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The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a summary for healthcare professionals

Mahon J, Lifschitz C, Ludwig T, Thapar N, Glanville J, Miqdady M, et al. BMJ Open. 2017;7 (11).

Over £72 million is spent each year in England to manage functional gastrointestinal (GI) symptoms, stated the researchers in their BMJ Open paper. They stress that this figure, which includes £49.1 million in NHS expenditure, is likely to be “a significant underestimate”.

The study, led by James Mahon from the York Health Economics Consortium, found that parents of children with functional GI disorders were spending £13.6 million per year on over-the-counter colic medicine to ease their children’s symptoms.

The researchers concluded that it is clear from the data that there is discrepancy between guidelines, which emphasise parental reassurance and nutritional advice, and their implementation in practice. This is evidenced by the amount spent on medicinal solutions which are not recommended, both prescribed and over the counter, to treat infant functional GI disorders.

“Some infants are being medicated unnecessarily, which is potentially detrimental to patient health outcomes and definitely a wasted cost, either to the taxpayer or to parents,” concluded the researchers.

The study was divided into two stages. Initially the researchers conducted a systematic literature review to identify studies published after 2005 that offered information on the volume and/or costs of treatments for functional GI disorders. This was followed by a cost of illness calculation using data from England.

For the cost of illness calculation, the researchers combined the different sources of publicly funded and parental out of pocket expenditure for children with functional GI disorders during the year 2014–2015. They estimated the total cost at £72.3 million per year (see table for breakdown of costs).

However, they stressed that this figure was likely to be “significantly higher in reality” as a number of potential costs had been excluded from the calculations. These included the cost of alternative therapies; diagnostic or treatment costs for admitted infants; outpatient consultations; proton pump inhibitors; parents’ days off work; reduced productivity of parents; side effect costs; prescription of constipation remedies; anti-allergy treatments.

Summary of costs of functional GI disorders and symptoms in England 2014/5

Cost area Value (million)
Prescriptions of colic/reflux/constipation medicines £5.8
Prescriptions of colic/reflux/constipation formulas £0.9
Health visitor appointments £3.5
GP appointments £26.0
Admitted patient care £9.3
A&E visits £3.6
Over the counter (OTC) colic medicines £13.6
OTC antiregurgitation formulas £9.6
Total costs £72.3


The researchers concluded that this study highlights the fact that guidelines, which recommend parental reassurance and nutritional advice, are not always being followed, resulting in some infants being medicated unnecessarily.

Our Careline

The information above is designed to help healthcare professionals support parents, but if you still need assistance, at Nutricia Early Life Nutrition we have two carelines with two dedicated phone numbers; one for your patients to call directly, and the other specifically for healthcare professionals. The Nutricia Early Life Nutrition healthcare professional helpline is staffed by people who understand what it’s like to be on the frontline of healthcare. Our team has over a hundred and fifty years’ cumulative experience, including hands-on experience in midwifery, as well as paediatric and neonatal nursing.

Our free healthcare professional helpline is open from 8am to 8pm, Monday to Friday. Just phone 0800 996 1234 for expert advice on infant feeding and nutrition, including common infant feeding problems such as cows’ milk allergy, colic, constipation and reflux.

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IMPORTANT NOTICE: Breastfeeding is best for babies. Infant formula is suitable from birth when babies are not breastfed. Follow-on milk is only for babies over 6 months, as part of a mixed diet and should not be used as a breastmilk substitute before 6 months. We advise that all formula milks including the decision to start weaning should be made on the advice of a doctor, midwife, health visitor, public health nurse, dietitian, pharmacist or other professional responsible for maternal and child care. Foods for special medical purposes should only be used under medical supervision. May be suitable for use as the sole source of nutrition for infants from birth, and/or as part of a balanced diet from 6–12 months. Refer to label for details.