For a new parent, nothing is as frustrating - and indeed, heartbreaking - as the sound of a crying infant. The causes are many, and most of the time a baby can be soothed with just some tender loving care. Yet between 5%-25% of the time, there seems to be no answer. The problem in many of these cases is a medical condition known officially as infantile colic although to most, it's simply known as colic.
Colic has been known for over a century and was originally associated with a combination of gastrointestinal disorders including diarrhea and cramping of the colon (hence the name colic). In 1948, an in-depth look at the condition suggested the cause was dietary in nature. Poor digestion and possible allergy would lead to neurological reactions expressed as crying. Since then, research has found several other causes including stress, neurological dysfunction and even exposure to cigarette smoke.
Though the search for a cause continues to be a research focus for many, the hunt for an effective cure is a much larger priority. Unfortunately, much like the elusive cause, there has been little to no agreement in the medical and public health community as to what exactly might work. Studies have focused on pharmacological treatments including such drugs as simethicone and dicyclomine, as well as incorporation of dietary changes to exclude allergens such as dairy, nuts and soy. While these methods have shown promise, very few have gained full acceptance.
Then in 2007, a group from the University of Turin attempted a different approach. Knowing that the cause of colic had originally been associated with the colon, they attempted to calm colic by using probiotics, in particular, a strain known as Lactobacillus reuteri. The bacterium had already shown its effectiveness in reducing diarrhea in children and was the perfect contender for the study. The team enrolled exclusively breastfed infants suffering from colic and gave them the bacteria 30 minutes after eating for 28 days. As expected, the rate of colic was reduced after seven days. This subsequently led to the search for other probiotics which could possibly do the job.
However, despite all the potential of the initial study, the results of other subsequent trials muddied the picture. This year alone, there have been extensive reviews from teams based in Australia and Saudi Arabia that claimed the only proven option was the use of L. reuteri in combination with breastfeeding. No other parameter - such as the use of formula or the choice of a different bacterium - appeared to have any positive results. However, both articles suggested that a larger trial was needed to provide the necessary evidence to make a strong conclusion.
This week, that requirement was finally met in an article published by a team of researchers from various universities and hospitals across Italy. The group studied 589 infants to determine whether the addition of L. reuteri to the baby's diet would reduce the incidence of not only colic but also gastric reflux and constipation. While there was little doubt that the addition of the bacterium would lead to a positive result, they were pleasantly surprised by the actual outcomes.
The clinical trial was fairly simple. The team provided parents with either a formulation containing L. reuteri or a placebo. Five drops of the solution was to be fed directly into the babies' mouths for a period of 90 days. During that time, any symptoms that would suggest the onset of one of the three conditions were to be reported. Just over 20% of the participants were excluded but the remaining 468 babes offered a very encouraging look at the benefit of probiotics in the very young.
After just one month of receiving the bacterial supplementation, babies were already showing less crying time and more regular bowel movements. By the end of the 90 days, even the effect of gastric reflux had been improved. But while this information was interesting, there was another parameter that had less to do with medicine and more to do with time and pocketbook management.
By the end of the study, there were fewer visits to the pediatrician and emergency ward, which is always a welcome sign. But parents also saved on average approximately US$120. This was due to less time away from work and fewer medications for the child. There was also observed reductions in stress and anxiety on the part of the parents. In essence, the addition of L. reuteri not only helped calm the children, but it also helped to keep the parents sane.
This article is a landmark as it opens the door to more testing and even other probiotic strains. Until now, most studies, including this one, have focused on one bacterium - L. reuteri. However, other bacteria, such as Lactobacillus acidophilus, which is known to be deficient in colic sufferers, and Lactobacillus rhamnosus, which has been shown to help reduce non-colic fussiness and crying, may also find themselves in clinical trials to find out if they too are beneficial. Until then, parents can be assured that when it comes to colic, there is a natural option that may offer infants relief from symptoms and the family a renewed sense of peace.
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