Effectiveness of Lactobacillus reuteri in infantile colic and colicky induced maternal depression: a prospective single blind randomized trial

Abstract

Infant colic, excessive crying of unknown cause, is a major burden to families and effects about 10-30 % of infants. Despite decades of research, the exact cause and treatment of infant colic has remained elusive. The use of Lactobacillus reuteri (DSM 17938) in infant colic is somewhat controversial and hence, we designed this study to evaluate its efficacy in infantile colic. We recruited predominantly or exclusively breastfed infants, aged less than 4 months in a placebo controlled observational randomized study. Participants' were assigned to receive L. reuteri at a dose 10(8) colony forming units (n = 21) and placebo (n = 21). Placebo was an identical formulation without live micro-organisms. Treatment was given to subjects for 21 days and they were followed for 4 weeks. Treatment success (primary outcome), daily reduction in crying time, parent satisfaction and reduction in maternal depression (secondary outcomes) were assessed at the end of study period. Treatment success was observed in all infants (100 %) of the probiotic group while it was seen in 15.7 % of the placebo group. Mean daily crying time was more significantly reduced to 32.1 ± 8.3 min/day (P < 0.01) from 200.9 ± 6.3 min/day in the probiotic group as compared to the placebo group (120.6 ± 20.0 min/day). Moreover, throughout the study period, parent's satisfaction and improvement in maternal depression (Edinburgh postnatal depression scale) was also significantly higher in the probiotic group. In our study population, reduction in crying time was significant (P < 0.01) even during first week of initiation of therapy. We conclude that L. reuteri (DSM 17938) reduces daily crying time and maternal depression during infantile colic. We suggest L. reuteri may be a safe and efficacious option for reducing infant colic.

Probiotics for management of infantile colic: a systematic review of randomized controlled trials

“…The characteristics of the seven included RCTs [9–15] that recruited a total of 471 infants are summarized in Table I. With one exception [13], all trials were double-blind and placebo controlled. All RCTs were published in English.…”

“…Five included RCTs involving 349 infants assessed the effect of administration of L. reuteri DSM 17938 at a daily dose of 10 8 colony forming units (CFU) given for 21 days [9, 10, 12, 13] or 28 days [11]. Four RCTs involved only infants with infantile colic who were breastfed exclusively or predominantly [9, 10, 12 13], and one RCT involved both breastfed and formula-fed infants [11].…”

Gut Microbiota Dysbiosis and Role of Probiotics in Infant Colic

“…Several small studies in predominantly breast-fed colicky infants have consistently reported a significant effect on infant colic vs. controls [37][38][39][40] and, according to meta-analysis, the effects were most evident after 21 days of supplementation [41]. However, a randomized study on a larger population including both breastfed and formula-fed colicky infants reported conflicting results, due to a lack of significant difference in responder rate in the overall population (P=0.23), and a significant increase in crying and especially fussing in the subgroup of formula-fed infants (79 minutes on average, P=0.005) [42,43].…”

Infantile Colic and Nursing Approaches: Review

“…ise yaptıkları çalışmada, probiyotiklerin (Lactobacillus reuteria) kolikli bebeklerin ağlama sürelerini anlamlı dü-zeyde düşürdüğünü göstermişlerdir. 17,61 Markestad yaptığı çalışmada, kolikli bebeklerin tedavisinde sükroz solüsyonunun plaseboya göre daha etkili bir yöntem olduğunu göstermiştir. 13,62 Huhtala ve ark.…”

“…12 Diğer tedavi yöntemleri arasında probiyotik kullanımı ve akupunktur gibi uygulamalar sayılabilir. [13][14][15][16][17] İnfantil koliğe hemşire yaklaşımı ise ailenin yaşadığı stresle baş etmesi için desteklenmeli, öz-güvenini artırıcı yöntemler denenmeli, koliğin sü-resini ve şiddetini azaltıcı tedavi yöntemleri aileye öğretilmelidir. 18 Bunun yanı sıra aileye davranış tedavisinde bebeğe daha az uyaran verilmesinin gerekliliği de öğretilmelidir.…”