Probiotics May Improve Colic

Summary
This study was performed to assess the efficacy of a bacteria called Lactobacillus reuteri on baby colic and to examine its relation with intestinal microorganisms. On treatment with either Lactobacillus reuteri or a placebo daily for 21 days, it was seen that there was a greater number of “responders” in the group treated with the Lactobacillus. Also, the counts of other common bacteria and ammonia were less in the group treated with Lactobacillus reuteri. The counts of fecal lactobacillus were increased and there were no adverse effects of the treatment.

Introduction
Infantile or baby colic is excessive crying in a usually normal infant. Though the cause of colic is not clear, it has been thought to occur as a result of excess gas formation in the abdomen by various microorganisms. These microorganisms causing the issues are usually thought to be Escherichia coli. They induce gas build-up and pain in the intestines, which leads to the constant crying in the infants.  Lactobacillus reuteri DSM 17 938, a probiotic microorganism that is beneficial to humans, has been found to reduce these symptoms in breastfed infants. Although previous studies on the effects of Lactobacillus have been conducted, this is a placebo-controlled blinded study that outweighs the results of previous studies.

Methodology
* The study was performed on 50 breastfed infants, all of whom were diagnosed with infantile colic.
* A few infants received Lactobacillus reuteri, while the rest had a placebo treatment. Five drops of either of these were given to the corresponding infants, each day for 21 days.
* The parents of the infants were interviewed to record gestational age, delivery method, weight at time of birth, underlying gastrointestinal disease if present, and crying time.
* Total crying time was recorded prior to treatment and during 7, 14 and 21 days of treatment. Fecal samples were collected prior to and after the treatment, to assess the Escherichia coli and ammonia levels.

Results
* The levels of Escherichia coli were higher in the Lactobacillus reuteri group at the beginning of the study. At the end of the study, there was a significant reduction in the Escherichia coli counts in those who received Lactobacillus reuteri, as compared to the placebo group. Lactobacilli were also significantly increased in the Lactobacillus reuteri group, at the end of the study.
* Certain bacteria use amino acids for fermentation, resulting in the formation of toxic byproducts like ammonia and indole in the intestines. There was significant reduction in the ammonia content of fecal matter in the infants who received Lactobacillus reuteri.
* All the infants had more than 180 minutes of crying initially. But by the end of three weeks, the infants in the placebo group had a crying time of 143 minutes/day, whereas those in the Lactobacillus reuteri group had a crying time of only 85 minutes/day.

Shortcomings
In this study, the responses shown by both groups of infants were almost the same.  Infants receiving the placebo too had reduction in crying by more than 50 percent, by the end of the study. This could have been due to the mother’s diet being free of cow’s milk, or a part the normal physiological growth of the infant, which usually resolves colic as the infant grows.

Conclusion
This study shows the pivotal role of Lactobacillus reuteri in controlling the symptoms of infantile colic. Most of the hypotheses on the causative factors of infantile colic have been answered by the success of this study. Lactobacillus reuteri was also well tolerated by all the infants treated, without any adverse effects. The importance of breastfeeding has been highlighted, as those in the placebo group, who were exclusively breastfed, had a significant reduction in crying, towards the end of the study. The causative factors of infantile colic could be inappropriate bacterial load in the intestine. These causative microorganisms could be removed by supplementation with probiotics such as Lactobacillus reuteri.

For More Information:
Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial
Publication Journal: The Journal of Pediatrics, August 2010
By Francesco Savino, PhD; Lisa Cordisco, PhD; University of Turin, Italy and the University of Bologna, Italy

*FYI Living Lab Reports Are Summaries of the Original Research.


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