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[Infants who cry a lot: incidence and management of this problem in family practice]
M J Tasche1, M A Bruijnzeels, B N van der Poel
1Erasmus Universiteit, Rotterdams Universitair Huisartsen Instituut.
Insights
General practitioners (GPs) frequently see infants with excessive crying, with colic diagnosed in over a third of cases. Management often involves observation rather than active intervention.
Area of Science:
- Pediatrics
- General Practice
- Infant Health
Objective:
To determine how frequently general practitioners (GPs) are consulted because of excessively crying infants and how such infants are managed.
Setting:
A stratified sample of 103 GP practices throughout The Netherlands.
Design:
Descriptive.
Method:
161 GPs from 103 practices for one year (in four groups, each for three months) recorded all their contacts with patients as a part of the National Study of Diseases and Items of Service in General Practice, conducted by the Netherlands Institute for Primary Health Care Research. An inventory was made of the infants who fulfilled the criteria of the 'colic syndrome' as to age, symptomatology and diagnosis.
Results:
Of the infants seen by the GPs, 10% displayed symptoms of excessive crying, colic or restlessness. In over one-third of this group a colic-like diagnosis was made; of the children from zero to four months this proportion was two-thirds. The probability of a child in the age group of 0 to 4 months being seen by the GP with colic-like symptoms and diagnosis amounted to 7.1% (cumulative incidence). The majority of the GPs were certain of their (mostly somatic) diagnoses. The GPs were consulted more often about these children, apart from the colic problem, than about their contemporaries, the difference being statistically significant. In only 30% of the cases did the GPs prescribe medication or a diet, or made a referral.
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