrics., 126 (2010), pp. e526-e533 http://dx.doi.org/10.1542/peds.2010-0433
Medline
40 V. Sung,H. Hiscock,M. Tang,F.K. Mensah,R.G. Heine,A. Stock
Probiotics to improve outcomes of colic in the community: protocol for the Baby Biotics randomised controlled trial
BMC Pediatr., 12 (2012), pp. 135 http://dx.doi.org/10.1186/1471-2431-12-135
Medline
41 K. Chau,M. Lau,S. Greenberg,J. Jacobson,P. Jazdani-Brojeni,N. Verma
Probiotics for Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial Investigating Lactobacillus reuteri DSM 17938
The Journal of pediatrics., 166 (2015), pp. 74-78 http://dx.doi.org/10.1016/j.jpeds.2014.09.020
Medline
42 T.B. Brazelton
Crying in infancy
Pediatrics., 29 (1962 Apr), pp. 579-588
Medline
43 R.S. Illingworth
Crying in infants and children
British medical journal., 1 (1955), pp. 75-78
Medline
44 R.G. Barr,M.S. Kramer,C. Boisjoly,L. McVey-White,I.B. Pless
Parental diary of infant cry and fuss behaviour
Archives of disease in childhood., 63 (1988), pp. 380-387
Medline
45 R.G. Barr
Colic and crying syndromes in infants
Pediatrics., 102 (1998), pp. 1282-1286
Medline
46 S.R. Poole
The infant with acute, unexplained, excessive crying
Pediatrics., 88 (1991), pp. 450-455
Medline
47 American Academy of Pediatrics. Committee on Nutrition
Hypoallergenic infant formulas
Pediatrics., 106 (2000), pp. 346-349
Medline
48 Bhatia J, F. G, American Academy of Pediatrics, Committee on Nutrition. Use of soy protein-based formulas in infant feeding. Pediatrics. 121. 2008.(1062-11068).
49 Leung A, A. O, Canadian Paediatric Society, Nutrition Committee. Concerns for the use of soy-based formulas in infant nutrition Paediatr Child Health. 2009;14:109-13.
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