Molecular identification of coliform bacteria from colicky breastfed infants.

OBJECTIVE: To determine the presence of intestinal coliform bacteria in colicky vs healthy infants. STUDY DESIGN: We isolated coliform strains from faeces and performed quantitative bacterial cultures in 41 colicky and 39 healthy breastfed infants, identified using PCR with species-specific primers, strain-specific Automated Ribotyping and the API-50E kit for Enterobacteriaceae to identify the most frequent strains. RESULTS: Coliform strains were more abundant in colicky infants (median 6.04 log(10) CFU/g faeces, range 2.00-8.76) vs controls (median 4.47 log(10) CFU/g faeces, range 1.00-8.08) (p = 0.026). Escherichia coli, Klebsiella pneumoniae, K. oxytoca, Enterobacter cloacae, E. aerogenes and Enterococcus faecalis were the predominant species in colicky and healthy infants. The counts of each bacterial species differed between the two groups, and the difference was significant (p = 0.002) for E. coli: median 6.30 log(10) CFU/g faeces (range 3.00-8.74) in colicky infants, and median 4.70 log(10) CFU/g faeces (range 2.00-5.85) in controls. CONCLUSIONS: This is the first study to evaluate the colonization patterns of gas-forming coliforms in colicky infants and healthy controls identified by molecular methods. Coliform bacteria, particularly Escherichia coli, were found to be more abundant in colicky infants. Our data could help to shed light on the cause of infantile colic.

Reduction of crying episodes owing to infantile colic: A randomized controlled study on the efficacy of a new infant formula.

OBJECTIVES: The aim of this study was to evaluate the efficacy on crying episodes owing to infantile colic of a new infant formula containing partially hydrolysed whey proteins, prebiotic oligosaccharides (OS), with a high beta-palmitic acid content. DESIGN: Prospective randomized controlled study. SETTING: Italy. SUBJECTS: Two hundred and sixty-seven formula-fed infants, aged less than 4 months, with infantile colic, were randomized to receive either the new infant formula (study treatment (ST)) or a standard formula and simethicone (6 mg/kg twice a day) (control treatment (CT)). A questionnaire was given to parents to evaluate for 14 days the daily number of colic episodes and crying time. RESULTS: Out of the 199 infants who completed the study, 96 were treated with the new formula and 103 were not treated. Infants receiving the new formula had a significant decrease in colic episodes after 1 week (2.47+/-1.94 at day 7 vs 5.99+/-1.84 at the study entry) compared to infants receiving the CT (3.72+/-1.98 at day 7 vs 5.41+/-1.88 at the study entry) (P < 0.0001). Also at day 14, the crying episodes were significantly different between the two groups of infants (1.76+/-1.60 in ST vs 3.32+/-2.06 in CT) (P < 0.0001). CONCLUSIONS: The use of a partially hydrolysed formula supplemented with fructo- and galacto-OS induces a reduction of crying episodes in infants with colic after 7 and 14 days when compared with a standard formula and simethicone.

Ghrelin and obestatin in infants, lactating mothers and breast milk.

AIM: To investigate the role of ghrelin and obestatin in infancy. METHODS: We measured ghrelin and obestatin concentrations in blood samples of infants, lactating mothers, and in breast milk. RESULTS: The median (interquartile range) serum ghrelin concentrations were 922.11 (868.44) pg/ml in infants, 667.88 (942.78) pg/ml in lactating mothers, and 526.4 (439.86) pg/ml in breast milk. The serum obestatin levels were 844.87 (805.14) pg/ml in infants, 759.105 (855.55) pg/ml in lactating mothers, and 846.6 (472.07) pg/ml in breast milk. A positive correlation was found for serum ghrelin concentrations in breastfed infants and lactating mothers (p < 0.001, r = 0.789), serum ghrelin concentrations in breastfed infants and in breast milk (p < 0.001, r = 0.581), serum ghrelin concentrations in lactating mothers and in breast milk (p = 0.021, r = 0.450), and serum obestatin concentrations in breastfed infants and in lactating mothers (p = 0.047, r = 0.609). CONCLUSION: We report for the first time the serum obestatin concentrations in infants and confirm the presence of correlations between ghrelin and obestatin in lactating mothers and breast milk. The correlations found early in infants' life, when hormones begin to exert their effects on feeding behavior, suggest that they may be involved in these processes.

