Comment: The quality of evidence is downgraded by several study limitations (unclear allocation concealment, incomplete outcome data, selective reporting, lack of washout period), by inconsistency (unexplained variability in results), and by imprecise results (few patients).
A Cochrane review [Abstract] 1 included 18 studies with a total of 1014 infants. Three studies comparing simethicone with placebo revealed no difference in daily hours of crying or in the number of infants who responded positively. There was low-quality evidence suggesting that herbal agents reduce the duration of crying compared with placebo (mean difference (MD) 1.33, 95% CI 0.71 to 1.96; 3 studies, n=279), with different magnitude of benefit noted across studies (I² = 96%). We found moderate-quality evidence indicating that herbal agents increase response over placebo (RR 2.05, 95% CI 1.56 to 2.70; 3 studies, n=277). Only one of the 5 studies of dicyclomine (48 infants) could be considered: more of the infants given dicyclomine responded than than those given placebo. One very low-quality study (n=86) comparing cimetropium bromide with placebo showed reduced crying duration and increased number of responders among infants treated with cimetropium bromide.
Date of latest search: 16 May 2016
Primary/Secondary Keywords