29 September 2014

episode

Health Report 29 min 3 speakers 8 chapters transcribed 3 days ago

▲ 0

Transcript

jump: chapters · speakers · find in transcript

Transcript

Transcript generated automatically by AI and may contain errors.

What is infant colic and could it actually be a form of migraine?

Dr. Norman Swan 0:00

Hello and welcome to the Health Report with me, Norman Swan. After today's program, you'll be left scratching your head about where the coalition government got the idea that we had a health system in crisis and that it was unsustainable. You'll also have a better idea of where there are savings to be made in large amounts, independent of GP radiology and pathology co payments. And if you've ever had to deal with a crying baby who you've been told has colic, you'll have a pretty good idea of what it is. what it actually might be and what to do about it. Amy Gelfand is a neurologist at the University of California, San Francisco and recently presented findings which suggest it's not infant colic at all, but migraine.

Amy Gelfand 0:37

Well, I'm not the first person to have thought about it. There are now several studies that have looked at the association between infant colic and migraine. And we did a study where we looked at the relationship between mothers who had migraine and the likelihood that their babies would go on to have colic because migraine is generally a genetic disorder and so if Mothers have it, their babies are more likely to go on to have it. And then most recently, as you know, we've looked at a a systematic review of all the medical literature to put it together in one place.

Dr. Norman Swan 1:06

Now one of the problems here is defining infant colleague. Right. So how did you define it?

Amy Gelfand 1:10

People define it in different ways, but the most common ways is either what's called Wessel's criteria or modified Wessel's criteria. Wessel is the first paper to have described colic back in nineteen fifty four. Although although

Dr. Norman Swan 1:24

parents could have described it for centuries.

Amy Gelfand 1:27

Exactly. crying for at least three hours a day, for at least three days a week, for at least three weeks. And sometimes people modify that to be just for one week. And when we did our study looking at mothers and infant colic, we used the just one week cutoff.

Dr. Norman Swan 1:42

And then there's fussing where the baby doesn't want to get on the breast or not and it's irritable. And then I trained in pediatrics and we were always taught, you know, are they drawing up their legs to their abdomen, which just gives you the sense that there's tummy pain going on, but of course there's no evidence that there's tummy pain.

Amy Gelfand 1:57

Exactly. There's no direct evidence for that localization, it's just what we think and it's rather hard to ask these babies and so the pain could be somewhere else in the body or it might not be pain exactly at all. It might just be that they're frustrated or scared or worried about something. We really don't know.

Dr. Norman Swan 2:12

Give me some paracetamol now.

Amy Gelfand 2:14

Exactly.

Dr. Norman Swan 2:16

So what did you find when you analyzed all these studies, the available evidence in the international literature?

Amy Gelfand 2:23

We found that when we combined all of the data from the studies h that have looked at this association between infant colic and migraine, that there is a rather robust association and that there seems to be at least a twofold, maybe as high as a sixfold, increase in odds of migraine if a baby has colic as an infant. And so what we think this means is that there's a genetic relationship where babies who are having infant colic are expressing an early life manifestation of migraine genes that later in life they'll express as migraine headache.

Dr. Norman Swan 2:53

And it's impossible to say at the moment whether it's headache that they're getting or what's called abdominal migraine, which often occurs in childhood where kids get abdominal pain and turn out later in life to have migraine headaches. That's exactly right. For a parent then listening to this, one question that they might have is, Well if I've got a colicky baby and it fits the description, what are the chances that that baby will actually develop migraine? What does it mean for the individual baby?

Amy Gelfand 3:19

I think it's hard to predict for any individual in that sense.

How did researchers define colic and what criteria were used in the studies?

Amy Gelfand 3:23

Certainly there's an increased likelihood and a bit of how high their likelihood is gonna depend on when you're looking at them and whether they're a girl or a boy. Before puberty, boys and girls are equally likely to be expressing migraine headache and then once they go through puberty, girls start to be more likely and as you come into late adolescence and early adulthood, girls are gonna be about threefold increased likelihood of expressing migraine as boys.