[Advances on the effects of the compounds of a phytotherapic agent (COLIMIL) on upper gastrointestinal transit in mice]. / Effetto di estratti titolati di Matricariae recutita, Foeniculum vulgare e Melissa officinalis (COLIMIL) sul transito gastrointestinale nei topi in vivo.

AIM: Phytotherapic agents, such as herbal formulations containing Matricariae recutita flowers (chamomile) extract, Foeniculum vulgare fruit (fennel) extract and Melissa officinalis aerial parts (lemon balm) extract have beneficial effects on gastrointestinal tract in colicky infants. However, the mechanism is largely unexplored and, particularly, it is not clear if it affects intestinal motility. The aim of this experimental study was to evaluate the effect of different herbal formulations containing Matricariae recutita extract, Foeniculum vulgare extract and Melissa officinalis extract on upper gastrointestinal transit in mice in vivo. METHODS: Gastrointestinal transit was measured in male ICR mice and in croton oil-treated mice after the oral administration of herbal formulations containing chamomile, fennel and lemon balm (ColiMil) and chamomile and lemon balm (ColiMil experimental). RESULTS: The herbal formulations tested (0.4-0.8 mL/mouse) dose-dependently and significantly inhibited gastrointestinal transit both in control and in croton oil-treated mice. Chamomile extract and lemon balm extract reduced significantly intestinal motility, but not fennel. At similar concentration ColiMil evoked a more consistent response than ColiMil experimental. CONCLUSION: Our findings directly demonstrate in vivo the effect of a combination of herbal formulations on intestinal motility. The observed inhibitory effect might be studied with clinical studies to test the efficacy of these compounds in the treatment of colicky infants.

Gastric emptying in infants: epigastric impedance versus scintigraphy.

AIM: To compare epigastric impedance versus scintigraphy in monitoring the gastric emptying of the same adapted milk formula in infants. METHODS: Seven infants with clinical symptoms of gastric motility disease underwent scintigraphy with 99mTc sulphur colloid for the 90 min following the ingestion of the same adapted milk formula, in order to evaluate gastric emptying. A bio-impedance device, connected to a PC, was prepared for this purpose with four standard electrodes placed anteriorly on the upper part of the body. The obtained graphs were compared to those of the scintigraphic method. Statistical analysis was performed using Pearson correlation. The confidence limits were set at 95%. Parental consent was obtained before each analysis. RESULTS: The gastric emptying patterns obtained with epigastric impedance were closely correlated to those shown by the scintigraphy (r = 0.86 +/- 0.08; p < 0.05). A significant correlation between the gastric emptying velocity measured by the two techniques was found (r = 0.94; p = 0.002). CONCLUSIONS: Epigastric impedance in infants provided estimates of gastric emptying that were closely correlated with scintigraphy. However, the limits derived from the epigastric impedance suggest that, at the moment, the two methods should not be used interchangeably.

Intestinal microflora in breastfed colicky and non-colicky infants.

BACKGROUND: Infantile colics are a common problem in the first months of life. During this period, a process of intestinal colonization rapidly occurs. A difference in the gut microflora could play an important role in the pathogenesis of colics, changing the metabolism of carbohydrates and fatty acids. Actually, in the literature, only few data have been collected about this topic. In this study, we evaluated intestinal microflora in breastfed colicky and non-colicky infants. METHODS: Seventy-one breastfed infants, aged 3.2 +/- 0.6 wk, free from episodes of gastroenteritis and without previous assumption of antibiotic and probiotic drugs, were enrolled in the study. They were divided into two groups: colicky (42 cases) and non-colicky (29 cases), according to Wessel's criteria. Stool samples were collected, diluted and cultured on several selective media to detect lactobacilli, clostridia, gram-negative anaerobes and Enterobacteriaceae. Statistical analysis was performed using Student's t-test, chi2 test and a non-parametric test (Mann-Whitney U-test). RESULTS: Differences in gut microflora were found among colicky and non-colicky infants: colicky infants were less frequently colonized by Lactobacillus spp., and more frequently by anaerobic gram-negative bacteria. CONCLUSION: Our study indicates that colicky infants have different patterns of gut microflora. Further studies are required to understand whether gut microflora is the primary cause of colics or its consequence.