Case scenario

Sarah, a 31-year-old first-time mother, brings her 7-week-old infant, Ben, into your pharmacy. Sarah is worried. Most evenings over the last three weeks, Ben has had episodes of prolonged and persistent crying. These have lasted about three hours. During these episodes, he is hard to console, and keeps pulling his legs up when laid down. He does not feed well during these episodes and keeps pulling off the breast.

Ben was born at 38 weeks via elective caesarean section with no antenatal concerns nor neonatal issues. There is no family history of atopy (a genetic tendency to develop allergic diseases such as asthma, atopic dermatitis and allergic rhinitis).1 Sarah is healthy with no medical history of note, and has not required any medicine. Ben is thriving and has two soft bowel actions daily. Besides these episodes of persistent and prolonged crying, he has been feeding well.

Sarah was previously advised to give Ben gripe water and, more recently, Infacol by a maternal child health nurse. For the last two weeks, she has excluded cow’s milk from her own diet. A family practitioner suggested Ben may have gastro-oesophageal reflux disease (GORD) and prescribed omeprazole, which he has received for the last two weeks.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Explain the prevalence, and signs and symptoms, of common functional FGIDs, such as colic, constipation and regurgitation in infants, and their impact on both the infants and their parents

  • Differentiate between FGIDs and more serious underlying conditions, such as cows’ milk allergy and lactose intolerance, and identify when to refer

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