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Brown JM, Baran JV, Lamos L, Beacker J, Florio J, Oliveros LV, Fabbrini AL, Farrar AA, Vanderhoof JA, Wilsey MJ. Extensively Hydrolyzed Formula and Infant Colic Symptoms: Secondary Analysis of a Prospective Cohort Study. Clin Pediatr (Phila) 2024; 63:1579-1584. [PMID: 38462840 DOI: 10.1177/00099228241236033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Cow's milk protein allergy (CMPA) affects 2% to 3% of infants and is managed with hypoallergenic formulas. The 2022 recalls of infant formulas due to factors including contamination led to specialty formula shortages, highlighting CMPA management challenges. Understanding health care providers' (HCPs) decision-making in transitioning to alternative formulas during shortages is crucial. Limited attention has been given to how pediatric physicians make these choices. This study utilized US HCPs' de-identified survey data to assess driving factors when switching extensively hydrolyzed formulas during shortages. A total of 104 eligible HCPs participated, including general pediatrics, pediatric allergy/immunology, and pediatric gastroenterology specialists. Safety, tolerability, and efficacy were identified as top factors for switching formulas. Formula 1 was considered well-tolerated, patient-accepted, and safe by all HCPs. Most expressed strong belief in Formula 1's safety and effectiveness. Findings inform CMPA management during shortages, offering guidance to HCPs for suitable formula selection and enhanced infant care.
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Affiliation(s)
- Jerry Mack Brown
- Office of Medical Education, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Jessica Victoria Baran
- Office of Medical Education, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Luke Lamos
- Office of Medical Education, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Jesse Beacker
- Office of Medical Education, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Jared Florio
- Office of Medical Education, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Lea Victoria Oliveros
- Office of Medical Education, Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - Abigail Lea Fabbrini
- Office of Medical Education, College of Osteopathic Medicine, Kansas City University, Kansas City, MO, USA
| | - Andrew Arthur Farrar
- Office of Medical Education, College of Osteopathic Medicine, Kansas City University, Kansas City, MO, USA
| | - Jon Arvid Vanderhoof
- Department of Gastroenterology Hepatology and Nutrition, Boys Town Hospital, Boys Town, NE, USA
| | - Michael John Wilsey
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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2
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Nau AL, Bassan AS, Cezar AB, de Carlos GA, Deboni M. Lactase for infantile colic: A systematic review of randomized clinical trials. J Pediatr Gastroenterol Nutr 2024; 79:855-862. [PMID: 38720550 DOI: 10.1002/jpn3.12231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 10/02/2024]
Abstract
Infantile colic is excessive crying for no apparent reason in an otherwise healthy infant. Although its physiopathology is not completely understood, therapies usually target gastrointestinal symptoms. This systematic review of randomized controlled trials (RCTs) analyzes the efficacy of lactase supplementation in infantile colic. PubMed, Embase, and Cochrane were searched for RCTs evaluating lactase supplementation in infants up to 6 months old with infantile colic. Out of six RCTs including 394 patients, three reported a significantly shorter crying time in the lactase group than in the placebo group, while the other three found no significant difference between groups. Of the two studies that performed the hydrogen breath test, only one reported a significant reduction in exhaled hydrogen levels. The pharmacological approach to infantile colic remains debatable, and new studies with standardized diagnostic criteria and outcomes are required to guide lactase supplementation in clinical practice.
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Affiliation(s)
- Angélica Luciana Nau
- Division of Pediatric Gastroenterology, Hospital Jaraguá, Jaraguá do Sul, Brazil
| | | | | | | | - Mariana Deboni
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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3
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Switkowski KM, Oken E, Simonin EM, Nadeau KC, Rifas-Shiman SL, Lightdale JR. Early-life risk factors for both infant colic and excessive crying without colic. Pediatr Res 2024:10.1038/s41390-024-03518-4. [PMID: 39242932 DOI: 10.1038/s41390-024-03518-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Infantile colic may represent gastrointestinal distress, yet most definitions emphasize excessive crying. Each may have distinct etiologies. DESIGN/METHODS In a pre-birth cohort, we used maternal reports of infant crying and apparent abdominal discomfort at 6mos to categorize infants as (1) unaffected (no excessive crying or colic), (2) excessive crying only, and (3) colic (abdominal discomfort +/- excessive crying). We examined associations of potential risk factors in separate models with excessive crying and colic (each vs. unaffected) using unadjusted multinomial logistic regression, and associations between count of risk factors and colic using logistic regression. RESULTS Of 1403 infants, 140 (10%) had excessive crying, and 346 (25%) colic. Infants that were non-Hispanic white, low birthweight, firstborn, or had a maternal history of atopy, high postpartum depressive symptoms, or persistent prenatal nausea, had a 40-80% higher relative risk of colic. Preterm birth was associated with double the risk. Being firstborn, low birthweight, and preterm birth predicted excessive crying. Infants with ≥four (vs. 0-1) of the seven identified risk factors had 3.9 times (95% CI: 2.6, 6.1) higher odds of colic. CONCLUSIONS Colic characterized by apparent abdominal discomfort can be phenotypically distinguished from excessive crying only. Multiple risk factors may further increase colic risk. IMPACT Infant colic characterized by apparent gastrointestinal distress may be phenotypically distinct from excessive crying only. Literature that defines colic only based on crying behaviors may miss important predictors. Mother-reported colic and excessive crying appear to have overlapping risk factors, with additional risk factors identified for colic. The presence of multiple risk factors increases the risk of colic, supporting a multifactorial etiology.
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Affiliation(s)
- Karen M Switkowski
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elisabeth M Simonin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kari C Nadeau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Jenifer R Lightdale
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA
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4
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Ateş Beşirik S, Geçkil E. The effect of therapeutic touch on colic symptoms in infantile colic infants: A randomised controlled study. J Paediatr Child Health 2024. [PMID: 39143930 DOI: 10.1111/jpc.16646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 07/26/2024] [Accepted: 08/04/2024] [Indexed: 08/16/2024]
Abstract
AIM This study aimed to examine the effects of therapeutic touch (TT) on infantile colic symptoms (Infant Colic Scale (ICS) score, crying time and sleep time). METHODS This randomised controlled trial included infants aged 4-12 weeks diagnosed with infantile colic in a pediatric unit of a hospital. Infants were assigned to intervention or control groups using a stratified randomisation method. The intervention group received TT sessions six times, 3 days a week, in addition to usual care for 2 weeks. The control group received the usual care. Data were collected using Mother-Infant Information Form, ICS, Crying and Sleep Time Follow-Up Forms. The infants were followed up for two weeks. RESULTS A total of 64 infants who met the criteria were included in the study, including intervention (n = 32) and control (n = 32) groups. There was a statistically significant difference between the groups (intervention and control) in terms of ICS scores (U = 4.5; P < 0.001; d = 3.252; 95% confidence interval (CI) = 2.505-3.999), crying time (F = 57.097; ŋp 2 = 0.461; P < 0.001) and sleep time (F = 17.884; ŋp 2 = 0.211; P < 0.001). When the intervention group was compared with the control group at all time points, the size of the effect (group × time interaction) was found to be high. CONCLUSIONS TT effectively relieved symptoms, decreased crying time and increased sleep time in infants with infantile colic. TT is recommended to relieve colic in infants.
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Affiliation(s)
- Selda Ateş Beşirik
- Department of Nursing, Department of Pediatric Nursing, Bucak School of Health, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Emine Geçkil
- Department of Pediatric Nursing, Nursing Faculty, Necmettin Erbakan University, Konya, Turkey
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5
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Brett BE, Vacaru S, Beijers R, de Weerth C. Infant colic and HPA axis development across childhood. Psychoneuroendocrinology 2024; 164:106965. [PMID: 38493596 DOI: 10.1016/j.psyneuen.2024.106965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/14/2024] [Accepted: 01/14/2024] [Indexed: 03/19/2024]
Abstract
This study examines the long-term impact of infant colic on Hypothalamic-Pituitary-Adrenal (HPA) axis development and the moderating role of attachment security, in a low-risk Dutch sample of 193 children. We assessed infant colic at 6 weeks, circadian cortisol concentrations at ages 1, 2.5, 6, and 10 years, and attachment security at 1 year. Findings indicated that infant colic was associated with steeper diurnal cortisol slopes and slightly higher cortisol concentrations throughout childhood. Attachment security did not moderate these associations. This is the first study to reveal a link between infant colic and the development of the HPA axis in healthy children beyond infancy. These findings have important implications for understanding early risk and protective factors in the stress system's development.
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Affiliation(s)
- Bonnie E Brett
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands.
| | - Stefania Vacaru
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Vrije Universiteit Amsterdam, the Netherlands
| | - Roseriet Beijers
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Montessorilaan 3, Nijmegen 6525HR, the Netherlands
| | - Carolina de Weerth
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands
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6
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Zeevenhooven J, Zeevenhooven L, Biesbroek A, Schappin R, Vlieger AM, van Sleuwen BE, L'Hoir MP, Benninga MA. Functional gastrointestinal disorders, quality of life, and behaviour in adolescents with history of infant colic. Acta Paediatr 2024; 113:1435-1443. [PMID: 38535502 DOI: 10.1111/apa.17215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/19/2024] [Accepted: 03/13/2024] [Indexed: 06/09/2024]
Abstract
AIM To assess the prevalence of functional gastrointestinal disorders (FGIDs), health-related quality of life (HRQOL), and behavioural problems in a cohort of adolescents with a history of infant colic (IC), as defined by Wessel's criteria. METHODS 388 adolescents, aged 15-18 years, who participated in a randomised controlled trial for infants with colic, were invited for our observational follow-up study. Prevalence of FGIDs was assessed with the Rome IV Questionnaire on Paediatric Gastrointestinal Disorders (RIV-QPGD), HRQOL through self-report of the Paediatric Quality of Life Inventory (PedsQL), and behavioural problems through parent-report of the child behaviour checklist (CBCL). Multivariable models were used to compare prevalence rates of FGIDs and HRQOL scores. RESULTS 190 (49%) adolescents with a history of IC (cases) and 381 controls were included (median age 17.0 [IQR 16.0-17.0] and 16.0 [15.0-17.0] years, respectively). Cases had a significantly higher risk for postprandial distress syndrome compared to controls (aOR 2.49 (95%CI 1.18-5.25), p = 0.002). After multivariable regression, total, physical and school HRQOL scores were significantly lower in cases compared to controls (p = 0.003, 0.001, and 0.009). CONCLUSION Adolescents with a history of IC demonstrate higher prevalence rates of postprandial distress syndrome compared to controls. However, conclusions should be made with caution due to attrition and information bias.
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Affiliation(s)
- Judith Zeevenhooven
- Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, Pediatric Gastroenterology, Hepatology and Nutrition, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucas Zeevenhooven
- Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Angela Biesbroek
- Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Renske Schappin
- Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arine M Vlieger
- Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Monique P L'Hoir
- Nutrition and Health over the Lifecourse, Wageningen University & Research, Wageningen, The Netherlands
| | - Marc A Benninga
- Emma Children's Hospital, Amsterdam UMC, Pediatric Gastroenterology, Hepatology and Nutrition, University of Amsterdam, Amsterdam, The Netherlands
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7
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潘 云, 吴 敏, 林 茜. [Research status and prospects of probiotics in functional gastrointestinal disorders in infants and toddlers]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:529-534. [PMID: 38802916 PMCID: PMC11135062 DOI: 10.7499/j.issn.1008-8830.2401141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/07/2024] [Indexed: 05/29/2024]
Abstract
Functional gastrointestinal disorders (FGIDs) are common digestive system diseases in children, which can severely affect the growth and development of infants and toddlers. Probiotics therapy, as a relatively safe treatment method, have attracted the attention of researchers. However, their effectiveness in treating FGIDs in infants and toddlers is still unclear. This article reviews the mechanisms of probiotics in treating FGIDs in infants and toddlers, explores the reasons for the inconsistency in various research results, and aims to provide assistance for the clinical treatment of FGIDs in infants and toddlers and future research.
