Probiotic alleviates crying in bubs with colic

Babies given a certain probiotic strain cry a lot less and seem to have a protective effect from colic and other gastrointestinal disorders new data in JAMA Pediatrics shows. The study results show at  that after a month the babies in the probiotic treatment group had a significant decrease in crying time, a significant increase in bowel movements but no difference in episodes of regurgitation when compared with placebo. The primary aim of the Italian researchers was to investigate whether supplementation with the probiotic L. reuteri DSM 17938 from birth could reduce inconsolable crying, improve regurgitation, and modify bowel movements in the first 3 months of life. They also investigated whether there was a cost-benefit of this supplementation for families and the wider community. This prospective, multicentre, double-masked, placebo-controlled randomised trial, involved 589 (468 completed the trial) infants born at 9 different neonatal units across Italy, between September 1, 2010 and October 30, 2012. The participants were randomly assigned to receive either 5 drops of L. reuteri DSM 17938 delivering a dose of 1 x 108 of colony forming units (n= 238), or placebo (n= 230). When the researchers followed up at the completion of the intervention period (3 months) they found that not only had the changes in crying time and bowels movements been maintained, but that there was also a significant decrease in the frequency of regurgitation in the probiotic group compared to placebo.  At the study’s completion the researchers also found that in the probiotic group there were less visits to the paediatric emergency department, parents took fewer days off (to care for sick children), and there was less use of medicines and natural or herbal products for gastrointestinal discomfort.  No adverse events relating to the trial were reported. Lactobacillus reuteri benefits baby, family and community There was also a cost-benefit attributed to the probiotic group. Per family, there was an average saving of €88 (approximately $135 AUD) and an additional saving to the community of €104 ($160 AUD). Infantile colic, while not considered a serious condition, accounts for up to 20% of visits to the paediatrician in the first 4 months of life.  In addition, it can cause stress, anxiety and contribute to the exhaustion felt by many new parents.  Constipation and vomiting are also commonly seen FGIDs in infants that impact on the quality of life of both baby and parents, and contribute to up to 25% of paediatric consultations.  With this in mind, the researchers found that using L. reuteri DSM 17938 prophylactically was a cost-effective way to help manage the symptoms associated with FGIDs, decrease visits to the doctors and time of work for parents and support parents stress and anxiety levels.  “L. reuteri can save money for both family and society and provide a helpful psychologic effect on parents.” “Indeed, it is well known that supporting parents by teaching them to manage the crying and, consequently, acting on parental vulnerability can have dramatic influence on parent-infant interactions and outcomes in these conditions.”  Probiotics: benefits beyond infant colic  FGIDs, while self-limiting, are associated with low-grade mucosal inflammation and motor or immune alteration. Infants that suffer colic are at an increased risk of developing abdominal pain, allergies, irritable bowel syndrome (IBS) and psychological problems later in life. In their paper the authors hypothesise, “Driving a change of colonisation during the first few weeks of life through giving lactobacilli may promote an improvement in intestinal permeability; visceral sensitivity and mast cell density and probiotic administration may represent a new strategy for preventing these conditions, at least in predisposed children.”  Source:  JAMA Pediatr. 2014 Jan 13. doi: 10.1001/jamapediatrics.2013.4367. [Epub ahead of print]

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