Pediatr Gastroenterol Hepatol Nutr.  2017 Jun;20(2):100-106. 10.5223/pghn.2017.20.2.100.

Innovative Dietary Intervention Answers to Baby Colic

• Xinias I
• Analitis A
• Mavroudi A
• Roilides I
• Lykogeorgou M
• Delivoria
• Milingos V
• Mylonopoulou M
• Vandenplas Y

• KMID: 2384823
• DOI: http://doi.org/10.5223/pghn.2017.20.2.100

Abstract

PURPOSE
The purpose of this paper is to evaluate the efficacy of a lactose- reduced synbiotic partial whey hydrolysate in formula fed infants presenting with colic and the impact of this dietary intervention in mean crying time and quality of life.
METHODS
Forty infants with infantile colic were treated during one month with parental reassurance and the intervention formula (partial whey hydrolysate, reduced lactose, Bifidobacterium lactis BB12 and galacto-oligosaccharides) and were compared to a control group of 20 infants with infantile colic treated with parental reassurance and a standard infant formula. Parents completed a quality of life (QoL) questionnaire assessing the burden of infantile colic. Wilcoxon test, t-test and Mann-Whitney test were used to compare QoL scores before and after intervention as well as between the intervention and control group.
RESULTS
At inclusion, duration of crying did not differ between both groups. Crying duration decreased with 2.7 hours (from 3.2 to 0.5 hours) in the intervention group while duration of crying decreased only with 1.2 hours in the control group (p<0.001). Stool composition became looser in the intervention group, but defecation frequency did not change. The median scores of the QoL questionnaire improved significantly in the intervention group for all parameters. In the control group, parameters improved significantly also but not for the parent-child and social interaction. The score changes were significantly greater in the intervention than in the control group.
CONCLUSION
The intervention formula (partial whey hydrolysate, synbiotic, reduced lactose) significantly reduced the duration of crying and improved QoL of the parents and infants.

Keyword

Colic; Lactose; Partial hydrolysate; Prebiotics; Probiotics; Galacto-oligosaccharide; Bifidobacterium lactis

MeSH Terms

Bifidobacterium
Colic*
Crying
Defecation
Humans
Infant
Infant Formula
Interpersonal Relations
Lactose
Parents
Prebiotics
Probiotics
Quality of Life
Synbiotics
Whey
Lactose
Prebiotics

Reference

1. Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2016; DOI: 10.1053/j.gastro.2016.02.016. [Epub ahead of print].

2. Savino F, Tarasco V. New treatments for infant colic. Curr Opin Pediatr. 2010; 22:791–797.

3. Radesky JS, Zuckerman B, Silverstein M, Rivara FP, Barr M, Taylor JA, et al. Inconsolable infant crying and maternal postpartum depressive symptoms. Pediatrics. 2013; 131:e1857–e1864.

4. Morris S, James-Roberts IS, Sleep J, Gillham P. Economic evaluation of strategies for managing crying and sleeping problems. Arch Dis Child. 2001; 84:15–19.

5. Brown M, Heine RG, Jordan B. Health and well-being in school-age children following persistent crying in infancy. J Paediatr Child Health. 2009; 45:254–262.

6. Canivet C, Hagander B, Jakobsson I, Lanke J. Infantile colic--less common than previously estimated. Acta Paediatr. 1996; 85:454–458.

7. Vandenplas Y, Abkari A, Bellaiche M, Benninga M, Chouraqui JP, Çokura F, et al. Prevalence and health outcomes of functional gastrointestinal symptoms in infants from birth to 12 months of age. J Pediatr Gastroenterol Nutr. 2015; 61:531–537.

8. Shenassa ED, Brown MJ. Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics. 2004; 114:e497–e505.

9. Garrison MM, Christakis DA. A systematic review of treatments for infant colic. Pediatrics. 2000; 106:184–190.

10. Hall B, Chesters J, Robinson A. Infantile colic: a systematic review of medical and conventional therapies. J Paediatr Child Health. 2012; 48:128–137.

11. Vandenplas Y, Benninga M, Broekaert I, Falconer J, Gottrand F, Guarino A, et al. Functional gastro-intestinal disorder algorithms focus on early recognition, parental reassurance and nutritional strategies. Acta Paediatr. 2016; 105:244–252.