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8
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Kozłowska-Jalowska A, Stróżyk A, Horvath A, Szajewska H. Effect of lactase supplementation on infant colic: Systematic review of randomized controlled trials. J Pediatr Gastroenterol Nutr 2024; 78:1009-1016. [PMID: 38426798 DOI: 10.1002/jpn3.12144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/09/2024] [Accepted: 01/20/2024] [Indexed: 03/02/2024]
Abstract
To systematically review evidence on the efficacy and safety of using a lactase supplementation for managing infant colic. The MEDLINE, EMBASE, and Cochrane Library databases were searched (up to September 2023) for randomized controlled trials (RCTs) comparing oral lactase supplementation with placebo or no intervention in infants younger than 6 months old with infant colic. The risk of bias was assessed using the revised version of the Cochrane risk-of-bias tool. Outcomes measured were selected according to a standardized core outcome set. Five RCTs involving a total of 391 infants were identified. Three RCTs reported reduced crying duration, but one showed effect only in a compliant group (40.4%, p = 0.0052). A meta-analysis of two RCTs found no difference in crying duration and fussing time during 1 week of lactase treatment compared with placebo (mean difference [MD] -17.66 min/day, 95% confidence interval [CI], -60.8 to 25.5; I2 = 68% and MD 2.75, 95% CI, -58.2 to 57.2; I2 = 80%, respectively). Other outcomes were assessed only in individual studies or not reported. The risk of bias was low in only one RCT, high in three, and raised some concerns in one. While individual trials have shown some promise, the overall evidence for the efficacy of lactase supplementation in treating infant colic remain inconclusive. Further well-designed RCTs are necessary to determine the effects of lactase on managing infant colic.
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Affiliation(s)
| | - Agata Stróżyk
- Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Andrea Horvath
- Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Hania Szajewska
- Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland
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9
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Rosa D, Zablah RA, Vazquez-Frias R. Unraveling the complexity of Disorders of the Gut-Brain Interaction: the gut microbiota connection in children. Front Pediatr 2024; 11:1283389. [PMID: 38433954 PMCID: PMC10904537 DOI: 10.3389/fped.2023.1283389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/27/2023] [Indexed: 03/05/2024] Open
Abstract
"Disorders of Gut-Brain Interaction (DGBIs)," formerly referred to as "Functional Gastrointestinal Disorders (FGIDs)," encompass a prevalent array of chronic or recurring gastrointestinal symptoms that notably impact the quality of life for affected children and their families. Recent studies have elucidated the intricate pathophysiology of DGBIs, underscoring their correlation with gut microbiota. This review seeks to explore the present comprehension of the gut microbiota's role in DGBI development. While other factors can contribute to DGBIs, the gut microbiota prominently influences the onset and progression of these conditions. According to the Rome IV diagnostic criteria, DGBI prevalence is approximately 40% worldwide. The Rome Foundation has diligently worked for nearly three decades to refine our comprehension of DGBIs. By centering on the gut microbiota, this review sheds light on potential therapeutic interventions for DGBIs, potentially enhancing the quality of life for pediatric patients and their families.
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Affiliation(s)
- Dimas Rosa
- Grupo de Investigación del Caribe y Centroamérica para la Microbiota, Probióticos y Prebióticos, GICCAMPP, la Romana, Dominican Republic
| | - Roberto Arturo Zablah
- Grupo de Investigación del Caribe y Centroamérica para la Microbiota, Probióticos y Prebióticos, GICCAMPP, la Romana, Dominican Republic
- Servicio de Gastroenterología y Endoscopia Digestiva, Hospital de Niños “Benjamín Bloom”, San Salvador, El Salvador
| | - Rodrigo Vazquez-Frias
- Grupo de Investigación del Caribe y Centroamérica para la Microbiota, Probióticos y Prebióticos, GICCAMPP, la Romana, Dominican Republic
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Ciudad de México, México
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10
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Park UJ, Jeong HI, Kim KH. Comparison of Effectiveness of Manual Therapy for Infant Crying: systematic review and meta-analysis of randomized controlled trials. J Pharmacopuncture 2023; 26:285-297. [PMID: 38162473 PMCID: PMC10739473 DOI: 10.3831/kpi.2023.26.4.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/02/2023] [Accepted: 09/13/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of nocturnal crying (NC) and infantile colic (IC). Methods Total effective rate, crying time and adverse events were used as outcome indicators. To assess the quality, the risk of bias was determined for each study by two authors, using the Cochrane Collaboration's risk of bias tool. RevMan 5.0 was used for data analysis. A total of 98 articles were identified from 6 electronic databases. Results Among them, twenty-seven studies which included 13 NC and 14 IC were included. Meta-analysis showed favorable effects tuina therapy on total effective rate (TER) of NC (RR 1.20 [95% CI 1.05 to 1.37], p = 0.007), chiropractic therapy on crying time change of IC (SMD -0.83 [95% CI -1.61 to -0.06], p = 0.04) and massage on total crying time of IC (SMD -0.86 [95% CI -1.09 to -0.63], p < 0.00001). This systematic review compares different manual therapies for the treatment of NC and IC. While tuina, chiropractic, and massage show results in alleviating symptoms, the overall evidence remains limited due to the low quality and heterogeneity of the included studies. Conclusion Therefore, further high-quality research with unified control groups is needed to establish manual therapy as a recommended treatment option for NC and IC. Protocol registration number is CRD42022348143 01/08/2022.
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Affiliation(s)
- Ui Jin Park
- College of Korean Medicine, Woosuk University, Jeonju, Republic of Korea
| | - Hye In Jeong
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kyeong Han Kim
- Department of Preventive Medicine, College of Korean Medicine, Woosuk University, Jeonju, Republic of Korea
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11
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Li J, Xu L, Liao J, Li X, Wang X, Wu Q, Zhu L. In vitro intestinal simulation system on the carbon source utilization characteristics and mechanism of interspecific syntrophic effects of Bifidobacterium longum CECT7894 and Pediococcus pentosaceus CECT8330. Front Pediatr 2023; 11:1276846. [PMID: 38155739 PMCID: PMC10752992 DOI: 10.3389/fped.2023.1276846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
The combination of Bifidobacterium longum and Pediococcus pentosaceus is a clinically effective probiotic formulation for alleviating infantile colic; however, their utilization characteristics and mechanism of action surrounding their combined use of sugar sources remains unclear. Using in vitro simulation technology, this study set up individual and mixed cultures of the two probiotics at unique concentrations, and different types of prebiotics, carbohydrates and polyols were added. Gas and short-chain fatty acid production, substrate utilization, as well as growth of the individual and mixed probiotics were detected at the beginning of fermentation, 24 h, and 48 h. Further, the mechanism of the syntrophic effect of the two probiotics was explored based on their growth characteristics. It was found that neither strain produced gas after 24 h and 48 h of cultivation, but could synergistically utilize fructo oligosaccharides (FOS) when mixed. There was an increasing trend of acetic acid production for B. longum in yeast extract, casitone and fatty acid (YCFA) and FOS medium with increasing of bacterial concentrations at 24 h and 48 h; whereas the trend for P. pentosaceus was less obvious. When bacterial concentrations were >5 billion CFU·g-1, the mixed culture showed significantly lower acetic acid production than B. longum alone. By adding lactic and acetic acids to the YCFA medium and observing P. pentosaceus growth, the results suggested that Pediococcus pentosaceus could use the acetic acid and lactic acid produced by Bifidobacterium longum for growth. When the bacterial concentration was 5 billion CFU·g-1, the acetic acid production of B. longum was significantly higher in the mixed cultures in lactulose, lactose, FOS, galactooligosaccharide, and inulin medium; whereas the reverse was true for culturing in xylitol, carboxymethyl cellulose sodium, and sorbitol medium. Further, the mixed cultures produced significantly more acetic acid than B. longum alone. In summary, through in vitro simulation experiments, the optimal ratio and potential interaction mechanisms between B. longum and P. pentosaceus were revealed here, offers a basis for understanding how the probiotic combinations may improve infant colic symptoms by influencing the gut pH and regulating the gut microbiota mechanisms.
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Affiliation(s)
- Jinjun Li
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
- Institute of Food Science, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Lei Xu
- Department of Orthopedics, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jiahao Liao
- College of Animal Science, Shanxi Agricultural University, Taigu, China
| | - Xiaoqiong Li
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
- Institute of Food Science, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Xin Wang
- Institute of Food Science, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Qinbin Wu
- Department of Gastroenterology, Affiliated Children’s Hospital of Soochow University, Suzhou, China
| | - Liying Zhu
- Institute of Food Science, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
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12
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Gencpinar P, Bal Yuksel E, Basarir G, Kanik A, Arslan FD, Olgac Dundar N, Karakoyun I. The Role of Breast Milk Neurotrophin Levels in Infantile Colic Pathogenesis: A Cross-Sectional Case-Control Study. Breastfeed Med 2023; 18:908-912. [PMID: 38100441 DOI: 10.1089/bfm.2023.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Objective: Immaturity of the digestive tract and enteric nervous system is a widely accepted theory for infantile colic (IC) etiopathogenesis. The study aimed to show whether neurotrophins that are necessary for normal functioning and development of the gastrointestinal system have a role in the pathogenesis of IC. Materials and Methods: The IC group (n = 75) comprising the mothers of infants with IC and the control group (n = 75) were included to this cross-sectional case-control study. Brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), ciliary neurotrophic factor (CNTF), and nerve growth factor (NGF) levels of breast milk samples were evaluated by immunosorbent analysis method. Results: The mean age of infants with IC was 7.3 ± 2.8 weeks, while the mean age of the control group was 8.1 ± 2.9 weeks (p = 0.110). No significant difference was found between the breast milk BDNF, GDNF, CNTF, and NGF levels of two groups (p = 0.941, p = 0.510, p = 0.533, p = 0.839, respectively). Conclusions: This is the first report comparing the neurotrophin levels of the breast milk samples taken from the mothers of infants with and without IC. The study demonstrated that breast milk neurotrophin levels of the mothers did not differ significantly between the infants with and without IC.
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Affiliation(s)
- Pinar Gencpinar
- Department of Pediatric Neurology, Tepecik Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Esra Bal Yuksel
- Department of Pediatrics, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Gunce Basarir
- Department of Pediatric Neurology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Ali Kanik
- Department of Pediatrics, Tepecik Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Fatma Demet Arslan
- Department of Medical Biochemistry, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Nihal Olgac Dundar
- Department of Pediatric Neurology, Tepecik Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Inanc Karakoyun
- Department of Medical Biochemistry, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
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13
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Montazeri R, Hasanpour S, Mirghafourvand M, Asghari Jafarabadi M, Mostafa Gharehbaghi M, Bani S. Psychometric Assessment of Infant Colic Scale in Iranian Population. J Caring Sci 2023; 12:228-234. [PMID: 38250002 PMCID: PMC10799268 DOI: 10.34172/jcs.2023.31959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/26/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Infant colic, causing excessive crying, poses anxiety for parents and a challenge for pediatricians and nurses. The Infant Colic Scale (ICS) serves to assess the severity and causal factors of colic. Despite its significance, the psychometric properties of ICS have not been evaluated in the Iranian population. This study seeks to address this gap by assessing the psychometric properties of ICS in Iran. Methods A sample of 220 mothers with 2-16-week-old term infants diagnosed with infantile colic was selected through convenience sampling. Following forward and back-translation, the face validity, content validity, and construct validity of ICS were systematically evaluated. Reliability was examined through both internal consistency (Cronbach's alpha) and test-retest stability methods. Results Content validity index (CVI) and content validity ratio (CVR) values for ICS were 0.94 and 0.81, respectively. The good fit indices confirmed the validity of the five-factor structure. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were 0.71 and 0.94, respectively. Conclusion The Persian version of ICS is a valid and reliable tool, suitable for assessing infantile colic in the Iranian population. Future studies and clinical practice can utilize this tool to identify major causes of this disorder in the Iranian context.
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Affiliation(s)
- Reihaneh Montazeri
- Student Research Committee, Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Hasanpour
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, VIC 3144, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC 3800, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manizheh Mostafa Gharehbaghi
- Pediatric Health Research Center, Department of Pediatrics and Neonatology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soheila Bani
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Kittel J, Nonnenmacher L, Apfelbacher C, Seelbach-Göbel B, Kabesch M, Melter M, Brandstetter S. [Frequency of Utilization of Medical and Paramedical Care in Infants with Excessive Crying: Cross- Sectional Analysis and Parent Survey]. KLINISCHE PADIATRIE 2023. [PMID: 37989211 DOI: 10.1055/a-2160-2608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND Infants can present in the first year of life with excessive, recurrent crying without an apparent illness or failure to thrive. The excessive crying results in a wide variety of problems for infants, parents and health care service. OBJECTIVES This study aimed at evaluating how often parents of children with excessive crying seek help in the medical and paramedical health care system and which therapies are prescribed. MATERIALS AND METHODS This study uses data collected within KUNO Kids health study. Families who participated completed questionnaires 4 weeks after birth and answered questions which screened for excessive crying. Families whose child was screened positive completed an additional questionnaire on symptoms, parental management and health care utilization. Data were analysed using descriptive statistics. RESULTS We received 238 questionnaires from children with excessive crying, 105 fulfilled the modified Wessel criteria. Of these 37 children (36%) were seen by a pediatrician because of crying. 57 (55%) received medications by the pediatrician. 51 (49%) of the parents specified that they also used paramedical therapies due to crying or whining, most often osteopathy. 45 (43%) adapted their own nutrition or their child's nutrition. CONCLUSIONS Our study shows that parents experience problems in dealing excessive crying. Frequent consultations with pediatricians or use of paramedical therapies are common, demanding additional resources. The parents received different diagnoses for excessive crying. Available drugs like Simeticon, homeopathy or manual therapy are recommended and applied despite largely missing evidence.
