Intestinal microflora in breastfed colicky and non‐colicky infants

Savino, Francesco; Cresi, Francesco; Pautasso, S.; Palumeri, E; Tullio, Viviana Cristina; Roana, Janira; Silvestro, Leandra; Oggero, R

doi:10.1111/j.1651-2227.2004.tb03025.x

Cited by 128 publications

(96 citation statements)

References 26 publications

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“…Our data are in line with the literature that has reported that the bacterial composition of faecal microflora is different in infants with and without colic (3)(4)(5)(6)(7)(8) and add new information about formula-fed infants. Intestinal microbiota can be investigated either by microbial quantification and by characterising some strains or by studying the metabolites produced, in this case ammonia, that can be considered as a marker for proteolytic fermentation by Enterobacteriaceae (13,23).…”

Section: Limitationssupporting

confidence: 81%

“…A peculiar gut microbial composition, such as a lower lactobacilli concentration in the first months of life, may favour the development of infantile colic (3). Furthermore, colicky infants present with higher counts of anaerobic Gram-negative bacteria and lower counts of intestinal lactobacilli than infants without colic (4,5). Additional proof of the link between the gut microbiota and infantile colic derives from a study in which gas-forming coliforms were prevalent in infants with colic but not in infants without colic (6).…”

Section: Introductionmentioning

confidence: 95%

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Comparison of formula‐fed infants with and without colic revealed significant differences in total bacteria, Enterobacteriaceae and faecal ammonia

Savino¹,

Quartieri

Marco³

et al. 2016

Acta Paediatrica

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Aim: This study compared the faecal microbial composition of formula-fed infants who did and did not have colic.Methods: Faecal samples from formula-fed infants under 16 weeks of age with (n = 38) and without (n = 39) colic were collected at Department of Pediatrics in Turin, Italy, between February 2014 and October 2015. The pH and faecal ammonia were determined and total bacteria, bifidobacteria, lactic acid bacteria and coliforms were quantified by fluorescent in situ hybridisation (FISH).Results: Faecal ammonia was significantly higher in the colicky infants than in the controls (483 vs. 216 lg/g, p < 0.05). The FISH counts of total bacteria were lower in colicky infants (1.8E10 AE 1.5E10) than in the controls (3.4E10 AE 3.0E10) (p < 0.05). The relative abundance of coliform bacteria was significantly higher in colicky infants (p < 0.05). No differences were observed for the bifidobacteria and lactic acid bacteria counts between the two groups.Conclusion: Our comparison of formula-fed infants with and without colic revealed significant differences in total bacteria, Enterobacteriaceae and faecal ammonia. This study provides the stimulus for further studies of the gut microbiome, using new methods of analysis such as 16S metagenomics sequencing in order to lead to more tailored dietary approaches.

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Section: Limitationssupporting

confidence: 81%

Section: Introductionmentioning

confidence: 95%

Comparison of formula‐fed infants with and without colic revealed significant differences in total bacteria, Enterobacteriaceae and faecal ammonia

Savino¹,

Quartieri

Marco³

et al. 2016

Acta Paediatrica

View full text Add to dashboard Cite

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“…Moreover, not only the steric distribution of fatty acids and carbohydrates lead to more physiological metabolism of nutrients and improve gut omeostasis but also the OS content seems to have a human milk-similar effect in growth Randomized controlled study for infantile colic F Savino et al promotion of beneficial intestinal flora (Lucas et al, 1997;Boehm et al, 2004;Knol et al, 2005). Growing evidence underlines that common gut disorders in infancy (including infantile colic, meterorism, flatulence, food intolerance and allergy) can also be mediated by gut flora (Lehtonen et al, 1994;Lindberg, 1999;Haller and Jobin, 2004;Savino et al, 2004Savino et al, , 2005. Breast-fed infants have been detected for a characteristic gut microflora (Walker and Duffy, 1998;Fanaro et al, 2003;Rinne et al, 2005) as well as colicky compared to non-colicky infants (Lehtonen et al, 1994;Savino et al, 2004Savino et al, , 2005.…”

Section: Molecular Weight Distribution (Kda ¼ Kilodalton)mentioning

confidence: 99%

“…Growing evidence underlines that common gut disorders in infancy (including infantile colic, meterorism, flatulence, food intolerance and allergy) can also be mediated by gut flora (Lehtonen et al, 1994;Lindberg, 1999;Haller and Jobin, 2004;Savino et al, 2004Savino et al, , 2005. Breast-fed infants have been detected for a characteristic gut microflora (Walker and Duffy, 1998;Fanaro et al, 2003;Rinne et al, 2005) as well as colicky compared to non-colicky infants (Lehtonen et al, 1994;Savino et al, 2004Savino et al, , 2005. Bifidobacteria and Lactobacillus seem to be predominant in breast-fed and notcolicky infants, whereas Gram-negative anaerobic bacteria seem to be predominant in the formula-fed and colicky ones.…”

