Mommaerts JL, Devroey D. It’s too soon to recommend probiotics for colic. .J Fam Pract. 2011;60:251-252.
Eerste auteur: Mommaerts JL
Jaar: 2011
Type: Publicatie
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.J Fam Pract
Abstract:
The authors of “Colicky baby? Here’s a surprising remedy” (PURLs, J Fam Pract. 2011;60:34-36) suggest that probiotics are a remedy for infantile colic. The study was funded by producers of probiotics, but the rigorous study design is deemed to make bias unlikely, leading the authors to recommend a change in practice. We very much hope this will be a big step forward, but feel the need to air our concerns: namely, that probiotics (cost: about $40 per month) may substitute for parental love (cost: $0 per lifetime). It’s a huge marketing opportunity, as 10% to 25% of infants have infantile colic.1 We are not fully convinced of the benefits.
To start with, the term “infantile colic” sug- gests an abdominal cause, although this “cause” is not mentioned in published criteria.2 It has been suggested that infantile colic may simply lie at the upper end of a normal distribution.3
Related to the treatment, no adverse events were reported, nor any differences be- tween the placebo and probiotics groups in frequency of stools or incidence of regurgita- tion or constipation.
Then why did the babies cry less? The an- swer seems obvious: because they have less pain. But why do babies have less pain from having an enhanced intestinal flora vs a natu- ral one, while having no change in gastrointes- tinal functions? Has nature gone astray? Could there have been factors that made mothers feel the difference between the treatment and the placebo groups, such as side effects that were not reported and that may have enhanced the placebo effect? (Notably, one study found a substantial placebo effect on colic.4) Babies are extremely emotionally symbiotic with their mothers, and thereby very prone to “sug- gestivity” coming from the mother (or father).
We certainly do not mean to suggest that colic is related to poor parenting skills. We do, however, see a need for more investigations before turning the prescription of probiotics for infantile colic into a clinical guideline.