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Medline ® Abstract for Reference 103

of 'Chronic functional constipation and fecal incontinence in infants and children: Treatment'

Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial.
Indrio F, Di Mauro A, Riezzo G, Civardi E, Intini C, Corvaglia L, Ballardini E, Bisceglia M, Cinquetti M, Brazzoduro E, Del Vecchio A, Tafuri S, Francavilla R
JAMA Pediatr. 2014;168(3):228.
IMPORTANCE: Infantile colic, gastroesophageal reflux, and constipation are the most common functional gastrointestinal disorders that lead to referral to a pediatrician during the first 6 months of life and are often responsible for hospitalization, feeding changes, use of drugs, parental anxiety, and loss of parental working days with relevant social consequences.
OBJECTIVE: To investigate whether oral supplementation with Lactobacillus reuteri DSM 17938 during the first 3 months of life can reduce the onset of colic, gastroesophageal reflux, and constipation in term newborns and thereby reduce the socioeconomic impact of these conditions.
DESIGN: A prospective, multicenter, double-masked, placebo-controlled randomized clinical trial was performed on term newborns (age<1 week) born at 9 different neonatal units in Italy between September 1, 2010, and October 30, 2012.
SETTING: Parents were asked to record in a structured diary the number of episodes of regurgitation, duration of inconsolable crying (minutes per day), number of evacuations per day, number of visits to pediatricians, feeding changes, hospitalizations, visits to a pediatric emergency department for a perceived health emergency, pharmacologic interventions, and loss of parental working days.
PARTICIPANTS: In total, 589 infants were randomly allocated to receive L reuteri DSM 17938 or placebo daily for 90 days.
INTERVENTIONS: Prophylactic use of probiotic.
MAIN OUTCOMES AND MEASURES: Reduction of daily crying time, regurgitation, and constipation during the first 3 months of life. Cost-benefit analysis of the probiotic supplementation.
RESULTS: At 3 months of age, the mean duration of crying time (38 vs 71 minutes; P < .01), the mean number of regurgitations per day (2.9 vs 4.6; P < .01), and the mean number of evacuations per day (4.2 vs 3.6; P < .01) for the L reuteri DSM 17938 and placebo groups, respectively, were significantly different. The use of L reuteri DSM 17938 resulted in an estimated mean savings per patient of€88 (US $118.71) for the family and an additional€104 (US $140.30) for the community.
CONCLUSIONS AND RELEVANCE: Prophylactic use of L reuteri DSM 17938 during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01235884.
Department of Pediatrics, Aldo Moro University of Bari, Bari, Italy.