Signs and symptoms
Colic is defined as episodes of crying for more than three hours a day, for more than three days a week for at least a three-week duration in an otherwise healthy child. It is most common around six weeks of age and gets better by six months of age. By contrast, infants normally cry an average of just over two hours a day, with the duration peaking at six weeks. With colic, periods of crying most commonly happen in the evening and for no obvious reason. Associated symptoms may include legs pulled up to the stomach, a flushed face, clenched hands, and a wrinkled brow. The cry is often high pitched (piercing). Effect on the family
An infant with colic may affect family stability and be a cause of short-term anxiety or depression in the father and mother. It may also contribute to exhaustion and stress in the parents.Persistent infant crying has been associated with severe marital discord, postpartum depression, early termination of breastfeeding, frequent visits to doctors, and a quadrupling of excessive laboratory tests and prescription of medication for acid reflux. Babies with colic may be exposed to abuse, especially shaken baby syndrome.In 2019 Cochrane conducted a systematic review on parent training programs for managing infantile colic. Seven studies with over 1100 participants met inclusion criteria. Limited evidence was found for the effectiveness of such programs, one meta-analysis showed some reduction in crying time. Causes
The cause of colic is generally unknown.
Alcaftadine is used to prevent eye irritation brought on by allergic conjunctivitis. It is a H1 histamine receptor antagonist.It was approved by the U.S. Food and Drug Administration (FDA) in July 2010, under the trade name Lastacaft. Pharmacology
Alcaftadine is an antagonist at three of the histamine receptors (1, 2 and 4). The main indication for Alcaftadine is for prevention of allergic conjunctivitis. By blocking these three receptors, Alcaftadine has been shown to significantly reduce the effects of allergens. This effect on histamine receptors seems to show lower rates of itching, eosinophil recruitment and redness after exposure to an allergen. The effect of alcaftadine seemed to reduce the amount of eosinophil cells significantly as compared to olopatadine 0.1%. When animal models were used to test alcaftadine, alcaftadine 0.25% seemed to show superior results for decreasing E-cadherin expression as compared to placebo. The reduction of E-cadherin means decreased junctions which would lead to progression of allergic conjunctivitis. Clinical relevance
When Alcaftadine was tested against placebo and olopatadine, only Alcaftadine 0.25% was shown to have a clinically significant reduction in conjunctival redness scores 7 and 15 minutes after administration. When clinical groups where compared to placebo, treatment with all three of the alcaftadine groups (0.05, 0.1 and 0.25%) showed a reduction in secondary endpoints of (lid swelling, conjunctival redness, ocular itching/tearing) as compared to placebo. Adverse effects
In studies comparing the effectiveness of olopatadine to alcaftadine, there was not a dose response increase of adverse effects as alcaftadine doses increases for 0.05% to 0.1% to 0.25%.