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Affiliation(s)
- Jochen Kittel
- University Children's Hospital Regensburg (KUNOClinics), University of Regensburg, Clinic St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany
| | - Lena Nonnenmacher
- University Children's Hospital Regensburg (KUNOClinics), University of Regensburg, Clinic St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - B Seelbach-Göbel
- Clinic of Obstetrics and Gynecology St. Hedwig, University of Regensburg, Regensburg, Germany
| | - Michael Kabesch
- University Children's Hospital Regensburg (KUNOClinics), University of Regensburg, Clinic St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Michael Melter
- University Children's Hospital Regensburg (KUNOClinics), University of Regensburg, Clinic St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNOClinics), University of Regensburg, Clinic St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
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15
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Mustafa M, Kariri TM, Majrabi RQ, Hufaysi AH, Abutalib Y, Khormi R, Alamri JM, Halawi M, Thurwi SA, Alhasani RA. Mothers' Perceptions and Attitudes About Infantile Colic in Jazan, Saudi Arabia. Cureus 2023; 15:e48210. [PMID: 38050512 PMCID: PMC10693718 DOI: 10.7759/cureus.48210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/06/2023] Open
Abstract
Background Infantile colic is excessive crying in infants who are otherwise healthy and whose origin is unknown. It is closely linked to maternal depression and is a risk factor for shaken baby syndrome and early cessation of breastfeeding. This study aims to assess mothers' knowledge and attitude about infantile colic in the Jazan region, as well as their knowledge of the causes, and the factors that affect their understanding. Methodology This descriptive cross-sectional study was conducted in the Jazan region, focusing on mothers who met the inclusion criteria. The data were collected using a self-administered Arabic electronic survey following participants' consent. The collected data were analyzed using SPSS Version 27 (IBM Corp., Armonk, NY) using the chi-square tests. Results This study examined mothers' perspectives on various aspects of infantile colic. A total of 215 (75.43%) out of the 285 participating mothers had experienced colic attacks in their infants, revealing statistically significant differences in urban/rural residence, education, birth order, and breastfeeding practices. Approximately half of the mothers agreed that bottle feeding could lead to colic (49.8%), while around half attributed colic to depression or anxiety (50.9%). Most mothers did not relate breastfeeding (69.8%) or smoking (60%) with colic. Around 55.5% believed that milk protein allergy could be a contributing factor. The majority acknowledged the value of massage (63.5%), placing a warm washcloth (59%), and showering the baby (58.6%). Mothers sought advice from diverse sources (56.5%), often family members (36.5%), with minimal doctor consultation (3.9%). Information about colic management was mixed (48.8%); 27.7% got information solely from healthcare staff, 13.7% exclusively depended on the internet, and 9.8% got information from TV and social media. Conclusion This study highlights maternal perspectives and practices regarding infantile colic, showing varying beliefs and approaches that help healthcare providers arrange educational and psychological support to improve infants' and mothers' well-being.
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Affiliation(s)
- Mai Mustafa
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Talal M Kariri
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Rania Q Majrabi
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Anwar H Hufaysi
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Yumna Abutalib
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Raud Khormi
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Joud M Alamri
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Majidah Halawi
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Shaden A Thurwi
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Raffan A Alhasani
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
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16
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Zhang X, Yu J, Wei Z, Fewtrell M. Determinants of infant behavior and growth in breastfed late preterm and early term infants: a secondary data analysis. World J Pediatr 2023; 19:983-991. [PMID: 37036644 DOI: 10.1007/s12519-023-00696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/29/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Late preterm and early term infants are at increased risk of poor growth, behavioral problems, and developmental delays. This study aimed to investigate the impact of maternal and infant characteristics, feeding practices, and breastmilk composition on infant behavior following late preterm and early term delivery, and to evaluate the association between infant behavior and growth. METHODS Data from 52 Chinese mothers and their late preterm/early term infants participating in the Breastfeed a Better Youngster study were used. Maternal and infant characteristics were collected using questionnaires at 1 week postpartum. Breastmilk macronutrient content was measured using a human milk analyzer, and infant behavior was assessed using a 3-day infant behavior diary at 8 weeks postpartum. Feeding practices were collected at both time points using questionnaires. Multivariate models were used to assess associations between potential predictors and infant behavior and between infant behavior and growth. RESULTS Exclusive breastfeeding was associated with greater sleep duration (P = 0.02) and shorter crying duration (P = 0.01). Mothers with a vocational education reported greater distress duration (P = 0.006). Greater colic duration was associated with higher maternal annual income (P = 0.004). There was no significant association between infant behavior and growth (all P > 0.05). CONCLUSIONS Exclusive breastfeeding might promote more favorable infant behaviors in late preterm/early term infants, while the development of infant distress behaviors was associated with some maternal characteristics (maternal education and annual income). However, due to the limitations of diary methods, determinants of infant behavior should ideally be assessed using more objective measures in larger samples.
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Affiliation(s)
- Xinzhuo Zhang
- Division of Medicine, University College London, London, UK
| | - Jinyue Yu
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Zhuang Wei
- Department of Child Healthcare, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Mary Fewtrell
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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17
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Doneray H, Tavlas G, Ozden A, Ozturk N. The role of breast milk beta-endorphin and relaxin-2 on infant colic. Pediatr Res 2023; 94:1416-1421. [PMID: 37142649 DOI: 10.1038/s41390-023-02617-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/29/2022] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The relationship between infant colic and breast milk beta-endorphin (BE) and relaxin-2 (RLX-2) has not been studied before. METHODS Thirty colic infants and their mothers constituted the study group, and the same sex, similar age and healthy infants and their mothers formed the control group. Maternal predisposing factors were analysed with questionnaires. RESULTS The frequency of headache and myalgia in the mothers was significantly higher in the study group compared to the control group. Sleep quality of mothers in the study group was worse than in the control group (p = 0.028). While breast milk RLX-2 level in the study group was not different from the control group, breast milk BE level in the study group was significantly higher than the control group (p = 0.039). A positive correlation was found between breast milk BE levels and crying times, and between sleep quality scores and crying times. Headache, myalgia, sleep quality and breast milk BE levels were found to have a significant effect on infant colic. CONCLUSIONS Breast milk RLX-2 has no role on infant colic. Breast milk BE may act as a biological mediator in transmitting of maternal predisposing factors such as poor sleep quality, headache and myalgia from mother to infant. IMPACT The relationship between infant colic and breast milk beta-endorphin (BE) and elaxin-2 (RLX-2) has not been studied before. Maternal sleep quality, headache, and myalgia are predisposing factors associated with infant colic. Breast milk RLX-2 has no effect on infant colic. Breast milk BE may play a role as a biological mediator in transmitting the effects of predisposing factors from mother to infant. Breast milk BE may be a mediator in biological communication between mother and infant.
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Affiliation(s)
- Hakan Doneray
- Department of Pediatric Endocrinology, Ataturk University Faculty of Medicine, Erzurum, Türkiye.
- Clinical Research Development and Design Application and Research Center, Ataturk University, Erzurum, Türkiye.
| | - Guzide Tavlas
- Department of Pediatrics, Ataturk University Faculty of Medicine, Erzurum, Türkiye
| | - Ayse Ozden
- Department of Pediatric Endocrinology, Erzurum Regional Training & Research Hospital, Erzurum, Türkiye
| | - Nurinnisa Ozturk
- Department of Medical Biochemistry, Ataturk University Faculty of Medicine, Erzurum, Türkiye
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Martínez-Lentisco MDM, Martín-González M, García-Torrecillas JM, Antequera-Soler E, Chillón-Martínez R. Osteopathic Manual Therapy for Infant Colic: A Randomised Clinical Trial. Healthcare (Basel) 2023; 11:2600. [PMID: 37761797 PMCID: PMC10531355 DOI: 10.3390/healthcare11182600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Infant colic is a multifactorial syndrome for which various therapeutic strategies have been proposed. In this study, we evaluate the effectiveness of osteopathic manual therapy in treating symptoms related to infant colic. METHOD A prospective, randomised, blinded clinical trial was conducted of patients diagnosed with infant colic. The treatment group were given osteopathic manual therapy, and their parents received two sessions of counselling. The control group received no such therapy, but their parents attended the same counselling sessions. The non-parametric Mann-Whitney U test was applied to determine whether there were significant differences between the groups for the numerical variables considered. For the qualitative variables, Fisher's exact test was used. The threshold assumed for statistical significance was 0.05. RESULTS A total of 42 babies were assigned to each group. Those in the experimental group presented less severe infant colic with a trend towards statistical significance after the first session (p = 0.09). In sucking, excretion, eructation and gas there were no significant differences between the groups. Crying was a statistically significant dimension both after the first intervention (p = 0.03) and two weeks after (p = 0.04). Regurgitation values were significantly lower in the experimental group during the three weeks of follow-up (p = 0.05). Values for sleep were lower in the experimental group, but the differences were not statistically significant. In both groups, colic severity decreased over time, with no side effects. CONCLUSIONS Treatment with osteopathic manual therapy alleviates the symptoms of infant colic and could be recommended for this purpose from the onset of the condition.
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Affiliation(s)
- María del Mar Martínez-Lentisco
- Andalusian Health Service, Almería Health District, 04002 Almería, Spain
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.M.-G.); (E.A.-S.)
| | - Manuel Martín-González
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.M.-G.); (E.A.-S.)
- Torrecárdenas University Hospital, 04009 Almería, Spain
| | - Juan Manuel García-Torrecillas
- Emergency and Research Unit, Torrecárdenas University Hospital, 04009 Almería, Spain;
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria Ibs, 18012 Granada, Spain
| | - Eduardo Antequera-Soler
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.M.-G.); (E.A.-S.)
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Melsaether C, Høtoft D, Wellejus A, Hermes GDA, Damholt A. Seeding the Infant Gut in Early Life-Effects of Maternal and Infant Seeding with Probiotics on Strain Transfer, Microbiota, and Gastrointestinal Symptoms in Healthy Breastfed Infants. Nutrients 2023; 15:4000. [PMID: 37764787 PMCID: PMC10538230 DOI: 10.3390/nu15184000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
We investigated the effects of two dosing regimens of two multi-strain probiotic products on the gut microbiota of breastfed infants, including the transfer of the dosed strains and clinical outcomes. In forty-seven dyads, infants were either exposed through maternal intake (MS) of Lactobacillus acidophilus LA-5, Bifidobacterium animalis subsp. lactis BB-12, Lacticaseibacillus rhamnosus LGG, and Bifidobacterium longum subsp. infantis Bifin02 from gestational week thirty-three until four weeks after birth (n = 24) or dosed directly (IS) with the same strains except for LA-5 starting within 24 h after birth until day 28 (n = 23). Infant stool samples were collected on day 0, 14, 28, and 42 after birth. Gastrointestinal symptoms were assessed by parents using an electronic diary. Microbiota composition was determined using 16S rRNA sequencing, and strain recovery was analyzed by qPCR. Notably, 100% of the IS infants were colonized with Bifin02 after 14 days as opposed to only 25% of the MS infants. Mean stool frequency was significantly lower in IS infants compared to MS infants and IS infants had softer stools on day 14, 28, and 42. A significantly steeper slope of progression of inconsolable crying and fussing was observed in MS infants compared to IS infants. In conclusion, direct infant seeding induced a faster increase in fecal bifidobacteria abundancy and Bifin02 recovery compared to dosed through the maternal intake.
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Affiliation(s)
- Cathrine Melsaether
- Chr. Hansen A/S, Boege Alle 10-12, 2970 Hoersholm, Denmark; (A.W.); (G.D.A.H.); (A.D.)
| | - Diana Høtoft
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark;
| | - Anja Wellejus
- Chr. Hansen A/S, Boege Alle 10-12, 2970 Hoersholm, Denmark; (A.W.); (G.D.A.H.); (A.D.)
| | - Gerben D. A. Hermes
- Chr. Hansen A/S, Boege Alle 10-12, 2970 Hoersholm, Denmark; (A.W.); (G.D.A.H.); (A.D.)
| | - Anders Damholt
- Chr. Hansen A/S, Boege Alle 10-12, 2970 Hoersholm, Denmark; (A.W.); (G.D.A.H.); (A.D.)
