title: Middle East Consensus Statement on the Diagnosis and Management of Functional Gastrointestinal Disorders in <12 Months Old Infants.
abstract: This paper covers algorithms for the management of regurgitation, constipation and infantile colic in infants. Anti-regurgitation formula may be considered in infants with troublesome regurgitation, while diagnostic investigations or drug therapy are not indicated in the absence of warning signs. Although probiotics have shown some positive evidence for the management of functional gastrointestinal disorders (FGIDs), the evidence is not strong enough to make a recommendation. A partially hydrolyzed infant formula with prebiotics and β-palmitate may be considered as a dietary intervention for functional constipation in formula fed infants. Lactulose has been shown to be effective and safe in infants younger than 6 months that are constipated. Macrogol (polyethylene glycol, PEG) is not approved for use in infants less than 6 months of age. However, PEG is preferred over lactulose in infants >6 months of age. Limited data suggests that infant formula with a partial hydrolysate, galacto-oligosaccharides/fructo-oligosaccharides, added β-palmitate may be of benefit in reducing infantile colic in formula fed infants in cases where cow's milk protein allergy (CMPA) is not suspected. Evidence suggests that the use of extensively hydrolyzed infant formula for a formula-fed baby and a cow's milk free diet for a breastfeeding mother may be beneficial to decrease infantile colic if CMPA is suspected. None of the FGIDs is a reason to stop breastfeeding.
authors.affiliation: Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
authors.affiliation: Department of Pediatrics, King Salman Hospital, Riyadh, Saudi Arabia.
authors.forename: Muath Abdurrahman
authors.initials: MA
authors.lastname: Alturaiki
authors.affiliation: Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
authors.forename: Wafaa
authors.initials: W
authors.lastname: Al-Qabandi
authors.affiliation: Department of Pediatrics, Al Adan Hospital, Kuwait City, Kuwait.
authors.forename: Fawaz
authors.initials: F
authors.lastname: AlRefaee
authors.affiliation: Department of Pediatric Gastroentrology, Hepatology and Pediatric Nutrition, St. Joseph Hospital, Beirut, Lebanon.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Bassil
authors.affiliation: Department of Pediatric Gastroenterology, Hotel Dieu de France, Beirut, Lebanon.
authors.forename: Bassam
authors.initials: B
authors.lastname: Eid
authors.affiliation: Department of Pediatrics, Cairo University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El Beleidy
authors.affiliation: Department of Pediatric Gastroenterology, King Faisal Specialist Hospital and Research Center, Ryiadh, Saudi Arabia.
authors.forename: Ali Ibrahim
authors.initials: AI
authors.lastname: Almehaidib
authors.affiliation: Department of Pediatric Gastroenterology, St. Georges Orthodox, Beirut, Lebanon.
authors.forename: Pierre
authors.initials: P
authors.lastname: Mouawad
authors.affiliation: Department of Pediatric Gastroentrology, Hepatology and Pediatric Nutrition, St. Joseph Hospital, Beirut, Lebanon.; Department of Pediatric Gastroenterology, St. Georges Orthodox, Beirut, Lebanon.
authors.forename: Maroun
authors.initials: M
authors.lastname: Sokhn
keywords: Breast feeding; Colic; Constipation; Diarrhea; Formula feeding; Gastrointestinal diseases; Regurgitation