Document Detail

The unsettled baby: crying out for an integrated, multidisciplinary primary care approach.
MedLine Citation:
PMID:  21034388     Owner:  NLM     Status:  MEDLINE    
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.
Pamela S Douglas; Harriet Hiscock
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  193     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  533-6     Citation Subset:  IM    
Gladstone Road Medical Centre, Brisbane, QLD, Australia.
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MeSH Terms
Breast Feeding
Diagnostic Errors
Food Hypersensitivity / diagnosis
Gastroesophageal Reflux / diagnosis
Infant, Newborn
Irritable Mood
Lactose Intolerance / diagnosis
Patient Care Team
Primary Health Care

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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