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20
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Bellaiche M, Tounian P, Oozeer R, Rocher E, Vandenplas Y. Digestive Tolerance and Safety of an Anti-Regurgitation Formula Containing Locust Bean Gum, Prebiotics and Postbiotics: A Real-World Study. Pediatr Gastroenterol Hepatol Nutr 2023; 26:249-265. [PMID: 37736220 PMCID: PMC10509020 DOI: 10.5223/pghn.2023.26.5.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/20/2023] [Accepted: 07/20/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose Infant regurgitation is associated with other functional gastrointestinal disorders and signs and symptoms that have a major impact on the quality of life of infants and their families. This study evaluated the safety, tolerance, and real-world effectiveness of an anti-regurgitation formula containing locust bean gum (LBG), prebiotics, and postbiotics to alleviate digestive symptoms beyond regurgitation. Methods This 3-month study involved infants with regurgitation requiring the prescription of an anti-regurgitation formula according to usual clinical practice. Outcomes included evaluation of the evolution of stool consistency and frequency; occurrence of colic, constipation, and diarrhea; and assessment of regurgitation severity. Infant crying, parental assessment of infant well-being, and parental satisfaction with the stool consistency were also evaluated. Results In total, 190 infants (average age: 1.9±1.1 months) were included. After three months, stool frequency and consistency remained within the normal physiological range, with 82.7% of infants passing one or two stools per day and 90.4% passing loose or formed stools. There was no significant increase in the number of infants with diarrhea, whereas a decrease was observed in the number of infants with constipation after 1 month (p=0.001) and with colic after both 1 and 3 months (p<0.001). Regurgitation severity and crying decreased and parental satisfaction with stool consistency, formula acceptability, infant well-being, and sleep quality increased. Monitoring of adverse events did not reveal any safety concerns. Conclusion Formulas containing LBG, prebiotics, and postbiotics were well tolerated and provided an effective strategy for managing infant regurgitation and gastrointestinal discomfort.
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Affiliation(s)
- Marc Bellaiche
- Department of Gastroenterology and Pediatric Nutrition, Hospital Robert-Debré, AP-HP, Paris, France
| | - Patrick Tounian
- Department of Pediatric Nutrition and Gastroenterology, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | | | | | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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21
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Peng Y, Ma Y, Luo Z, Jiang Y, Xu Z, Yu R. Lactobacillus reuteri in digestive system diseases: focus on clinical trials and mechanisms. Front Cell Infect Microbiol 2023; 13:1254198. [PMID: 37662007 PMCID: PMC10471993 DOI: 10.3389/fcimb.2023.1254198] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives Digestive system diseases have evolved into a growing global burden without sufficient therapeutic measures. Lactobacillus reuteri (L. reuteri) is considered as a new potential economical therapy for its probiotic effects in the gastrointestinal system. We have provided an overview of the researches supporting various L. reuteri strains' application in treating common digestive system diseases, including infantile colic, diarrhea, constipation, functional abdominal pain, Helicobacter pylori infection, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases. Methods The summarized literature in this review was derived from databases including PubMed, Web of Science, and Google Scholar. Results The therapeutic effects of L. reuteri in digestive system diseases may depend on various direct and indirect mechanisms, including metabolite production as well as modulation of the intestinal microbiome, preservation of the gut barrier function, and regulation of the host immune system. These actions are largely strain-specific and depend on the activation or inhibition of various certain signal pathways. It is well evidenced that L. reuteri can be effective both as a prophylactic measure and as a preferred therapy for infantile colic, and it can also be recommended as an adjuvant strategy to diarrhea, constipation, Helicobacter pylori infection in therapeutic settings. While preclinical studies have shown the probiotic potential of L. reuteri in the management of functional abdominal pain, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases, its application in these disease settings still needs further study. Conclusion This review focuses on the probiotic effects of L. reuteri on gut homeostasis via certain signaling pathways, and emphasizes the importance of these probiotics as a prospective treatment against several digestive system diseases.
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Affiliation(s)
- Yijing Peng
- Department of Neonatology, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
- Wuxi Children’s Hospital, Children’s Hospital of Jiangnan University, Wuxi, China
| | - Yizhe Ma
- Department of Neonatology, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
- Department of Pediatric, Jiangyin People’s Hospital of Nantong University, Wuxi, China
| | - Zichen Luo
- Department of Neonatology, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Yifan Jiang
- School of Medicine, Nantong University, Nantong, China
| | - Zhimin Xu
- College of Resources and Environment, Innovative Institute for Plant Health, Zhongkai University of Agriculture and Engineering, Guangzhou, China
| | - Renqiang Yu
- Department of Neonatology, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
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22
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Kizhakkayil Tency N, Roy A, Krishnakumaran N, Thomas AM. Unraveling Abdominal Migraine in Adults: A Comprehensive Narrative Review. Cureus 2023; 15:e43760. [PMID: 37727183 PMCID: PMC10506737 DOI: 10.7759/cureus.43760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/21/2023] Open
Abstract
Abdominal migraine is a condition characterized by recurrent episodes of abdominal pain accompanied by migraine-associated symptoms, primarily affecting pediatric populations. Its occurrence in adults is often overlooked due to limited literature on adult abdominal migraine. This article provides an overview of the current understanding and management of abdominal migraine in adult populations, including the diagnostic criteria, pathophysiology, differentiating features of other associated gastrointestinal pain syndromes, and various treatment approaches based on available literature. The review acknowledges the limitations, including the scarcity of literature on adult abdominal migraine and the absence of a systematic approach. It emphasizes the need for further research to enhance our understanding of this condition and establish evidence-based treatment guidelines specifically for adults. Accurate diagnosis and patient education are crucial for physicians in recognizing abdominal migraine as a differential diagnosis in cases of long-standing recurrent abdominal pain, promoting the importance of further research to advance our knowledge and improve patient outcomes.
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Affiliation(s)
| | - Archa Roy
- Department of Internal Medicine, Government T D Medical College, Alappuzha, IND
| | | | - Anju Maria Thomas
- Department of Internal Medicine, Government T D Medical College, Alappuzha, IND
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Fishbein MH, Kronberg J, Alvarado S, Bohm D, Ideran P, Scarborough DR. A Multidisciplinary Approach to Infants With GERD-Like Symptoms: A New Paradigm. J Pediatr Gastroenterol Nutr 2023; 77:39-46. [PMID: 37084339 DOI: 10.1097/mpg.0000000000003802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
OBJECTIVES Infants with gastroesophageal reflux disease (GERD)-like symptoms have been classically defined as having a wide array of symptoms. In these instances, anti-reflux medications are ineffective and overprescribed. Rather these symptoms are more attributable to dysphagia and unsettledness/colic. To address these conditions at our center, both speech language pathologist (SLP) and/or occupational therapist (OT) have contributed to evaluation. We hypothesized that dysphagia and unsettledness/colic are highly prevalent, yet under recognized in this population. METHODS Full-term infants with typical development and under 6 months of age (N = 174) were included. Infants with suspected dysphagia and/or evident colic/unsettledness were evaluated by SLP and OT, respectively. RESULTS GERD-like symptoms were present in 109 infants with attributes of dysphagia in n = 46, unsettledness/colic in n = 37, and combined in n = 26. CONCLUSION A multidisciplinary approach, including SLP and OT, is recommended for the evaluation of infants with GERD-like symptoms.
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Affiliation(s)
- Mark H Fishbein
- From Feinberg School of Medicine at Northwestern University, Chicago, IL
| | | | | | - Diana Bohm
- Northwestern Medicine at Central DuPage Hospital, Winfield, IL
| | - Patricia Ideran
- Northwestern Medicine at Central DuPage Hospital, Winfield, IL
| | - Donna R Scarborough
- the Department of Speech Pathology and Audiology, Miami University, Oxford, OH
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24
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García-Santos JA, Nieto-Ruiz A, García-Ricobaraza M, Cerdó T, Campoy C. Impact of Probiotics on the Prevention and Treatment of Gastrointestinal Diseases in the Pediatric Population. Int J Mol Sci 2023; 24:9427. [PMID: 37298377 PMCID: PMC10253478 DOI: 10.3390/ijms24119427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Despite the high prevalence of gastrointestinal disorders (GIDs) in infants and children, especially those categorized as functional GIDs (FGIDs), insufficient knowledge about their pathophysiology has limited both symptomatic diagnosis and the development of optimal therapies. Recent advances in the field of probiotics have made their potential use as an interesting therapeutic and preventive strategy against these disorders possible, but further efforts are still needed. In fact, there is great controversy surrounding this topic, generated by the high variety of potential probiotics strains with plausible therapeutic utility, the lack of consensus in their use as well as the few comparative studies available on probiotics that record their efficacy. Taking into account these limitations, and in the absence of clear guidelines about the dose and timeframe for successful probiotic therapy, our review aimed to evaluate current studies on potential use of probiotics for the prevention and treatment of the most common FGIDs and GIDs in the pediatric population. Furthermore, matters referring to know major action pathways and key safety recommendations for probiotic administration proposed by major pediatric health agencies shall also be discussed.
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Affiliation(s)
- José Antonio García-Santos
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (J.A.G.-S.); (A.N.-R.); (M.G.-R.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Avda del Conocimiento 19, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs-GRANADA), Health Sciences Technological Park, Avda. de Madrid 15, 18012 Granada, Spain
| | - Ana Nieto-Ruiz
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (J.A.G.-S.); (A.N.-R.); (M.G.-R.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Avda del Conocimiento 19, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs-GRANADA), Health Sciences Technological Park, Avda. de Madrid 15, 18012 Granada, Spain
| | - María García-Ricobaraza
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (J.A.G.-S.); (A.N.-R.); (M.G.-R.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Avda del Conocimiento 19, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs-GRANADA), Health Sciences Technological Park, Avda. de Madrid 15, 18012 Granada, Spain
| | - Tomás Cerdó
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (J.A.G.-S.); (A.N.-R.); (M.G.-R.)
- Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), Av. Menéndez Pidal, s/n, 14004 Córdoba, Spain
- Centre for Rheumatology Research, Division of Medicine, University College London, Gower Street, London WC1E 6BT, UK
| | - Cristina Campoy
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (J.A.G.-S.); (A.N.-R.); (M.G.-R.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Avda del Conocimiento 19, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs-GRANADA), Health Sciences Technological Park, Avda. de Madrid 15, 18012 Granada, Spain
- Spanish Network of Biomedical Research in Epidemiology and Public Health (CIBERESP), Granada’s Node, Carlos III Health Institute, Avda. Monforte de Lemos 5, 28028 Madrid, Spain
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25
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Tanrıverdi DÇ, Karaahmet AY, Bilgiç FŞ. Colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic: systematic review and metaanalysis. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230071. [PMID: 37222334 DOI: 10.1590/1806-9282.20230071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/12/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a meta-analysis of the available evidence. METHODS The literature review for this systematic review was conducted between December 2022 and January 2023 using five electronic databases, namely PubMed, CINAHL, Scopus, Web of Science, and ULAKBİM. Published articles were scanned using MeSH-based keywords. Only randomized controlled trials conducted in the past 5 years were included. The data were analyzed using the Review Manager computer program. RESULTS This meta-analysis included three studies involving a total of 386 infantile colic infants. After nonpharmacological treatment, it was found that infants with infantile colic reduced crying time (standardized mean difference: 0.61; 95%CI 0.29-0.92; Z=3.79; p=0.00002), improved sleep duration (standardized mean difference: 0.22; 95%CI -0.04 to 0.48; Z=1.64; p=0.10), and decreased crying intensity (mean difference: -17.24; 95%CI -20.11 to 14.37; Z=11.77; p<0.000001). CONCLUSION According to the meta-analysis findings, it was determined that the risk of bias was low in the studies included and that nonpharmacological chiropractic, craniosacral, and acupuncture treatments applied to infantile colic infants in the three included studies reduced crying time and intensity and increased sleep duration.
