Miller-Loncar C, Bigsby R, High P, Wallach M, Lester B
Brown Medical School, Department of Pediatrics, Infant Development Center, Women and Infants Hospital of Rhode Island & E. P. Bradley Hospital, Providence, RI 02905, USA.
Arch Dis Child. 2004 Oct;89(10):908-12. doi: 10.1136/adc.2003.033233.
To examine the relation between colic and feeding difficulties and their impact on parental functioning for a primarily clinic referred sample.
Forty three infants (and their mothers) were enrolled between 6 and 8 weeks of age. Infants were divided into two groups, colic (n = 19) and comparison (n = 24), based on a modified Wessel rule of three criteria for colic. Families were assessed at two visits; one occurred in the laboratory and one occurred in a paediatric radiology office. Outcome measures included the clinical assessment of infant oral motor skills, behavioural observation of mother-infant feeding interactions, maternal questionnaires on infant crying, sleeping and feeding behaviours, and the occurrence of gastro-oesophageal reflux (GOR) in the infants using abdominal ultrasound.
Infants in the colic group displayed more difficulties with feeding; including disorganised feeding behaviours, less rhythmic nutritive and non-nutritive sucking, more discomfort following feedings, and lower responsiveness during feeding interactions. Infants in the colic group also had more evidence of GOR based on the number of reflux episodes on abdominal ultrasound as well as maternal report of reflux. Mothers in the colic group reported higher levels of parenting stress.
Results provide the first systematic evidence of feeding problems in a subgroup of infants with colic. Data also illustrate the impact of these difficulties on parental and infant functioning. The association between feeding difficulties and colic suggests the potential for ongoing regulatory problems in infants presenting with clinically significant colic symptoms.
针对主要由诊所转诊而来的样本,研究腹绞痛与喂养困难之间的关系及其对父母生活状况的影响。
招募了43名6至8周大的婴儿(及其母亲)。根据改良的韦塞尔腹绞痛三条标准,将婴儿分为两组,腹绞痛组(n = 19)和对照组(n = 24)。对家庭进行两次访视;一次在实验室进行,一次在儿科放射科办公室进行。结果测量包括对婴儿口腔运动技能的临床评估、母婴喂养互动的行为观察、母亲关于婴儿哭闹、睡眠和喂养行为的问卷调查,以及使用腹部超声检查婴儿胃食管反流(GOR)的发生情况。
腹绞痛组的婴儿在喂养方面表现出更多困难;包括喂养行为紊乱、有节律的营养性和非营养性吸吮较少、喂食后不适更多,以及喂养互动期间反应性较低。根据腹部超声反流发作次数以及母亲关于反流的报告,腹绞痛组的婴儿也有更多胃食管反流的证据。腹绞痛组的母亲报告的育儿压力水平更高。
研究结果首次提供了腹绞痛婴儿亚组存在喂养问题的系统证据。数据还说明了这些困难对父母和婴儿生活状况的影响。喂养困难与腹绞痛之间的关联表明,出现具有临床意义的腹绞痛症状的婴儿可能存在持续的调节问题。