Probiotics may help babies with constipation

NEW YORK (Reuters Health) - Some probiotics may help treat chronic constipation in babies, according to a new study.

Probiotics are a kind of bacteria that can help balance out populations of bacteria in the intestines, keeping bacteria that cause disease from taking over. Children with constipation have been shown to have different types of bacteria in their stool than healthy children, suggesting that taking probiotics might help ease their symptoms.

But there had been no definitive evidence to recommend that kids with chronic constipation be treated with probiotics, the authors say.

(In this study, the researchers used a bacterium called Lactobacillus reuteri, which is found naturally in the intestines of some people. The bug was named after the German microbiologist who discovered it, Gerhard Reuter. It’s unclear if that Reuter is related to Baron Paul Julius Reuter, the founder of Reuters, but Thomson Reuters had nothing to do with this study.)

Led by Dr. Paola Coccorullo of the University of Naples “Federico II” in Italy, the authors followed 44 infants that had been referred to their pediatrics department with chronic constipation. Half of those infants were assigned to take a dose of L. reuteri mixed with a few drops of oil once a day for eight weeks, while the others were fed an inactive placebo.

The researchers asked parents to keep track of how often their baby had a bowel movement and the consistency of the stool, in addition to babies’ “inconsolable crying spells.”

When it came to stool consistency and crying, it didn’t matter whether a baby was taking L. reuteri or the placebo. Both groups had general improvements in their stool consistency but cried more later in the study than at its start.

Babies taking probiotics, however, had significantly more bowel movements than babies on the placebo after two, four, and eight weeks, suggesting an improvement in their constipation. At the beginning of the study, the probiotic babies had, on average, less than three bowel movements per week. By week eight, they had an average of almost five.

The probiotic treatment had no side effects, according to the report, which is published online in The Journal of Pediatrics.

Studies have shown that about three percent of babies suffer from constipation before their first birthday, and approximately a third of those continue to have symptoms for at least six months. Babies can be at risk for constipation when they switch from breast milk to formula or from baby food to solid food.

While not going so far as to recommend that parents of infants with constipation run to the pharmacy for probiotics, the authors conclude that “probiotics as a natural, safe, and well-tolerated treatment may provide a simple and attractive way” to treat chronic constipation in babies.

Current practices shouldn’t change based on this study alone, said Dr. Marc Benninga, a pediatric gastroenterologist and nutritionist at Emma Children’s Hospital in Amsterdam, who was not involved with the study. “I would never start with probiotics,” he told Reuters Health, saying that parents should try oral laxatives first.

Some doctors also recommend giving babies water or extra fiber to combat constipation.

Benning said more studies of the effectiveness of L. reuteri are needed. Noos, an Italian company that sells the probiotic, provided it and the placebo, and contributed to the costs of publishing the paper in the journal.

The FDA classifies probiotics as a food or dietary supplement. They are available without a prescription, but companies that sell them are not allowed to market them as treatments for specific diseases.

SOURCE: The Journal of Pediatrics, online June 14, 2010.