TY - JOUR
KW - Breast Feeding
KW - Crying
KW - Diagnostic Errors
KW - Food Hypersensitivity/diagnosis
KW - Gastroesophageal Reflux/diagnosis
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Irritable Mood
KW - Lactose Intolerance/diagnosis
KW - Parents
KW - Patient Care Team
KW - Primary Health Care
AU - P. S. Douglas
AU - H. Hiscock
A1 - 
AB - Unsettled behaviour in the first few months of life is a common clinical problem, with the associated risks of postnatal depression, premature cessation of breastfeeding, long-term psychological disturbance, and child abuse. Parents of new babies complain of difficulty accessing appropriate care and receiving conflicting advice. Although organic disturbance is implicated in only 5% of cases, gastro-oesophageal reflux disease, food allergies and lactose intolerance are often mistakenly diagnosed in unsettled babies. There is no evidence that acid-suppressive medications help in treating unsettled behaviour and, until the hypothesis that proton-pump inhibitors may predispose to food allergies has been properly investigated, treatment with acid-suppressive medications should be avoided in this population. Although unsettled behaviour in infants is commonly a transient neurodevelopmental phenomenon that peaks at 6 weeks of age, failure to diagnose other correctable problems, including breastfeeding difficulty and cows milk allergy, risks entrenching anxiety and disrupted mother-infant interactions in the long term. In the current climate of health system reform, the design and evaluation of an integrated, evidence-based, multidisciplinary primary care approach to management of unsettled babies and their mothers is a priority.
BT - The Medical journal of Australia
C5 - General Literature
CP - 9
CY - Australia
IS - 9
JF - The Medical journal of Australia
N2 - Unsettled behaviour in the first few months of life is a common clinical problem, with the associated risks of postnatal depression, premature cessation of breastfeeding, long-term psychological disturbance, and child abuse. Parents of new babies complain of difficulty accessing appropriate care and receiving conflicting advice. Although organic disturbance is implicated in only 5% of cases, gastro-oesophageal reflux disease, food allergies and lactose intolerance are often mistakenly diagnosed in unsettled babies. There is no evidence that acid-suppressive medications help in treating unsettled behaviour and, until the hypothesis that proton-pump inhibitors may predispose to food allergies has been properly investigated, treatment with acid-suppressive medications should be avoided in this population. Although unsettled behaviour in infants is commonly a transient neurodevelopmental phenomenon that peaks at 6 weeks of age, failure to diagnose other correctable problems, including breastfeeding difficulty and cows milk allergy, risks entrenching anxiety and disrupted mother-infant interactions in the long term. In the current climate of health system reform, the design and evaluation of an integrated, evidence-based, multidisciplinary primary care approach to management of unsettled babies and their mothers is a priority.
PP - Australia
PY - 2010
SN - 0025-729X; 0025-729X
SP - 533
EP - 536
EP - 
T1 - The unsettled baby: crying out for an integrated, multidisciplinary primary care approach
T2 - The Medical journal of Australia
TI - The unsettled baby: crying out for an integrated, multidisciplinary primary care approach
U1 - General Literature
U2 - 21034388
VL - 193
VO - 0025-729X; 0025-729X
Y1 - 2010
ER -