Written by Greg Arnold, DC, CSCS. Eight weeks of  probiotic supplementation resulted in a significant improvement in bowel movement frequency in infants under one year old compared to the placebo group.

probioticsConstipation in infants can be a very stressful condition for parents to care for and for infants to endure. Nearly 1 in 3 infants worldwide are estimated to suffer from some form of constipation in infancy 1 and 90-95% of cases having no known cause 2. Laxatives are thought to help only 60% of constipated children 3, with research showing 53% of children still having constipation after 1 year of treatment and 52% being constipated 5 years later 4. With symptoms that include infrequent, painful evacuation of stools and fecal incontinence 3, the need for safe and effective treatment methods are needed.

Fortunately, probiotics may be a viable treatment. A 2010 study 5 involved 44 infants (24 males, 20 females) aged 6 to 10 months of age and admitted to the Pediatrics wing of a hospital in Italy with chronic constipation (having at least 2 of the following: 2 or less defecations per week, history of excessive stool retention and painful or hard bowel movements, presence of a large fecal mass in the rectum, and history of large-diameter stools 6.

The infants were weaned onto solid food with purees with a dose of 0.5 grams of fiber per kilogram of bodyweight per day according to guideline proposed by the American Academy of Pediatrics Committee on Nutrition 7. They were then given either Lactobacillus reuteri (1 x 108 colony-forming units given once daily after a feeding = 22 infants) or a placebo (22 infants) for 8 weeks. The parents provided data in a daily diary on bowel movements, stool consistency, and presence of inconsolable crying episodes.

After 8 weeks, those in the probiotics group noticed a significant improvement in bowel movement frequency compared to the placebo group. Specifically:

Baseline8 weeks (p = 0.027)
Probiotics Group
1-2 Bowel Movements/week7/22 infants0/22 infants
3-4 Bowel Movements/week13/22 infants4/22 infants
5-7 Bowel Movements/week4/22 infants18/22 infants
Placebo Group
1-2 Bowel Movements/week11/22 infants7/22 infants
3-4 Bowel Movements/week6/22 infants3/22 infants
5-7 Bowel Movements/week5/22 infants12/22 infants

No significant differences were noted between the two groups regarding stool consistency (p = 0.48) or inconsolable crying episodes (= 0.08). No adverse effects were reported in either group. The improvements seen in the placebo group could be attributed to the fiber given to the infants through the purees before the supplementation period started.

For the researchers, “On the basis of our results, probiotics as a natural, safe, and well-tolerated treatment may provide a simple and attractive way to treat infantile functional chronic constipation” and that “A possible link between constipation and changes in intestinal flora needs to be evaluated in the future.”

Source: Coccorullo, Paola, Caterina Strisciuglio, Massimo Martinelli, Erasmo Miele, Luigi Greco, and Annamaria Staiano. “Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study.” The Journal of pediatrics 157, no. 4 (2010): 598-602.

© 2010 Mosby, Inc. All rights reserved.

Posted August 11, 2016.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY.  You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101(10):2401-2409.
  2. Loening-Baucke V. Chronic constipation in children. Gastroenterology. 1993;105(5):1557-1564.
  3. van Ginkel R, Reitsma JB, Buller HA, van Wijk MP, Taminiau JA, Benninga MA. Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology. 2003;125(2):357-363.
  4. Staiano A, Andreotti MR, Greco L, Basile P, Auricchio S. Long-term follow-up of children with chronic idiopathic constipation. Dig Dis Sci. 1994;39(3):561-564.
  5. Coccorullo P, Strisciuglio C, Martinelli M, Miele E, Greco L, Staiano A. Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study. The Journal of pediatrics. 2010;157(4):598-602.
  6. Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2006;130(5):1519-1526.
  7. Williams CL, Bollella M, Wynder EL. A new recommendation for dietary fiber in childhood. Pediatrics. 1995;96(5 Pt 2):985-988.