Effects on Crying Time in Colicky Infants With the Supplementation of Lactobacillus Reuteri DSM 17938
Status:
Unknown status
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
Infant colic is a common condition characterized by excessive crying. The otherwise healthy
infant aged less than 3 months is difficult to console during the periods with crying. The
condition is defined by modified Wessel's criteria i.e. crying for more than 3 hours of the
day, for more than 3 days of the week for at least 1 week.
The description of infant colic hasalso been defined by Rome III diagnostic criteria
andincludes infants from birth to 4 months of age,without failure to thrive, that are showing
paroxysms of irritability, fussing or crying that starts and stops without obvious cause. The
episodes last 3 or more hours/day and occur at least 3days/week for at least one week. The
infant has no signs of central nervous system or intrinsic developmental difficulties, is
normal on physical examination, and has normal growth patterns.
Although infant colic is considered to be self limiting it is a distressing problem for
families. It is in fact one of the most common reasons why parents seek the advice of a
paediatrician or family practitioner during their child's first 3 months of life Up to 20% of
infants under three months are affected by infant colic.
Infant colic could have significant adverse effects on family quality of life and could even
be a trigger for shaken baby syndrome. Parental perception associated with colicky complaints
is therefor strongly recommended to be an outcome measure in trials of infantile colic.
Measurement of parental/family quality of life and parental perception of colic severity with
the help of a Visual Analogue Scale (VAS) in a Polish study showed that the use of a
probiotic, Lactobacillus reuteri DSM 17938, could improve the perceived problems.
The relationship between infant colic and gastroenterological, allergical and psychological
disorders later in childhood was studied in a prospective study on 96 infants divided into
two groups, colicky and non-colicky. The children diagnosed with infant colic, showed an
increased susceptibility to recurrent abdominal pain, allergic and psychological disorders in
childhood when they were 10 years old.
The aetiology of infantile colic seems to be multifactorialbut is,despite many years of
research, still unknown. The intestinal microbiota differs between infants with and without
colic and has therefore been suggested to have a potential role. Other possible explanations
are for example gut motility disturbances, low-grade mucosal inflammation and visceral
hypersensitivity.
Evidence suggests thatadministration of the probioticL. reuteri DSM 17938 might offer some
benefit.L. reuteri DSM 17938 has been tested for its effect on crying in colicky infants and
has been demonstrated to have a significantly favourable effect on crying time in fivetrials.
One is a randomized trial that compared the probioticto Simethicone; three areplacebo
controlled randomized double blind trials and yet another is a placebo controlled randomized,
single blind, observational study. A fifth studydid not find any effect.
Combining the results in a meta-analysis from three double blind, placebo controlled
randomized trials (published at the time of the analysis, including the neutral one) found
that, compared with placebo, L. reuteri administration reduced crying time at day 21 with
about 40 min.
Recently it has been documented in a clinical trial that prophylactic use of L. reuteriDSM
17938during the first three months of lifereduced the onset offunctional gastrointestinal
disorders, particularly functional constipation, regurgitation and infantile colic.
In conclusion, the administration L. reuteri DSM 17938 may reduce the crying time in children
with infantile colic, especially those fed predominantly or exclusively with breast milk.
However, further randomized controlled studies, are required to be able develop
recommendations in the management of infant colic.
The present trial is undertaken to further document the effect of L. reuteri DSM 17938 on
crying in colicky infants.
Phase:
N/A
Details
Lead Sponsor:
Shanghai Children's Hospital
Collaborators:
BioGaia AB Shanghai Children's Medical Center Suzhou University Affiliated Children's Hospital