Friendly bacteria help calm colicky babies

NEW YORK (Reuters Health) - Italian researchers offer some hopeful news for parents of colicky babies: a daily dose of “good” bacteria may help their child to cry less.

After three weeks of treatment with probiotic bacteria, babies cried for an average of about a half-hour a day, while infants who received a placebo were still crying for an hour and a half daily. At the study’s outset, babies in both groups were crying for five to six hours a day.

The cause of colic, traditionally defined as inconsolable crying for at least three hours a day, on at least three days in a week and lasting for at least three weeks, isn’t clear. It affects up to 28 percent of babies under three months of age, according to lead author Dr. Francisco Savino of Regina Margherita Children Hospital in Turin, Italy.

Causes are “most likely multifactorial,” Savino noted in an e-mail to Reuters Health, and may include social and psychological factors, as well as allergies to certain foods, including cow’s milk. He added that recent research suggests that babies with colic have an abnormal balance of bacteria in their guts.

Savino and his team had previously tested the probiotic Lactobacillus reuteri against simethicone, the anti-gas remedy found in over-the-counter medications such as Gas-X, and found L. reuteri was much more effective in improving colicky symptoms. Another group of Italian researchers published a study last month that found L. reuteri was more helpful than placebo for treating constipation in babies.

In the current study, published in Pediatrics and funded by BioGaia AB of Stockholm (a company that makes probiotic infant drops for babies, among other products containing L. reuteri), the researchers compared the “good bacteria” to placebo.

Parents gave their babies five drops of the active probiotic, a suspension of freeze-dried L. reuteri in oil, or a placebo consisting of the same oil minus the bacteria, once a day a half-hour before feeding the baby in the morning. All of the infants were exclusively breastfed and mothers were asked to abstain from drinking cow’s milk during the three week test. The study was double-blind, meaning neither the patients nor the researchers knew whether a participating baby was receiving active treatment or placebo.

At the beginning of the study, the 25 babies in the probiotic group were crying for 370 minutes a day, on average, compared to 300 minutes for the 21 babies in the placebo group, which wasn’t a statistically significant difference, meaning it could have been due to chance.

On day 21, babies in the probiotic group averaged 35 minutes of crying a day, compared to 90 minutes for the placebo babies. Seven days into the study, 20 of the babies in the probiotic group had showed a response to treatment (defined as a 50 percent or greater reduction in crying time), compared to 8 of the placebo group; at 14 days, 24 of the probiotic babies and 13 of the placebo babies had responded; and at 21 days, 24 of the probiotic group had responded to treatment, compared to 15 of the placebo group.

The researchers also tested stool samples from the infants before and after treatment and confirmed an increase in the probiotic bacteria among the infants given the supplement; these babies also showed a reduction in the amount of Escherichia coli in their stool and less ammonia. Theories about the causes of colic include the possibility that an overabundance of E. coli in the intestines of colicky babies could produce excess gas.

The authors speculate that the probiotic might help babies by improving their gut function and calming intestinal nerves. They also note that the considerable decrease in crying time among the babies who received the placebo might be attributable to the mothers’ milk-free diet or just growing out of the colicky stage, as most babies eventually do, during the study period.

After a pediatrician has examined a colicky child to rule out any underlying cause of disease and address any feeding problems, “our results suggest a potential role of L. reuteri as a new safe therapeutic approach to infantile colic,” Savino said.

SOURCE: Pediatrics, September 2010.