Section: Molecular Weight Distribution (Kda ¼ Kilodalton)mentioning

confidence: 99%

“…Some differences in gut microflora have been shown also in colicky infants (Lehtonen et al, 1994;Savino et al, 2004). Recently, we have evaluated intestinal lactobacilli species in breast-fed infants with infantile colic, finding that Lactobacillus brevis and Lactobacillus lactis lactis might be involved in the pathogenesis of this problem increasing meteorism and abdominal distension (Savino et al, 2005).…”

Section: Introductionmentioning

confidence: 96%

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Reduction of crying episodes owing to infantile colic: a randomized controlled study on the efficacy of a new infant formula

et al. 2006

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Objectives: The aim of this study was to evaluate the efficacy on crying episodes owing to infantile colic of a new infant formula containing partially hydrolysed whey proteins, prebiotic oligosaccharides (OS), with a high b-palmitic acid content. Design: Prospective randomized controlled study. Setting: Italy. Subjects: Two hundred and sixty-seven formula-fed infants, aged less than 4 months, with infantile colic, were randomized to receive either the new infant formula (study treatment (ST)) or a standard formula and simethicone (6 mg/kg twice a day) (control treatment (CT)). A questionnaire was given to parents to evaluate for 14 days the daily number of colic episodes and crying time. Results: Out of the 199 infants who completed the study, 96 were treated with the new formula and 103 were not treated. Infants receiving the new formula had a significant decrease in colic episodes after 1 week (2.4771.94 at day 7 vs 5.9971.84 at the study entry) compared to infants receiving the CT (3.7271.98 at day 7 vs 5.4171.88 at the study entry) (Po0.0001). Also at day 14, the crying episodes were significantly different between the two groups of infants (1.7671.60 in ST vs 3.3272.06 in CT) (Po0.0001). Conclusions: The use of a partially hydrolysed formula supplemented with fructo-and galacto-OS induces a reduction of crying episodes in infants with colic after 7 and 14 days when compared with a standard formula and simethicone.

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Probiotics to Prevent or Treat Excessive Infant Crying

et al. 2013

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IMPORTANCE Excessive infant crying is common, distressing, but without proven effective prevention or management options. Probiotics may be a promising solution. OBJECTIVE To examine whether probiotics are effective in the prevention/management of crying ("colic") in infants 3 months or younger. DATA SOURCES A systematic search of MEDLINE, EMBASE, and the Cochrane Library, supplemented by the metaRegister of Controlled Trials. STUDY SELECTION Studies that randomized infants 3 months or younger to oral probiotics vs placebo or no or standard treatment with the outcome of infant crying, measured as the duration or number of episodes of infant crying/distress or diagnosis of "infant colic." Twelve of the 1180 initially identified studies were selected. DATA EXTRACTION AND SYNTHESIS This review/meta-analysis was conducted according to guidelines from the Cochrane Handbook for Systematic Reviews of Interventions, with reporting following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were independently extracted by 3 of us. MAIN OUTCOME(S) AND MEASURE(S) Infant crying, measured as the duration or number of episodes of infant crying/distress, or diagnosis of "infant colic." RESULTS Of the 12 trials (1825 infants) reviewed, 6 suggested probiotics reduced crying, and 6 did not. Three of the 5 management trials concluded probiotics effectively treat colic in breastfed babies; 1 suggested possible effectiveness in formula-fed babies with colic, and 1 suggested ineffectiveness in breastfed babies with colic. Meta-analysis of 3 small trials of breastfed infants with colic found that Lactobacillus reuteri markedly reduced crying time at 21 days (median difference, -65 minutes/d; 95% CI, -86 to -44). However, all trials had potential biases. Meanwhile, of 7 prevention trials, 2 suggested possible benefits. Considerable variability in the study populations, study type, delivery mode/dose of probiotic supplementation, and outcomes precluded meta-analysis. CONCLUSIONS AND RELEVANCE Although L reuteri may be effective as treatment for crying in exclusively breastfed infants with colic, there is still insufficient evidence to support probiotic use to manage colic, especially in formula-fed infants, or to prevent infant crying. Results from larger rigorously designed studies applicable to all crying infants will help draw more definitive conclusions.

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Intestinal microflora in breastfed colicky and non‐colicky infants

Abstract: Our study indicates that colicky infants have different patterns of gut microflora. Further studies are required to understand whether gut microflora is the primary cause of colics or its consequence.

Cited by 128 publications

References 26 publications

Comparison of formula‐fed infants with and without colic revealed significant differences in total bacteria, Enterobacteriaceae and faecal ammonia

Comparison of formula‐fed infants with and without colic revealed significant differences in total bacteria, Enterobacteriaceae and faecal ammonia

Reduction of crying episodes owing to infantile colic: a randomized controlled study on the efficacy of a new infant formula

Probiotics to Prevent or Treat Excessive Infant Crying

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