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Affiliation(s)
- Doğan Çağrı Tanrıverdi
- Mehmet Akif Ersoy Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Pediatric Cardiology - İstanbul, Turkey
| | - Aysu Yıldız Karaahmet
- Haliç Üniversitesi, Faculty of Health Sciences, Department of Midwifery - İstanbul, Turkey
| | - Fatma Şule Bilgiç
- Haliç Üniversitesi, Faculty of Health Sciences, Department of Midwifery - İstanbul, Turkey
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26
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Chandran D, Warren K, McKeone D, Hicks SD. The Association between Infant Colic and the Multi-Omic Composition of Human Milk. Biomolecules 2023; 13:biom13030559. [PMID: 36979494 PMCID: PMC10046316 DOI: 10.3390/biom13030559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Infant colic is a common condition with unclear biologic underpinnings and limited treatment options. We hypothesized that complex molecular networks within human milk (i.e., microbes, micro-ribonucleic acids (miRNAs), cytokines) would contribute to colic risk, while controlling for medical, social, and nutritional variables. This hypothesis was tested in a cohort of 182 breastfed infants, assessed with a modified Infant Colic Scale at 1 month. RNA sequencing was used to interrogate microbial and miRNA features. Luminex assays were used to measure growth factors and cytokines. Milk from mothers of infants with colic (n = 28) displayed higher levels of Staphylococcus (adj. p = 0.038, d = 0.30), miR-224-3p (adj. p = 0.023, d = 0.33), miR-125b-5p (adj. p = 0.028, d = 0.29), let-7a-5p (adj. p = 0.028, d = 0.27), and miR-205-5p (adj. p = 0.029, d = 0.26) compared to milk from non-colic mother-infant dyads (n = 154). Colic symptom severity was directly associated with milk hepatocyte growth factor levels (R = 0.21, p = 0.025). A regression model involving let-7a-5p, miR-29a-3p, and Lactobacillus accurately modeled colic risk (X2 = 16.7, p = 0.001). Molecular factors within human milk may impact colic risk, and provide support for a dysbiotic/inflammatory model of colic pathophysiology.
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Affiliation(s)
- Desirae Chandran
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Kaitlyn Warren
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Daniel McKeone
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Steven D Hicks
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA
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27
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Harskamp-Van Ginkel MW, Klazema W, Hoogsteder MHH, Chinapaw MJM, van Houtum L. The need of having a plan in excessive infant crying - A qualitative study of parents' experiences of healthcare support. Acta Paediatr 2023; 112:434-441. [PMID: 36477912 PMCID: PMC10107859 DOI: 10.1111/apa.16618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
AIM Excessive infant crying increases parents' concerns regarding their infant's health and the burden of parenting. We aimed to gain insight into the healthcare support needs of parents with excessively crying infants. METHODS An exploratory qualitative study was conducted in the Netherlands. We performed semi-structured interviews with parents of 12 infants between June and December 2020, followed by inductive and deductive thematic analysis. RESULTS Parents described what their needs were with regard to the assessment of infant crying and support by professionals. Long-lasting crying made parents feel that there must be a somatic cause. If they could soothe their infant, they gained more confidence that their infant was healthy. We identified four interrelated themes: (i) confidence in the professional; (ii) seeking a somatic cause for the crying; (iii) seeking acknowledgment; and (iv) exhaustion of parents and feelings of failure. CONCLUSION Parental support needs were best fulfilled by professionals who took them seriously, demonstrated medical expertise, and offered a practical plan. Perinatal parental education on normal infant behaviour and infant soothing techniques might improve parental self-efficacy at an early stage and prevent medicalization of excessive crying.
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Affiliation(s)
- Margreet W Harskamp-Van Ginkel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Willemien Klazema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mariëtte H H Hoogsteder
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, The Netherlands
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28
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Lemoine A, Tounian P, Adel-Patient K, Thomas M. Pre-, pro-, syn-, and Postbiotics in Infant Formulas: What Are the Immune Benefits for Infants? Nutrients 2023; 15:1231. [PMID: 36904230 PMCID: PMC10004767 DOI: 10.3390/nu15051231] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
The first objective of infant formulas is to ensure the healthy growth of neonates and infants, as the sole complete food source during the first months of life when a child cannot be breastfed. Beyond this nutritional aspect, infant nutrition companies also try to mimic breast milk in its unique immuno-modulating properties. Numerous studies have demonstrated that the intestinal microbiota under the influence of diet shapes the maturation of the immune system and influences the risk of atopic diseases in infants. A new challenge for dairy industries is, therefore, to develop infant formulas inducing the maturation of immunity and the microbiota that can be observed in breastfed delivered vaginally, representing reference infants. Streptococcus thermophilus, Lactobacillus reuteri DSM 17938, Bifidobacterium breve (BC50), Bifidobacterium lactis Bb12, Lactobacillus fermentum (CECT5716), and Lactobacillus rhamnosus GG (LGG) are some of the probiotics added to infant formula, according to a literature review of the past 10 years. The most frequently used prebiotics in published clinical trials are fructo-oligosaccharides (FOSs), galacto-oligosaccharides (GOSs), and human milk oligosaccharides (HMOs). This review sums up the expected benefits and effects for infants of pre-, pro-, syn-, and postbiotics added to infant formula regarding the microbiota, immunity, and allergies.
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Affiliation(s)
- Anaïs Lemoine
- Pediatric Nutrition and Gastroenterology, Trousseau Hospital, Assistance Publique—Hôpitaux de Paris, Sorbonne Université, F-75012 Paris, France
- UMR1319, Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, F-78350 Jouy-en-Josas, France
- Paris Center for Microbiome Medicine (PaCeMM) FHU, AP-HP, F-75571 Paris, France
| | - Patrick Tounian
- Pediatric Nutrition and Gastroenterology, Trousseau Hospital, Assistance Publique—Hôpitaux de Paris, Sorbonne Université, F-75012 Paris, France
| | - Karine Adel-Patient
- Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d’Immuno-Allergie Alimentaire, Université Paris-Saclay, CEA, INRAe, F-91190 Gif-sur-Yvette, France
| | - Muriel Thomas
- UMR1319, Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, F-78350 Jouy-en-Josas, France
- Paris Center for Microbiome Medicine (PaCeMM) FHU, AP-HP, F-75571 Paris, France
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29
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Pérez-Escamilla R, Tomori C, Hernández-Cordero S, Baker P, Barros AJD, Bégin F, Chapman DJ, Grummer-Strawn LM, McCoy D, Menon P, Ribeiro Neves PA, Piwoz E, Rollins N, Victora CG, Richter L. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet 2023; 401:472-485. [PMID: 36764313 DOI: 10.1016/s0140-6736(22)01932-8] [Citation(s) in RCA: 138] [Impact Index Per Article: 138.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 02/10/2023]
Abstract
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Cecília Tomori
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Sonia Hernández-Cordero
- Research Center for Equitable Development (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Purnima Menon
- International Food Policy Research Institute, New Delhi, India
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, WHO, Geneva, Switzerland
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Linda Richter
- Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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30
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Sammallahti S, Serdarevic F, Tiemeier H. Excessive Crying, Behavior Problems, and Amygdala Volume: A Study From Infancy to Adolescence. J Am Acad Child Adolesc Psychiatry 2023; 62:675-683. [PMID: 36758936 DOI: 10.1016/j.jaac.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/30/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to understand the mechanisms underlying excessive crying and irritability in infancy, research into the neurobiology of excessive crying is needed. We examined whether excessive crying and irritability in infancy are associated with behavioral problems and amygdala volume among children and adolescents. METHOD This study included 4,751 singleton children from the prospective population-based Generation R Study cohort, born in the Netherlands in 2002 to 2006. Excessive crying (>3 hours on at least 1 day/wk) and irritability (Mother and Baby Scales questionnaire) were parent-rated at 3 months. Amygdala volume was measured at 10 years using magnetic resonance imaging, and internalizing and externalizing were parent-rated at 1.5, 3, 6, 10, and 14 years and self-rated at 14 years. Covariates included child age, sex, national origin, gestational age, and maternal age, psychopathology score, parity, education, relationship status, and family income. RESULTS Children who cried excessively in infancy had higher parent-rated internalizing (effect estimate = 0.20 SD-units, 95% CI = 0.14, 0.27) and externalizing (0.17 SD-units, 95% CI = 0.10, 0.24) throughout childhood (linear mixed models), and smaller amygdala volume at 10 years (-0.19 SD-units, 95% CI = -0.32, -0.06) (linear regression model). The pattern of associations for both behavioral problems and amygdala volume was similar for irritability. CONCLUSION Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and may be linked with neurobiological differences in the development of the amygdala.
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Affiliation(s)
- Sara Sammallahti
- Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands; University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | - Henning Tiemeier
- Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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31
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Cooper RE. Editorial: Early Crying in Infancy: An Indicator of Emotional, Behavioral, and Neurobiological Outcomes in Childhood. J Am Acad Child Adolesc Psychiatry 2023; 62:627-628. [PMID: 36758937 DOI: 10.1016/j.jaac.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
Psychiatric disorders contribute to substantial morbidity and mortality among young people. While the majority of clinical diagnoses are still being made in adolescence and young adulthood,1 underlying susceptibility or vulnerability factors are increasingly being recognized in early life-some as early as infancy. Identifying such factors in children in early stages of development offers an opportunity to intervene and potentially prevent later development of psychiatric disorders. Further, leveraging neuroimaging data associated with early developmental trajectories will improve our understanding of the complex interplay between neurobiological variation and psychiatric morbidity.
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Affiliation(s)
- Rebecca E Cooper
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia.
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32
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Infantile Colic and Long-Term Outcomes in Childhood: A Narrative Synthesis of the Evidence. Nutrients 2023; 15:nu15030615. [PMID: 36771322 PMCID: PMC9921915 DOI: 10.3390/nu15030615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
About 1 in 4 infants comes forward with prolonged crying, agitation, or infant colic (IC) during the first three months of life and is referred for medical evaluation. The pathogenesis remains poorly understood, as do its implications for future health. The aim of this narrative review was to critically examine and discuss the available literature on long-term consequences of excessive crying and/or colic. Most studies display an association between IC and the onset of functional gastrointestinal disorders (FGIDs) years later, probably related to the presence of common etiopathogenetic factors (environmental, dietary, intestinal dysmotility, visceral hypersensitivity). Although allergic disease in first-degree relatives may be a risk factor for IC, the latter does not appear to be a risk factor for subsequent atopic disease in the individual. Overall, there seems to be a relationship between IC and subsequent headaches, of the migraine type. Similarly, behavioral problems in children with a history of IC appear to be associated with higher parental stress scores. However, the current evidence is based on associations, and currently, a causal relationship between excessive crying and IC and long-term consequences remains not documented.
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33
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6 Wochen alter Säugling, schreit seit Stunden fast durchgehend. Monatsschr Kinderheilkd 2023. [DOI: 10.1007/s00112-022-01679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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34
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Dargenio VN, Castellaneta S, Panico S, Papagni ME, Dargenio C, Schettini F, Francavilla R, Cristofori F. Probiotics and gastrointestinal diseases. Minerva Pediatr (Torino) 2022; 74:703-723. [PMID: 36315413 DOI: 10.23736/s2724-5276.22.07031-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
During the past decades, scientists have discovered the intimate role of the gut microbiome in human health, and since then, several papers have been published to investigate if the use of biotics (probiotics, prebiotics, synbiotics, and postbiotics) may have a beneficial impact on human health both in treatment and prevention. We now ask ourselves whether we have reached the finish line or just a new starting point, as the evidence supporting the use of biotics in several conditions still needs a lot of work. Many questions remain unanswered today because the evidence differs depending on the indication, used strain, and amount and duration of administration. Herein we will summarize the evidence on probiotics in some gastrointestinal diseases such as infantile colic, functional abdominal pain disorders, celiac disease, acute gastroenteritis, inflammatory bowel disease, and Helicobacter pylori infection.
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Affiliation(s)
- Vanessa N Dargenio
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy
| | - Stefania Castellaneta
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy
| | - Serena Panico
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy
| | - Maria E Papagni
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy
| | - Costantino Dargenio
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy
| | - Federico Schettini
- Neonatology and Neonatal Intensive Care Unit, University of Bari Aldo Moro, Bari, Italy
| | - Ruggiero Francavilla
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy -
| | - Fernanda Cristofori
- Section of Pediatrics, Interdisciplinary Department of Medicine, Giovanni XXIII Children's Hospital, University of Bari Aldo Moro, Bari, Italy
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35
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Pang Y, Ermann Lundberg L, Mata Forsberg M, Ahl D, Bysell H, Pallin A, Sverremark-Ekström E, Karlsson R, Jonsson H, Roos S. Extracellular membrane vesicles from Limosilactobacillus reuteri strengthen the intestinal epithelial integrity, modulate cytokine responses and antagonize activation of TRPV1. Front Microbiol 2022; 13:1032202. [PMID: 36466671 PMCID: PMC9712456 DOI: 10.3389/fmicb.2022.1032202] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/24/2022] [Indexed: 09/05/2023] Open
Abstract
Bacterial extracellular membrane vesicles (MV) are potent mediators of microbe-host signals, and they are not only important in host-pathogen interactions but also for the interactions between mutualistic bacteria and their hosts. Studies of MV derived from probiotics could enhance the understanding of these universal signal entities, and here we have studied MV derived from Limosilactobacillus reuteri DSM 17938 and BG-R46. The production of MV increased with cultivation time and after oxygen stress. Mass spectrometry-based proteomics analyses revealed that the MV carried a large number of bacterial cell surface proteins, several predicted to be involved in host-bacteria interactions. A 5'-nucleotidase, which catalyze the conversion of AMP into the signal molecule adenosine, was one of these and analysis of enzymatic activity showed that L. reuteri BG-R46 derived MV exhibited the highest activity. We also detected the TLR2 activator lipoteichoic acid on the MV. In models for host interactions, we first observed that L. reuteri MV were internalized by Caco-2/HT29-MTX epithelial cells, and in a dose-dependent manner decreased the leakage caused by enterotoxigenic Escherichia coli by up to 65%. Furthermore, the MV upregulated IL-1β and IL-6 from peripheral blood mononuclear cells (PBMC), but also dampened IFN-γ and TNF-α responses in PBMC challenged with Staphylococcus aureus. Finally, we showed that MV from the L. reuteri strains have an antagonistic effect on the pain receptor transient receptor potential vanilloid 1 in a model with primary dorsal root ganglion cells from rats. In summary, we have shown that these mobile nanometer scale MV reproduce several biological effects of L. reuteri cells and that the production parameters and selection of strain have an impact on the activity of the MV. This could potentially provide key information for development of innovative and more efficient probiotic products.