12. Biagioli E, Tarasco V, Lingua C, Moja L, Savino F. Pain-relieving agents for infantile colic. Cochrane Database Syst Rev. 2016; 9:CD009999.

13. Lasekan JB, Jacobs J, Reisinger KS, Montalto MB, Frantz MP, Blatter MM. Lactose-free milk protein-based infant formula: impact on growth and gastrointestinal tolerance in infants. Clin Pediatr (Phila). 2011; 50:330–337.

14. Savino F, Ceratto S, Poggi E, Cartosio ME, Cordero di Montezemolo L, et al. Preventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938. Benef Microbes. 2015; 6:245–251.

15. Kanabar D, Randhawa M, Clayton P. Improvement of symptoms in infant colic following reduction of lactose load with lactase. J Hum Nutr Diet. 2001; 14:359–363.

16. Miller JJ, McVeagh P, Fleet GH, Petocz P, Brand JC. Effect of yeast lactase enzyme on "colic" in infants fed human milk. J Pediatr. 1990; 117:261–263.

17. Kearney PJ, Malone AJ, Hayes T, Cole M, Hyland M. A trial of lactase in the management of infantile colic. J Hum Nutr Diet. 1998; 11:281–285.

18. Vandenplas Y, Ludwig T, Bouritius H, Hourihane J, Huet F. O-174 The combination of scGOS/lcFOS with fermented infant formula reduces the incidence of colic in 4 week old infants. Arch Dis Child. 2014; 99:Suppl 2. A91–A92.

19. Infantile Colic. National Institute for Health Care and Excellence, Clinical Knowledge Summaries [Internet]. Available from: http://cks.nice.org.uk/colic-infantile. (website only available in UK).

20. Jakobsson I, Lothe L, Ley D, Borschel MW. Effectiveness of casein hydrolysate feedings in infants with colic. Acta Paediatr. 2000; 89:18–21.

21. Lucassen PL, Assendelft WJ, Gubbels JW, van Eijk JT, Douwes AC. Infantile colic: crying time reduction with a whey hydrolysate: a double-blind, randomized, placebo-controlled trial. Pediatrics. 2000; 106:1349–1354.

22. Estep DC, Kulczycki A Jr. Treatment of infant colic with amino acid-based infant formula: a preliminary study. Acta Paediatr. 2000; 89:22–27.

23. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, et al. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics. 2010; 126:e526–e533.

24. Harb T, Matsuyama M, David M, Hill RJ. Infant colic-what works: a systematic review of interventions for breast-fed infants. J Pediatr Gastroenterol Nutr. 2016; 62:668–686.

25. Sung V, Hiscock H, Tang ML, Mensah FK, Nation ML, Satzke C, et al. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ. 2014; 348:g2107.

26. Pärtty A, Lehtonen L, Kalliomäki M, Salminen S, Isolauri E. Probiotic Lactobacillus rhamnosus GG therapy and microbiological programming in infantile colic: a randomized, controlled trial. Pediatr Res. 2015; 78:470–475.

27. Fatheree NY, Liu Y, Ferris M, Van Arsdall M, McMurtry V, Zozaya M, et al. Hypoallergenic formula with Lactobacillus rhamnosus GG for babies with colic: A pilot study of recruitment, retention, and fecal biomarkers. World J Gastrointest Pathophysiol. 2016; 7:160–170.

28. Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long-term consumption of infant formulas containing live probiotic bacteria: tolerance and safety. Am J Clin Nutr. 2004; 79:261–267.

29. Savino F, Cresi F, Maccario S, Cavallo F, Dalmasso P, Fanaro S, et al. "Minor" feeding problems during the first months of life: effect of a partially hydrolysed milk formula containing fructo- and galacto-oligosaccharides. Acta Paediatr Suppl. 2003; 91:86–90.

30. Savino F, Palumeri E, Castagno E, Cresi F, Dalmasso P, Cavallo F, et al. Reduction of crying episodes owing to infantile colic: a randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr. 2006; 60:1304–1310.

31. Giovannini M, Verduci E, Gregori D, Ballali S, Soldi S, Ghisleni D, et al. Prebiotic effect of an infant formula supplemented with galacto-oligosaccharides: randomized multicenter trial. J Am Coll Nutr. 2014; 33:385–393.