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reference
Savino F, Cordisco L, Tarasco V, et al. Lactobacillus reuteri DSM 17938 in childhood colic: a randomized, double-blind, placebo-controlled trial.Pediatrics.2010;126(3):e526-e533.
design
Randomized, double-blind, placebo-controlled trial
Participant
Fifty exclusively breastfed colicky infants
Study medications and dosage
The infants were randomly assigned to receive bothL. reuteriDSM 17938 (10(8) CFU) or placebo daily for 3 weeks. Parent questionnaires monitored daily crying time and side effects. Stool samples were taken for microbiological analysis.
Key findings
They takeL. reuteriexperienced a significant reduction in daily crying time. Stool microbiology revealed an increase in lactobacilli and a decrease in lactobacilliEscherichia coliin the treatment group.L. reuteriwas well tolerated and no side effects were noted.
Breastfeeding can be an equally effective treatment as it improves the microbial environment in the gut.
Effects on practice
In naturopathy it is known that probiotics effectively combat many gastrointestinal complaints, even as monotherapy. The same authors conducted a similar study in 2007, which found that a related probiotic strain,L. reuteriATCC 77530 resulted in a reduction in colic symptoms in 95% of the treatment group versus 7% in the control group.1Critics of this study point out that it was not blinded and the control subjects were treated with simethicone.2Therefore, blinding both groups in this study and removing confounding medications increases its strength and significance. The mechanisms behind the benefits of probiotics are not fully understood. However, there is some evidence in the literature: Savino and colleagues state that probiotics could improve intestinal motility and function3and reduce visceral pain.4.5In addition, other research has shown that infants with colic have altered stool microflora and that elevated stool calprotectin levels are found in these children.6Interestingly, calprotectin is a marker of intestinal inflammation and possibly increased intestinal permeability7.8and may serve as a predictor of irritable bowel disease later in life.
Breastfeeding can be an equally effective treatment as it improves the microbial environment in the gut. This explains why a review of 79 articles shows that breastfed babies have a lower risk of developing irritable bowel disease later in life.9There is currently no general consensus about which probiotic strains are most effective for treating colic. Other strains that have been shown to be effective for colic include:Bifidobacterium lactisAndStreptococcus thermophilus.10It is very likely that other strains also benefit, warranting further research in this area.