I wanted to pass on a summary of an article that was posted on medscape this week. It highlights that there is some encouraging research looking at probiotics and colic. There is so much going on in the world of probiotics and gut microbes! I’m going to a research talk on Friday about pediatric gut microbiotia and I will post the highlights!
Jordi Cuñé, Jonathan Santas. Infant Colic: Is a Solution at Hand? Medscape. Mar 19, 2014.http://www.medscape.com/viewarticle/822073
(please go to medscape link to read full article, you will need to register with medscape to read it).
Infant colic may be referred to as excessive crying syndrome. There is a lack of agreement on the diagnostic criteria for colic in infants. A definition of colic is needed and will most likely include time criteria, parental perception, and infant characteristics.
Interventions can include:
- Drug therapies: Simethicone , dicyclomine hydrochloride and cimetropium bromide
- “Natural” treatments: plant extracts (ie, Matricaria chamomilla [chamomile], Foeniculum vulgare [fennel], Melissa officinalis [lemon balm], and Mentha piperita [peppermint oil])
- Nutritional interventions (based on theory that infantile colic can result from food allergies or digestion problems): partially hydrolyzed whey proteins formulas, Lactase therapy, High-fiber or fiber-enriched formulas
- Complementary therapies: massage or chiropractic treatment
Current Research:
Probiotics have been proposed as a promising alternative for modulating gut microbiota, improving health, and improving crying.
- 2013 study: microbial DNA in 12 infants with colic found that colicky infants displayed a less diverse and altered intestinal microbiota compared with healthy control infants
- 2013 study revealed 80 breast-fed, full-term infants found that probiotics may be effective as a treatment strategy for crying.
Author states there is a lack of clinical evidence to fully support any one treatment for colic although probiotics is showing some promise. Author points out need for further research.
Probiotics are such great jewels for gut comfort in both children and adults. When I think about the majority of kids on my caseload, they share a lot of the same determinants of gut microbiota. Many of them were born via C-section and so they were already initially exposed to more bacteria from the hospital environment versus babies who were born vaginally. Also, many of these children could not breast-feed for one reason or another and therefore, their intestinal culture looks much different that babies who were breast-fed. And lastly, a lot of these children were born pre-maturely and so they higher counts of c-diff in their intestines. These are typically the same children who have trouble staying well due to weaker immune systems. Probiotics doe have such great benefits. One word of caution, many of them contain traces of dairy so if patients are taking them but have dairy intolerances/allergies, it’s important to make sure it’s completely dairy free.
I think we are going to be seeing more and more research on the use of probiotics for many gastrointestinal conditions. In addition to the factors Allison mentions, many of the children I see in clinic have had several upper respiratory illnesses and been on multiple rounds of antibiotics, further altering the gut flora. I have had good success with probiotics. The major obstacle is expense, but worth the cost if it results in comfort for the child. I do inform parents that probiotics are not regulated by the FDA.
Nannette Blois-Martin, MSN, RN, CPNP
Feeding Team Coordinator
Pediatric Gastroenterology
Coastal Children’s Services