The bugs that keep us healthy

Lactobacillus reuteri is one of a few naturally occurring strains of lactobacilli colonizing the human colon. In fact, L. reuteri is found in the digestive tracts of many animals, and is also present in many meats and milk products. It is passed from healthy mothers to their newborns via breast milk. When it colonizes the gut, L. reuteri supports the immune system and helps prevent infections.

Bugs that ease babies’ insides

The study included 44 infants with chronic constipation, marked by two or fewer bowel movements per week, hard bowel movements that were large and painful to move, and the presence of a large mass of feces retained in the rectum. The infants were at least six months old, had been weaned, and were being fed formula. Half of the babies were given five drops of a probiotic liquid providing 100 million colony-forming units of L. reuteri per day for eight weeks, while the other half received placebo. Parents kept track of bowel movement frequency, stool consistency, and episodes of inconsolable crying.

At the end of the study, comparisons were made between the babies receiving the probiotic and placebo:

• The frequency of bowel movements more than doubled in the infants receiving the probiotic.
• Bowel movement frequency increased more in the probiotic group compared with placebo.
• The number of babies passing hard stools decreased steadily in the probiotic group from 19 at the beginning of the study to only 4 at the end.
• Compared to babies receiving placebo, stool consistency improved more in the probiotic group, but this difference was not statistically significant.

Unexpectedly, episodes of inconsolable crying increased in both groups during the study, and this change was slightly more pronounced in the probiotic group.

Combatting your little one’s chronic constipation

The findings suggest that L. reuteri can be effective for increasing stool frequency in chronically constipated infants. “On the basis of our results,” the study’s authors said, “probiotics as a natural, safe, well-tolerated treatment may provide a simple and attractive way to treat infantile functional chronic constipation.” The reason for the increased crying seen in both groups in this study remains elusive.

Here are some additional measures you can take if your baby suffers with constipation:

• Water. Be sure your baby is getting enough water to keep stools from becoming dry and hard.
• Fruit. The fibers and sugars in fruits help to stimulate digestive movement and support the growth of healthy gut bacteria. Try pureed pears, peaches, and prunes.
• Tummy massage. Give your baby a gentle massage with warm hands, making counter-clockwise circles on baby’s abdomen.
• Take a closer look at diet. Some babies are sensitive to specific foods, and will have normal bowel movements if they avoid these foods. The most common offenders: gluten grains like wheat and barley, cow’s milk products, eggs, corn, and soy. Consult with a healthcare practitioner who can guide you through an elimination diet that is well balanced and nutritious.

(J Pediatr 2010;157:598–602)