Opciones de tratamiento del cólico 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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