Diagnosis and management of Functional GI Disorders

The symptoms of FGIDs can cause discomfort for an infant and huge amounts of stress for parents. Once satisfied the infant has no serious underlying disease, there are a number of ways healthcare professionals can approach the problem, ensuring any intervention plan attends to both the infant and the family¹, these include:

• Parental reassurance and support
  
• Practical management
• Nutritional management
• Medical management

First and foremost, parents need support. It is important to consider that concerns about FGIDs are not only about the infant’s symptoms, but also about the family’s wellbeing. It is necessary to, not only make a diagnosis, but also recognise the impact of the symptom(s) on the family’s emotions and ability to function1.

Once you have reassured the parents, practical tips and advice can help, such as teaching appropriate responses to their infants, more effective soothing, and where appropriate, reviewing their feeding practices^2-3.

• Avoid overfeeding – try feeding smaller amounts more frequently
• Feed the infant in an upright position
• Burp the infant frequently before, during and after feeding
• If the infant is bottle fed, check the hole in the teat is not too large – this can cause infants to gulp their feed too quickly

• Gentle motion (for example pushing the pram and rocking the crib)
• ‘White noise’ (for example from a vacuum cleaner, hairdryer or running water)
• Bathing the infant in a warm bath
• Preventing the infant from swallowing air by sitting them upright during feeding
• Minimising stimulation by placing the infant in a quiet environment

• Resting when possible
• Asking family and friends for support
• Meeting other parents with infants of the same age

• Give extra cooled boiled water between normal feeds⁷
• If using infant formula, ensure it is made up exactly as directed by the manufacturer and not diluted or over-concentrated
• Gently move infant’s legs in a bicycling motion, or carefully massage their tummy to help stimulate their bowels
• Giving a warm bath may help

Breastfeeding is the best source of nutrition for infants and provides many benefits⁸. In managing digestive problems in infants, it is important to avoid the use of drugs and invasive procedures where possible. Nutritional management is generally the preferred option⁹.

Medical management can be considered as an option if nutritional management does not suffice.