Abstract
Infant colic is a distressing condition of unknown etiology. An aberrant gastrointestinal microbiota has been associated, and Lactobacillus reuteri supplementation has been shown to reduce crying and/or fussing time (‘crying time’) in some infants with colic. The relationship between L. reuteri gut colonization and crying time has not been examined. We investigated the relationship between L. reuteri colonization and fecal microbiota (microbial diversity and Escherichia coli), intestinal inflammation, and crying time in infants with colic, using a subset of 65 infants from the Baby Biotics trial, which randomized healthy term infants aged <13 weeks with infant colic to receive probiotic L. reuteri DSM 17938 (1 × 108 colony forming units) or placebo daily for 28 days. We observed an overall reduction in median crying time, regardless of L. reuteri colonization status (n = 14 colonized). There were no differences in E. coli colonization rates or densities, microbial diversity or intestinal inflammation by L. reuteri colonization status. We found that L. reuteri density positively correlated with crying time, and E. coli density negatively correlated with microbial diversity. As density of L. reuteri was associated with increased crying time, L. reuteri supplementation may not be an appropriate treatment for all infants with colic.
Highlights
Infant colic is a distressing condition characterized by crying and/or fussing of unknown cause that affects up to 28% of infants under three months of age[1]
We recently reported results of a double blind, randomized, placebo-controlled trial evaluating L. reuteri supplementation for the treatment of infant colic in Melbourne, Australia (Baby Biotics trial, Current Controlled Trials ISRCTN95287767 (25/10/2010)) that found no effect on crying time when compared to placebo[16]
Fecal samples were collected on day 28 of treatment and examined for L. reuteri and E. coli colonization, microbial diversity, and calprotectin
Summary
Infant colic is a distressing condition characterized by crying and/or fussing of unknown cause that affects up to 28% of infants under three months of age[1]. One study found that infants with colic had lower microbial diversity and elevated fecal calprotectin (a marker of gut inflammation) compared with healthy infants[9]. The finding that infants with colic have an altered intestinal microbiota has led to the investigation of probiotic supplementation for the treatment of this condition, with the aim of promoting a healthy intestinal microbiota and reducing intestinal inflammation. Several clinical trials suggest Lactobacillus reuteri may reduce crying and/ or fussing time (referred to as ‘crying time’) in some infants with colic[11,12,13,14,15]. We recently reported results of a double blind, randomized, placebo-controlled trial evaluating L. reuteri supplementation for the treatment of infant colic in Melbourne, Australia (Baby Biotics trial, Current Controlled Trials ISRCTN95287767 (25/10/2010)) that found no effect on crying time when compared to placebo[16]. We investigated the role of E. coli, which has been implicated in infant colic[4,7,17]
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