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Affiliation(s)
- Yanhong Pang
- Department of Molecular Sciences, Uppsala BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ludwig Ermann Lundberg
- Department of Molecular Sciences, Uppsala BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
- BioGaia AB, Stockholm, Sweden
| | - Manuel Mata Forsberg
- The Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - David Ahl
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | | | - Anton Pallin
- Department of Molecular Sciences, Uppsala BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Eva Sverremark-Ekström
- The Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Roger Karlsson
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Nanoxis Consulting AB, Gothenburg, Sweden
| | - Hans Jonsson
- Department of Molecular Sciences, Uppsala BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Stefan Roos
- Department of Molecular Sciences, Uppsala BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
- BioGaia AB, Stockholm, Sweden
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Buffone F, Monacis D, Tarantino AG, Dal Farra F, Bergna A, Agosti M, Vismara L. Osteopathic Treatment for Gastrointestinal Disorders in Term and Preterm Infants: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:1525. [PMID: 36011182 PMCID: PMC9408562 DOI: 10.3390/healthcare10081525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
The aim of this systematic review and meta-analysis is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants. Eligible studies were searched on PubMed, Scopus, Embase, Cochrane, Cinahl, and PEDro. Two reviewers independently assessed if the studies were randomized controlled trials (RCTs) and retrospective studies with OMT compared with any kind of control in term or preterm infants to improve gastrointestinal disorders. Nine articles met the eligibility criteria, investigating OMT compared with no intervention, five involving term infants, and the remaining treating preterm infants. Five studies showed low risk of bias. In the meta-analysis, two studies were included to analyze the hours of crying due to infantile colic, showing statistically significant results (ES = −2.46 [−3.05, −1.87]; p < 0.00001). The quality of evidence was “moderate”. The other outcomes, such as time to oral feeding, meconium excretion, weight gain, and sucking, were presented in a qualitative synthesis. OMT was substantially safe, and showed efficacy in some cases, but the conflicting evidence and lack of high-quality replication studies prevent generalization. High-quality RCTs are recommended to produce better-quality evidence.
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Affiliation(s)
- Francesca Buffone
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- PPCR, Harvard T.H. Chan School of Public Health—ECPE, Boston, MA 02115, USA
| | - Domenico Monacis
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, 71122 Foggia, Italy
| | - Andrea Gianmaria Tarantino
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Fulvio Dal Farra
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Bergna
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Massimo Agosti
- Woman and Child Department, Varese Hospital, Insubria University, 21100 Varese, Italy
| | - Luca Vismara
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy
- Department of Neurosciences, University of Torino, 10126 Torino, Italy
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Prevalence of Functional Gastrointestinal Disorders in Brazilian Infants Seen in Private Pediatric Practices and Their Associated Factors. J Pediatr Gastroenterol Nutr 2022; 75:17-23. [PMID: 35622063 DOI: 10.1097/mpg.0000000000003469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES To assess the prevalence of the most frequent functional gastrointestinal disorders (FGIDs) in Brazilian infants seen in private pediatric clinics and their relationship with cesarean delivery, breastfeeding, and history of prematurity. METHODS This cross-sectional study enrolled 5080 infants under 12 months old with routine visits in private pediatric clinics in Brazil. The mothers answered questions about the type of delivery, type of feeding (breast milk, infant formula, cow milk, mixed feeding), history of prematurity, and gastrointestinal symptoms. Rome IV criteria were used to diagnose FGIDs. RESULTS The prevalence of infant regurgitation was 10.7% (487/4560); infant colic, 6.1% (131/2162); infant dyschezia, 4.0% (157/3895); functional constipation, 7.6% (341/4506); and functional diarrhea, 0.09% (2/2186). Prematurity was associated ( P < 0.05) with infant regurgitation (odds ratio [OR] = 1.41; 95% confidence interval [CI]: 1.05, 1.90), infant colic (OR = 1.97; 95% CI: 1.19, 3.24), infant dyschezia (OR = 1.64, 95% CI: 1.02, 2.64), and functional constipation (OR = 1.44; 95% CI: 1.02, 2.02). Prematurity was associated ( P < 0.001) with two or more FGIDs between 21 days and 150 days of age (OR = 3.06; 95% CI: 1.74, 5.37). CONCLUSION FGIDs are common in infants seen in the private pediatric practice in Brazil. History of prematurity was associated with infant regurgitation, infant colic, functional dyschezia, and functional constipation.
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38
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Pediatric Aspects of Nutrition Interventions for Disorders of Gut-Brain Interaction. Am J Gastroenterol 2022; 117:995-1009. [PMID: 35416794 PMCID: PMC9169765 DOI: 10.14309/ajg.0000000000001779] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/09/2022] [Indexed: 12/11/2022]
Abstract
Dietary factors may play an important role in the generation of symptoms in children with disorders of gut-brain interaction (DGBIs). Although dietary modification may provide successful treatment, there is a relative paucity of controlled trials that have shown the effectiveness of dietary interventions. This study is a narrative review that explores the existing literature on food and pediatric DGBIs. The following have been shown to be beneficial: (i) in infants with colic, removing cow's milk from the infant's diet or from the maternal diet in those who are breastfed; (ii) in infants with regurgitation, adding thickeners to the formula or removing cow's milk protein from the infant's diet or the maternal diet in those who are breastfed; and (iii) in children with pain-predominant DGBIs, using soluble fiber supplementation or a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet. In children with functional constipation, there is no evidence that adding fiber is beneficial. Given that most dietary interventions include restriction of different foods in children, a thoughtful approach and close follow-up are needed.
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Nilsson T, Leijon A, Sillén U, Hellström AL, Skogman BH. Bowel and bladder function in infant toilet training (BABITT) - protocol for a randomized, two-armed intervention study. BMC Pediatr 2022; 22:294. [PMID: 35590259 PMCID: PMC9118841 DOI: 10.1186/s12887-022-03355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the last decades, the average age for toilet training has increased in the western world. It is suggested that the postponed initiation of toilet training is a contributing factor to problems related to bowel and bladder control. Functional gastrointestinal and urinary tract disorders are prevalent in childhood, causing suffering in affected children and for their families, and consuming healthcare resources. To evaluate whether assisted infant toilet training can prevent functional gastrointestinal and urinary tract disorders in young children, we are conducting a randomized intervention study with a 4-year follow-up. METHODS This randomized two-armed intervention study will include 268 Swedish infants recruited at six child healthcare centers in Region Dalarna located in the central part of Sweden. The intervention entails parents being instructed and practicing assisted infant toilet training with their child. Children are randomized to start assisted infant toilet training at 0-2 months or at 9-11 months of age. The primary objective is to determine the efficacy of assisted infant toilet training initiated at 0-2 months on the prevalence of functional gastrointestinal disorders (defined as infant colic, infant dyschezia and/or functional constipation) up to the age of 9 months. Secondary objectives are to evaluate whether assisted toilet training initiated during the first year of life reduce the prevalence of functional gastrointestinal disorders (defined as functional constipation, gastrointestinal symptoms and/or stool toileting refusal) and urinary tract disorders (defined as bladder dysfunction and/or urinary tract infections) up to the age of 4 years. Furthermore, infant-to-mother attachment, parental stress, the toilet training process and overall parental experiences will be evaluated/explored. DISCUSSION This protocol article presents the rationale and design of a randomized two-armed intervention study that will determine the efficacy of assisted infant toilet training on functional gastrointestinal disorders up to the age of 9 months. Furthermore, the study will evaluate whether assisted infant toilet training during the first year of life can prevent functional gastrointestinal and urinary tract disorders in children up to 4 years of age. If effective, assisted infant toilet training could be recommended in child healthcare settings and new evidence-based guidelines on infant toilet training could be implemented. TRIAL REGISTRATION The study protocol was retrospectively registered at ClinicalTrials. gov ( NCT04082689 ), initial release June 12th, 2019).
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Affiliation(s)
- Terese Nilsson
- Department of Family medicine and Center for Clinical Research Dalarna - Uppsala University, Region Dalarna County, Falun, Sweden.,Department of Medicine and Health Sciences, Örebro University, Örebro, Sweden
| | - Anna Leijon
- Department of Family medicine and Center for Clinical Research Dalarna - Uppsala University, Region Dalarna County, Falun, Sweden.,Department of Medicine and Health Sciences, Örebro University, Örebro, Sweden
| | - Ulla Sillén
- Department of Pediatric Surgery, Pediatric Uronephrologic Centre, Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Anna-Lena Hellström
- Institute of Health and Care Sciences, University of Gothenburg, Göteborg, Sweden
| | - Barbro Hedin Skogman
- Department of Medicine and Health Sciences, Örebro University, Örebro, Sweden. .,Department of Pediatrics and Center for Clinical Research Dalarna - Uppsala University, Region Dalarna County, Falun, Sweden.
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40
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Van Daele E, Kamphorst K, Vlieger AM, Hermes G, Milani C, Ventura M, Belzer C, Smidt H, van Elburg RM, Knol J. Effect of antibiotics in the first week of life on faecal microbiota development. Arch Dis Child Fetal Neonatal Ed 2022; 107:fetalneonatal-2021-322861. [PMID: 35534183 PMCID: PMC9606546 DOI: 10.1136/archdischild-2021-322861] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/17/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Infants are frequently exposed to antibiotics (AB) in the first week of life for suspected bacterial infections. Little is known about the effect of AB on the developing intestinal microbiota. Therefore, we studied intestinal microbiota development with and without AB exposure in the first week of life in term born infants. METHODS We analysed the faecal microbiota from birth until 2.5 years of age by 16S rRNA gene amplicon sequencing in a cohort with 56 term born infants, exposed to AB in the first week of life (AB+) (AB for 2-3 days (AB2, n=20), AB for 7 days (AB7, n=36)), compared with 126 healthy controls (AB-). The effects of AB and duration were examined in relation to delivery and feeding mode. RESULTS AB+ was associated with significantly increased relative abundance of Enterobacteriaceae at 3 weeks and 1 year and a decrease of Bifidobacteriaceae, from 1 week until 3 months of age only in vaginally delivered, but not in C-section born infants. Similar deviations were noted in AB7, but not in AB2. After AB, breastfed infants had lower relative abundance of potentially pathogenic Enterobacteriaceae compared with formula fed infants and recovered 2 weeks faster towards controls. CONCLUSIONS AB exposure in the first week of life alters faecal microbiota development with deviations in the relative abundance of individual taxa until 1 year of age. These alterations can have long-term health consequences, which emphasises the need for future studies aiming at restoring intestinal microbiota after AB administration.
