Breath hydrogen response to milk containing lactose in colicky and noncolicky infants

Moore, D J; Robb, T. A.; Davidson, Geoffrey P.

doi:10.1016/s0022-3476(88)80567-5

Cited by 81 publications

(27 citation statements)

References 19 publications

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“…Lactose challenge was performed in only 27/80 infants and 16 of them showed a relapse. Most of our babies improving on a lactose reduced formula had colic as one of their main symptoms, but a majority of studies do not support a role for lactose intolerance in infantile colic [3,15,18,21,23]. Further studies are needed in order to elucidate this unexpected finding.…”

Section: Discussionmentioning

confidence: 96%

Cow's milk protein intolerance in infants under 1 year of age: A prospective epidemiological study

et al. 1993

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Incidence and clinical manifestation of cow's milk protein intolerance (CMPI) were studied in 1158 unselected newborn infants followed prospectively from birth to 1 year of age. No food changes were required in 914 infants who were used as healthy controls. When CMPI was suspected (211 infants), diagnostic dietary interventions according to a standard protocol were performed. After exclusion of lactose intolerance, two positive cow's milk elimination/challenge tests were considered diagnostic of CMPI. Two hundred and eleven symptomatic infants were examined for possible CMPI. A large group of 80 infants improved on a lactose reduced formula. In 87/211 infants CMPI was excluded (sick controls). Finally CMPI was proven in 26 infants. The calculated incidence rate for CMPI was 2.8%. The principal symptoms in infants with CMPI were gastrointestinal, dermatological and respiratory in 50%, 31% and 19% respectively. A positive family history for atopy (first or second degree relatives) was more frequent in either CMPI infants (65%), or sick controls (63%) when compared to either healthy controls (35%) or infants improving on a low lactose formula (51%). Differences between patients with CMPI and sick controls were only found for the presence of atopy in at least 2 first degree relatives [(5/26 in CMPI infants and 4/87 in sick controls (P < 0.05)] and for multiorgan involvement [10/26 infants with CMPI as opposed to 12/87 in the sick control group (P < 0.02)]. These statistical differences are too weak to be of clinical value.

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Section: Discussionmentioning

confidence: 96%

Cow's milk protein intolerance in infants under 1 year of age: A prospective epidemiological study

et al. 1993

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“…Indeed, an elevated breath hydrogen excretion (indicative of a high bacterial metabolic activity) has been reported in colicky infants, suggesting malabsorption of lactose to be the cause of the colic [68]. …”

Section: The Evidence: Benefits Of Fermented Formulae On Gi Functimentioning

confidence: 99%

“…Indeed, consumption of fermented milk products was shown to considerably alleviate GI symptoms (abdominal pain, diarrhea, flatulence) linked to the colonic fermentation of undigested lactose [68,84,85]. The lactase enzyme produced by Streptococcus thermophilus or most Lactobacillus bulgaricus strains during the fermentation process resists gastric stress and is also postulated to be one of the main engines responsible for the beneficial health effect of fermented infant formulae, particularly regarding the effect observed on symptoms linked to the distal digestive tract, i.e.…”

Section: Potential Mechanisms Of Action: How?mentioning

confidence: 99%

GI Symptoms in Infants Are a Potential Target for Fermented Infant Milk Formulae: A Review

et al. 2014

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Besides pre- and pro-biotic-containing infant formulae, fermented infant formulae are commonly used to relieve or prevent symptoms of gastrointestinal (GI) discomfort in young infants. During the fermentation process in cow’s milk-based formulae, the beneficial bacteria modulate the product by forming several beneficial compounds, which contribute to the alleviation of the symptoms observed. This review summarizes the clinical evidence on the impact of fermented infant formulae on common pediatric GI-symptoms. The potential mechanisms involved are discussed: i.e., the lactose and protein (in-) digestibility, effects on gastric emptying and gut transit and modulation of the colonic microbiota. Although initial evidence indicates a beneficial effect of fermented formulae on GI discomfort in newborns, validation and confirmation of the clinical proof obtained so far is warranted, as well as further research to (more fully) understand the mode of action.

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“…It has also been demonstrated that less methane is produced by stool of colicky infants and this could be due to an inability of the gut microbiota to convert hydrogen to methane with a gastrointestinal hydrogen accumulation [8]. Moreover few old data support the notion that colicky infants produce more breath hydrogen in the fasting state and in response to feedings, which is thought to be evidence of lactose intolerance [9-11]. …”

Section: Introductionmentioning

confidence: 99%

Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants

et al. 2011

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BackgroundInfantile colic is a common disturb within the first 3 months of life, nevertheless the pathogenesis is incompletely understood and treatment remains an open issue. Intestinal gas production is thought to be one of the causes of abdominal discomfort in infants suffering from colic. However, data about the role of the amount of gas produced by infants' colonic microbiota and the correlation with the onset of colic symptoms are scanty. The benefit of supplementation with lactobacilli been recently reported but the mechanisms by which they exert their effects have not yet been fully defined. This study was performed to evaluate the interaction between Lactobacillus spp. strains and gas-forming coliforms isolated from stools of colicky infants.ResultsStrains of coliforms were isolated from stools of 45 colicky and 42 control breastfed infants in McConkey Agar and identified using PCR with species-specific primers, and the BBL™ Enterotube™ II system for Enterobacteriaceae. Gas-forming capability of coliforms was assessed in liquid cultures containing lactose as sole carbon source. The average count of total coliforms in colicky infants was significantly higher than controls: 5.98 (2.00-8.76) log10 vs 3.90 (2.50-7.10) CFU/g of faeces (p = 0.015). The following strains were identified: Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter cloacae and Enterococcus faecalis. Then, 27 Lactobacillus strains were tested for their antagonistic effect against coliforms both by halo-forming method and in liquid co-cultures. Lactobacillus delbrueckii subsp.delbrueckii DSM 20074 and L. plantarum MB 456 were able to inhibit all coliforms strains (halo-forming method), also in liquid co-cultures, thus demonstrating an antagonistic activity.ConclusionsThis study shows that two out of 27 strains of Lactobacillus examined possess an antimicrobial effect against six species of gas-forming coliforms isolated from colicky infants. Our findings may stimulate new researches to identify which Lactobacillus strains can improve colicky symptoms by acting on coliforms gut colonization.

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Breath hydrogen response to milk containing lactose in colicky and noncolicky infants

Cited by 81 publications

References 19 publications

Cow's milk protein intolerance in infants under 1 year of age: A prospective epidemiological study

Cow's milk protein intolerance in infants under 1 year of age: A prospective epidemiological study

GI Symptoms in Infants Are a Potential Target for Fermented Infant Milk Formulae: A Review

Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants

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