Preventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938

Infants were recruited in four centres in North-West Italy. 138 infants were assessed for eligibility, 113 ones underwent randomisation and 105 completed the study. Newborns aged less than 10 days of life, with gestational age between 37 and 42 weeks, birth weight from 2,500 to 4,300 g and normal physical examination were recruitable. Premature infants and infants affected by outcomes of perinatal hypoxia or necrotising enterocolitis have been excluded. Patients were randomly assigned to receive five drops containing Lactobacillus reuteri DSM 17938 (108 cfu) with 400 UI of vitamin D3 or only 400 UI of vitamin D3 daily. The primary endpoints concern the administration of pain relieving agents (cimetropium bromide at least three times per week or simethicone at least five times per week) from baseline to 12 weeks. Additional analyses were done on the percentage of infants that switched from an exclusive breastfeeding to a partial or exclusive formula feeding from baseline to 12 weeks. Data concerning the number of calls to the paediatricians and the number of visits at paediatricians’ ambulatories due to infantile colic have been collected by paediatrician and analysed. Comparing the two groups, the relative risk was 0.04 (95% confidence interval (CI)=0.01-0.31) for cimetropium bromide, 0.24 (95% CI=0.14-0.41) for simethicone and 0.37 (95% CI=0.17-0.80) for the administration of infant formula, showing a protective action of L. reuteri. The treatment group showed a lower number of paediatric consultations related to episodes of infant colic than the control group (P<0.0001). L. reuteri DSM 17938 supplementation at the tested dosage could reduce parental discomfort due to infantile colic. The consumption of this probiotic is associated with a reduction of paediatric consultations for infantile colic, as well as use of pain relieving agents and of infant formula.

Infantile Colic: The Mysterious Crying

Infantile colic is a distressing condition in infants, pathogenesis of which is still not clear. Several treatment strategies have been attempted before, but only some of them proven successful. The aim of this paper is to review studies on treatment options for infantile colic. For this, a systematic literature review was done on studies regarding pathophysiology, medical and conventional interventions for infantile colic from 1954 to March 2011. Forty nine articles included in Cochrane database were reviewed. Fourteen studies on pathophysiology and risk factors, 7 studies on effect of infantlie colic on parents and family,19 studies on management, 5 studies on other related factors and 4 literature reviews were included for review. Pathophysiology has been described in various ways in different studies and yet not conclusive. Regarding studies on management, simethicone could not significantly control colic, dicyclomine hydrochloride had serious side effects and cimetropium bromide results were favourable, but milder side effects were noted. Some nutritional studies reported low-allergen maternal diets in breastfed infants but suitability of these methods are questionable in Bangladesh. Behavioural studies on the use of decreased stimulation and contingent music were favourable in some studies. Mixed herbal tea and probiotic like Lactobacillus reuteri studies showed encouraging results. There are some scientific evidences to support a low-allergen maternal diet in breastfed infants with infantile colic. Some encouraging results exist for mixed herbal tea, cimetropium bromide and probiotics. DOI: http://dx.doi.org/10.3329/jemc.v2i1.11927 J Enam Med Col 2012; 2(1): 33-39