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Affiliation(s)
- Emmy Van Daele
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Kim Kamphorst
- Pediatrics, Amsterdam Gastroenterology, Metabolism & Nutrition, Amsterdam Reproduction & Development, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
- Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Arine M Vlieger
- Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Gerben Hermes
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Christian Milani
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma Department of Chemical Life Sciences and Environmental Sustainability, Parma, Emilia-Romagna, Italy
- Interdepartmental Research Centre "Microbiome Research Hub", University of Parma, Parma, Emilia-Romagna, Italy
| | - Marco Ventura
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma Department of Chemical Life Sciences and Environmental Sustainability, Parma, Emilia-Romagna, Italy
- Interdepartmental Research Centre "Microbiome Research Hub", University of Parma, Parma, Emilia-Romagna, Italy
| | - Clara Belzer
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Hauke Smidt
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Ruurd M van Elburg
- Pediatrics, Amsterdam Gastroenterology, Metabolism & Nutrition, Amsterdam Reproduction & Development Amsterdam, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands
| | - Jan Knol
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
- Nutricia Research BV, Utrecht, The Netherlands
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Vilar‐Compte M, Pérez‐Escamilla R, Orta‐Aleman D, Cruz‐Villalba V, Segura‐Pérez S, Nyhan K, Richter LM. Impact of baby behaviour on caregiver's infant feeding decisions during the first 6 months of life: A systematic review. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 3:e13345. [PMID: 35363420 PMCID: PMC9113474 DOI: 10.1111/mcn.13345] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 01/04/2023]
Abstract
Caregivers are often concerned about baby behaviours. Without adequate counselling, parental response can lead to altering infant feeding and jeopardizing breastfeeding. We conducted a systematic review to assess the evidence about the influence of baby behaviours perceived as problematic (crying, sleep waking and posseting) on infant feeding decisions during the first 6 months of life (self‐reported milk insufficiency, breastfeeding duration and introduction of formula). The review focused on quantitative studies published in English, Portuguese or Spanish without date restriction. The search was designed with the support of a medical librarian and conducted in seven databases. Data were managed in Covidence and risk of bias was assessed through the Johanna Briggs Institute critical appraisal checklists. Synthesis of the literature was guided by a conceptual model of the impact of baby behaviours on caregivers feeding practices. We retrieved and reviewed 4312 titles/abstracts and selected 22 for review; 10 were purely descriptive and 12 were cross‐sectional, prospective and quasi‐experimental studies. Although studies from diverse regions were included in the review, more than half were from high‐income countries. All studies reported that baby behaviours affect feeding decisions, the most common baby behaviours studied were crying and fussiness, and the studies suggested relationships with lactation problems and reports of milk insufficiency, maternal breastfeeding confidence, breastfeeding duration and discontinuation, and introduction of formula. There are many factors that lead to perceiving baby behaviours as problematic and there is a need to provide anticipatory guidance to parents and caregivers, starting in pregnancy and counselling through well‐trained health providers. Although normal infant behaviour is highly variable, caregivers often perceive infant fussing/crying, posseting and sleep to be problematic. How caregivers interpret such ‘problems’ is critical in shaping how they deal with them and the impacts they have on infant feeding practices. Developing baby behaviour is not routinely included in training of health care staff, who often misinterpret baby behaviours and advise changes in feeding strategies. There is a need for large‐scale studies addressing such issues, as well as clearer guidelines for health professionals and caregivers about common baby behaviours and how to cope with them.
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Affiliation(s)
- Mireya Vilar‐Compte
- Department of Public Health Montclair State University Montclair New Jersey USA
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
| | - Dania Orta‐Aleman
- Human Nutrition Program, Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Valeria Cruz‐Villalba
- Research Institute for Equitable Development Universidad Iberoamericana Mexico City Mexico
| | - Sofía Segura‐Pérez
- Community Nutrition Unit Hispanic Health Council Hartford Connecticut USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library Yale University New Haven Connecticut USA
| | - Linda M. Richter
- DSI‐NRF Centre of Excellence in Human Development, School of Public Health University of the Witwatersrand Johannesburg South Africa
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Hofman D, Kudla U, Miqdady M, Nguyen TVH, Morán-Ramos S, Vandenplas Y. Faecal Microbiota in Infants and Young Children with Functional Gastrointestinal Disorders: A Systematic Review. Nutrients 2022; 14:974. [PMID: 35267949 PMCID: PMC8912645 DOI: 10.3390/nu14050974] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 01/27/2023] Open
Abstract
Functional gastrointestinal disorders (FGIDs) refer to gastrointestinal tract issues that lack clear structural or biochemical causes. Their pathophysiology is still unclear, but gut microbiota alterations are thought to play an important role. This systematic review aimed to provide a comprehensive overview of the faecal microbiota of infants and young children with FGIDs compared to healthy controls. A systematic search and screening of the literature resulted in the inclusion of thirteen full texts. Most papers reported on infantile colic, only one studied functional constipation. Despite methodological limitations, data show alterations in microbial diversity, stability, and colonisation patterns in colicky infants compared to healthy controls. Several studies (eight) reported increases in species of (pathogenic) Proteobacteria, and some studies (six) reported a decrease in (beneficial) bacteria such as Lactobacilli and Bifidobacteria. In addition, accumulation of related metabolites, as well as low-grade inflammation, might play a role in the pathophysiology of infantile colic. Infants and toddlers with functional constipation had significantly lower levels of Lactobacilli in their stools compared to controls. Microbial dysbiosis and related changes in metabolites may be inherent to FGIDs. There is a need for more standardised methods within research of faecal microbiota in FGIDs to obtain a more comprehensive picture and understanding of infant and childhood FGIDs.
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Affiliation(s)
- Denise Hofman
- FrieslandCampina, Stationsplein 1, 3818 LE Amersfoort, The Netherlands;
| | - Urszula Kudla
- FrieslandCampina, Stationsplein 1, 3818 LE Amersfoort, The Netherlands;
| | - Mohamad Miqdady
- Ped. GI, Hepatology & Nutrition Division, Sheikh Khalifa Medical City, P.O. Box 51900, Abu Dhabi 51133, United Arab Emirates;
| | - Thi Viet Ha Nguyen
- Department of Pediatrics, Hanoi Medical University, Hanoi 116001, Vietnam;
| | - Sofía Morán-Ramos
- Unidad de Genomica de Poblaciones, Instituto Nacional de Medicina Genomica, Mexico City 14610, Mexico;
| | - Yvan Vandenplas
- Paediatric Gastro-Enterology and Nutrition, Vrije Universiteit Brussel, UZ Brussel, KidZ Health Castle, 1050 Brussels, Belgium;
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Chen K, Zhang G, Xie H, You L, Li H, Zhang Y, Du C, Xu S, Melsaether C, Yuan S. Efficacy of Bifidobacterium animalis subsp. lactis, BB-12 ® on infant colic - a randomised, double-blinded, placebo-controlled study. Benef Microbes 2021; 12:531-540. [PMID: 34550055 DOI: 10.3920/bm2020.0233] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
To evaluate the administration of Bifidobacterium animalis subsp. lactis, BB-12® (BB-12) on infant colic in breastfed infants, a double-blind, placebo-controlled randomised study was conducted in Chengdu, China from April 2016 to October 2017 with 192 full-term infants less than 3 months of age and meeting the ROME III criteria for infant colic. After a 1-week run-in the infants were randomly assigned to receive daily BB-12 (1×109 cfu/day) or placebo for 3 weeks. Crying/fussing time were recorded using a 24 h structured diary. The primary endpoint was the proportion of infants achieving a reduction in crying and fussing time of ≥50% from baseline. Parent's/caregiver's health related quality of life was measured using a modified PedsQL™ 2.0 Family Impact Module and immunological biomarkers were evaluated from faecal samples at baseline and after the 21-day intervention. The percentage of infants achieving a reduction in the daily crying/fussing time ≥50% after the 21-day intervention was significantly higher in the infants supplemented with BB-12 (P<0.001). The mean number of crying episodes was significantly reduced in the BB-12 group compared to the placebo group (10.0±3.0 to 5.0±1.87 vs 10.5±2.6 to 7.5±2.8, respectively) (P<0.001) and the mean daily sleep duration was markedly increased from baseline to end of intervention in the BB-12 group compared to the infants in the placebo group (60.7±104.0 vs 31.9±102.7 min/day, respectively) (P<0.001). The faecal levels of human beta defensin 2, cathelicidin, slgA, calprotectin and butyrate were statistically higher in the BB-12 group compared to the placebo group after the 21-day intervention. At the end of the intervention the parent's/caregiver's physical, emotional and social functioning scores were significantly higher for the BB-12 group compared to the placebo group (all P<0.05). Supplementation of BB-12 is effective in reducing crying and fussing in infants diagnosed with infant colic.
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Affiliation(s)
- K Chen
- Department of Nutrition, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, Chengdu, 6100131, China P.R.,Department of Child Health Care, Chengdu New Century Women's and Children's Hospital, No.77, Baojia Lane, Qingyang District, Chengdu, China P.R
| | - G Zhang
- Department of Pediatric Intensive Care Unit, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, Chengdu, China P.R
| | - H Xie
- Department of Pediatrics, Dayi Maternal and Child Health Care Hospital, No. 539, Inner Mongolia Avenue, Jinyuan Town, Dayi County, Chengdu, China P.R
| | - L You
- Department of Child Health Care, Nanxin Community Health Service Center, N0. 168, Guanghe 1st Street, Wuhou District, Chengdu, China P.R
| | - H Li
- Department of Child Health Care, Qingbaijiang Maternal and Child Health Care Hospital, No.87, Qingjiang South Road, Qingbaijiang District, Chengdu, China P.R
| | - Y Zhang
- Department of Child Health Care, Jinniu Maternal and Child Health Care Hospital, No.12, Changyue Road, Jinniu District, Chengdu, China P.R
| | - C Du
- Department of Child Health Care, Longquanyi Maternal and Child Health Care Hospital, No.383, Yuyang Road, Longquanyi District, Chengdu, China P.R
| | - S Xu
- Department of Child Health Care, Huili Maternal and Child Health Care Hospital, No. 41, Jindai Road West Section, Guoyuan Township, Huili County, Xichang, China P.R
| | - C Melsaether
- Chr. Hansen A/S, HH Clinical Development, Kogle Alle 6, 2970 Hoersholm, Denmark
| | - S Yuan
- Department of Nutrition, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, Chengdu, 6100131, China P.R
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Bellaiche M, Ludwig T, Arciszewska M, Bongers A, Gomes C, Świat A, Dakhlia F, Piollet A, Oozeer R, Vandenplas Y. Safety and Tolerance of a Novel Anti-Regurgitation Formula: A Double-Blind, Randomized, Controlled Trial. J Pediatr Gastroenterol Nutr 2021; 73:579-585. [PMID: 34417399 PMCID: PMC8528134 DOI: 10.1097/mpg.0000000000003289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/29/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES A novel anti-regurgitation (AR) formula has been designed to support gut health and improve gastrointestinal (GI) symptoms beyond regurgitation. This study assessed the tolerance and safety of this new AR formula. METHODS This was a 4-week double-blind, randomized, controlled trial with a 4-week extension in formula-fed infants with regurgitation. The new AR (Test) formula contained 0.4 g/100 mL locust bean gum (LBG) as thickener, partly fermented formula with postbiotics, and short-chain galacto-oligosaccharides (scGOS) and long-chain fructo-oligosaccharides (lcFOS) (0.4 g/100 mL, ratio 9:1). The Control AR formula contained LBG (0.4 g/100 mL) with postbiotics and has a history of safe use. The primary outcome was the Infant Gastrointestinal Symptom Questionnaire (IGSQ) sum score including stooling, spitting-up/vomiting, crying, fussiness and flatulence. RESULTS All 182 infants screened were enrolled in the study. The primary analysis showed the equivalence of the IGSQ sum scores at Week 4 between groups. IGSQ sum scores improved significantly within 1 week (Mixed Model Repeated Measurement [MMRM], P < 0.001). Post-hoc analyses showed a bigger improvement of the IGSQ score in the Test (n = 38) versus Control (n = 44) group (MMRM, P = 0.008) in infants with more severe gastrointestinal (GI) symptoms (IGSQ score ≥35). Stool characteristics were comparable between groups. Growth related z scores were in line with the WHO child growth standards and both groups showed improvement of regurgitation. Adverse events did not show any safety concerns. CONCLUSIONS The novel AR formula combining LBG, scGOS/lcFOS and postbiotics is well-tolerated, safe and supports adequate growth during the intervention. Post-hoc analyses suggest that the formula results in more improvement of GI symptom burden in infants with more severe symptoms.
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Affiliation(s)
| | | | | | - Anke Bongers
- Danone Nutricia Research, Utrecht, The Netherlands
| | | | - Agnieszka Świat
- Centrum Medyczne Promed
- Centrum Medyczne Plejady, Krakow, Poland
| | - Faouzi Dakhlia
- Centre Condorcet, Hôpital Privé d’Antony, Antony, France
| | | | - Raish Oozeer
- Danone Nutricia Research, Utrecht, The Netherlands
| | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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45
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LenglarT L, Caula C, Moulding T, Lyles A, Wohrer D, Titomanlio L. Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine. J Neurogastroenterol Motil 2021; 27:482-494. [PMID: 34642268 PMCID: PMC8521460 DOI: 10.5056/jnm20290] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
Migraine is one of the most frequent causes of primary headache and 9% of children suffer from migraines. Most children will continue to experience migraine attacks as adults, therefore it is imperative that we have a thorough understanding of this major health issue. This article considers the so-called abdominal variants of migraine, which are more commonly seen in children rather than adults: abdominal migraine, cyclic vomiting syndrome, and infantile colic. Other functional abdominal pain disorders such as irritable bowel syndrome and functional dyspepsia have also been linked to migraine in clinical studies. The common pathophysiological root of these diseases seems to be the gut-brain axis mechanism. Abdominal variants of migraine are considered pediatric precursors of migraine whereas the functional abdominal pain disorders related to migraine seem to share a pathophysiological root with no temporarily link as for today. In this review we aim to describe the epidemiological background, the current pathophysiological theories and the relationship of each disease to migraine. This review is the first to compile abdominal variants of migraine and functional abdominal pain disorders associated with migraine and we endeavor to elucidate the broad spectrum of migraine-related episodes in children.
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Affiliation(s)
- Léa LenglarT
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Caroline Caula
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Thomas Moulding
- Department of Specialty and Integrated Medicine, The Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Annabel Lyles
- Department of Oncology, The Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Delphine Wohrer
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Luigi Titomanlio
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France.,Pediatric Migraine and Neurovascular Diseases Unit, APHP - Hopital Robert Debré, Paris, France.,Paris University, INSERM U1141, DHU Protect, Paris, France
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Despriee ÅW, Mägi CAO, Småstuen MC, Glavin K, Nordhagen L, Jonassen CM, Rehbinder EM, Nordlund B, Söderhäll C, Carlsen KL, Skjerven HO. Prevalence and perinatal risk factors of parent-reported colic, abdominal pain and other pain or discomforts in infants until 3 months of age - A prospective cohort study in PreventADALL. J Clin Nurs 2021; 31:2784-2796. [PMID: 34704296 DOI: 10.1111/jocn.16097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To estimate the prevalence and perinatal risk factors associated with parent reported colic, abdominal pain and pain or other discomforts in infants until 3 months of age. BACKGROUND Infant colic is a common concern for parents and clinicians. The prevalence varies in different studies and its symptoms overlap with other conditions like abdominal pain and discomfort. Diagnosis criteria are challenging, pathogenesis unclear and risk factors are conflicting. DESIGN This was a prospective cohort study. METHODS The 1852 mother-child pairs from the PreventADALL prospective birth-cohort answering the 3 months questionnaire were included. Information on perinatal risk factors was collected from the inclusion visit and questionnaires during pregnancy at 18 and 34 weeks, as well as birth charts. STROBE checklist was followed. RESULTS The reported prevalence of colic was 3% (59/1852), abdominal pain 22% (415/1852) and pain or other discomfort 6% (119/1852), with a total of 26% (478/1852) infants. Mothers on sick leave in pregnancy and reporting any allergic diseases had a significantly higher odds of reporting infant colic, abdominal pain and pain or other discomforts. Mothers with higher perceived stress in pregnancy exhibited a trend towards higher odds for reporting infant pain. Mothers coming from Sweden were less likely to report infant abdominal pain compared to mothers from Norway. CONCLUSIONS The prevalence of abdominal pain and pain or other discomforts was higher than the prevalence of colic. Perinatal risk factors connected to maternal health were associated with all three symptoms. RELEVANCE TO CLINICAL PRACTICE Colic and abdominal pain are stressful, symptoms overlap and risk factors for both can be identified in pregnancy. Our study suggests that it is difficult for parents to distinguish among infant colic, abdominal pain and other pain or discomfort and some report two or all three symptoms. Identifying the perinatal risk factors associated with infant pain may help target and support parents.
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Affiliation(s)
- Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,VID Specialized University Oslo, Oslo, Norway
| | - Caroline-Aleksi Olsson Mägi
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | - Kari Glavin
- VID Specialized University Oslo, Oslo, Norway
| | - Live Nordhagen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,VID Specialized University Oslo, Oslo, Norway
| | - Christine M Jonassen
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Center for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Håvard Ove Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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47
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Kruijff I, Veldhuis MS, Tromp E, Vlieger AM, Benninga M, Lambregtse‐van den Berg MP. Distress in fathers of babies with infant colic. Acta Paediatr 2021; 110:2455-2461. [PMID: 33840149 DOI: 10.1111/apa.15873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/31/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
AIM The aim of this case-control study was to compare parental stress, depression, anxiety and bonding problems between fathers and mothers of babies with infant colic and parents of control infants. METHODS Parents of 34 infants with infant colic and 67 control dyads were included. Parental feelings were assessed using validated questionnaires. RESULTS Fathers as well as mothers of infants with infant colic showed significantly higher mean scores compared with controls on stress (20.9 ± 5.8 and 25.5 ± 7.2 vs 16.4 ± 6.1 and 14.7 ± 7.0), depression (5.6 ± 4.0 and 9.1 ± 4.8 vs 2.9 ± 2.9 and 4.0 ± 3.1), anxiety (41.9 ± 9.2 and 46.0 ± 10.2 vs 32.4 ± 8.4 and 32.2 ± 9.3) and bonding problems (16.1 ± 8.1 and 13.7 ± 5.9 vs 8.7 ± 6.3 and 5.0 ± 4.4). In fathers, after adjustments for infant and parental confounders and maternal negative feelings, depression and anxiety were significantly increased in the infant colic group (difference of 2.7 (p = 0.017) and 8.6 (p = 0.002)). CONCLUSION In fathers of infants with infant colic, the experienced distress is strongly associated with maternal distress, except for depression and anxiety. Paediatricians should be aware of these paternal feelings as parental reassurance and support is one of the cornerstones in the treatment of infants with colic.
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Affiliation(s)
- Ineke Kruijff
- Department of Pediatrics St Antonius Hospital Nieuwegein The Netherlands
| | | | - Ellen Tromp
- Department of Epidemiology and Statistics St Antonius Hospital Nieuwegein The Netherlands
| | - Arine M. Vlieger
- Department of Pediatrics St Antonius Hospital Nieuwegein The Netherlands
| | - Marc.A. Benninga
- Department of Pediatric Gastroenterology and Nutrition Amsterdam University Medical Center Amsterdam the Netherlands
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Di Chio T, Sokollik C, Peroni DG, Hart L, Simonetti G, Righini-Grunder F, Borrelli O. Nutritional Aspects of Pediatric Gastrointestinal Diseases. Nutrients 2021; 13:nu13062109. [PMID: 34205445 PMCID: PMC8235230 DOI: 10.3390/nu13062109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022] Open
Abstract
In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively “harmless” nature. Apart from a diet’s therapeutic role, nutritional support is crucial in maintaining growth and improving clinical outcomes in pediatric patients. Despite the absence of classical “side effects”, however, it should be emphasized that any dietary modification might have negative consequences on children’s growth and development. Hence, expert supervision is always advised, in order to support adequate nutritional requirements. Unfortunately, the media provide an inaccurate perception of the role of diet for gastrointestinal diseases, leading to misconceptions by patients or their caregivers that tends to overestimate the beneficial role of diets and underestimate the potential adverse effects. Moreover, not only patients, but also healthcare professionals, have a number of misconceptions about the nutritional benefits of diet modification on gastrointestinal diseases. The aim of this review is to highlight the role of diet in pediatric gastrointestinal diseases, to detect misconceptions and to give a practical guide for physicians on the basis of current scientific evidence.
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Affiliation(s)
- Teresa Di Chio
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Via Ospedale 12, 6500 Bellinzona, Switzerland;
- Correspondence: (T.D.C.); (C.S.); (F.R.-G.); (O.B.)
| | - Christiane Sokollik
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children’s Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland
- Correspondence: (T.D.C.); (C.S.); (F.R.-G.); (O.B.)
| | - Diego G. Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy;
| | - Lara Hart
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, McMaster University, Hamilton, ON L8N 3Z5, Canada;
| | - Giacomo Simonetti
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Via Ospedale 12, 6500 Bellinzona, Switzerland;
- Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Franziska Righini-Grunder
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Lucerne Children’s Hospital, Cantonal Hospital Lucerne, 6000 Lucerne, Switzerland
- Correspondence: (T.D.C.); (C.S.); (F.R.-G.); (O.B.)
| | - Osvaldo Borrelli
- Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, University College London (UCL) Institute of Child Health and Great Ormond Street, London WC1N 3JH, UK
- Correspondence: (T.D.C.); (C.S.); (F.R.-G.); (O.B.)
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Dimitratos SM, Brown H, Shafizadeh T, Kazi S, Altmann T, Ostrer B. Symptomatic relief from at-home use of activated Bifidobacterium infantis EVC001 probiotic in infants: results from a consumer survey on the effects on diaper rash, colic symptoms, and sleep. Benef Microbes 2021; 12:27-34. [PMID: 34057053 DOI: 10.3920/bm2020.0229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The gut microbiome during infancy is directly involved in the digestion of human milk, development of the immune system, and long-term health outcomes. Gut dysbiosis in early life has been linked to multiple short-term ailments, from diaper dermatitis and poor stooling habits, to poor sleep and fussiness, with mixed results in the scientific literature on the efficacy of probiotics for symptom resolution. Despite the growing interest in probiotics for consumer use, observed symptomatic relief is rarely documented. This study aims to evaluate observed symptomatic relief from at-home use of activated Bifidobacterium infantis EVC001 in infants. Consumer feedback was collected over a 2-year period via a 30-day post-purchase online survey of B. infantis EVC001 (Evivo®) customers. Outcome measures included observed changes in diaper rash, symptoms of colic, and sleep behaviours in infants fed B. infantis EVC001. A total of 1,621 respondents completed the survey. Before purchasing B. infantis EVC001, the majority of respondents visited the product website, researched infant probiotics online, or consulted with their doctor or other healthcare professional. Of the participants whose infants had ever experienced diaper rash, 72% (n=448) reported improvements, and 57% of those reported complete resolution of this problem. Of those who responded to questions about gassiness/fussiness, naptime sleep, and night-time sleep behaviours, 63% (n=984), 33% (n=520), and 52% (n=806) reported resolution or improvements, respectively. Although clinical data regarding probiotic use are often inconclusive for symptom resolution, home use of B. infantis EVC001 in infants improved diaper rash, gassiness/fussiness, and sleep quality within the first week of use in a significant number of respondents who engaged in a voluntary post-purchase survey. These outcomes may be a result of the unique genetic capacity of B. infantis EVC001 to colonise the infant gut highlighting the importance of strain selection in evaluating the effects of probiotic products.
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Affiliation(s)
- S M Dimitratos
- Department of Nutrition, University of California, Davis, Davis, CA 95616, USA
| | - H Brown
- Evolve BioSystems, Inc, Davis, CA 95618, USA
| | | | - S Kazi
- Evolve BioSystems, Inc, Davis, CA 95618, USA
| | - T Altmann
- Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.,Calabasas Pediatrics Wellness Center, Calabasas, CA 91302, USA
| | - B Ostrer
- Evolve BioSystems, Inc, Davis, CA 95618, USA
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50
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Karatas N, Isler Dalgic A. Is foot reflexology effective in reducing colic symptoms in infants: A randomized placebo-controlled trial. Complement Ther Med 2021; 59:102732. [PMID: 33984498 DOI: 10.1016/j.ctim.2021.102732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 03/12/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Infantile colic and its accompanying crying represent a major source of stress and have negative physiological, emotional and psychological effects on infants and parents. The aim of this study was to examine the efficacy of foot reflexology for reducing symptoms of infantile colic. DESIGN The study was conducted as a single-blind, randomized, placebo-controlled trial with a sample population of 45 infants diagnosed with infantile colic. METHODS Simple randomization was used to select a reflexology (study) group (n = 20) and a placebo group of infants with colic (n = 25). The parents and biostatistician were blinded to group assessment. Foot reflexology, or stimulating reflex points on the foot, was implemented with the reflexology group. Placebo foot reflexology, or noneffective touch, was used with the placebo group. Over a two-week period, both interventions were performed four times for 20 min each time by the researcher. The researcher collected data using the information form, the Infant Colic Scale (ICS), and a diary of daily crying duration. RESULTS The trial ended with the completion of the data. In each group, 20 infants were studied. The means of the Infant Colic Scale scores and daily crying duration were significantly lower in the foot-reflexology group than in the placebo foot-reflexology group (p < .001). Infants with colic in the reflexology group cried less and experienced fewer symptoms than before treatment. CONCLUSIONS Foot reflexology is a non-invasive and safe nursing intervention that is effective for reducing crying duration and symptoms in infants with colic.
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Affiliation(s)
- Nimet Karatas
- Akdeniz University, Faculty of Nursing, Department of Pediatric Nursing, Antalya, Turkey.
| | - Aysegul Isler Dalgic
- Akdeniz University, Faculty of Nursing, Department of Pediatric Nursing, Antalya, Turkey.
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